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PEP AND HIV
May 10, 2011

AM A MIDWIFE, DELIVERYING SEXUAL REPRODUCTIVE HEALTH SERVICES AT THE CLINIC. AM COMMONLY CONFRONTED WITH A QUESTION AS TO... WHAT HAPPENS TO THE HIV ASSUMED TO HAVE BEEN INTRODUCED BY ACCIDENTAL EXPOSURE AFTER A COURSE OF PEP TREATMENT? I ALWAYS FEEL INADEQUATE IN RESPONDING TO THIS, BECAUSE IT ALWAYS FEELS APPROPRIATE TO SAYS, 'IT DIES' BUT THEN THIS RESPONSE IS FOLLOWED BY, ...WHAT IS ITS LIFESPAN? AND WHY DOES PEP WORK DIFFERENTLY TO HAART, WHY DOESN'T IT CONTAIN THE VIRUS UNTIL IT DIE? PLEASE, THE ANSWER TO THIS QUESTION WILL BE SIGNIFICANT AS SOME OF MY CLIENT HAD STOPPED TREATMENT WITH HOPE THAT VIRUS IS GONE AND HAVE ACCUSED US OF HAVING A CURE FOR THE VIRUS i.e ( PEP)

Response from Dr. Frascino

Hello,

Antiretroviral mediations work on different aspects of the HIV lifecycle, depending on their mechanism of action (nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, fusion inhibitors, CCR5 co-receptor antagonists, etc.). PEP uses identical antiretrovirals as certain HAART regimens and the mechanism of action is the same. The purpose of PEP is to prevent or abort an HIV infection before HIV has the chance to establish infection in the lymphoid tissues. HIV that is blocked from entering susceptible immune cells, such as CD4 cells, dies relatively quickly. (We don't have an exact number of hours or days as there are many variables.) A full course of PEP lasts 28 days.

Unfortunately we don't have a cure for HIV. We can prevent or abort some infections using antiretroviral drugs (PEP). But this is not a cure for HIV/AIDS. These identical drugs are used to treat established HIV (highly active antiretroviral therapy: HAART).

Hope that helps.

Dr. Bob



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