Friday, August 13, 2010

What is AIDS?

What is AIDS?

AIDS stands for acquired immune deficiency syndrome.

AIDS is the result of damage to the immune system. A damaged immune system is unable to protect the body against certain specific 'opportunistic' infections and tumours.

These infections and tumours are called opportunistic because they are caused by organisms normally controlled by the immune system, but that 'take the opportunity' to cause disease when the immune system has been damaged.

The timing and types of clinical problems affecting persons with AIDS can vary widely and this is why it is termed a syndrome. AIDS is a collection of different signs and symptoms that are all part of the same underlying medical condition, human immunodeficiency virus infection.

Friday, August 6, 2010

What about PEP and PrEP?

What about PEP and PrEP?

PEP stands for Post-Exposure Prophylaxis. PrEP stands for Pre-Exposure Prophylaxis. Both involve using antiretroviral drugs to prevent HIV infection.

PEP has long been used in hospitals and other "occupational" settings. It involves giving a short course of antiretroviral treatment to someone who may have been exposed to HIV, such as a hospital worker who is accidentally stuck with a sharp instrument or needle that was recently used on someone known to be infected with the virus. In this situation, a 28-day course of HIV treatment—usually a combination of two or three approved antiretrovirals—is started to help prevent the virus from establishing infection in the body.

PEP can also be used in "non-occupational" situations, such as possible exposure to the virus after sexual activity or injection drug use. According to guidelines from the CDC, however, It is only intended for people who have engaged in high-risk activity with someone known to be HIV positive and when the person seeks care within 72 hours of exposure. As with possible occupational exposure to the virus, it is best if PEP is started within hours of a possible non-occupational exposure. It will not likely be effective if started more than 48 to 72 hours after possible exposure.

If you fear that you may have been exposed to HIV and are trying to figure out if PEP is right for you, get in touch with your doctor or a nearby hospital emergency room immediately!

PrEP is an experimental HIV prevention approach. It involves using HIV medications before possible exposure to the virus. The concept of providing a preventive before exposure to an infectious agent is not new. For example, travelers to an area where malaria is common are advised to take medication before and during travel to prevent the disease. The medicine to prevent illness is then already in their bloodstream if they are exposed to the malaria parasite. Researchers believe that the same concept may work to protect people from HIV infection. Theoretically, if HIV replication can be inhibited from the moment the virus enters the body, it may not be able to establish a permanent infection.

PrEP studies are still being conducted to determine if this approach is safe and effective. A recent study found that taking the oral HIV drug Truvada (tenofovir plus emtricitabine), when combined with condoms and counseling, was able to prevent infection by 44 percent in men who have sex with men (MSM) and transgender women who have sex with men. In those who reported taking at least 90 percent of their doses correctly, Truvada cut infections by 73 percent. The CDC, however, is cautioning people not to begin using PrEP on their own.

There are a number of reasons for this, including the fact that we don't yet know how frequently a person needs to get tested while on PrEP. If a person does become infected, and continues to use Truvada before they next get tested, they could become resistant to one or both of the drugs contained in the combination pill. Second, the study was only conducted in MSM and we don't yet know how well it will work to prevent transmission from vaginal sex or from injection drug use. There are four other PrEP studies currently in progress, and it will be important to see how well PrEP works in other populations and settings before firm recommendations can be issued. The CDC is currently working on interim guidelines for providers.