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Question about Dr.Bob
Jul 29, 2006

Hey Dr.Bob..

I'm just wondering what you're specific symptoms were when you were infected by the HIV bug..how quickly did they appear, what were they and WHY DID"NT PEP work for you?/

Response from Dr. Frascino

Hello,

All of this information can be found in the archives, so I see little benefit in revisiting it in detail again. In brief, my ARS following my primary HIV infection from an occupational exposure (severe hollow-bore needle stick and laceration while treating a patient with advanced-stage AIDS) was typical. I developed most of the common ARS symptoms a number of weeks following the exposure and seroconverted shortly thereafter.

We had only a few antiretroviral drugs available in January 1991. (This was five years before the potent new drugs protease inhibitors, non-nucleosides, etc. came on the scene). We didn't know much about PEP nor was their much experience using it. The patient I was treating had advanced-stage AIDS and had been on AZT for quite some time. In retrospect, undoubtedly he was resistant to it, but we had no other options at the time, nor did we even have resistance tests to detect the presence of drug resistance.

I took AZT immediately after the exposure, but it was most likely not effective because the viral strain I acquired was already resistant to this drug. In the past 15 years, we've learned a considerable amount about how and when to use PEP so that it is most efficacious in preventing potential HIV infection. However, I should point out that even today, with over 20 anti-HIV drugs on the market, we still see PEP failures, despite PEP being appropriately proscribed and taken. It certainly helps reduce the chance of infection after significant HIV exposure, but it doesn't completely eliminate that possibility. You can read more about PEP and its limitations in the archives.

OK, enough about me. What about you?

Dr. Bob



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