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Three new studies show the potential
promise, as well as challenges, of using HIV drugs to prevent infection among
healthy but high-risk patients.
Two studies of African heterosexuals
show pre-exposure prophylaxis (PrEP) reduced the rate of HIV infection by 62
percent to 75 percent, a rate similar to that seen in PrEP studies involving
gay men. A third study focusing on African women ended early after showing no
effect, mostly because fewer than 40 percent of participants took the pills as
prescribed.
The studies overall bolster the idea
of PrEP as one of the several powerful HIV prevention tools, said Myron Cohen,
a professor at the University of North Carolina and co-author of an editorial
accompanying the studies.
“We’re at some sort of turning point
in the AIDS epidemic,” said Cohen. “It’s not a single thing going on here. It’s
the culmination of what’s happened for 30 years. ... Each of them is moving the
political world to start thinking about an AIDS-free generation.”
A lingering challenge is finding
ways to motivate uninfected patients to take the drugs properly. Researchers
should investigate if the women in Africa stopped taking the drugs due to side
effects or because they underestimated their risk of infection, Cohen said.
About 3 percent of the women became infected during the study, whether they
received the drugs or a placebo.
In two of the trials, patients were
randomly assigned to receive either Truvada (tenofovir and emtricitabine) or
placebo. In a third, they were randomly assigned to placebo, Truvada or
tenofovir. The Truvada and tenofovir groups had similar results.
In May, a Food and Drug
Administration advisory panel recommended the agency approve Truvada for PrEP.
[PNU editor’s note: The three
studies and editorial appear in the New England Journal of Medicine (2012;doi:
10.1056/NEJMoa1108524; doi: 10.1056/NEJMoa1202614; doi: 10.1056/NEJMoa1110711;
and doi: 10.1056/NEJMe1207438]
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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