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Few Questions about Meds
Nov 29, 2008

Hello doctor !

I have a few questions about HIV HIV-Meds and experimental therapies.

1. If a Person was in high risk, would ,lets say 10 days after exposition a PCR deetct HIV compounds in blood? How accurate is PCR (also in percent)?

2. What is the best, most promising hiv experimental therapy and where it can be done (in EU as well?)?

3.Can a hiv+ try to get new hiv vaccine , how is the name of this hiv vaccine?

and

4. what is the best tolerated regime (hiv meds) for patients with damaged kidney?

THANK YOU SO MUCH

Mario

Response from Dr. McGowan

Mario,

Great qusetions: 1) HIV PCR is usually positive in 2-3 weeks, so 10 days is a reasonable time. PCR is very sensitive, but may show a "false positive" redaing if the level is low. This is why we generally do not use the PCR for making a diagnosis of HIV (except in newborns when the antibody test is not accurate due to the presence of the mother's antibody).

2) There are some promising new therapies undergoing study now..nothing that can be recommended at this point. For example the use of a monoclonal antibody to block HIV from attaching to the CD4 cell, it is being made by TaiMed Biogenics. Also new therapies using VRX496 by VIRxSYS Corporation which uses an "antisense" gene to block the virus from making copies of it's envelope. This is an early form of gene therapy. There are also maturation inhibitors under study (Bevirimat (PA-457) which stop the virus from produsing functional virus particles. You can consult with your doctor to find out where the studies may be available near you.

3. The HIV vaccine trials for therapeutic vaccines are undergoing a re-evaluation due to poor results from studies to date. Right now it would be best to wait for new vaccine strategies to be developed. Keep posted.

4. Most of the protease inhibitors, non-nucleoside analog inhibitors, fusion inhibitors, CCR5 antagonists, integrase inhibitor (raltegravir) and abacavir can be dosed without modification in people with kidney dysfunction. Many excellent options are available.

Joe


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