Pep: Can Early HIV/AIDS Infections Be Prevented?
By Sadaf Qadir
With 36.7 million people living with the HIV infection globally as of 2015, it is clear that HIV has a huge impact in global healthcare . But what is HIV?
HIV stands for ‘Human Immunodeficiency Virus’ and, true to its name, attacks the immune system . HIV targets immune cells called T-cells for destruction which results in a weakened immune system . When the T-cell count falls very low, a person is said to have Acquired Immune Deficiency Syndrome or AIDS; however, if treatment is managed, a person may avoid getting to this stage .
HIV is spread via bodily fluid contact which includes sexual activity, needle sharing, and breast milk . New HIV infections occur due to transmission through these actions . While there is no cure, the treatment option is taking antiretroviral therapy (ART) drugs, which reduce the chances of advancing to AIDS and prolongs HIV infected people’s lifespans . However, prevention methods through education and awareness have played a major role in decreasing the number of new infections.
In recent years, a new drug called Post-Exposure Prophylaxis (PEP) has been developed as a prevention method for people who suspect they have come in contact with HIV . PEP involves taking ART drugs within 72 hours of exposure, every day for 28 days . As of 2005, the medication is available to anyone who can access and afford it . While the pill is expensive, ranging from $600 to $1,000 per 28-day prescription, it is possible for healthcare providers to apply for free PEP medications through the manufacturer .
PEP has been gaining more interest over the years as a prevention method and is used as an emergency option especially for healthcare workers . However, it still has its limitations. PEP does have side effects including nausea, headache, fatigue, and general feeling of illness . It is also not 100 percent effective [7, 8]. In healthcare workers, HIV infections were reduced by 79 percent post-exposure to the virus . However, because the drug is still fairly new, there are no conclusive data on its implications in non-healthcare settings . Additionally, concerns have been raised about PEP’s potential to be considered as the “morning after” pill for HIV/AIDS when it should be used as an emergency prevention method and not as a safety net for those who want to continuously engage in risky behavior . As these drugs are taken more often, drug resistance can occur and different types and amounts are then required . PEP has also led to the development of Pre-Exposure Prophylaxis, which may be an option for those who frequently are exposed to HIV (e.g. healthcare workers in Africa) .
As more research is conducted and more people around the world start considering PEP, it will become easier to gauge its efficacy and potential . For now, it is useful to know that PEP is an option in case of an emergency .
4) Cummins, J., W. Nathan, and A. D. Badley. 2014. Making Sense of How HIV Kills Infected CD4 T Cells: Implications for HIV Cure. Molecular and Cellular Therapies 2: 20.