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Expired drugs vs no drugs-How long are they effective?
Mar 1, 2001

Two weeks ago my partner developed what appears to be one KS lesion on his calf. He is HIV positive and has endured opportunistic difficulties in the past. Considering economic constraints on PWA, his loss of professional career and insurance, it has become necessary to appeal to social programs. The bureaucracy adds a long duration to actual medical attention. Over a year ago he was feeling healthy, but his labs indicated he begin antivirals. He was prescribed one month of the cocktail by his provider. He didn't suffer side effects. However, he was forced to choose between unsecured appointments at the clinic or income from a traveling job. In light of his seemingly good health he chose to work. He was forced to quit the cocktail. Regarding the newfound KS we realize the urgency to begin antivirals. Yet, the duration re-entering the social system may be compromising his system further. I have a full prescription for the cocktail dated three years old. It will be enough to keep him going until he can be seen by the clinic. Is it safe to give him these drugs? Finally, what is your view on visiting a state-funded hospital emergency room to receive immediate medical attention? The clinic administrators have offered this as an alternative. I thank you for your help. Sincerely, TC

Response from Dr. Dezube

Dear TC: Although you ask a seemingly straight-forward (and interesting and sad) question, the question is anything but simple. Even if your partner were to take expired cocktail, he would still need to have safety labs drawn (blood counts, liver function tests, and so on) as well as have his viral load and CD4 measured. If he has no insurance for drugs, then I imagine these labs tests will also present a problem. Also it is not a great idea to start these drugs without seeing a provider regularly. I would highly recommend that he seek help from one of the many local AIDS organizations; they can often be life-savers in this situation. Although I obviously don't know what your geographic location is, most states and organizations have some type of safety net. Good luck.


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