You're Negative- Take These Meds

[+ Lucky]

That's what some folks might hear soon from their doctor. Even if HIV negative, your constant barebacking puts you at risk, so take the AIDS meds anyway. This is one of 3 ideas being put forth today in the Washingto Post by leading AIDS researcher Dr. Anthony Fauc.:

Here is the story:

 

A Policy Cocktail for Fighting HIV

 

By Anthony S. Fauci

Thursday, April 16, 2009

 

Nearly 30 years after the first cases were recognized in the United States, HIV/AIDS remains an incurable disease that is devastating large swaths of our country and the rest of the world. To understand the magnitude of the destruction, look around our nation's capital. Last month, D.C. health officials announced that 3 percent of city residents had full-blown AIDS or were infected with HIV. Not only is that infection rate on a par with rates in some African countries, but the D.C. data were based only on those who have been tested for HIV; the actual rate is probably much higher. Globally, an estimated 33 million people carry the virus. In 2007 alone, about 2.7 million new infections occurred.

 

The annual number of new HIV infections in the United States -- about 56,000 -- has remained fairly constant for more than a decade. That's right, 56,000 people are infected in this country every year. Clearly, our efforts at HIV prevention have been insufficient. Drastic action and new approaches are urgently needed.

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Vaccines have historically been mankind's best weapon against the worst infectious diseases. But HIV's unique and formidable nature has presented challenges to the development of an effective vaccine. Although we remain committed to the research necessary to find a preventive HIV vaccine, a licensed product is not likely to be available in the near future.

 

In the absence of a vaccine, three bold new approaches to controlling the HIV/AIDS pandemic are being discussed by those working in medicine and public health. These approaches are still in the conceptual and testing phases, but if applied as a group, it's possible they could have a dramatic effect.

 

The first approach would provide a daily dose of antiretroviral medicines to people who are not infected with HIV but are at high risk of becoming infected. This strategy, known as pre-exposure prophylaxis, or PrEP, is based on the concept that blocking HIV's replication immediately after exposure to the virus may prevent infection.

 

A somewhat similar strategy of treating HIV-infected mothers before and during delivery and treating their newborns for a limited time afterward has virtually eliminated mother-to-child HIV transmission in the United States.

 

The National Institutes of Health and other organizations are conducting clinical PrEP trials among various at-risk populations. Initial findings are expected later this year. Of course, safety and cost-effectiveness will be important factors to consider even if the approach proves effective in preventing infection.

 

The second approach would involve universally available, voluntary, annual testing for HIV infection and immediately providing antiretroviral therapy to those who test positive. The potent combinations of antiretroviral medicines available today can suppress the amount of HIV in an infected person's body to extremely low levels, resulting in longer lives and better health.

 

Plus, it has been clearly shown that those who have less HIV in their blood are less infectious to others. In fact, when a drug regimen suppresses HIV to certain low levels, the risk that the infected person will infect another through sexual contact appears to be greatly reduced, even though the virus has not been eradicated. New modeling research suggests that implementing a voluntary "test and treat" approach could dramatically reduce new HIV cases beginning within a decade and ultimately halt the pandemic.

 

Universal voluntary testing and treatment potentially could have a transformational effect on public health. Before this approach can be implemented, however, we must pursue a research agenda that includes studies of feasibility, efficacy, the benefits to individual patients vs. the benefits to society, and cost-effectiveness.

 

The third approach relates to the lifelong treatment that most people with HIV eventually need. Certainly, this care imposes financial and other burdens on patients, their families and health-care systems. But now, for the first time, AIDS researchers are pursuing major efforts to cure HIV infection. This might entail purging all vestiges of the virus from a person's body, a difficult challenge. Perhaps more likely, though still difficult, would be a "functional cure" -- therapies that suppress the virus to such low levels that an HIV-infected person would no longer need treatment because his or her immune system could keep the residual virus in check. The latter result would be more likely if therapy were initiated early in the course of infection, when significant immune function remains. The NIH plans soon to launch an initiative designed to solicit novel ideas for an HIV cure from the scientific community.

 

It is too early to predict the success or even the feasibility of such a three-pronged approach. Just the research to determine feasibility would be extremely costly. It is clear, however, that new methods of fighting infection must be pursued, and it is encouraging that new NIH funding provided through the American Recovery and Reinvestment Act offers the chance to at least explore such an approach, with the hope that an end to the HIV/AIDS pandemic could be within our reach.

 

The writer is director of the National Institute of Allergy and Infectious Diseases, a part of the National Institutes of Health.

[+ Charlie]

Start buying stock in big pharma today!

[zeferrelli]

be not the first by whom the new are tried

[MsGuy]

Start buying stock in big pharma today!

 

Just an order of magnitude guestimate, but, with current drug prices, aren't we talking several hundred billion dollars a year in the US alone?

[Guest greatness]

wow

 

I don't think you can give a medical advice based on a news article. There is a possibility that you might get sued. PEP is not a morning after pill for HIV. It does have side effects. I had to take it because of an occupational exposure. I have completed PEP medication and after 4 month from the exposure date I am negative. Side effects from the medications were just HORRIBLE! I wonder how many people can finish the tightly scheduled drugs. My doctor told me about half of people did not complete PEP medication due to its side effects. So I think using a condom is still a good idea.

[Guest zipperzone]

So I think using condom is still a good idea.

 

Even if they do perfect a regime that "protects" you from the virus, I know I will always rely on condoms. The less risk the better.

[TruthBTold]

What are potential side-effects?

[Steven_Draker]

What are potential side-effects?

 

http://hivinsite.ucsf.edu/InSite?page=ar-05-01

 

Look under "Adverse Events" on the link above.

[Guest greatness]

Well

 

http://hivinsite.ucsf.edu/InSite?page=ar-05-01

 

Look under "Adverse Events" on the link above.[/color]

 

I had a severe skin problem that lasted a week but wasn't sure that was because of the infection or not. It really depends on the person. I just couldn't handle it but rather than being sick rest of my life so I finished the regime. I feel sorry for people who got infected and I admire Steven for participating in AIDS/LIFE cycle. I hope I can see you there although I don't know your real name or face.

[+ purplekow]

I had a severe skin problem that lasted a week but wasn't sure that was because of the infection or not. It really depends on the person. I just couldn't handle it but rather than being sick rest of my life so I finished the regime. I feel sorry for people who got infected and I admire Steven for participating in AIDS/LIFE cycle. I hope I can see you there although I don't know your real name or face.

 

You may not know his face, but that ass is unmistakable.

[Steven_Draker]

I admire Steven for participating in AIDS/LIFE cycle. I hope I can see you there although I don't know your real name or face.

 

Greatness, thank you for the kind words. I'll be riding under the name 'Steven Draker' and my number on the Ride is 4788. It would be nice to say hello. Check your personal email.

 

Best, Steven ~

[Ivan]

PEP and PrEP are different

 

Seems like PEP and PrEp are being mixed up in this thread.

 

PEP, which greatness refers to, is POST-Exposure Prophylaxis. This combination of drugs is used to fight a possible exposure to HIV after it has happened and is quite strong. The basic regimen is either Retrovir (AZT, Zidovudine, ZDV) 300mg twice daily + Epivir (lamivudine)300mg daily;or can be taken as Combivir one tablet twice daily. More details at

http://aids.about.com/od/occupationalexposure/a/pep.htm, including posible side effects of the dosage.

 

PrEP, which Fauci refers to in the article Lucky quotes, is PRE-Exposure Prophylaxis. Tests have been conducted abroad and early tests also in this country. The main drug is Tenofovir, which has been used for several years, including for the treatment of HIV infection. See the January 2009 factsheet at

http://www.cdc.gov/hiv/resources/Factsheets/prep.htm. Tenofovir is listed on the page Steven links to, but that is Tenofovir in a treatment setting and not the prevention approach that Fauci proposes.

 

One of the major issues about PrEP usage is that men will revert to unsafe sexual practices because they think that PrEP protects them against HIV infection (which has not been proven conclusively, and the dosages have not been determined, nor are long-term side effects known) -- thus, condoms and other safe sex practices are still required. Because of the length of drug testing and negative reaction in the gay and black communities to this approach (taking a daily dose of a drug), I assume that PrEP will not be available for prescription by your local doctor for many years, if at all -- note that Fauci is speaking of initial clinical trials, which would be followed by larger clinical trials, which usually last 2 or 3 years and then results need to be analyzed. So definitely continue using condoms.

[Steven_Draker]

Ivan, thank you for the clarification and for the preciseness in your reply.

 

Best,

[Guest greatness]

thanks so much for your clarification. I was just letting people know side effects of PEP. It was just horrible. I strongly urge people to use condoms instead of considering taking medication. Thanks.