&lt;p&gt;Condom broke in Thailand &lt;span style=&quot;color: #ff0000;&quot;&gt;|&lt;/span&gt; Emergency PEP&lt;/p&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h1&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Emergency PEP study in monkeys&lt;/strong&gt;&lt;/span&gt;&lt;/h1&gt;
&lt;hr /&gt;
&lt;h3&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Bictegravir pills and elvitegravir inserts prevent infection in monkeys after viral exposure&lt;/strong&gt;&lt;/span&gt;&lt;/h3&gt;
&lt;div class=&quot;clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field-item&quot;&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&amp;ldquo;It&amp;rsquo;s exciting to see three study presentations on post-exposure prophylaxis (PEP) after years of not having any,&amp;rdquo; commented&amp;nbsp;Professor Sharon Hillier of the University of Pittsburgh,&amp;nbsp;chairing&amp;nbsp;a session at the&lt;/span&gt;&amp;nbsp;&lt;a href=&quot;http://www.aidsmap.com/conference/croi-2020&quot;&gt;Conference&amp;nbsp;on Retroviruses and Opportunistic Infections (CROI 2020)&lt;/a&gt;&amp;nbsp;&lt;span style=&quot;color: #99ccff;&quot;&gt;yesterday. The three studies&amp;nbsp;provided a lot of new information about what regimens might, and might not, work as PEP; in other words, if taken&amp;nbsp;&lt;em&gt;after&lt;/em&gt;&amp;nbsp;exposure to HIV to prevent an infection becoming established.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;PEP as a prevention method has been around for longer than PrEP, initially as an emergency measure for healthcare professionals and others who may be exposed to HIV at work, and&lt;/span&gt;&amp;nbsp;&lt;a href=&quot;https://www.aidsmap.com/about-hiv/how-effective-post-exposure-prophylaxis-pep&quot;&gt;subsequently for individuals exposed to HIV through sexual exposure.&lt;/a&gt;&amp;nbsp;&lt;span style=&quot;color: #99ccff;&quot;&gt;However, PEP studies are rare,&amp;nbsp;partly&amp;nbsp;because it is unethical to run&amp;nbsp;placebo-controlled studies of PEP.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Perhaps as a result of the lack of research attention,&amp;nbsp;the recommended regimen for PEP remains three HIV drugs (tenofovir and emtricitabine plus either a protease or an integrase inhibitor), to be taken for 28 days after infection. Much of this course of treatment might be unnecessary, given that in gay men at least in&lt;/span&gt;&amp;nbsp;&lt;a href=&quot;http://www.aidsmap.com/news/dec-2015/ipergay-prep-study-results-published&quot;&gt;the IPERGAY study&lt;/a&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;, just&amp;nbsp;four TDF/FTC (tenofovir disoproxil fumarate and emtricitabine)&amp;nbsp;pills &amp;ndash; a double dose taken the day before and one on each of the two days after sex &amp;ndash;&amp;nbsp;work&amp;nbsp;just as well as regular daily PrEP.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Dr Elena Bekerman of Gilead Sciences and colleagues conducted a new dose-ranging study of PEP in monkeys to see what regimen and dosing schedule was effective in preventing HIV infection after they were challenged (exposed to) a virulent monkey-adapted HIV (SHIV).&lt;/span&gt;&lt;/p&gt;
&lt;h4&gt;&amp;nbsp;&lt;/h4&gt;
&lt;hr /&gt;
&lt;h4&gt;&lt;strong&gt;&lt;a href=&quot;https://www.aidsmap.com/about-hiv/glossary?term=&quot;&gt;simian human immunodeficiency virus (SHIV)&lt;/a&gt;&lt;/strong&gt;&lt;/h4&gt;
&lt;p&gt;An artificial form of HIV&amp;nbsp;adapted to cause infection and disease in monkeys. It combines elements of a virus that affects monkeys (SIV) with the envelope protein of HIV itself. Researchers study SHIV as a way to learn more about HIV.&lt;/p&gt;
&lt;hr /&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The rhesus macaques were challenged eight times rectally with SHIV, with challenges two weeks apart. The regimens given were either a two-drug regimen of&amp;nbsp;tenofovir alafenamide and emtricitabine (brand name as a medicine for humans,&amp;nbsp;&lt;em&gt;Descovy&lt;/em&gt;), or a three-drug combination of&amp;nbsp;these two drugs and the integrase inhibitor bictegravir (marketed for humans as&amp;nbsp;&lt;em&gt;Biktarvy&lt;/em&gt;).&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;An initial drug-level study, which tested three different doses of bictegravir (25, 50 and 100mg) suggested that the 25mg dose of bictegravir might be enough to prevent infection, so that dose was used.&lt;/span&gt;&lt;/p&gt;
&lt;div&gt;&amp;nbsp;&lt;/div&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;In the first of two studies, seven groups of six monkeys each received either:&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Nothing (control group)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;PrEP: either the two- or three-drug combination, given two hours beforehand and 24 hours after exposure&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;PEP: either the two- or three-drug combination, given 24 and 48 hours after exposure&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Delayed PEP: either the two- or three-drug combination, given 48 and 72 hours after exposure.&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The PrEP regimens worked: the two-drug combination&amp;nbsp;prevented five out of six monkeys from infection, and the three-drug combination with bictegravir protected&amp;nbsp;all six. This in&amp;nbsp;itself is&amp;nbsp;interesting, as it may provide more evidence suggesting&amp;nbsp;that the full IPERGAY regimen (a&amp;nbsp;&lt;em&gt;double&lt;/em&gt;&amp;nbsp;dose before exposure and two taken 24 and 48 hours after the double dose) is necessary to offer 100% protection.&lt;/span&gt;&lt;/p&gt;
&lt;blockquote&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&quot;The third drug for PEP&amp;nbsp;appears to be necessary: two drugs work&amp;nbsp;for PrEP but not for PEP.&quot;&lt;/span&gt;&lt;/p&gt;
&lt;/blockquote&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;However, the PEP regimens did not work. They only delayed rather than prevented infection, and the efficacy calculated for the two- and three-drug combinations was 52% and 58% respectively &amp;ndash; and in fact this was not statistically significant from no protection, i.e. could have been a chance finding. The same doses taken 48 and 72 hours after exposure were even less effective.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;A second study was therefore conducted. In this, there were no control or PrEP groups; everything was post-exposure. The bictegravir dose was increased to 100mg and four dosing schedules were tested, including two providing&amp;nbsp;PEP sooner after exposure:&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;6&amp;nbsp;and 30 hours after exposure&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;12 and 36 hours after exposure&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;24 and 48 hours after exposure&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;48 and 72 hours after exposure.&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The two-drug combination was not tested again with the last two schedules as it had already been shown to be ineffective.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;In the 6- and 30-hour schedule, the three-drug&amp;nbsp;regimen with bictegravir protected five out of six monkeys from eight exposures, equivalent to an efficacy of 90%. &lt;br /&gt;In the 12- and 36-hour schedule, it protected four out of six monkeys, and the two infections&amp;nbsp;only occurred at exposures seven and eight; this was equivalent to 82% efficacy.&lt;/p&gt;
&lt;p&gt;Four monkeys were also protected in the 24- and 48-hour schedule, but those were infected sooner and the efficacy was not quite statistically significant. &lt;br /&gt;There was no significant protection offered by the 48- and 72-hour schedule, or by either of the two-drug regimens.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;What have we learned from these studies? &lt;/strong&gt;&lt;br /&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Firstly, that the third drug for PEP&amp;nbsp;appears to be necessary: two drugs work&amp;nbsp;for PrEP but not for PEP. &lt;/span&gt;&lt;br /&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Secondly, starting PEP promptly,&amp;nbsp;ideally within 12 hours of exposure and certainly within 24 hours, really does make a difference to its efficacy. &lt;/span&gt;&lt;br /&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;There is also no new evidence that extending PEP beyond 36 hours helps.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h3&gt;&lt;strong&gt;Small, discreet vaginal insert also works as PEP&lt;/strong&gt;&lt;/h3&gt;
&lt;hr /&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;In a second study, Dr Charles Dobard of the US Centers for Disease Control and Prevention (CDC) tested a small topical insert or mini-suppository containing the two drugs TAF and elvitegravir, which can be used vaginally or rectally, as a method of PEP.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;At least year&amp;rsquo;s CROI,&lt;/span&gt;&amp;nbsp;&lt;a href=&quot;http://www.aidsmap.com/news/mar-2019/taf-quick-dissolve-combination-prep-insert-effective-against-hiv-infections-monkeys&quot;&gt;Dobard demonstrated that the insert was 92% effective when used as PrEP&lt;/a&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;.&amp;nbsp;At this conference, the insert was dosed as PEP, being inserted vaginally four hours after the monkeys were exposed to SHIV.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Four out of five monkeys given a placebo insert were infected after two to 13 challenges with SHIV; in contrast, none given the TAF/elvitegravir insert were infected after 13 challenges with follow-up (to catch late infections) to 20 weeks. In this study at least, this equated to an efficacy of 100%, and suggested that this technology could be a convenient and discreet addition to the HIV prevention toolbox.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;a href=&quot;http://www.aidsmap.com/news/mar-2020/two-pep-doses-spaced-week-apart-protect-monkeys-injected-hiv-one-dose-might-work&quot;&gt;For the third study of PEP, using the novel anti-HIV drug islatravir, see this report.&lt;/a&gt;&lt;/p&gt;
&lt;/div&gt;
&lt;div class=&quot;clearfix text-formatted field field--name-field-references field--type-text-long field--label-above&quot;&gt;
&lt;h3 class=&quot;field-label&quot;&gt;&amp;nbsp;&lt;/h3&gt;
&lt;h3 class=&quot;field-label&quot;&gt;&lt;strong&gt;References&lt;/strong&gt;&lt;/h3&gt;
&lt;div class=&quot;field-item&quot;&gt;
&lt;p&gt;Bekerman E et al.&amp;nbsp;&lt;em&gt;BIC/FTC/TAF postexposure prophylaxis protects macaques against rectal SHIV infection.&lt;/em&gt;&amp;nbsp;Conference on Retroviruses and Opportunistic Infections (CROI 2020), abstract 87, 2020.&lt;br /&gt;&lt;a href=&quot;http://www.croiconference.org/sessions/bicftctaf-postexposure-prophylaxis-protects-macaques-against-rectal-shiv-infection&quot;&gt;View this abstract on the conference website&lt;/a&gt;.&lt;br /&gt;&lt;a href=&quot;http://www.croiwebcasts.org/console/player/44699?mediaType=audio&amp;amp;&quot;&gt;Watch the webcast on the conference website.&lt;/a&gt;&lt;/p&gt;
&lt;p&gt;Dobard C et al.&amp;nbsp;&lt;em&gt;On-demand HIV postexposure prophylaxis by TAF/EVG vaginal inserts in macaques.&lt;/em&gt;&amp;nbsp;Conference on Retroviruses and Opportunistic Infections (CROI 2020), abstract 88, 2020.&lt;br /&gt;&lt;a href=&quot;http://www.croiconference.org/sessions/demand-hiv-postexposure-prophylaxis-tafevg-vaginal-inserts-macaques&quot;&gt;View this abstract on the conference website&lt;/a&gt;.&lt;br /&gt;&lt;a href=&quot;http://www.croiwebcasts.org/console/player/44700?mediaType=audio&amp;amp;&quot;&gt;Watch the webcast on the conference website.&lt;/a&gt;&lt;/p&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;h1&gt;&lt;strong&gt;KOCITAF as Emergency PEP to prevent HIV infection in Bangkok, Pattaya, Phuket&amp;nbsp;Chiang Mai - Thailand&lt;/strong&gt;&lt;/h1&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;To order Kocitaf - Dolutegravir, Emtricitabine &amp;amp; Tenofovir Alafenamide HIV Treatment Medication&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;strong&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;For more information about the medication and ordering process, &lt;/span&gt;&lt;/strong&gt;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;strong&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;please email&lt;/span&gt;&amp;nbsp;&lt;a href=&quot;mailto:info.silom@pulse-clinic.com&quot;&gt;pulseliving@pulse-clinic.com&lt;/a&gt;&amp;nbsp;&lt;span style=&quot;color: #ff99cc;&quot;&gt;or chat on your preferred platform.&amp;nbsp;&lt;/span&gt;&lt;/strong&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;text-align: center;&quot;&gt;&lt;span style=&quot;color: #ffffff;&quot;&gt;&lt;strong&gt;&amp;nbsp;&lt;a href=&quot;https://wa.me/66842262569&quot;&gt;&lt;img src=&quot;https://cms.pulse-clinic.com/Files/WhatsApp.png&quot; width=&quot;48&quot; height=&quot;82&quot; /&gt;&lt;span style=&quot;text-decoration: underline;&quot;&gt;&lt;span class=&quot;w-30 inline-block px-2 md:px-4 mt-3&quot;&gt;+66-84-226-2569&lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/strong&gt;&lt;strong&gt;&lt;a href=&quot;https://lin.ee/32kmr2VS&quot;&gt;&lt;img src=&quot;https://cms.pulse-clinic.com/Files/line-logo.png&quot; width=&quot;50&quot; height=&quot;85&quot; /&gt;&lt;span style=&quot;text-decoration: underline;&quot;&gt;&lt;span class=&quot;w-30 inline-block px-2 mt-3&quot;&gt;@pulserx&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;&lt;/strong&gt;&lt;strong&gt;&lt;a href=&quot;weixin://dl/chat?pulseclinic&quot;&gt;&lt;img src=&quot;https://cms.pulse-clinic.com/Files/WeChat_App_Icon.png&quot; width=&quot;50&quot; height=&quot;85&quot; /&gt;&amp;nbsp;&lt;span style=&quot;text-decoration: underline;&quot;&gt;&lt;span class=&quot;w-30 inline-block px-2 mt-3&quot;&gt;PulseClinic&lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2&gt;&lt;strong&gt;A new anti-HIV drug has arrived in Thailand&lt;/strong&gt;&lt;/h2&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The combination anti-HIV drug Kocitaf was now approved by the Food and Drug Administration of Thailand on February 3, 2021, and is intended for the treatment of adults and adolescents (aged 12 years and over and has It is hoped that the government will soon allow people living with HIV to receive the drug with gold patents and social security. What are the advantages and disadvantages of this drug compared to the current popular formulation (Teevir brand)? First of all, I would like to present a fairly academic content so that the reader can gain a rather in-depth knowledge of the drug.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;Kocitaf contains&lt;/p&gt;
&lt;ul&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Tenofovir alafenamide fumarate (TAF) 25 mg&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Emtricitabine (FTC) 200 mg&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Dolutegravir (DTG) 50 mg&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;h2&gt;&lt;strong&gt;Introduction to the division process of the HIV virus&lt;/strong&gt;&lt;/h2&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;antiretroviral drugs used to treat people with HIV Multiple combinations are required. This is because the HIV virus is complex in the process of reproduction. HIV is a retro virus, observed by its genetic transcription process, from the underlying RNA to DNA, which appears to be a reverse process. It relies on the resources of white blood cells to regenerate itself, which consists of several steps. both within the nucleus and other elements of the cell Therefore, a single drug is not enough to inhibit the replication of the virus. The rough process of virus propagation is as follows (1) (shown in Figure 1).&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;Attaches to the cell wall and enters the cell (Virus entry)&lt;/p&gt;
&lt;ul&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Transcription RNA to make viral DNA (Reverse Transcription)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;into the nucleus, its DNA is inserted into the DNA of the cell (Integration)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;DNA strands are removed as mRNA and Genomic RNA and leave the nucleus. (Transcription)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Viral mRNA is decoded to synthesize proteins to make up new viral components. (Translation)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The protein strands are cut into tiny particles to prepare for cleavage. (Cleavage)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Genomic RNA and synthesized proteins make up several new viruses (Assembly)&lt;/span&gt;&lt;/li&gt;
&lt;li&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The new virus prepares to leave the cell wall intact (Budding and Maturation)&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;img src=&quot;https://cms.pulse-clinic.com/Files/HIV%20MEDS/reproductive-cycle-hiv-1-sites-action-major-classes-antiretroviral-medications-kocitaf%20for%20pep.jpg&quot; width=&quot;900&quot; height=&quot;783&quot; /&gt;&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Source: Gandhi M, Gandhi RT. Single-pill combination regimens for treatment of HIV-1 infection. N Engl J Med. 2014;371:248-59.&lt;br /&gt;&amp;copy; 2014 Massachusetts Medical Society. Figure and Legend Reproduced with permission.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;h2&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;&lt;br /&gt;A new drug of choice for emergency PEP and treating people with HIV&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p&gt;&lt;strong&gt;Kocitaf&lt;/strong&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt; contains two non-nucleoside reverse transcriptase inhibitors (NNRTIs), &lt;/span&gt;&lt;strong&gt;TAF&lt;/strong&gt; &lt;span style=&quot;color: #99ccff;&quot;&gt;and emtricitabine. Combined with one Integrase strand transfer inhibitors (INSTIs), &lt;/span&gt;&lt;strong&gt;Dolutegravir&lt;/strong&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;by TAF and Emtricitabine It inhibits HIV viral replication in Process 2 (Reverse transcription) and Dolutegravir inhibits Process 3 (Integration).&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The 2017 Thailand HIV Treatment and Prevention Guidelines state that TDF is the basic antiretroviral drug. It is most commonly used as a first-line treatment. (2) In general, for treatment, TDF is usually taken as one tablet (300 mg) once a day in combination with other antiretrovirals. However, this dosage was quite high. which the drug recipient must take every day continuously Therefore, they are more likely to experience side effects from the use of this drug, such as nephrotoxicity and bone marrow, which requires regular monitoring of kidney function.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Tenofovir Alafenamide fumarate (TAF)&lt;/strong&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt; is a new drug that is gaining attention. It can help reduce side effects on kidneys and bones by using doses much lower than TDF.&lt;br /&gt;&lt;br /&gt;&lt;/span&gt;&lt;/p&gt;
&lt;h3&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Dolutegravir (DTG)&lt;/strong&gt;&lt;/span&gt;&lt;/h3&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;It is a second-generation integrative inhibitors and was approved by the U.S. Food and Drug Administration (FDA) in 2013 for its high resistance to HIV virus. Tivicay 10, 25, and 50 mg single tablets are available, and Triumeq combined tablets contain Abacavir 600mg, Lamivudine 300mg, Dolutegravir 50mg.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The pharmacokinetics of Dolutegravir is more than 98.9% bound to blood proteins. Its volume of distribution is 17.4 L. The plasma half-life is 14 hours. The drug is metabolized via UGT1A1 and partially via the CYP3A enzyme. It affects CYP3A. When used with dolutegravir, it also affects the level of dolutegravir in the body. For example, antacids or multiionic drugs can decrease dolutegravir levels. The drug is eliminated in the stool by 53%.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;It was found that the food taken with this drug increase the amount of drug absorption but reduces the rate of drug absorption But it is not clinically insignificant. Therefore, this drug may or may not be taken with food.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Interactions between dolutegravir and metformin (for diabetes) were found to increase Metformin levels 2.4-fold and peak Metformin 2-fold.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Dolutegravir plus Rifampicin (tuberculosis treatment) has been found to decrease dolutegravir by 54%. Therefore, dolutegravir 50 mg originally taken once a day may need to be increased to twice a day.&lt;/span&gt;&lt;/p&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Dolutegravir side effects such as insomnia, headache, and depression can occur in patients with a history of psychiatric problems. Pregnant women should be careful Especially at less than 8 weeks of gestation, if you have not started antiretroviral therapy. It is advisable to start with another antibody formulation instead. If you are over 8 weeks pregnant, you can receive Dolutegravir under close monitoring by your doctor.&lt;/span&gt;&lt;/p&gt;
&lt;h2&gt;&amp;nbsp;&lt;/h2&gt;
&lt;h2&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;New recommendation from WHO&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;The World Health Organization has released an Update of recommendations on first- and second-line antiretroviral regimens Policy brief 22 July 2019, recommending Dolutegravir over Efavirenz due to less drug&amp;ndash;drug interactions, faster viral suppression, higher genetic barrier to drug resistance Although dolutegravir may cause weight gain, the issue of neural tube defects in infants in Botswana is unclear. and from the study compare with efavirenz-based No differences were found, including the incidence in other countries did not increase.&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;To order Kocitaf - Dolutegravir, Emtricitabine &amp;amp; Tenofovir Alafenamide HIV Treatment Medication&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;strong&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;For more information about the medication and ordering process, &lt;/span&gt;&lt;/strong&gt;&lt;/p&gt;
&lt;p style=&quot;text-indent: 0px; margin: 0px; text-align: center;&quot;&gt;&lt;strong&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;please email&lt;/span&gt;&amp;nbsp;&lt;a href=&quot;mailto:info.silom@pulse-clinic.com&quot;&gt;pulseliving@pulse-clinic.com&lt;/a&gt;&amp;nbsp;&lt;span style=&quot;color: #ff99cc;&quot;&gt;or chat on your preferred platform.&amp;nbsp;&lt;/span&gt;&lt;/strong&gt;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;text-align: center;&quot;&gt;&lt;span style=&quot;color: #ffffff;&quot;&gt;&lt;strong&gt;&amp;nbsp;&lt;a href=&quot;https://wa.me/66842262569&quot;&gt;&lt;img src=&quot;https://cms.pulse-clinic.com/Files/WhatsApp.png&quot; width=&quot;48&quot; height=&quot;82&quot; /&gt;&lt;span style=&quot;text-decoration: underline;&quot;&gt;&lt;span class=&quot;w-30 inline-block px-2 md:px-4 mt-3&quot;&gt;+66-84-226-2569&lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/strong&gt;&lt;strong&gt;&lt;a href=&quot;https://lin.ee/32kmr2VS&quot;&gt;&lt;img src=&quot;https://cms.pulse-clinic.com/Files/line-logo.png&quot; width=&quot;50&quot; height=&quot;85&quot; /&gt;&lt;span style=&quot;text-decoration: underline;&quot;&gt;&lt;span class=&quot;w-30 inline-block px-2 mt-3&quot;&gt;@pulserx&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;&lt;/strong&gt;&lt;strong&gt;&lt;a href=&quot;weixin://dl/chat?pulseclinic&quot;&gt;&lt;img src=&quot;https://cms.pulse-clinic.com/Files/WeChat_App_Icon.png&quot; width=&quot;50&quot; height=&quot;85&quot; /&gt;&amp;nbsp;&lt;span style=&quot;text-decoration: underline;&quot;&gt;&lt;span class=&quot;w-30 inline-block px-2 mt-3&quot;&gt;PulseClinic&lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;

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