While Pride is the topic on most everyone’s minds, I’ve been thinking heavily about the way AIDS prevention strategy seems to be shifting to the use of PrEP as if that is all there is, and a reasonable option. No one is really talking about this, but they should be.
PrEP is shorthand for a use of the drug Tenofovir in a preventative role. The dosage is the same as that taken by patients who are HIV+. Therefor, the side effects and issues associated with Tenofovir apply even if no one is saying so.
Just as taking Tenofovir as HIV treatment is a long term therapy (forever, or until a better drug is on the market), PrEP is a long term, everyday therapy too.
Long-term therapy with the antiretroviral drug tenofovir increases the risk of end-stage liver disease and liver cancer, according to data from the D:A:D study published in the online edition of AIDS. Five-year cumulative use of the drug increased the relative risk of serious liver disease by 46%.
The relationship between tenofovir and serious liver disease surprised the study’s authors, who call for further research into this finding. As expected, treatment with the so-called “d” group of antiretrovirals, d-4T (stavudine) and ddI (didanosine) also increased the risk of serious liver-related outcomes, as did therapy with fosamprenavir. The investigators call for patients taking “d” drugs and other antiretrovirals associated with liver disease to have intensified monitoring of liver function.
In other words, otherwise healthy men are beginning to take a potent medication that increases their vulnerability to liver disease and liver cancer. Does this really make a lot of sense?
Without a doubt, the use of PrEP as a preventative treatment looks promising on paper. It, in theory can totally stop the spread of most forms of the HIV virus. But anyone who is considering PrEP ought be looking at the whole picture, and then making the choice which is best for them.
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