Drug Cocktails Urged for Those Exposed to HIV
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ATLANTA – In a major policy shift, the government recommended for the first time yesterday that people exposed to the AIDS virus from rapes, accidents, occasional drug use, or unsafe sex receive drug cocktails that can keep them from becoming infected.
Previously, federal health officials recommended emergency drug treatment only for health-care workers accidentally stuck with a needle, splashed in the eye with blood, or exposed in some other way on the job. That recommendation was first made in 1996.
The Centers for Disease Control and Prevention expanded its guidelines to rape victims and many others yesterday. It said treatment should start no more than 72 hours after a person has been exposed to the virus, and the drugs should be used by patients for 28 days.
It is a major shift away from a policy that some doctors had called unconscionable and that put America years behind much of Europe and other nations.
“The severity of the HIV epidemic dictates we use all available tools to reduce infection,” said Dr. Ronald Valdiserri of the CDC. He stressed that emergency drug treatment is a “safety net,” not a substitute for abstinence, monogamy, and the use of condoms and sterile needles.
People accidentally exposed to the AIDS virus are usually given a three drug combination that includes AZT and 3TC.
In tests on primates, drug cocktails prevented infection with the monkey version of HIV 100% of the time if given within 24 hours of exposure to the virus, and 52% of the time if administered within 72 hours, said Dr. Charles Gonzalez, assistant professor of medicine at New York University School of Medicine and a member of the New York State AIDS Institute medical guidelines board.
However, there is no data from clinical trials on how effective the drugs are in stemming HIV infection in people.
The new guidelines do not bind the American government to pay for the treatment regimen through Medicare or Medicaid, and no federal money has been allocated to help carry out the recommendations.
“It’s unconscionable they didn’t have a policy for rape victims. It’s just ludicrous. They knew they were well behind the curve,” Dr. Gonzalez said.
The CDC said it hesitated to recommend wider use of AIDS drugs because it did not have enough information on their effectiveness. But the agency said better information has been gathered over the past several years from animal and lab studies and from state and city programs that offer HIV drugs to rape victims and others.