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Doc wants me to decide length of PEP
Jun 11, 2004

Dear Dr. Frascino...

D'abord, merci mille fois pour tout ce que tu fais sur ce site!

Question is this... I initiated PEP within 15 hours of high risk male to male intercourse on June 1. Doc started me on Combivir and Viramune. All is going well with the therapy so far.

At my HMO, protocol seems to require PEP of a 6-week duration. During my meeting with my doc, however, he said that at six weeks, he would "see how I feel about going longer" with the PEP treatment. I know from this site that PEP is generally prescribed for 28 days (4 weeks). Now, I would hate to be responsible for my own seroconversion if I halted PEP at six weeks instead of 8 or 9 (for example). But it seems to me that, if it ain't gonna work after 6 weeks of PEP, it ain't gonna work for a longer period either. It's a rather tough decision to make though!

What do you think? Any reason to take my PEP for longer than 6 weeks!

Thank you so much! Tu es merveilleux!

Response from Dr. Frascino

Salut,

Je ne comprends pas pourquoi ton médecin veut que tu décides la durée de ton traitement de PEP. C'est incroyable et choquant. Tu as raison. On peut prendre PEP pour quatre semaines. Il n'y a aucune raison de le prolonger. On devrait suivre le protocole de PEP bien établi qui inclut le PEP pour quatre semaines et des examens de VIH à niveau de base, entre quatre et six semaines, à douze semaines et à six mois. Ton HMO devrait consulter avec un spécialiste de VIH/SIDA et ne pas demander que des patients gèrent leurs propres traitements. Et puis quoi encore ? Te demanderont-ils que tu enlèves aussi ta propre vésicule biliaire ?

Bonne chance (avec le PEP et ton HMO) !

Dr. Bob



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