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Sixth International CongressDrug Therapy in HIV Infection17-21 November, 2002
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Animal studies have indicated that it is possible to abort HIV infection through the use of antiretroviral agents. Moreover, studies of mother-to-child transmission suggest that a substantial proportion of the benefits of antiretroviral therapy actually reflects post-exposure prophylaxis (PEP) provided to the neonate. A retrospective study of occupational HIV exposure suggested that PEP with zidovudine monotherapy reduced HIV transmission by approximately 81%. In Brazil, 202 MSM were enrolled in a study we conducted to evaluate the feasibility, safety, and behavioral effects of PEP for sexual exposures. A total of 11 HIV seroconversions were observed: 10 were among non-PEP users and 1 occurred despite PEP. Sexual risk-taking behavior was reduced in this cohort. We believe that nonoccupational PEP is not likely to play a central role in HIV prevention, but is potentially of critical importance to specific individuals. It is unlikely that the benefits of this approach will ever be proven because of the ethical and practical obstacles to conduct an efficacy study. Nevertheless, modeling suggests that targeted use of PEP after high-risk exposures can be cost effective.
Presenting author: Mauro Schechter
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1 Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, Brazil.
2002-11-17
PL6-1
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