PEPping up your HIV defenses
Torres, G.
Gmhc Treatment Issues the Gay Men's Health Crisis Newsletter of Experimental Aids Therapies 12(5): 8-9
1998
ISSN/ISBN: 1077-1824 PMID: 11365480 Document Number: 491710
Post-exposure treatment (PEP), for post-sexual exposure of HIV using antiretroviral therapy, is being investigated. Many experts recommend the administration of antiretroviral therapy as soon as possible, preferably within 72 hours of unprotected sex. Treatment regimens are modeled after those used for occupational exposure, i.e., zidovudine and lamivudine for four weeks, with didanosine and stavudine as alternatives. A protease inhibitor should be considered if the source of the potential infection has AIDS, a high viral load (over 50,000 copies/ml), or has already been treated with any of the nucleoside analogs under consideration for the exposed person. PEP is frequently offered in cases of sexual assault because perpetrators of rape are often HIV-infected. Patients with repeated exposures should be counseled on preventing exposure to infection, and they should be advised that PEP is unlikely to be 100 percent effective. PEP carries the risk of developing and transmitting resistant HIV strains. PEP should not be withheld from any individual with a significant exposure. To date, only San Francisco has experience with PEP.