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subtype E survival time
Apr 24, 2004

Dear Dr. Sherer,

I am 30 years coming from Germany, "old Europe". Never really had a girlfriend in my life. I was so frustrated about it so that I decided to make vacation in Thailand with a close friend last December. I got acquainted to a young lady in a disco (no prostitute!) and afterwards I met her in bed. I protected myself, but condom broke. As she had her menses I got all her blood on my penis.

This horror-story sounds unbelieveable, but it is the complete truth!

Now I am positive with subtype E. Do you have experiences with this subtype? I have heard it would be the toughest of all HIV-virus and hardly to treat. Is this true? What do you recommend in this case? Have you heard of special therapies concerning it? What kind of ART does not work because of resistance? Is there a another progression and survival time for me than it would be with normal HIV-1 B? Looking forward to your reply.


P.S.: Thank you and your colleagues for the efforts you bring in for HIV. THE BODY is a super service. We dont have something like that here in my country.

Response from Dr. Sherer

Subtype E appears to differ from other subtypes in its transmissibility, parcitularly due to hetersexual contact.

In other ways it behaves much like other HIV subtypes, including its response to therapy. There are no known 'special therapies' for the treatment of subtype E - the selection of drugs is the same as for one with subtype B, or another subtype.

I suggest that you find one of many HIV experts in Germany and have this discussion, particularly if your CD4 cell count is 350 cells or below, or if you have a high viral load (above 55,000).

In the US, the HHS Guidelines recommmend for initial therapy either an efavirenz containing regimen or a lopinavir/ritonavir containing regimen. And there are many alternatives.

Most importantly, seek medical care promptly, now that the shock of this 'unbelievable' event has worn off. It is not unbelievable at all, it is quite common.

Remember that in the US and Europe, the average time to getting sick from the moment of HIV infection is 10 years, and the prospects for you to get onto effective HIV therapy in this era are very good.

NNRTI microbicide: TMC-120

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