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US regulators approve first daily anti-HIV drug

Truvada, which is designed for use by healthy adults who are at risk of HIV, should be mixed with safe sex and regular testing.

Truvada, which is already used to treat patients with HIV, can now be used to help prevent infection in people who don't have HIV.
Truvada, which is already used to treat patients with HIV, can now be used to help prevent infection in people who don't have HIV.
Image: Jeff Chiu/AP

THE FIRST EVER daily pill to help prevent HIV infection has been approved by US regulators, for use by healthy adults who are at risk for getting the virus that causes AIDS.

Truvada, made by Gilead Sciences in California, has been on the market since 2004 and has now been approved by the Food and Drug Administration for a new use as a tool to help ward off HIV, in combination with safe sex and regular testing.

The pill as pre-exposure prophylaxis (PrEP) has been hailed by some AIDS experts as a potent new tool against Human Immunodeficiency Virus, while other health care providers are concerned it could encourage risky sexual behaviour.

In addition, the regimen is estimated to cost around $14,000 per year, making it out of reach of many.

“Truvada alone should not be used to prevent HIV infection,” said Debra Birnkrant, director of the division of antiviral products at the FDA.

“Truvada as PrEP represents another effective, evidence-based approach that can be added to other prevention methods to help reduce the spread of HIV.”

The FDA said Truvada should be used as “part of a comprehensive HIV prevention strategy that includes other prevention methods, such as safe sex practices, risk reduction counseling, and regular HIV testing.”

Truvada was previously approved as a treatment for people infected with HIV to be used in combination with other antiretroviral drugs.

Support of independent panel

The decision by the FDA followed the advice of an independent panel in May that supported Truvada for prevention in uninfected people, after clinical trials showed it could lower the risk of HIV in gay men and heterosexual couples.

One study of men who were sexually active with other men but were not infected with the virus that causes AIDS found 44 per cent fewer infections in those taking Truvada versus a placebo. Those in the study who took the drug regularly had almost 73 per cent fewer infections.

A second study on heterosexual couples in which one partner was infected with HIV and the other was not showed that Truvada reduced the risk of becoming infected by 75 per cent compared with a placebo.

Common side effects were the same as experienced by people with HIV who were taking Truvada, and included diarrhoea, nausea, abdominal pain, headache, and weight loss.

However, the adherence rate – meaning how often people in the study actually took the drug daily – was low in the study of men who have sex with men, at just 30 per cent, Birnkrant said. In the study of heterosexual partners, adherence was much higher, at between 80 and 90 per cent.

Therefore, the drug label must include special instructions for health care providers on how to counsel potential users of the drug.

The drugmaker must also include a warning that Truvada for PrEP “must only be used by individuals who are confirmed to be HIV-negative prior to prescribing the drug and at least every three months during use.”

Video: HIV home test approved by US Food and Drug Administration

About the author:

Gavan Reilly

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