Better AIDS drugs, or just fewer suicides?

December 19, 2009

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I’m on a roll this month with AIDS research reports that intrigue me, particularly because so many of them raise more questions than they answer.  I’m not sure if there is a Holiday uptick in these reports, or if the cold weather just means I have more time on my hands to sit at the computer.

In any event, this study recently reported a greater than 50% decrease in suicides among “HIV-positives” in Switzerland since the introduction of highly active antiretroviral therapy (HAART), aka the AIDS drug cocktail that includes protease inhibitors.

The report tries to explain the decrease by stating:  “In the pre-HAART era, high suicide rates were driven by disease progression, which at that time could not be prevented.”

There is no reference given to support this supposition.  It is also very possible that researchers are guilty of AIDSpeak, referring to laboratory markers such as viral load and cd4 counts, rather than actual illness, which is what really matters when referring to “disease progression”.

When HAART was first proposed, it was with a great deal of hyperbole and optimism, to the extreme of coining the term “Lazurus Syndrome”.  It is not surprising that people with such an ominous diagnosis hanging over their heads would take encouragement from this psychological media blast.

So the question my mind still begs:  are reports of increased life expectancy on HAART likely biased by this previously unreported fact?

In other words, if fewer poz people on HAART are offing themselves prematurely, would that not skew the research numbers on life expectancy?

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