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Truvada To Prevent HIV Infection Hits The News Again

Big news today is that Truvada, the combination HIV treatment has been approved for marketing as a PreEP or Pre Exposure Prophalaxis medication to help reduce the risk of HIV infection in “high risk individuals”.

This has been considered a big step forward after Truvada was deemed safe as PrEP in May this year.

As reported in the San Francisco Chronicle:

Truvada, made by Gilead Sciences in Foster City, was approved in 2004 to treat people already infected with HIV, but studies have shown the drug is also effective at reducing the risk of contracting the virus.

“It’s a huge milestone that could change the course of the epidemic,” said Dr. Robert Grant, a UCSF professor and a researcher with the Gladstone Institute for Virology and Immunology who led one of the two studies on which the FDA approval was based.

“The main challenge is for everyone to start thinking of HIV as a problem that can be prevented,” he said.

The daily pill is aimed at an estimated 415,000 Americans whose sexual activity puts them at the highest risk for contracting HIV, the virus that leads to AIDS. About 1.2 million Americans have HIV.

This news has resonated in Australia with Star Observer reporting:

National Association of People Living with HIV/AIDS (NAPWA) spokesman Bill Whittaker told the Star Observer the news was a “game-changer”.

“It’s really a dramatic development in the fight against HIV because for the first time we have a drug that can be used by HIV-negative people at high risk of becoming HIV-infected which will prevent infection or give a high level of protection against infection,” he said.

“We’ve never had that before.”

Whittaker added Truvada was not a “silver bullet” against HIV infection and needed to be used with condoms and other safe-sex practices…

Australian Federation of AIDS Organisations (AFAO) deputy CEO Simon Donohoe has also backed the call to immediately begin Truvada clinical trials in Australia.

“Truvada has the potential to make a significant dent in the HIV infection rate,”

Naturally there are a number of concerns about this step forward. Some questions I have include:

  • Who is considered a “high risk individual” for HIV infection?
  • Why is it that safe sex works for some people at not others?
  • Is there a risk this could lead to further resistent HIV strains killing one of the key HIV treatments used in Australia?
  • Who will pay for the $18,000 annual bill for this treatment? Will PrEP HIV prevention only be available to those that can afford it?

Clearly HIV prevention is a complex issue. While a once a day tablet sounds like the perfect solution for breaking the HIV cycle, will this help reduce the burdon of HIV worldwide or could it be a move by pharmaceutical companies to cash in on a market that has flattened with current patents coming to a close?

I’m sure the debate will continue.

Yours in good health.

Dr George

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