It is an old drug. One that has been used for more than 20 years ago for the first time in the area of HIV treatment. One that is now in place but only as a generic. The reason is that Nevirapine has a bad reputation, because at the time, about every fifth Patient at the beginning of therapy, severe adverse drug reactions. “As a result, it got more and more into oblivion,” says HIV expert Pietro Vernazza.
wrong, is the chief physician and head of the Department of infectious diseases at the cantonal hospital of St. Gallen at our Meeting in his office. He has the advantages and disadvantages of this pharmaceutical “Oldtimers” are now studied in more detail and a fierce defender for a Comeback. About half of his patients, he has converted successfully for this active substance.
If patients are pre-treated with any other HIV drug, then with Nevirapine rare side effects, and it will also tolerate excellent. “We know, unlike other HIV drugs, no long-term side effects of the substance,” stresses Vernazza, the care for more than 30 years, HIV patients and, among other things, also the President of the Federal Commission for sexual health. Add to this that the insurance companies could save as a result, each year the cost of several million.
Unprotected Sex for HIV-Positive
The 62-year-old doctors is not known that he is not necessarily to the Mainstream. If he thinks a thing is right, it can also be not so fast by some critics to be talked out of. So Vernazza was together with the chief physician of Enos Bernasconi of the Lugano and the clinic chief Bernard Hirschel from Geneva in 2008, HIV-Affected, had a good effective HIV therapy, were able to again have fear-free unprotected Sex.
“hit The message like a bomb,” recalls Pietro Vernazza. Because the so-called Swiss Statement broke with a carved in stone Dogma. For the courage of the Swiss pioneers received a lot of praise, but also scolding. The typical allegation was that you would make with this statement, the decades of prevention work is broken.
However, Vernazza was convinced that if you have a proper treatment, the risk of contagion is negligible. Because with the laboratory analyses, he showed that the viral load in the semen or in the vaginal fluid of a treated HIV-positive Person was generally undetectable. “We took the patient to the fear,” says Vernazza. This was a breakthrough. Affected couples would henceforth be able to your desire to have children in a natural way to meet. In the meantime, he say to HIV-positive mothers under treatment, in fact, that you are breast-feeding their babies.
On the surface of the infected immune cell, many tiny HI-virus. Photo: Reuters
thanks to advances in the treatment of HIV and Aids in contrast to the past, to your absolute horror lost. In Switzerland today, no one has to die young as a result of HIV. But as Vernazza, in the middle of the 1980s, in the Canton hospital, first as an assistant doctor worked, he had still, as the patients experienced by the immune deficiency disease and at the end of brain infections, pneumonia, fungal diseases, or cancer died.
in 1985, he built in St. Gallen, a clinic for HIV-Positive. Two-thirds of the patients were drug-dependent. Often, the edge wanted to have to do constant, with none like something. “For the tests I had to take always the blood, because no one else did,” says Vernazza. In the company of a HIV-infection often quickly once disparagingly as “lust disease of Gay men, Junkies, and prostitutes” that are to blame.
“I accept other ways of life, and am also interested in this – a sign of appreciation,” emphasizes Vernazza, which contributes to our conversation, green pants and red socks, it is not like a traditional medical look. Also the woman with whom he has three adult children, works in the cantonal hospital and as a nurse right next door in the building. Because there, on the top floor of its outpatient examination rooms, keeps him climbing the stairs of one house to the other every day. On the way, he’s singing – from Pop to Italian Canzone.
standard therapy currently costs 15’000 Swiss francs per year
Today, the proliferation of HI-viruses efficiently not stop, so that they are undetectable. But some of inactive HIV viruses remain in the body, somewhere in the blood, in the bone marrow, in the intestines or in the lymph nodes. These dormant pathogens can become active. “Therefore, it is essential that the individuals Concerned are life-long daily medication,” says Vernazza. This is causing also high cost.
A standard therapy with the current standard combination pill is about 15’000 Swiss francs per Patient and year. Therefore, the St. Gallen HIV expert wants to show now with a large study, that for many patients, treatment with the two drugs Nevirapine and lamivudine only acts well, but also not so expensive. It would only cost just under 5000 Swiss francs per Patient and year. The bottom line is that the health insurance companies would be converted, when about a third of the total of 16’600 HIV-Treated in Switzerland to these medicines, approximately 55 million Swiss francs to save, he figures.
“the pharmaceutical lobby is much too strong”
this, he has shown in a pilot study with 20 patients. Now he wants to prove it in big style, with 200 patients. “Unfortunately, the pharmaceutical lobby is far too strong,” complained he. And the Swiss national Fund, have rejected the funding of the study recently, because Nevirapine is of interest to anyone. The make him helpless, because from his point of view, the Use would be medically and financially, are enormous.
Increasingly, not only HIV-Positive, but also HIV-Negative to him. They are usually from the gay scene and want to protect yourself with a pill preventative. “After so many years of fear during Sex, whether with or without a condom, they finally have the opportunity to experience the Sex to be relaxed and loose,” he says. “Some people we recommend the prophylaxis also, because we recognize in a conversation, that you have a very high risk of HIV infection.”
Vernazza campaigns against stigma and discrimination. It is important for him that his Team learns to reflect prejudice and dismantle. For example, if someone is coming repeatedly with a Syphilis in the clinic.
(editing Tamedia)
Created: 10.05.2019, 19:04 PM
