HIV prevention drug to be trialed by Britain's NHS

After a High Court case, an HIV prevention drug is soon to be available on the NHS. NHS England has issued a statement saying that pre-exposure prophylaxis (PrEP) treatment for HIV shall be available to an initial 10,000 people for a trial period of three years.

The drug called Truvada is an agent that if taken before unprotected sexual intercourse may reduce the risk of transmission of HIV infection from an infected partner to the other by nearly 86%. NHS has been insisting on the availability of this agent to be taken up by the local authorities while the High court ruled that NHS should be paying for PrEP. From September this year thus, PrEP will be offered through sexual health clinics across London, Brighton, Manchester, Liverpool and Sheffield.

More clinics would be included from October and the three-year-old trial shall begin on a full-fledged basis from April 2018. Persons with an HIV positive partner would be the first priority in terms of distribution of this drug. NHS England estimates that this trial would cost £10m.

According to Simon Stevens, chief executive of NHS England, this is a “major new intervention” in the fight against HIV/AIDS and this should aid and “supercharge” the worldwide efforts to prevent HIV. He called it a “milestone” in the past three decades worth of battle against this infection.

Deborah Gold, chief executive of the National AIDS Trust, called this a “pivotal” moment that could transform the English HIV epidemic. From September, people at high risk of HIV would now be able to access this drug via this NHS-funded trial in England. She added that this would improve and save many lives.

Ian Green, chief executive of sexual health charity Terrence Higgins Trust, added that this PrEP trial has been slowly and steadily “gaining momentum. Now that a start date is set, it is a heartening move he said. It is important that the trial reaches all the persons who need it he said calling spring 2018 “not soon enough”. He explained that this trial would protect over 10,000 people at risk of HIV.

The NHS list price of Truvada is £355.73 for 30 tablets.

Pre Exposure Prophylaxis

Pre exposure prophylaxis (PrEP) involves taking HIV medicines daily by persons who are at a high risk of contracting the infection. This lowers their risk of getting the infection significantly. It is highly effective for preventing HIV when used as advised.

Studies have shown that persons who take daily PrEP reduce the risk of getting HIV from sex by over 90%. Among injected drug users the risk reduction is over 70%. When combined with other protection methods such as using condoms and barrier contraceptives rather than having unprotected sex, the risk of getting HIV can be further lowered.

For PrEP, an combination of tenofovir and emtricitabine sold under the name Truvada is approved for daily use as PrEP. Daily use of Truvada can prevent an HIV negative person from getting HIV from a sexual partner who is HIV positive or an injection-drug-using partner who is HIV positive. PrEP is much less effective when it is not taken regularly and continuously.

PrEP is recommended for persons who are exposed to HIV infection from sexual partners, gay or bisexual men who have had unprotected anal sex without using a condom or been diagnosed with an STD in the past 6 months or a heterosexual man or woman who has unprotected sex with multiple and sometimes unknown partners. PrEP is also recommended for those who have used injected drugs in the past 6 months and have shared needles in the past 6 months.

Truvada can cause side effects like nausea. There are little or no serious side effects with the use of this medication.

References

  1. https://www.england.nhs.uk/2017/08/nhs-england-announces-worlds-largest-single-prep-implementation-trial-to-prevent-hiv-infection/
  2. https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis
  3. https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/20/87/post-exposure-prophylaxis--pep-
  4. https://www.cdc.gov/hiv/basics/pep.html
  5. http://www.who.int/hiv/topics/prophylaxis/en/

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