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Drugs May Offer AIDS Prevention

Posted by Zonk on Tue Mar 28, 2006 07:38 AM
from the here's-hoping dept.
Science
FlipFlopSnowMan writes "There is an interesting article on MSNBC about the possibility of preventing AIDS using the same pills that are currently used to fight the virus in affected individuals." From the article: "The drugs are tenofovir (Viread) and emtricitabine, or FTC (Emtriva), sold in combination as Truvada by Gilead Sciences Inc., a California company best known for inventing Tamiflu, a drug showing promise against bird flu. Unlike vaccines, which work through the immune system -- the very thing HIV destroys -- AIDS drugs simply keep the virus from reproducing. They already are used to prevent infection in health care workers accidentally exposed to HIV, and in babies whose pregnant mothers receive them."
+ -
story

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[+] Possible Breakthrough for AIDS Cure 787 comments
kryonD writes "Researchers believe they have found a new compound that could finally kill the HIV/AIDS virus, not just slow it down as current treatments do. While most of the community is still hesitant to comment on this until it passes peer review, initial results show that their method attacks and kills ALL variations of the virus. A fast track through the FDA could have one of the world's leading problems licked in less than a decade."
[+] Your Rights Online: AIDS Drug Patent Revoked In US 357 comments
eldavojohn writes "Doctors Without Borders is reporting that four patents for tenofovir disoproxil fumarate, a key AIDS/HIV drug, have been revoked on grounds of prior art. This is potentially good news for India & Brazil who need this drug to be cheap; if the US action leads to the patent being rejected in these countries, competition could drastically lower prices. But the ruling bad news for Gilead Sciences. The company has vowed to appeal. We discussed this drug before."
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  • Why'd you have to release this story? Now sex workers all over the world will be killing each other to get their hands on these drugs. Eventually their diseases will become super-strains and come back with a vengence!
    • Yeah no kidding. Even if you fuck someoone bareback who definitely has AIDS, the odds of transmission are still only like 1 in 10,000.

      Have they really tested this drug on THAT many accidentally exposed healthcare workers? Isn't it possible that perhaps the people exposed just didn't get the disease?

      • Re:Ah, man.. (Score:5, Insightful)

        by dario_moreno (263767) on Tuesday March 28 2006, @07:56AM (#15009789) Homepage Journal
        "odds are 1 in 10000"...rather 1 in 1000, and even more for receptive sex, and if you do it once a day, you get almost a 1 in 2 chance of catching it after 500 days. Check Chad Douglas on google...always on top, positive after 5 years, dead after 15.

      • Yeah no kidding. Even if you fuck someoone bareback who definitely has AIDS, the odds of transmission are still only like 1 in 10,000.

        Have they really tested this drug on THAT many accidentally exposed healthcare workers? Isn't it possible that perhaps the people exposed just didn't get the disease?

        No, nitwit. "Accidentally exposed healthcare workers" generally means needle pricks and contact with infected blood. Google "post exposure prophylaxis" [google.com] (PEP) to see what's done now. This treatment would certai
    • Yes folks! The next time you want to do the wild thing with one of those crazy ladies of the night. Go for prevention. Its simple its easy and its cheap.

      1- Navigate to the My Video folder.

      2- Click on one of your numerous porn clips.

      3- Wank!

      See folks. Stopping the spread of AIDS is easy...and its on your hands*.


      *-Three sessions of thirty seconds per day recommended. Lubricants, may apply.

    • Why'd you have to release this story? Now sex workers all over the world will be killing each other to get their hands on these drugs.

      Yeah, especially since - as we all know - reading slashdot is the favorite pastime of sex workers worldwide.
    • This is slashdot. Nobody here is having sex with anyone.

  • Cash cow? (Score:5, Insightful)

    by Tx (96709) on Tuesday March 28 2006, @07:45AM (#15009758) Journal
    Q. How to make more money from expensive AIDS drugs?

    A. Obvious - sell it to people who don't have AIDS as well as people who do.

    As I understand, these drugs are very expensive, and personally I can't see any justification for using them prophylactically.
    • ...personally I can't see any justification for using them prophylactically. Get AIDS and you will find a justification....
    • While I'm not fan of pharmaceuticals in general, the fact that you're making this comment suggests to me that you're not in a high-risk group. I didn't RTFA, but even the summary gives a couple ways this type of drug is already being used before a person contracts HIV.

      If, for example, you worked with HIV-positive people you couldn't trust or were sexually active within a high-risk group you might have a different opinion. I don't condone visiting prostitutes, but I can see that HIV/AIDS infections among

    • Well, I think what they might be usefull for is in many of the African countries where AIDS rates are extremely high, and the drugs would be sold at cost. Provide the drugs for free to prostitutes and you'll lower the rate the disease spreads at. It probbably even works for preventing disease transmission for someone who has AIDS, since it sounds like it lowers the HIV virus load.

      I would agree that no one is going to buy these drugs at the retail rate of several hundred dollars/month as a prohylactic thou
    • If you are like me and are married (or in a monogomous relationship) and don't use IV drugs, then you likely don't need these meds. If you are a gay man who has unprotected sex, or are an IV drug user, then these drugs are a good idea. (Yes- I understand that getting someone who doesn't care about themselves enough to not shoot up with needles, to take a prophylactic drug may not be likely).
      • If you are a gay man who has unprotected sex, or are an IV drug user, then these drugs are a good idea.

        i hope you are only using these as an example, because straight people can get AIDS too ya know, and not just from going to see a prostitute.

        of course if someone is having sex with so many different people they fear that they need such a drug, well maybe instead they should think about changing their lifestyle, they might actually be happier
        • Look, it was a big deal a few years ago when straight people hit the 50% make of HIV infections in the US, hit as high in the upper 50s, and then saw a rise in the gay community. Some speculated that while the 50% mark made it easier to sell AIDS as a problem for everyone, not just the gay community, it also caused the gay community to take their eye off the ball.

          Regardless, say 50% of the AIDS cases are in the male gay community. The male gay community is between 1.5% and 3.5% of the US population. That
    • How about in regions where AIDS is an everyday reality? There are places in Africa where it's over 70% infection. In such situations, AIDS preventing drugs would be justified. It's just a matter of affording the $1000/month price tag...
  • Actually, I think you'll find Tamiflu is useless against bird flu [timesonline.co.uk]!

  • Same hype as with Tamiflu? (Score:3, Insightful)

    by Opportunist (166417) on Tuesday March 28 2006, @07:54AM (#15009786)
    Tamiflu is an overhyped, not really effective anti-flu drug. Not more. It would be a bomb in the budget of Roche if we didn't "suddenly" (read: 3 years after it was first detected) get "washed over" (read: Every couple of days we find a dead bird somewhere on the planet) by the "epidemic" (read: Umm... yeah, somewhere in the Far East a handful of people died who pretty much washed their hands in infected bird blood).

    Now everyone's crazy to get their hands on Tamiflu. Is it me or does it smell like a well placed marketing hype that the media picked up all too eagerly, since there's nothing else going on that would make people buy their news?
    • yeah, somewhere in the Far East a handful of people died who pretty much washed their hands in infected bird blood

      Incorrect - nearly all of them cleaned up after live or dead birds. The flu virus in birds is secreted out in bird urine/feces and infects by getting back into the respiratory pathways soon after that (both in birds and humans). Birds pecking in "dung" get infected from other birds. People who are cleaning after them (and you have to clean a henhouse quite regularly) get infected as well.

      This is

      • And? Anyone here doing heavy farm work?

        No?

        Then where's the craze?

        My guess is that people go apeshit about it because we all know the "normal" flu, we all have it from time to time, so it's something we relate to something "common", something as ordinary as a common cold.

        If it was called a "bird disease" or even "bird killer virus", nobody would bother to listen.
  • Wouldn't this speed up the development of virus strains resistant to those medicines?

    • Perhaps that is the point. Got to keep the business going, no? (Too bad this is only partially a joke.)
    • You can't look at AIDS like a picture on a wanted poster, there are simply too many mutations.

      You may take this drug, and be able to counter act some strains of the pathogen however if you contract someone else's weakened (but not yet dead) strain, your body could become an incubator for a new strain that tolerates this medication and find yourself infected.

      What nobody has mentioned or pointed out, you would have to take these pills for the rest of your life in order for them to be effective. AIDS sleeps mo

  • Ummm... (Score:4, Insightful)

    by spaztik (917859) on Tuesday March 28 2006, @07:56AM (#15009793)
    This is all well and good but...
    In the United States, wholesale costs are $417 for a month of tenofovir and $650 for Truvada.
    Who is going to be able to afford this stuff?
  • We would all be better off if there was simply a vaccine for viral diseases, instead of drugs which have been proven to stimulate the evolution of resistant strains. Vaccines on the other hand have been proven to not only reduce the incidence of disease, but also virtually completely eradicate them, e.g. smallpox. Vaccines have the advantage of being able to adapt along with the evolving virus. Drugs do not.

  • Save the melodramatic crap (Score:5, Informative)

    by Fhqwhgadss (905393) on Tuesday March 28 2006, @08:00AM (#15009807)
    What's with the qoute at the end: This is very promising. For us to be involved in a potential solution to the big HIV crisis and pandemic is very exciting.

    Pandemic? Really? Tuberculosis affects far more people worldwide but doesn't have all the sensationalism that we see surrounding AIDS. I don't mean to imply that nothing is being done about TB, or that AIDS isn't a problem, but I'm tired of the media treating this disease like we're all living on the set of "Rent"

    My father..AIDS! My sister...AIDS!
    My uncle and my cousin and her best friend AIDS.
    Gays, straights, whites and spades,
    everyone has AIDS.
    My grandma and my old dog Blue.
    The Pope has got it and so do you.
    Come on everybody we've got quiltin' to do.
    Gonna break down these barricades everyone has AIDS,
    AIDS, AIDS, AIDS...
    • In 1990, over 5 million people worldwide, practically all of them children, were dying of diarrhea. But did you see Bono appear at the Grammy Awards with a brown ribbon on his lapel?

    • Ummm. You may be right if you go by infections. But if you go by mortality statistics, HIV kills more people than any identifiable infectious agent. Period.

      In 2002, 3.9 million people died from "lower respiratory infections", 2.8M from HIV, 1.8M from miscellaneous diahrreheal illnesses, 1.6M from TB, 1.2 from Malaria, and 0.6M from Measles, according to the 2003 WHO World Health Report.

      Furthermore, one of the major reasons TB is becoming harder to keep ahead of is HIV. The 2005 World Bank Annual Report sa

      • Re:Save the melodramatic crap (Score:4, Informative)

        by will_die (586523) on Tuesday March 28 2006, @08:39AM (#15009981) Homepage
        (statistics tend to prove this out- people like sex, seek it out, and are generally not monogamous)

        Which surveys?
        If anything surveys tend show that people are primarily mongamous and are happy in a with a relationship with a single person.
        Look at something like the http://www.zogby.com/soundbites/ReadClips.dbm?ID=1 1954 [zogby.com] from late 2005. The survey was done online so you would expect that it to be a little high on the anything goes side.
        Even there you get over 70% of the people in a monogamous relationship, the majority for over 5 years.
        While they may seek it out people don't tend to pay, less then 15%. This number is about the same for various other surveys.
        If you get thoses types of numbers in an survey where people had to activly seek out the survey the numbers are going to be a lot less if you did a truly random survey of the population.
        • Did you even READ the article?? "Just 39 percent of people who took the survey always ask whether a new partner is infected with HIV, the virus that causes AIDS, or other STDs. Nearly one-third said they never check on a prospective partner's sexual health status, and among those with less than a high school education, almost 50 percent never discuss the issue of STDs with a new partner -- troubling statistics given the deadliness of AIDS and rising rates of genital herpes and other diseases." This alon
          • This alone indicates the amount of risk people are willing to take is high!

            Or it means people don't ask stupid questions. If someone knows they have HIV and are still going to have sex with you, they're not going to go, "Oh, yeah, I have AIDS. I just didn't think you'd care."

            "Wait, you didn't WANT herpes? Dude, I'm sorry, I didn't know. Totally my bad."
      • But I think there's a large social issue here.

        You hit the nail right on the head. In the United States at least, AIDS is far more of a social problem than a medical problem. The fact that it firt appeared in the gay male community has had an enormous impact on the way that the disease is perceived.

        For society that was founded on puitanical grounds, AIDS has been a godsend (pun intended). The evangelicals had a way to immediately lash out against homosexuality as the cause of all of our problems. When

  • Terrific Idea (Score:3, Insightful)

    by scrub76 (637816) on Tuesday March 28 2006, @08:02AM (#15009812) Homepage
    The evidence that AIDS drugs can prevent infections comes not only from exposed health care workers, but also monkey studies. If monkeys are given AIDS drugs up to 48 hours before exposure to SIV (the causitive agent of simian AIDS), they fail to become infected. That has been known since the late 90s. There is some data suggesting that the drugs can't always protect against multiple exposures to SIV, but those studies used only one drug at a time (not a cocktail of pills, like you would take if you had HIV).

    As an HIV researcher myself, I realize that we are not going to have a highly effective, preventative vaccine for HIV any time in the near future. There are no clear 'winners' in the pipeline right now, and even if a vaccine looked effective right now, it would be years (and millions of new infections) before it clears human testing and it broadly available. Issues like viral resistance to the vaccine, incomplete protection from infection, potential side effects, and a false sense of security would plauge any vaccine that is developed -- and these are many of the same issues confronting the use of drugs as HIV preventatives.

    One major hurdle to testing these drugs in populations highly affected by HIV is to convince them that this intervention is not a magic bullet. There will be problems, some of which we probably can't predict. There will be breakthrough infections in people taking the drugs. And the long-term health consequences aren't known. So far, these concerns have led to the abandonment of several trials of PrEP (using tenofovir in HIV-, high-risk populations) around the world. Hopefully the new data (using multiple drugs together works better than tenofovir alone) will encourage vulnerable populations that the potential benefits may outweigh the risks.

  • Yeah, all this is well and good, but don't forget the 2 P's, Patents and Profits. A company makes products for profit, whether they make clothing or life-saving drugs. If it is not profitable, they will not produce. This is linked with patents. IIRC, there was a major dispute with the big pharma companies a few years back, ended up with a drug taken off the market. And let's not forget the penicillin disputes (Chain, Merck-Sharp-Dome, Florey, Fleming etc.)

  • This is tough to read over and over again (Score:3, Interesting)

    by Loundry (4143) on Tuesday March 28 2006, @08:25AM (#15009904) Journal
    As an AIDS heretic, I find articles like these tiresome to read. There have been many, many such articles about "curing AIDS" which have all proven to be sound and fury signifying nothing. I think the reason for this is because AIDS has become something much larger than a disease. It is a way of life for thousands of scientists, a huge cash cow for drug manufacturers, and a political plank for both gay activists and gay-bashing activists.

    If you are open to the idea that the orthodoxy about AIDS might not be correct or might not be scientific, then I suggest you read these two pieces of investigative journalism that came out a couple of months ago. They detail in the most succinct way possible how AIDS came about, and that is *VERY* hard to do because of how immensely complex this subject is.

    http://www.sparks-of-light.org/HIVGATE%20-%20revie w%20copy.pdf [sparks-of-light.org]

    http://www.sparks-of-light.org/AIDSGATE%20-%20what %20caused%20AIDS%20if%20not%20HIV.pdf [sparks-of-light.org]

    If you think that I'm insane, or that I just want to have a whole lot of unprotected sex, or that I'm a conspiracy theorist, then please just ignore this post. It means that you are not open-minded to criticism of your ideas, and the only thing I want to do is give criticism of the HIV-AIDS hypothesis a fair hearing. I believe that there are HUGE problems with the hypothesis and it has led to many people getting fabulously wealthy off of what has turned out to be misdiagnosis. I am aware that this is a serious charge, and I do not take this subject lightly.

    All of that is in effort to say, "Don't mod me down. Don't be a jerk. Don't prevent someone who *wants* to hear what I have to say from hearing it." I hope it works.

    • Re:This is tough to read over and over again (Score:5, Informative)

      by geekyMD (812672) on Tuesday March 28 2006, @03:22PM (#15012974)
      What a bunch of tripe. Michael Moore would be really proud of the first paper. (I didn't read the second one, sorry) I can excuse the writer if 1/2 of the inaccuracies are from an ignorance of the field, but it honestly seems like she's trying to dissuade. Virtually every 3rd paragraph contains and inaccuracy or inappropriate insinuation that is subtle enough to be missed by someone who isn't trained in these fields. The author focuses her arguments by looking at small segments of the literature and history and ignoring the broader sweeps. For example:

      The paper's initial assertion is that AIDS was introduced as a polio virus. Simple logical disproof: 1) polio vaccine is given across social/habitual classes. 2) There has not been 1 case of AIDS where the person didn't have one of the following three risk factors: blood transfusion, risky sex*, IV drug use. 3) Not everyone in the US has previous three risk factors. 4) If 2 is true 1 or 3 must be false or at least excruciatingly improbable. 5) 3 is true, therefore 1 must be false. QED. (*risky sex = sexual activity where both partners are not exclusively monogamous to each other at any time during or prior to their relationship)

      Several pages deal with the controversy surrounding the initial discovery of the HIV virus. There was also controversy surrounding the discovery of DNA, therefore we shouldn't believe DNA is the 'source code' of life?

      She makes light of the microliter aliquots used in the CBC tests but fails to mention that all CBC tests (test which count the types and number of cells in your blood) uses these metrics. We shouldn't trust tests for hundreds of diseases including leukemia, polycythemia, or even iron deficiency based on this implication. (for example, look at the normals on this page: http://www.saintfranciscare.com/11377.cfm [saintfranciscare.com])

      She also does not respect the validity of the HIV Load test, saying that since it uses PCR (a very common technique in medicine) it cannot be accurate. (no more genetic testing, goodbye cancer diagnosis, goodbye endocrinology) She also asserts that the HIV Load assay will give false-positives and is inaccurate if the procedures are not followed. Yes, it does give false positives, it is a HIGHLY sensitive test, with a low specificity. It is not a screening test, and it cannot be used for one because of its high false positive rate. Additionally, I challenge anyone to find a test in any field that is valid when its procedures are not followed. (magnetism doesn't attract wood, therefore magnetism is false)
      http://www.labtestsonline.org/understanding/analyt es/viral_load/test.html [labtestsonline.org]

      But the coup-de-gras for me was her statistics that showed how low CD4 counts don't correlate to AIDS. (AIDS is, incidentally, practically being defined by low CD4 count)

      * "61% of people with CD4 count = 200 in 1997 were AIDS free"
      * -response: Yes, CD4=200 is the upper limit at which you see AIDS symptoms, this is expected

      * "190,000 Americans in 1993 with CD4 count=200 were AIDS free"
      * -response: See above, plus in 1993 the AIDS definition was changing so you see changes in the statistics. Additionally, that number is far less than a quarter of the number of AIDS cases in the US that year. (http://wonder.cdc.gov/wonder/data/aidsPublic.html [cdc.gov])

      * "No studies have been done to show removal of anti-retrovirals = disease"
      * -response: No, but anti-retovirals have been tightly correlated to increased CD4 counts, and their withdrawal to lower CD4 counts. It has also been shown repeatedly (and even in this paper!) that low CD4 count correlates with disease.

      The list goes on and on. I just pointed out a few of the most egregious and most easily refuted examples. It just goes to show that if someone really wants to believe someth
        • First off, I did not mean to make it personal. Just my own views. I can see how what I said could be insulting, and I really did not mean that. Science moves forward by challenging the establishment. 200 years ago if you told someone that the heard functions to pump blood they would have laughed at you. 50 years ago universal precautions were virtually unknown. Sometimes the 'crackpots' get it right, so its neccicary to regorously examine their claims. I'm sorry you've been insulted for your views, I

  • But... (Score:2, Informative)

    by Theatetus (521747)

    ... what if one of the various "environmental factors" models is right rather than the "single pathogen" model? IE, retroviruses start multiplying in people whose immune systems are shot already -- it's the symptom; not the cause.

    I know we like single-pathogen disease models but frankly those are pretty rare. Especially with autoimmune and immunodeficient disorders, it's not as easy as people think to even define the given disorder in the first place, let alone establish a pathogenic cause. Take lupus: the

    • face the facts (Score:4, Insightful)

      by penguin-collective (932038) on Tuesday March 28 2006, @10:48AM (#15010937)
      what if one of the various "environmental factors" models is right rather than the "single pathogen" model?

      That's just not a serious possibility anymore; here are just some basic observations:

      • While clinical diagnosis relies on symptoms, HIV infection has been followed in minute detail from initial transmission to death numerous times, in the presence and absence of treatment, in individuals with completely different histories, at the molecular level, at the tissue level, and at the clinical level.
      • The epidemiology of HIV has been studied extensively: the disease is clearly transmissible and no other factor than an existing HIV infection is associated with transmission.
      • Drugs specifically targeted at HIV have increased survival rates tremendously, while changes in lifestyle have had limited effect.
      • The molecular mechanisms of resistance to HIV infection (found in a few percent of the population) are well understood.


      Single pathogens are sexy for epidemiologists.

      Yes, and they are also the rule for infectious diseases. While susceptibility and severity of a disease may vary with environmental factors, for infectious diseases, there is usually a well-defined, clearly characterizable pathogen responsible.

      • The epidemiology of HIV has been studied extensively: the disease is clearly transmissible and no other factor than an existing HIV infection is associated with transmission.

        Well, that's just not true, and the fact that people keep repeating it doesn't make it so.

        • The presence of antibodies is not a determinant of virus load (and in the case of newborns of mothers with HIV, is not even an indication of the presence of the virus).
        • Kashala, et al, published in the Journal of Infectious Diseases that the '
      • AIDS diagnosis as it is practiced today assumes HIV-AIDS causation.

        Which makes sense, because the evidence as it is observed today indicates HIV-AIDS causation. See the sibling of your post for details. There's no more reason to believe AIDS is caused by anything besides HIV than there is to believe the moon landing was faked.
  • Now I can get spam offering bootleg copies of yet another drug from "teh ultmate online pahrm hacy"

  • are you nuts! (Score:5, Informative)

    by Anonymous Coward on Tuesday March 28 2006, @09:24AM (#15010312)
    as an AIDS counsellor, I've worked with many people who are taking these drugs on a daily basis. While they are a brilliant development and have already saved millions of lives, they are EXTREMELY TOXIC; they are totally unsuitable for preventive purposes, apart from being very expensive, they require regular blood tests for specialised medical monitoring (to check your body's responses, get the doses correct, etc), and there are often really grim side effects (such as vomiting, diahoerrea, nausea, fatigue, depression, etc etc); I know many who have chosen to come off the drugs because the quality of their life had got so bad from the side effects that they would rather die with a bit of diginity.

    They hammer your immune system; it's like taking poison every day, it's a bit like chemotherapy in ways.. in fact, that's not a bad analogy: why don't we all start on an ongoing course of chemotherapy as a preventive measure against getting cancer?

    ps. I'm not an Anonymous Coward, I'm a *Lazy* Anonymous Coward from Ireland

  • What to expect. (Score:5, Insightful)

    by sammy baby (14909) on Tuesday March 28 2006, @09:46AM (#15010480) Journal
    Expect immediate, heavy resistance from the ultra-right wing, Christian conservative political forces in the US. Experience has shown that if there's a disease that increases the potential negative consequences of having sex, especially those which disproportionately affect women, they will oppose efforts to provide treatment. (Women in heterosexual relationships carry an increased risk of HIV transmission when compared to men, although they have a decreased risk in homosexual relationships. The reasons I leave as an exercise for the reader.)

    Case in point: the human papilloma virus, or HPV. Now here's the thing with HPV: it's sexually transmitted, condoms don't protect against it, and doctors believe that it's responsible for seven out of ten cases of cervical cancer later in life. So, if we could develop a vaccine against it, that would be a huge strike against cancer, right?

    Well... sure. But ultra right groups like the Family Research Council oppose such a vaccine, even though pharmaceutical companies have already conducted successful clinical trials. Why? Because they want to scare people into not having sex.

    If this is the reaction an HPV vaccine (or, for that matter, condoms) gets, how do you think they're going to react to a cure to something which disproportionately affects gay men?
          • You can't be serious...lets have a comparison [womhealth.org.au]:
            • The US. To my knowledge, there are quite a few places that take the abstinence-only route. You have a teenage birth rate of 51.1 babies per thousand females.
            • Australia. No problems getting sex-ed through over here to my knowledge, and a teenage birth rate of 16.3 babies per thousand females.

            While it is not the only factor involved, there is a very big difference.

  • Idiotic. (Score:3, Insightful)

    by Jafafa Hots (580169) on Tuesday March 28 2006, @09:55AM (#15010552) Homepage Journal
    Oh great. All we have to do is have every healthy person in the world spend $20k-$40k per year on drugs that kill their liver and otherwise destroy thier health... for the rest of their lives. What a great solution!

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