********** HOPE (HIV- Off the Press Express)A new direction is being studied to control HIV with some hopeful findings-
Merck is a drug company that has led in developing HIV treatments. Scientists at Merck have newly published information about compounds that cause irregularities in the reverse transcriptase enzyme forcing abnormal (premature) synthesis of viral enzymes. These abnormal enzymes lead to abnormal HIV virions that are impotent and may cause a newly identified effect of killing of the HIV-infected cells.
If it this works as expected it will be useful in shutting off the constant HIV production. HIV infected cells become viral factories (using the cell’s own processes to reproduce virus) and spew thousands of new HIV particles into an infected individual’s blood daily when untreated. Most of our treatments are simply “birth control” of the virus, reducing but not destroying the virus that resides inside the human cells. Killing these infected cells would reduce the viral burden in people with HIV.
The new drugs are called Targeted Activators of Cell Kill (TACK) and appear to work at two stages of HIV development. First, similar to Non-nucleoside reverse transcriptase inhibitors (NNRTI) medicines that are currently in use, these drugs work at the early point of viral reproduction to competitively bind and therefore stop the enzyme inside CD4 lymphocytes (T4 cells). In addition the TACK compounds are noted to also increase the death of HIV-infected CD4 cells. Currently available drugs that appear to have some TACK properties are efavirenz and rilpivirine (and probably etravirine and doravirine).
It appears these drugs and others may be tweaked to more targeted effects creating premature (not fully developed) HIV protease enzymes. Instead of leading to more HIV, these defective proteases turn on the CD4 cell and cause it’s death, thereby reducing the number of cell factories and cutting down on the number of HIV virions – leading to better disease control.
Studies are underway and the medications may become available by 2026.
SLee MD
Reference
1. News- https://www.aidsmap.com/news/jul-2023/novel-drugs-turn-hiv-against-itself-might-clear-infected-cells-body
2. Original- Balibar CJ et al. Potent targeted activator of cell kill molecules eliminate cells expressing HIV-1. Science Translational Medicine 15: 684, 2023.
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Quality and Safety Concerns About Unregulated GLP-1 Meds. (Mounjaro, Ozempic, etc.)
The Food and Drug Administration and the American Diabetes Association (ADA) advised against the use of unapproved compounded glucagon-like peptide 1 receptor agonist (GLP-1 RA) medication classes. The unregulated versions of these medicines that are often marketed to consumers may be dangerous.Compounded GLP-1 RA and dual GIP/GLP-1 RA products have been associated with clinically important dosing errors and adverse events. There are counterfeit products in the US drug supply chain and may be advertised online.Joshua J. Neumiller, PharmD, CDCES, of the Department of Pharmacotherapy, Washington State University, Spokane, Washington authored the ADA statement.• Non-FDA–approved compounded products are not recommended due to uncertainty about their content and resulting concerns about safety, quality, and effectiveness.• Some compounding pharmacies may use ingredients that are different from those in the approved drug. For example semaglutide sodium and semaglutide acetate are not the same chemical structure as the samaglutide base used in the authentic medication. There is no lawful basis for human use of these salts which have different activities and side effects from the approved semaglutide.The ADA points out that compounded products may not be chemically identical to the FDA-approved versions (some have been found to contain impurities including bacteria, high impurity levels, different chemical structures, or no active ingredients) and may result in nonstandard dosing or have contaminating chemicals that may cause harm.• Always verify that the compounding pharmacy is registered with FDA.The FDA has received over 500 adverse event reports regarding the compounded forms including:• Reports of over 100 hospitalizations (renal failure, anaphylaxis, etc.) • 10 deaths
For more information call the FDA 855-543-3784Or go to https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-patients-dosing-errors-associated-compounded
For more information call the FDA 855-543-3784Or go to https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-patients-dosing-errors-associated-compounded
********** HOPE (HIV- Off the Press Express)
What's up with Point of Care Rapid Syphilis Testing?
While it is nice to be able to get immediate results, it is a bit tricky regarding timing and accuracy of the tests.
Recently a person in KC who had previously been treated for syphilis had a new exposure and was checked using a rapid RPR. The test was negative although it should show positive in this case. Don't be fooled by inaccurate tests. The results for current effective testing for syphilis takes about 1-2 days.
SLee MD
Condoms are highly recommended to prevent STI transmissions of all sorts.
If you believe you may have been exposed to HIV, please call right away. The Doc Shop (913-362-0220) offers same (or next) day post-exposure prophylaxis treatment to prevent the infection from taking hold in your body.
Best if started as soon as possible or within 72 hours.
Click below for additional information -
Prevention of HIV
***** HIV prevention medications or PrEP (Pre-Exposure Prophylaxis) can be taken BEFORE sexual activity to prevent the disease. These medicines may be available free for at-risk individuals. Please check with the Doc Shop for further information.
Pills are available to take daily (for people having frequent possible exposures) or intermittently for a couple of days (for people who may only have sporadic exposures) .
Don't wait for an exposure to cause you worry! Call to set up a telehealth or in-person visit to get started protecting yourself from this life-long infection.
Call us at 913-362-0220
** Prevention of other Sexually Transmitted InfectionsSyphilis, Gonorrhea, Chlamydia
Medications for pre-exposure and post-exposure prevention of the bacterial-caused sexually transmitted diseases including Syphilis, Gonorrhea and Chlamydia has been shown to be effective.
A study from August 2022 showed taking a common antibiotic as soon as possible after sexual exposure to bacterial infections (STI's) may be effective in reducing the likelihood of transmission for gonorrhea, chlamydia and syphilis. Call today to start on this preventive treatment.
SLee MD Doc Shop 913-362-0220