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Questions for Dr Young
Jan 1, 2014

hello, Doctor Young, I have some questions regarding HIV: Could you please explain me this nano-formulated antiretrovirals? (how are they working, why doses decrease advantages disadvantages , etc??) Why docotrs (worldwide) donz give HIV-PEP after unprotected insertive oral sex? Because it is not a HIV-Risk at all? It can save lives .... (?) What do you think is the best medication for hIV-Infection at this time? Attachement Inhibitors, Integrase Inhibitors or Fusion-Inhibitors or other class ?? Is there any promissing HIV-vaccine (preventive and therapeutic) at this time?

THANK YOU

Sincerely

Madlene from Paris

Response from Dr. Young

Hello and Happy New Year to you.

1) Nanoparticle ART are a new strategy to formulate and deliver medications. The nanoparticles are like a microscopic sponge and allow for a lot of drug to be crammed into a small particle. The drug can then be slowly released from the particle over time. This has the potential to permit very infrequent dosing of medications. The first nanoparticle formulated meds are the experimental integrase inhibitor, called 744 for short and the NNRTI rilpivirine. Both may permit once montly, or perhaps less frequent dosing.

2) PEP and PrEP are both very effective in preventing HIV in risky situations. Insertive oral sex is very low risk. This is why most experts wouldn't recommend PEP after such exposure.

3) The best medications for first line treatment involve the use of 2NRTIs and a third medication. My favorite 3rd class are the integrase inhibitors. They are very potent and very well tolerated.

4) Vaccines... :-( Not much on the near term future, and indeed several significant setbacks. So it will be a while before we see either therapeutic or preventive vaccines on the menu.

Be well, BY



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