(Adnkronos) - “La terapia antiretrovirale a lungo effetto ( Long Acting) è un'opzione promettente nella gestione dell'HIV, poiché offre vantaggi significativi per la qualità di vita dei pazienti”.
Cosi Paolo Maggi, professore associato presso Università degli Studi della Campania Luigi Vanvitelli, a margine del Convegno “Le malattie infettive nel setting del paziente immunocompromesso” in corso a Napoli.
Cosi Paolo Maggi, professore associato presso Università degli Studi della Campania Luigi Vanvitelli, a margine del Convegno “Le malattie infettive nel setting del paziente immunocompromesso” in corso a Napoli.
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NewsTranscript
00:00What is long-acting therapy?
00:04Long-acting therapy is easy to understand by translating it, because it means long-term therapy.
00:11The therapies that we normally take have a duration of half a day, a day.
00:18In these cases, we are talking about therapies that have a duration of two months.
00:23That is, I do my injection and I am covered, from the point of view of therapy, for the next two months.
00:31This is a big innovation, of course, but let's think that we are only at the beginning of this new era,
00:38because drugs are already being studied, which can be administered every six months,
00:44or even, perhaps with the help of the technique of subcutaneous implants, every year.
00:52To understand the scope of this, which is a revolution in medical terms,
00:57that up to 15-20 years ago, so not a century ago,
01:02it was normal for our patients to take up to 10-12 compresses a day.
01:08Now, we have made enormous efforts to contain therapy in one compress a day,
01:14now there is this huge leap in quality, to be able to do therapy in much longer periods of time,
01:23which, for the positive side, for the person who lives with HIV, has considerable advantages, also compared to other pathologies.
01:33What is the situation in Campania?
01:35First of all, let's say that therapy is not refundable, as many have had to say to patients,
01:42but let's also try to understand why.
01:44So, first of all, I wanted to emphasize one thing.
01:48Why is this therapy important in HIV?
01:52Can it really become a salvation for these patients?
01:58Well, if I am hypertensive, if I have high blood pressure, and I forget to take therapy,
02:09or I went on a trip and I left my box of drugs at home,
02:15well, the worst thing that can happen to me is that the pressure rises.
02:18After that, I take therapy again and the pressure goes down.
02:21This is not the case for people who live with HIV,
02:24because skipping therapy can mean that the virus becomes resistant to that therapy,
02:30and it can also become extremely difficult to find drugs that can counteract this type of resistance.
02:38But there is something else.
02:40That is, the patient with high blood pressure,
02:45let's always stick to this example,
02:47who shows that he is taking a compress,
02:51nothing happens, we are all hypertensive.
02:54A positive serum that shows the therapy you are taking is a terrible discrimination, it is a stigma.
03:02There are patients who need to travel,
03:08they often have difficulty getting this drug,
03:11and you cannot allow the interruption of this therapy.
03:15That is why it is important to have it.
03:18And that is why it becomes a significant problem that in the countryside this therapy is very difficult to obtain.
03:28So, on the question, the answer is, we are saying many, too many, no.
03:34And the probability that these patients go elsewhere to be cured is certainly a high probability.
03:44Also because people who live with HIV are very different from the type of many years ago.
03:51They are educated people, educated, informed by the Internet.
03:55Knowing that this therapy exists, they ask for it.
03:58And it is really a problem not to be able to meet the needs of a certain type of patients who need this therapy.
04:09They will not all be, but surely there are many.
04:13These drugs can only be administered with ambulatory services.
04:19That is, the patient must be followed in the ambulance to be able to prescribe this drug.
04:25The countryside region is the only one, or one of the few,
04:29that still remains with the management of patients who live with HIV in day hospitals.
04:34If they are managed in day hospitals, they cannot obtain this drug.
04:39The problem is that now, therefore, we must in some way
04:44generate a transition from hospital management to ambulatory management,
04:50which theoretically could already happen.
04:54What is the obstacle at this time?
04:56That we must guarantee the privacy of patients.
04:59There are nodes, from this point of view, that must be dissolved, which are typical of HIV.
05:06Because HIV patients have a special protection of privacy,
05:13which is guaranteed by a law of the state, the law 135 of the 90.
05:17We cannot send our patients to ask for an exemption in an office,
05:24or with requests for exams at hand,
05:28in which it is clear that those exams are because they are positive.
05:32If we fail to protect this privacy,
05:35we are in full violation of the law 135 of the 90.
05:38So we must find instruments, which are also present in other regions,
05:45that protect the absolute privacy,
05:49the right to the privacy of these patients,
05:55which allows us to cure them.
05:57Because a patient who does not see the privacy protected,
06:01is a patient who flees, does not heal, prefers to give up therapy.
06:04Or try to leave.
06:05Or try to leave.