Researchers moot daily pill to keep HIV at bay

Mexico City: Can a pill a day help prevent infection from HIV, the virus that causes AIDS?

No one knows. But researchers in a number of countries are conducting trials and planning others to test the unproven strategy that a daily pill, or a combination of drugs, can prevent HIV.

By mid-2009, more people will be enrolled in such trials than in all of those for HIV vaccines and microbicides, the AIDS Vaccine Advocacy Coalition said in a report issued here on Sunday at the start of the 17th International AIDS Conference.

Lawrence K. Altman, for The New York Times

Initial findings of the safety and effectiveness might come early next year, although researchers do not know how they will compare to the disappointing results of recent tests of HIV vaccines and microbicides, chemicals that women can put in their vagina to prevent HIV infection.

In the face of those bleak findings, some AIDS experts say testing the prophylactic use of antiretroviral drugs, called PrEP, for pre-exposure prophylaxis, is now the most promising research in HIV prevention efforts as scientific investigation of vaccines and microbicides continues.

The Centers for Disease Control and Prevention, which released a report on Saturday showing that the number of people newly infected with HIV in the US in recent years was 40% higher than has long been reported, said that PrEP was among the strategies that needed to be developed to substantially reduce the incidence of HIV. An estimated 2.7 million people become infected each year worldwide.

“We cannot wait for the study results to begin to prepare for the optimal use and delivery of PrEP,” said Pedro Goicochea, an investigator in a PrEP study in Peru and Ecuador. “Instead, we should look ahead to consider all of the possible outcomes of these trials and make real plans for making PrEP available to those who can benefit from it, as quickly and safely as possible if it is proven effective.”

The US Agency for International Development, the CDC and the National Institutes of Health are paying in part for all of the trials. The Bill & Melinda Gates Foundation is paying for part of two. The organizations have undertaken the trials because of the success in giving antiretroviral drugs to pregnant women to prevent HIV infection in their infants and drugs to prevent malaria.

In 2007, Family Health International completed a similar study of the antiretroviral drug tenofovir for HIV prevention among young women in Ghana, providing the first data showing such use was both safe and acceptable among uninfected users. But the study did not indicate if PrEP was effective in preventing new infections.

Initial PrEP studies are testing tenofovir. Infected people taking these licensed drugs have shown limited side effects like nausea, diarrhea and intestinal gas. But their safety must be established among noninfected people as well as among participants who become infected in the study. Up to 15,000 people are expected to be participating in trials by mid-2009. NYT NEWS SERVICE

Drug addicts benefit from HIV drugs too

Drug abusers benefit just as much from HIV drugs as people who are infected sexually or some other way, Canadian researchers reported on Sunday. Their finding, published in the Journal of the American Medical Association and presented at an international AIDS meeting in Mexico City, contradicts widespread worry that drug abusers cannot stick to treatment. “A large number of prior reports have demonstrated that because of issues of social instability related to illicit drug addiction, HIV-infected injecting drug users may not be deriving the full benefits of HAART (HIV drugs),” Dr. Julio Montaner of the University of British Columbia and St Pauls Hospital in Vancouver, Canada, and colleagues wrote.

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