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Subscribe to RSSDrugs used to control the AIDS virus can also be used to protect uninfected people, researchers concluded on Tuesday in a “last-word” review of the data.
Their report, released in the Cochrane Library, bolsters calls for policies backing distribution of the drugs to people most at risk from the virus -- including gay and bisexual men, drug users, and women in some African-American communities as well as across the developing world.
The findings also underscore the debate over how best to use scarce resources to fight the pandemic of human immunodeficiency virus or HIV, which infects 33 million people globally, including more than a million in the United States. It has killed 25 million people. There is no cure and no vaccine.
But studies are showing hope on several fronts.
“We think we are at the beginning of the end of the AIDS epidemic,” Dr. Diane Havlir, an AIDS specialist at the University of California, San Francisco, and one of the organizers of a giant, international AIDS conference being held in Washington, D.C. later this month, told reporters on Tuesday. “Over the past three years, there has been a series of breakthroughs in interventions that can dramatically curb the rate of infections with HIV.”
Work on a vaccine is promising, it’s been shown clearly that circumcising men protects them from infection, and it’s also obvious that treating infected people not only keeps them alive and healthy, but it helps prevent them from infecting others. Work is also progressing on a microbicide -- a gel that women could use to protect themselves from infected husbands and partners. And now research is also showing that giving people a once-a-day dose of the pills used to treat HIV can keep them from becoming infected in the first place.
The studies on this last approach, called pre-exposure prophylaxis or PrEP, have been mixed. So Charles Okwundu of Stellenbosch University in South Africa and colleagues studied the studies.
They looked at experiments involving more than 9,800 people around the world at high risk of becoming infected with HIV, including gay or bisexual men and sex workers. The drug tenofovir alone -- sold under the brand name Truvada by Gilead Sciences -- cut the risk of HIV infection by nearly two-thirds, while trials using Truvada with a second drug called emtricitabine, brand name Emtriva, cut the risk by 49 percent, they reported in the Cochrane Library, a journal that seeks to find the “last word” on studies.
It’s not clear why using two drugs seemed to be less effective than using just one, but the trials were done very differently and using different groups of people.
"Our findings suggest that antiretroviral drugs can reduce the risk of HIV infection for people in high risk groups," Okwundu said in a statement. "However, in the search for highly reliable HIV prevention strategies, it is important to determine how pre-exposure prophylaxis can best be combined with existing programs, as no strategy is likely to be 100 percent effective."
Okwundu’s team noted controversy over using PrEP.
“One concern is the long-term side effects of antiretroviral drugs used over many years by uninfected individuals,” they noted.
These include possible kidney damage and bone loss. In addition, if people don’t take the drugs consistently, they could develop what is known as resistant virus -- infections that defy the use of drugs. This can hurt the patients themselves, and they can also pass this resistant and hard-to-treat virus to others.
“There also are concerns that PrEP will lead to an increase in high-risk behavior,” Okwundu’s team adds. “If PrEP is not completely effective, even a partial reduction in use of safer sex could lead to an increased rate of HIV transmission.”
And the drugs are expensive -- Truvada costs more than $1,000 a month in the United States, although Gilead allows for much cheaper generic versions to be made and distributed in the developing world.
Despite the concerns, in May a panel of Food and Drug Administration advisers recommended that the FDA approve the pills for this use. Already, doctors can and often do prescribe the pills as they like, but FDA approval would clear the way for U.S. insurance companies to pay for it and for the company to promote the drug for this use.
Related stories on Vitals:
- FDA approves first rapid, at-home HIV test
- Experimental AIDS therapy may be the beginning of the end
- Study: 1 in 900 sex acts spreads HIV
Melissa Harris-Perry sat down with former House Speaker Nancy Pelosi on Friday to discuss - among many issues - the congresswoman's work in combating the HIV crisis. Christopher MacDonald Dennis, dean of multicultural life at Macalester College, joins Harris-Perry to talk about what HIV and AIDS looks like in America today.
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Homophobes won't like it, they enjoy using AIDS to hate gays
Yes, you can use pills to prevent AIDS, review finds
By Maggie Fox
"Drugs used to control the AIDS virus can also be used to protect uninfected people, researchers concluded on Tuesday in a “last-word” review of the data."
An article that confuses AIDS with HIV has no credibility.
Where does it "confuse" the AIDS/HIV nomenclature? HIV is a pathogen, AIDS is the pathology. HIV isn't a condition or disease state, it is an organism.
Pharma bliss--$1k per month to treat a disease you don't even have.
Two errors: you think $1k/month/patient is profitable, and you incorrectly assume (or simply misread) that these pharmaceutics are actually sold to the patients in question.
The number of prophylactic users of these ARV drugs is minuscule, there is simply no margin to be had. They lose money even if all infected patients pay full price. Second, the vast majority of the generic drugs are donated (or significantly subsidized) to the cohorts that are being studies (undeveloped nations, high-risk potentials, etc.). You simply have no idea what you are espousing.
Whatever happened to the broad spectrum antiviral DRACO? It was announced and going to testing and then all talk dissapeared. I'm concerned that it might have been buried by those who profit from anti-viral research. Maggie Fox, if you are reading these, I for one would really like an update about that. Way beyond just HIV, its hard to imaging many things that would reduce overall health care costs more than DRACO could have.
Just who would join a clinical study ,take the drug and allow themselves to be infected.
People who are desperate for money,but it's extremely sad.
The fact is only 49% is not a preventive to start, second.... it is HIV not AIDS that it is meant... so already badly studied. 3rd why would you take a medication with so many side affects just to have a 49% chance you might not catch HIV.. this study is totally flawed and should not have even been published! Shame.. make sure you really know what you publish and get the facts right! stop pushing profits for big Pharma!
There is not one iota of sense or truth in your (oddly) bolded diatribe.
49% reduction in infection is a SIGNIFICANT finding. The most significant preventative we have to date. This is a metaanalysis, whereby most studies would kill for a 49% reduction.
No, the researchers are quite sure in the fact that they refer to it as AIDS. HIV is the pathogen, AIDS is the pathology. I makes no scientific (or grammatical sense) to refer to the condition as HIV.
This study, its metrics, indices, and findings are all quite solid. Hence the fact they are published in Cochrane Library. You do know what that is and what they do, right? These facts are as "solid" and comprehensive as anything to date in the ARV field. Seminal work, truly.
And what profits? The companies that manufacture these therapies for undeveloped and developing countries, as well as those in high-risk strata are more often than not donating the drugs, and always at a loss.
Please, please, please understand your debate before spouting nonsense.
Why would you need a drug to prevent AIDS anyhow? Don't sleep with strangers, at least without protection, and don't share needles. Problem solved. Geesh.
Heath...there are many (both heterosexual and homosexual) relationships where one person has HIV and the other does not. Other forms of protection are not 100% effective either so, while this may only be 50% effective, it does add another "layer" of protection for the non-infected person.
Many persons infected with the virus are married to partners who carry it, and they do not know. Also, there is much cultural taboo for using protection in certain cultures, which helped to create epidemic proportions of HIV infected persons.
And what if the condom breaks, Heath?
This is not a solution. We need a vaccine.
You don't need a vaccine....all you need is a condom. A heck of a lot cheaper and much more effective. Nothing however is 100% effective....even a vaccine. People have to start changing their behaviors and that costs nothing.
John - Yes...we DO need a vaccine. This epidemic is now in its 35th year and only a portion of society has changed their behaviors. It's pretty clear that certain other parts of society will not change thier beahaviors (or refuse to get educated about it). A prime example of that is the fact that HIV is spreading like wildfire in the poorest regions of Africa.
. ^
Aids is a pandemic because of the Homosexual agenda of saying what two consenting adults do in their bed room is no ones business, well 33 million people have HIV now. Homosexuality is a deviant and immoral practice. the next Item on their list is to get the age of consent dropped around the world to 9 like in Mexico.
Though your ignorance and bigotry is truly disgraceful, you're misunderstanding of factual observations is really unforgivable. The most at risk population strata are not homosexuals. Transmission between homosexuals as a whole is (and has been) in rapid decline since the mid-1990s. However, infection amongst heterosexual partners, as a sub-populace, continues to grow in Saharan and sub-Saharan Africa, where the populace of infected is exponentially higher than in even the most at risk homosexual populace.
I know ignorance can be blissful, but in your case you use it to promote an unhealthy, incorrect, and fatal logical stance.
Richard, I read comments like yours and dismiss them immediately. You're just a drone for the haters of the world.
While the ignorance of some people is mind blowing.... the one thing you can always count on is the general stupidity of those that think that gays started AIDS. The fact is no one clearly knows where it started or what caused it. Anyone heard of the "anal sex with a monkey" theroy?
NOT true.
This is so sad, People there is cures for AIDS and CANCER ! I have seen it work but people have been killed to keep this from you ! Millions of dollars spent for research and for WHAT ? Looking for a cure that is all ready know, Cancer and AIDS are the number two money makers for the drug company's and they will kill anybody who gives the cure away.
The only truly intelligent thing is to either find a vaccine or a cure. To think that it is just a gay disease is truly ridiculous.
If you ever get in to a situation where you need a blood transfusion Richard, just remember that the blood supply does not come from blue haired old ladies and nuns. It is truly a for profit huge business.
Just ask a Hemophiliac or any other user of blood product.
Writer Maggie Fox hopefully review(s) Comment(s) on (her) Health-related Story(s) posted here. We've yet to see a(ny) mention in her (otherwise quite good) Article(s), of a pair (two ++spreading in "Only-Guess(ed)-At #'s" in the U.S., since 1980 and 1982) of "Cousin(s)" or "BioCousin(s)" of HIV. Reprehensibly and harmfully, the name(s)/bioacronym(s) of the(se) two STD (Onco)Retrovirus(es), have never been Disclosed/Explained-in-Print-to-the-Public, in/by the U.S. (Government's "Public Health" Agencies). An NIH/NINDS Researcher/PhD/MD estimated to us in 2007, that based on his/the NIH's experience(s) -- "Less than 5% of American(s) generally, and <30% of U.S. Physician/MDs, have ever seen or heard (of) 'HTLVs'. They have no idea that HIV has Cousin(s), and they're Unable to Define 'HTLV'. They're (all) thus at needlessly-heighten(ed) risk, to defenselesly + or ++contract this 'State-Secret' BioAgent. This is in effect an unprecedented and horrific State-Caused Public Health and BioEthic(s) Crisis, with the U.S. Obstructing/Suppressing the 'Option or (Human/Constitutional) Right of Bio-Self-Defense'. I/We support your work(ing) with Legislator(s), to Enact a Dually-Protective anti-HIV and also anti-HTLV Policy Initiative..." (paraphrased). Also, there are no specific "Anti-HTLV or AntiOncoRetroViral (AORV, our term/acronym) Drug(s)", from any "PharmCo" in the U.S. We'd appreciate a phone call, "Snail-mail" (letter), and/or e-mail from Reporter Maggie Fox. Four Publisher(s) have already done five Story(s) on the "HIV vs. HTLV Policy(s) Reconfiguration" Work we're doing, with e.g. U.S. Congressmember(s) and NYS Legislator(s)...