MORE MARIJUANA RESEARCH NEEDED

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This is the conclusion for years by many published articles, including mine. There isn’t strong enough evidence for many of the uses recommended by bud tenders and articles with weaker evidence. The problem is money. The US government’s official position is that it is a harmful highly addictive substance and that there is no medical benefit; so there has been no funding for the plant research. Companies make money from items they can control, such as ingredients in the plant but they can’t control the sale of the plant products. Therefore, there is a great increase in marijuana ingredient research. This makes sense since we have brain receptors (CB1 and CB2) that respond to cannabis chemicals.

A speaker at the American Academy of Addiction Psychiatry presented her paper that reviewed the current literature (I have seen many of these on cannabis) and called for more funding and research (again). The government sets the funding priorities on research questions that are not funded by business since they are about the only ones who will pay for these important studies.

TESTED FOR TUBERCULOSIS?

If you haven’t been tested in a while and you socialize with people new to the US, it is probably a good idea to get tested for TB. Also, if you have lived in large groups such as jails or homeless shelters, you are at risk. This can be done with the skin test that must be read 2 or 3 days later, or getting a blood test that can only be done in the afternoons at labs. Unlike the skin test, the blood test is not positive due to the BCG vaccine many have received in other countries. There are now much shorter medication combinations you can take if positive rather than the 6 months of the standard medications. Contact your public health department or your provider if you would like to get tested Those with positive tests have a 10% lifetime risk of having serious TB unless they take the simple, short course of medication.

EBOLA VACCINE 100% EFFECTIVE

The researchers vaccinated the group of contacts of a diagnosed Ebola case with either placebo or the active product. None of the product recipients got Ebola and 23 of the placebo patients did. The total number of patients was 5837. Since so few got infected taking the placebo (inactive product), it is obvious that the people were being very careful on their own not to get the disease by avoiding contact. This is great news. Now, with time, they can see if the immunity lasts longer than a few weeks, otherwise it is only good for after an outbreak, not to prevent an outbreak.

CURED MEATS WORSEN ASTHMA

Research on the diets and asthma symptoms of patients showed that eating cured meats (e.g. bacon, pastrami, ham) had more asthma problems. We already know that cured meats are associated with many cancers.

TWO DRUG HIV COMBO WORKS WELL

For years we have been giving triple drug combinations since two drug combinations have been too weak to control HIV in the vast majority for a long time. Two of the more powerful drugs: Rilpiverine (in Complera®) and dolutegravir (in Triumeq®) have been shown to control HIV as well as 3 and 4 drug combinations. This is probably good news since the less medications a person takes, the less risk of side effects. But there needs to be a study comparing the long-term side effects from these two combinations. The rilpiverine must be taken with 500 calories or greater (e.g. a sandwich or more) and stomach acid problem treatment must be supervised by a provider.

SAME DAY TREATMENT FOR HIV

A large study in Haiti showed that treating HIV on the same day of diagnosis had better outcomes. San Francisco does this too. This was compared to the standard care of waiting the 21 days for the lab tests and meeting with the HIV specialist.  Paul Sax from Harvard (whom we’ve had speak at our bimonthly IE HIV Association meetings) says the effect may be the enthusiasm of the staff and patient that made the difference in getting the patient to not miss pills rather than a medical or physical reason—that a short delay did not cause worsening of the disease. This makes sense to me.

Most of my patients don’t have sex after a positive test for months since it is such a shock and they don’t want to transmit HIV to another and they need to process how to explain their status to their partner. So transmission (Treatment as Prevention, TaSP) or the risk of worsening health don’t seem to be strong reasons to rush to treatment.

HIV STIGMA HURT A PHYSICIAN-RESEARCHER’S CAREER

Eric Winer had hemophilia and caught Hepatitis C and HIV from blood product transfusions. He had to be very secretive about it in the 1980s and 90s since he saw how many in the health care professions discriminated against those with HIV. He was cured from the Hepatitis C with 2 years of the ribavirin/interferon injection treatment (very difficult treatment). His dentist asked him not to come back since staff were concerned about transmission. This high-level cancer researcher spoke about his life at a major breast cancer meeting. We are taught to treat all patients as if they have HIV or Hepatitis C and use Universal Precautions so the danger of transmission is low. I don’t tell my patients to lie about their HIV, but warn them to be careful and alert to discrimination at medical and dental facilities.

Be Safe! Wear protection. Keep those questions coming.

Daniel Pearce, D.O., FACOI, AAHIVS

Clinical Associate Professor of Medicine, Loma Linda University School of Medicine

Adjunct Professor of Internal Medicine and HIV, Touro University California College of Osteopathic Medicine and Midwestern University Arizona College of Osteopathic                      Medicine

HIV Specialist, Assistant TB Physician, Riverside County Public Health Department

Hepatitis C Specialist and Researcher, Southern California Liver Centers, Riverside

Researcher, Inland Empire Liver Foundation and Clinical & Translational Research Center

REFERENCES: Medscape®

 

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