Soon, a pill to prevent HIV infection?

Daily Use Of Drug May Shield People At High Risk Of Contracting Virus

    Silver Spring (Maryland):

    The first drug shown to prevent HIV infection won the endorsement of a panel of US federal advisers, clearing the way for a landmark approval in the 30-year fight against the virus that causes AIDS.

    In a series of votes on Thursday, a Food and Drug Administration advisory panel recommended approval of the daily pill Truvada for healthy people who are at high risk of contracting HIV, including gay and bisexual men and heterosexual couples with one HIV-positive partner.

    The FDA is not required to follow the panelís advice, though it usually does. A final decision is expected by June 15. Gilead Sciences Inc., based in Foster City, California, has marketed Truvada since 2004 as a treatment for people who are infected with the virus.

    The medication is a combination of two older HIV drugs, Emtriva and Viread. Doctors usually prescribe it as part of a drug cocktail to repress the virus. While panelists ultimately backed Truvada for prevention, the 12-hour meeting highlighted a number of concerns created by the first drug to prevent HIV.

    In particular, the panel debated whether Truvada might lead to reduced use of condoms, the most reliable defence against HIV. The experts also questioned the drugís effectiveness in women, who have shown much lower rates of protection in studies. Panelists struggled to outline steps that would ensure patients take the pill every day. In clinical trials, patients who didnít take their medication diligently were not protected, and patients in the real world are even more likely to forget than those in studies.

    ďThe trouble is adherence, but I donít think itís our charge to judge whether people will take the medicine,Ē said Dr Tom Giordano of Baylor College of Medicine, who voted in favour of the drug. ďI think our charge is to judge whether it works when itís taken and whether the risks outweigh the benefits.Ē