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are sustiva and combivir effective forms of pep?
Apr 13, 2014

Late last month I was prescribed combivir and sustiva by the doc at an urgent care clinic and started taking them 60-65 hours post exposure. From reading a few articles the past few days it sounds like this prescription is outdated by a few years.

I am 14 days into the pep regimen and have the following questions: - is this combination still considered an effective form of pep - is it as effective of other combinations? are there numbers on this? - at this point should I continue this regimen or look to switch to more effective drugs - assuming this is an outdated prescription, shouldn't the urgent care clinic have known this (located in south florida)? it seems like poor judgement to be using guidelines on hiv from over 10 year ago.

thanks.

Response from Dr. Young

Hello and thank you for posting your question about post -exposure prophylaxis.

You're correct in that regimented you're prescribed is a bit out of date. This does not mean that the regimen won't work but rather that it is more likely to cause side effects and consequently premature discontinuation of treatment. Additionally there are relatively high rates of transmitted drug resistance with virus resistant to the efavirenz (Sustiva), and such this medication is generally not recommended for postcoital prophylaxis this country.

The New York State AIDS Institute is issued recent guidelines on nonoccupational postexposure prophylaxis. These guidelines now "recommends tenofovir + emtricitabine (Truvada) plus raltegravir (Isentress) as the preferred initial nPEP regimen because of its excellent tolerability, proven potency in established HIV infection, and ease of administration. Zidovudine is no longer recommended in the preferred PEP regimen because it is believed to have no clear advantage in efficacy over tenofovir while having significantly higher rates of treatment-limiting side effects."

Hope that helps, BY



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