Truvada preventivo: non per tutti

Circa il truvada dato come preventivo escono delle note di alcuni professori che smentiscono che si dovrebbe dare il truvada a tutti, non solo per una questione finanziaria, ma anche perche' inutile.
Gli unici che potrebbero beneficiare del truvada preventivo sono i gay e i bisex ad alto rischio (e chi sarebbero??).

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Only some men should use AIDS drug for prevention

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8:00pm GMT+0100

By Maggie Fox, Health and Science Editor

WASHINGTON | Thu Jan 27, 2011 2:54pm EST

(Reuters) - Only high-risk gay and bisexual men should use Gilead's HIV drug Truvada to protect themselves from the AIDS virus, federal officials said on Thursday in the first official guidance on using the drug.

A study published last November showed that the pill, which combines two AIDS drugs, reduced the HIV infection rate by nearly 44 percent in high-risk gay and bisexual men. [ID:nN2287379]. It worked even better if the men used the drug consistently.

Some doctors have already been using the experimental approach, called pre-exposure prophylaxis, or PrEP for short. This use of the drug is not approved by the U.S. Food and Drug Administration, which has approved Truvada for treating HIV infection.

But the U.S. Centers for Disease Control and Prevention decided to issue some guidance for doctors who may want to prescribe the drug to protect people at very high risk of infection with the fatal and incurable virus.

"Concerns exist that without early guidance, various unsafe and potentially less effective PrEP-related practices could develop among health-care providers and MSM (men who have sex with men) beginning to use PrEP in the coming weeks and months," the CDC says in its guidance.

For instance, people might be tempted to use other HIV drugs, which have not been shown to prevent infection, they might just take the pills occasionally, they might not get screened for infection first and they might not get the needed counseling.

'SATURDAY NIGHT SPECIAL'

"Let's be really clear -- the use of this medication is not a license for unsafe sex and it's not a Saturday night special," said Dr. Michael Horberg, vice chairman of the HIV Medicine Association and director of HIV and AIDS for Kaiser Permanente in California.

"You can't just pop a pill as you are getting ready to go out Saturday night."

The CDC guidelines stress this.

"Until the safety and efficacy of PrEP is determined in trials now under way with populations at high risk for HIV acquisition by other routes of transmission, PrEP should be considered only for men who have sex with men," the guidelines say.

High-risk gay and bisexual men include those who have frequent, unprotected sex with others.

Patients should be tested to make sure they do not have HIV and they need to be counseled about other ways to protect themselves, including consistent use of condoms, the CDC said.

"Health-care providers should report any serious adverse events," the guidance adds.

Horberg said the advice was "reasoned" and said only doctors experienced with HIV medications should consider prescribing PrEP for patients.