Ff9RUARY 200 I-----------THE SOUTHERN AfRICAN JOURNAL Of HIV MEDICINE

The issue of post-exposure prophylaxis following sexual

assault is addressed by Charlene Smith and the exper-
iences in a rape crisis centre are described by Or Wulfson.

The insights provided by these contributions are inval-

uable to our clinicians, many of whom have expressed

their inadequacy when having to deal with this medical

emergency. The Sunninghill Hospital protocol will go a
long way towards helping in this regard.

The Clinicians Society would urge the State to consider
providing post-exposure prophylaxis to survivors of

sexual assault at no charge. This will help to allay the

tremendous emotional devastation and fear of acquiring

disease that these individuals live through.

DES MARTIN
Editor, Southern African Journal ofHIV Medicine
Presiden~ Southern African HIV Clinicians Society.

Zidovudine was approved for use as an antiretroviral
agent in 1987. It was used, at that time, as a single agent

to treat patients with HIV infection. The therapeutic

effect of this monotherapy was, however, of short dur-
ation due to the rapid development of viral resistance to

the drug. Subsequently the use of two drugs (dual
therapies) became the standard of care. Their anti-

retroviral effect was more pronounced and of a longer

duration, but regrettably viral resistance once again

limited the therapeutic effects. Following the Inter-
national AIDS Conference in Vancouver in 1996 triple

combination therapies (HAART) were endorsed and

proved to be effective in the majority of patients treated,
as evidenced by profound and durable suppression of

viral loads and an impressive rise in CD4 counts.

FROM THE
EDITOR

It is only now, 5 years later, that clinicians who treat HIV
are encountering some of the long-term side-effects and

toxicities associated with these therapies. The proceed-

ings of a workshop examining the metabolic disturbances

associated with certain of the therapies is highlighted
in this issue of the Journal. Flowing from this workshop
it was evident that there is a clear need to formulate
guidelines for monitoring drug-associated metabolic

disturbances in our populations. There may be distinct

differences in the frequency and patterns of these

disturbances. The intriguing question of structured

treatment interruptions (STi) is reviewed by Sanne and

colleagues and may represent one strategy to minimise
these toxicities. .