||joya banerjee [ profile ]
More info on pre-exposure prophylaxis
Nov 24th, 2010 - 07:07:10
2010_1124 TP on Antiretorviral drug survey NIH funded.docx
Daily Pill Greatly Lowers AIDS Risk, Study Finds
By DONALD G. McNEIL Jr.
Published: November 23, 2010
Healthy gay men who took an anti-AIDS pill every day were well
protected against contracting H.I.V. in a study suggesting that a new
weapon against the epidemic has emerged.
& unofficially from PEPFAR,
From: Fanning, Mary M
Here are talking points that we can use to discuss the results of the
iPrex study. As Liz Trudeau has summarized, this is a preliminary
study looking at one at risk population. The questions that remain as
to its potential use for prevention are many and it is not yet
confirmed to be effective, nor have guidelines for how, with whom,
when and for how long to use this been addressed. The study teams
involved in the full range of studies are working together to try to
address these critical questions. One of the greatest concerns of the
study teams is the potential for ARV resistance if this preventive
strategy is rolled out to the population without determining whether
the recipients are HIV positive or not. For individuals who are HIV
positive, this would represent sub-standard treatment and thus promote more rapid development of resistance. There are several studies that will be completed in the next 12 months or so that will serve to validate the results, particularly in other populations that will have broader relevance to the situation in SA. There is still much work to be done to determine the best use of this prevention tool if the
additional studies confirm its benefit in broader populations at risk.
When speaking to people about the study please be sure to give a full
picture. The main effort at the moment will be to initiate a
discussion on these issues while we are awaiting results. In my
previous position, I was responsible for getting these studies set up
and started, and I am happy to discuss the results and issues if this
would be helpful.
Mary Fanning MD, PhD
877 Pretorius St.
Pretoria, South Africa 0001
Talking Points: NIH-Funded Study on Daily Dose of Antiretroviral Drug
- The New England Journal of Medicine published research findings from
the iPrEx study funded by the National Institutes of Health (NIH) and
the Bill and Melinda Gates Foundation testing the efficacy of
pre-exposure prophylaxis (PrEP).
- The study found that a daily dose of an oral antiretroviral drug
taken by HIV-negative gay and bisexual men and transgender women
reduced the risk of acquiring HIV infection by 43.8 percent. The data
showed even higher levels of protection from infection, up to 73
percent, among those participants who adhered most closely to the
daily drug regimen.
- This study is the first of its kind and we will need to validate
these findings with other research, much of which is currently
- There are still many unanswered questions, such as whether this
approach is effective in other populations. We also need to examine
whether PrEP works effectively with other antiretroviral medications.
- There are also critical questions about when and for how long
individuals need to take these medications and how to combine PrEP
with other prevention tools to achieve maximum results.
- We also need to better understand how to exploit the promise of PrEP
without sending signals that lead individuals to stop using condoms or
taking other steps that may increase their risk of becoming infected
- This regime was proven effective in gay and bisexual men - the group
responsible for more than half of all new HIV infections in the United
States and the only group where HIV incidence has been rising in
recent years. We all hope that this will be shown to work for
heterosexuals, people who inject drugs, and others.
- These results also compliment the promising study results announced
at the International AIDS Conference in July from the CAPRISA study
that demonstrated the efficacy of one of the two drugs used in the
iPrEx study (tenofovir) when used as a vaginal microbicide.
- President Obama: I am encouraged by this announcement of
groundbreaking research on HIV prevention. While more work is needed,
these kinds of studies could mark the beginning of a new era in HIV
prevention. As this research continues, the importance of using proven
HIV prevention methods cannot be overstated.