The Doc on HIV
HIV prevention after exposure: PEP (Post-Exposure Prophylaxis)- prevention should begin within 72 hours of exposure. If you have had an exposure please call. 913-362-0220 (Answered 24/7 for emergencies)
HIV treatment: If you are newly diagnosed with HIV and want to consider treatment options, or if you have had HIV for many years and would like an experienced consultation about treatment, please call for an appointment. 913-362-0220
Primary HIV prevention: PrEP (Pre-Exposure Prophylaxis)- preventive treatment plans including daily or episodic pills have been shown to be very effective in preventing new HIV infections. Now an injectable form of prevention (given every 2 months) is available. Let us help you consider what prevention option is best for you.
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For an appointment through the internet (button below) or call 913-362-0220 to speak to a live answering service 24/7.
HIV is a virus that causes AIDS (Acquired Immune Deficiency Syndrome) if it is left unchecked. Today there are a number of very effective suppressive treatments that stop the progression of the disease and can even help very damaged immune systems recover. People with HIV who take regular treatment have nearly the same life-expectancy of people without HIV. Let our experience help guide you to your best treatment options.
Above - Drawing of cut-away of HIV Virion- showing the GP-120 proteins on the surface and the RNA coils inside the capsid.
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The following types of HIV medicines are currently available:
- Nucleoside antiretrovirals (analogs of natural nucleosides). This group of medicines "fake out" the viral mechanisms that put together new viral DNA strands causing disruption of viral replication.
- Non-nucleoside reverse transcriptase inhibitors. These medicines work by competitive binding that shuts down the enzyme that translates the viral RNA into DNA and prevents reproduction of the virus.
- Protease inhibitors. These drugs competitively bind and shut off the enzyme that clips and packages proteins critical to the viral reproduction.
- Integrase inhibitors. These compounds bind to enzymes that help the virally derived DNA integrate into the human nuclear DNA blueprint.
- Cell surface attachment, binding and fusion inhibitors. These medicines inhibit HIV entry into the human cells.
- Capsid inhibitors. This class of medicine works to interfere with the HIV capsid which is the protein that encapsulates the viral genetic material and enzymes and stops the viral reproduction.
Most commonly the medications are used in combinations that stop HIV replication at more than one point in the viral life-cycle. A full listing of the medications is available by clicking to the NIH sponsored website below.
Cabenuva is the newest therapeutic break-through for HIV treatment. It is a dual combination of medications similar to others. Cabenuva differs in that it is a once monthly treatment rather than daily. This injectable medicine was recently approved by the FDA and is now available in KC. Call us for more information about starting this treatment. The pharmaceutical company information site is accessed by clicking below.
Above- Colorized Electronmicrograph of HIV virions attaching to a T-cell surface (Getty)
Current medications are very effective in controlling most HIV. But, side effects, drug interactions and previous medication use may make a difference. The choice of anti-retroviral treatment (ART) is a crucial one for people living with HIV and should not be decided without careful consultation with a knowledgeable HIV treater. Mistakes in prescribing may result in long-term consequences. Please call with your questions and to schedule an appointment with Dr. Sharon Lee, who was among the first HIV treating physicians in Kansas City.
Trust your health care to a doctor whose thirty-five+ years of experience has earned national confidence. Dr. Lee is a recognized leader in the field of HIV and has been a member of boards and guideline review committees at the CDC, HIV Medicine Association, ACTHIV Institute and other national groups to establish and teach Standards of Care for Prevention and Primary Care of people with HIV.
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The US national HIV medical organizations, HIVMA and AAHIVM, are in agreement regarding the necessary experience in HIV Care to practice independently in the field:1) Patient Management Management of at least 25 patients with HIV over the preceding 36 months.2) Continuing Medical Education At least 45 hours of HIV-related continuing medical education in the preceding 36 months.3) Either pass a credentialling exam after at least 36 months of experience or have significant clinical and professional experience in HIV medicine, defined as a minimum of at least five years.
Practitioners with less than the above listed experiences should have direct oversight by a recognized HIV provider.
Dr. Lee has over thirty-five years of experience and is a preceptor for ten or more new trainees in HIV medicine annually.
Prevention Science- HIV VaccinesOver the forty years I have provided health care for people with HIV. One of the greatest challenges has been finding a method of prevention that works.
First up was the use of condoms. Initially barriers to mixing body fluids was the only thing we knew of to stop HIV transmission. Although male condoms were found to be protective, they are relatively unwieldy to use and are not always popular. Female condoms while effective, have never caught on. During the 1990’s prevention methods including topical applications of treatments to the anus and/or vagina were tested and found to be unsuccessful.
The search for a vaccine began in the early 1980’s. Vaccine trials in Kansas City and around the world were launched. Dr. Jonas Salk (inventor of the polio vaccine) and many others applied their knowledge and skills toward developing a vaccine. In 1986 a French doctor (Zagury) rushed to try a promising vaccine on himself (skipping animal trials). Multiple attempts since that first daring effort have failed to develop a protective vaccine.
After the success of the COVID vaccines, mRNA vaccines were developed targeting HIV, but to date these have also been ineffective at helping produce protective antibodies. Scientists continue to search for a vaccine, but for now HIV vaccines continue to be beyond our reach.
(https://www.healio.com/news/infectious-disease/20230417/hiv-vaccine-research-at-a-crossroads-after-recent-failures)SLee MD
First up was the use of condoms. Initially barriers to mixing body fluids was the only thing we knew of to stop HIV transmission. Although male condoms were found to be protective, they are relatively unwieldy to use and are not always popular. Female condoms while effective, have never caught on. During the 1990’s prevention methods including topical applications of treatments to the anus and/or vagina were tested and found to be unsuccessful.
The search for a vaccine began in the early 1980’s. Vaccine trials in Kansas City and around the world were launched. Dr. Jonas Salk (inventor of the polio vaccine) and many others applied their knowledge and skills toward developing a vaccine. In 1986 a French doctor (Zagury) rushed to try a promising vaccine on himself (skipping animal trials). Multiple attempts since that first daring effort have failed to develop a protective vaccine.
After the success of the COVID vaccines, mRNA vaccines were developed targeting HIV, but to date these have also been ineffective at helping produce protective antibodies. Scientists continue to search for a vaccine, but for now HIV vaccines continue to be beyond our reach.
(https://www.healio.com/news/infectious-disease/20230417/hiv-vaccine-research-at-a-crossroads-after-recent-failures)SLee MD