Video: Daily drug a game-changer in fight against HIV?

  1. Closed captioning of: Daily drug a game-changer in fight against HIV?

    >> game changer in the fight against the tread of hiv. a new and it i retro viral given to gay men to reduce their rick of infection by at least 44%. men who faithfully took the drug every day saw their risks decline by 95%. robert bazell joins us. the drug is called truvada?

    >> a commonly used hiv drug for treatment around the world.

    >> and so now how is it being watched and how are they using it to benefit people that currently do have aids but also --

    >> no, no, it's to take people who are not infected that are having sex or using drugs or mostly are having sex with somebody who is infected to prevent infection. so you can think of it as more of like a chemical condom in the sense that it's providing protection. and this is important because condoms don't always work right, people don't always use them, and more important in the large parts of the word and this was just a study on gay and by sexual men, but there are large parts of the world where women don't have any control over what their partners do. so if you can give them something they can use to protect themselves from infection, it would be empty powering.

    >> just to be cheer, ilear, it's not being used to treat infection?

    >> it is. but this was a different use of the same drug. it did prevent infection with the numbers you cited. in fact president obama just came out with a statement from the white house saying he was impressed by the results and he hopes that they will limit the spread of aids in the future. the u.n. came out with a report and said that even though the rate of aids infection in the world is slowing down, 33 million people rin effectare infected. so anything that can possibly reduce the rate of hiv infection is a big step forward.

    >> and researchers were concerned that this might give people a false sense of security.

    >> that's always been the case with anything that you use that's prevention. but prevention messages didn't always work and all the men that were in this group were given condoms and counsel to use safe sex , so this happened even more than that.

    >> more research to come.

Truvada
PAUL SAKUMA  /  AP
Daily doses of Truvada, a pill already used to treat infection with HIV, the virus that causes the disease, helped prevent healthy gay men from catching it through sex with an infected partner.
msnbc.com news services
updated 11/23/2010 1:49:41 PM ET 2010-11-23T18:49:41

Scientists have an exciting breakthrough in the fight against AIDS. A pill already used to treat HIV infection turns out to be a powerful weapon in protecting healthy gay men from catching the virus, a global study found.

Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services. Men who took their pills most faithfully had even more protection, up to 73 percent.

  1. Don't miss these Health stories
    1. Splash News
      More women opting for preventive mastectomy - but should they be?

      Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

    2. Larry Page's damaged vocal cords: Treatment comes with trade-offs
    3. Report questioning salt guidelines riles heart experts
    4. CDC: 2012 was deadliest year for West Nile in US
    5. What stresses moms most? Themselves, survey says

Researchers had feared the pills might give a false sense of security and make men less likely to use condoms or to limit their partners, but the opposite happened — risky sex declined.

The results are "a major advance" that can help curb the epidemic in gay men, said Dr. Kevin Fenton, AIDS prevention chief at the U.S. Centers for Disease Control and Prevention. But he warned they may not apply to people exposed to HIV through male-female sex, drug use or other ways. Studies in those groups are under way now.

Video: Drug a game-changer in fight against HIV? (on this page)

"This is a great day in the fight against AIDS ... a major milestone," said a statment from Mitchell Warren, head of the AIDS Vaccine Advocacy Coalition, a nonprofit group that works on HIV prevention.

  1. Don't miss these Health stories
    1. Splash News
      More women opting for preventive mastectomy - but should they be?

      Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

    2. Larry Page's damaged vocal cords: Treatment comes with trade-offs
    3. Report questioning salt guidelines riles heart experts
    4. CDC: 2012 was deadliest year for West Nile in US
    5. What stresses moms most? Themselves, survey says

Condoms still 'first line of defense'
Because Truvada is already on the market, the CDC is rushing to develop guidelines for doctors using it for HIV prevention, and urged people to wait until those are ready.

"It's not time for gay and bisexual men to throw out their condoms," Fenton said. The pill "should never be seen as a first line of defense against HIV."

Story: Your laptop could be cooking your testicles
Story: 5 most common misdiagnosis for men
Story: Guys, these 7 health checks could save your life

As a practical matter, price could limit use. The pills cost from $5,000 to $14,000 a year in the United States, but only 39 cents a day in some poor countries where they are sold in generic form.

Dr. Howard Jaffe, president of the Gilead Foundation, said the company was not planning any price changes.

Whether insurers or government health programs should pay for them is one of the tough issues to be sorted out, and cost-effectiveness analyses should help, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

"This is an exciting finding," but it "is only one study in one specific study population," so its impact on others is unknown, Fauci said.

His institute sponsored the study with the Bill & Melinda Gates Foundation. Results were reported at a news conference Tuesday and published online by the New England Journal of Medicine.


It is the third AIDS prevention victory in about a year. In September 2009, scientists announced that a vaccine they are now trying to improve had protected one in 3 people from getting HIV in a study in Thailand. In July, research in South Africa showed that a vaginal gel spiked with an AIDS drug could cut nearly in half a woman's chances of getting HIV from an infected partner.

Gay and bisexual men account for nearly half of the more than 1 million Americans living with HIV. Worldwide, more than 40 million people have the virus, and 7,500 new infections occur each day. Unlike in the U.S., only 5 to 10 percent of global cases involve sex between men.

"The condom is still the first line of defense," because it also prevents other sexually spread diseases and unwanted pregnancies, said the study leader, Dr. Robert M. Grant of the Gladstone Institutes, a private foundation affliated with the University of California, San Francisco.

But many men don't or won't use condoms all the time, so researchers have been testing other prevention tools.

AIDS drugs already are used to prevent infection in health care workers accidentally exposed to HIV, and in babies whose pregnant mothers are on the medication. Taking these drugs before exposure to the virus may keep it from taking hold, just as taking malaria pills in advance can prevent that disease when someone is bitten by an infected mosquito.

The strategy showed great promise in monkey studies using tenofovir (brand name Viread) and emtricitabine, or FTC (Emtriva), sold in combination as Truvada by California-based Gilead Sciences Inc.

The company donated Truvada for the study, which involved about 2,500 men at high risk of HIV infection in Peru, Ecuador, Brazil, South Africa, Thailand and the United States (San Francisco and Boston). The foreign sites were chosen because of high rates of HIV infection and diverse populations.

More than 40 percent of participants had taken money for sex at least once. At the start of the study, they had 18 partners on average; that dropped to around 6 by the end.

The men were given either Truvada or dummy pills. All had monthly visits to get HIV testing, more pills and counseling. Every six months, they were tested for other sexually spread diseases and treated as needed.

After a median followup of just over a year, there were 64 HIV infections among the 1,248 men on dummy pills, and only 36 among the 1,251 on Truvada.

Among men who took their pills at least half the time, determined through interviews and pill counts, the risk of infection fell by 50 percent. For those who took pills on 90 percent or more days, risk fell 73 percent. Tests of drug levels in the blood confirmed that more consistent pill-taking gave better protection.

The treatment was safe. Side effects were similar in both groups except for nausea, which was more common in the drug group for the first month but not after that. Unintended weight loss also was more common in the drug group, but it occurred in very few. Further study is needed on possible long-term risks.

What's next?
All participants will get a chance to take Truvada in an 18-month extension of the study. Researchers want to see whether men will take the pill more faithfully if they know it helps, and whether that provides better protection. About 20,000 people are enrolled in other studies testing Truvada or its component drugs around the world.

The government also will review all ongoing prevention studies, such as those of vaccines or anti-AIDS gels, and consider whether any people currently assigned to get dummy medicines should now get Truvada since it has proved effective in gay men.

Gilead also will discuss with public health and regulatory agencies the possibility and wisdom of seeking approval to market Truvada for prevention. The company has made no decision on that, said Dr. Howard Jaffe, president of Gilead Foundation, the company's philanthropic arm. Doctors can prescribe it for this purpose now if patients are willing to pay for it, and some already do.

Some people have speculated that could expose Gilead to new liability concerns, if someone took the pill and then sued if it did not protect against infection.

"The potential for having an intervention like this that has never been broadly available before raises new questions. It is something we would have to discuss internally and externally," Jaffe said.

Until the CDC's detailed advice is available, the agency said gay and bisexual men should:

  • Use condoms consistently and correctly.
  • Get tested to know their HIV status and that of their partners, and get tested and treated for syphilis, gonorrhea and other infections that raise the risk of HIV.
  • Get counseling to reduce drug use and risky sex.
  • Reduce their number of sexual partners.

The Associated Press and Reuters contributed to this report

Interactive: Global AIDS epidemic

Discuss:

Discussion comments

,