D-day for the Pill for HIV

Published: November 5, 2014

The Huffington Post
Original Article:  huff.to/1wxSKMG

The media coverage of the unexpectedly early success of two trials of pre-exposure prophylaxis – PrEP – has generally been positive, sometimes overly so ("NHS to offer tablet which can reduce HIV risk by 90%" said The Independent – not yet it won’t).

But I haven’t seen anything that actually explains why the results of the PROUD and IPERGAY studies are so important, or why they represent a gear-change in the accelerating race towards the end of HIV.

To recap: PrEP means taking an anti-HIV pill daily, or in advance of exposure, to prevent HIV infection. It’s not a new idea: think quinine in pink gin to stop malaria, think statins to stop heart attacks, think above all of the contraceptive pill.

It’s different from post-exposure prophylaxis (PEP), which means taking, so to speak, the morning-after pill.

So what just happened is that on 16 October the researchers behind the PROUD trial, in which 545 gay men in England were given daily pills of the anti-HIV medicine Truvada(R) either immediately or after a year’s delay, announced that what had been intended as a mere pilot study had been so dramatically successful that they were offering all participants immediate PrEP.

Less than two weeks later, the scientists behind the IPERGAY trial – which offered 400 French and Canadian gay men PrEP (or placebo pills) to be taken in advance of sex – announced that they, too, were offering PrEP to all the men on placebo because, prompted by PROUD, they’d taken a look at their data and found high levels of effectiveness too.

Both teams were cagey about putting figures on what they’d seen in their studies but IPERGAY’s lead researcher Jean-Michel Molina let slip to a couple of gay magazines that effectiveness was in the order of 80%; PrEP stopped four out of five infections that would otherwise have happened. PROUD is unlikely to have lower effectiveness than this, and may well have higher.

Full text of article available at link below:  huff.to/1wxSKMG

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