Regular intake of AIDS drug 'Tenofovir' helps reduce risk of HIV infection: Study

[webfact]

Regular intake of AIDS drug 'Tenofovir' helps reduce risk of HIV infection: Study
By English News



BANGKOK, June 13 - The regular use of AIDS drug 'Tenofovir' can help reduce the risk of HIV infection among injecting drug users, according to research conducted by the Thai government and the US Centre for Disease Control and Prevention (CDC).

The two agencies, joined by US Ambassador to Thailand Kristie A Kenney, told a news conference that a daily dose of 'Tenofovir' can help prevent HIV infection by 49 per cent, while a regular dose of the drug can help reduce the risk by 74 per cent.

The study was started in 2005 by Thailand's Dr Kajit Chupanya and Dr Michael Martinas from the CDC among 2,413 uninfected men and women using injectable drugs. It was part of the prevention of HIV infection project in Bangkok by using 'Tenofovir', scientifically known as Pre-Exposure Prophylaxis (PrEP).

The results were published online yesterday by the medical journal The Lancet.

Seventeen of 1,207 participants receiving Tenofovir became infected with HIV virus, while 33 of the other group of participants given placebo were infected.

A side-effect of using the drug is nausea.

"This translates to a 49 percent reduction in the risk of HIV infection among participants taking Tenofovir," said Dr. Michael Martin, Chief of Clinical Research for the study from the US Centre for Disease Control and Prevention.

The Bangkok Metropolitan Administration (BMA), Thailand's Public Health Ministry and the CDC will apply the study's results to further prevent HIV infection in Thailand. (MCOT online news)


-- TNA 2013-06-13

[joeaverage]

interesting, but it seems to me the only way to come up with anything definitive on this would be controlled exposure to the virus under identical circumstances on each of the test subjects, and that seems unlikely.

Edited June 13, 2013 by joeaverage

[steveromagnino]

Preventative HIV meds taken for high risk groups is proven to work in multiple studies worldwide.

I think what is not being looked at, however, is the risk that those contracting HIV and taking single line therapy will quickly promote the development of drug resistant strains of the disease, which is a major concern as the salvage therapies tend to be more expensive and with greater side effects. In markets with a lot of HIV medication there are quite high rates of resistance for frontline treatments already.

On the flip side, drug resistant mutations tend to be less damaging than non drug resistant strains.

However, this is a long term issue that needs to be examined.

A charity I work with for kids with HIV some of the damage to the poor kids is pretty brutal (although hard to say how much is from meds and how much is from the disease); not sure whether I'd want to be seeing the same side effects, just to be able to go bareback or shoot up with used needles.....and those groups who engage in such activities can they really be trusted to take meds every day, on time every time - one would think not. A bunch of drug resistant strains of Hivvie floating around....hmmm not really something to look forward to; presumably the 17 who caught it anyhow, either weren't taking the drug properly or the strain is immune to the drugs already (resistant).

[mommysboy]

madness. killing kids.

[falang07]

"A side-effect of using the drug is nausea."

And what about the side effects killing the immune system and in the end the user? Pharmaceutical fairy tales.

[geriatrickid]

"A side-effect of using the drug is nausea." And what about the side effects killing the immune system and in the end the user? Pharmaceutical fairy tales.

Thank you for your contribution to medical research. Where can I read more about your claim that the drug "kills" the immune system? Do you understand how the drug molecule works? It is specific to an enzyme.

How is it that none of the Hepatitis B and HIV-1 patients treated with the drug have any recorded indications of the drug "killing" their immune systems? In this specific 6 year study, nothing of the sort was recorded. Drugs do have side effects, but in this case, there is nothing to even remotely support your allegation, which is quite simply, ignorant.

Do you have an alternative viable solution to the current health crisis, or are you just content to offer up statements that demonstrate an absence of understanding on how viruses replicate?

[thomash]

Just another excuse for the legal drug pushers to make more money!

[steveromagnino]

"A side-effect of using the drug is nausea." And what about the side effects killing the immune system and in the end the user? Pharmaceutical fairy tales.

Thank you for your contribution to medical research. Where can I read more about your claim that the drug "kills" the immune system? Do you understand how the drug molecule works? It is specific to an enzyme.

How is it that none of the Hepatitis B and HIV-1 patients treated with the drug have any recorded indications of the drug "killing" their immune systems? In this specific 6 year study, nothing of the sort was recorded. Drugs do have side effects, but in this case, there is nothing to even remotely support your allegation, which is quite simply, ignorant.

Do you have an alternative viable solution to the current health crisis, or are you just content to offer up statements that demonstrate an absence of understanding on how viruses replicate?

GK I see we have a common interest :_)

The AIDS myth believers are out in force on this one!

Obviously the drug cocktail does not 'kill' the immune system any more than treating any other disease with a proven treatment. The CD4, white blood cell, anecdotal evidence, fatality rate, opportunistic infection stats all say....the cocktail works. The charity I help with the last kid they lost was in about 2009, prior to HAART they were more like a hospice, since the advent of the cocktail, even low grade high side effect treatments like the generic GPO and first generation protease inhibitors the decision to take or not take for almost everyone is a no brainer. Even insurers are starting to accept HIV+ applicants...slowly but surely. It's not a death sentence, just as diabetes and other chronic conditions now can be treated.

What they are now learning, though, is even with the cocktail, somehow the immune system is in a permanent state of inflammation, and now we are starting to see what happens when people with HIV age like a normal person rather than passing away after 8-12 years; they are more susceptible to certain diseases (separated out from the lipodystrophy buffalo hump, etc symptoms from taking certain meds and in some cases from HIV itself) such as dementia, heart issues, digestive issues, cholesterol issues, etc.

We see a lot of this in the kids, who for the most part seem to suffer more so from fat loss, stunted growth and some seem to have some memory issues which might be part and parcel of the meds. I am sure their nutrition and health suffers, because Thai diet is high in starch, whereas the best defense seems to be lower carbs higher protein diet.

I've tried the meds once, the easiest to handle meds, to see what it was like for a day. Similar to a massive hangover and nausea which lasted for a couple of days; and that's one day. I presume you get used to it taking it every day (the kids don't even think about it when they take their meds) but to accept this nausea by choice....I'd rather bag it and not share needles if that's what it took to avoid it.

To suggest that a bit of nausea and the other side effects is worse than dying. Well, I guess all the evidence in the world cannot refute 'a mate at a pub'.

Still question the benefits of preventative meds, when the alternative is an outbreak of resistant strains if people don't have the fear of god to make sure they take everyday. Different if some of the trials for single dose multi day drugs ends up becoming a reality.

[webfact]

Anti-retroviral lowers HIV risk among injecting drug users: study
Tanatpong Kongsai
The Nation

BANGKOK: -- Daily intake of the anti-retroviral drug tenofovir significantly reduces the risk of infection with the Aids virus among injecting drug users, according to a joint Thai-US study.

The findings were announced at a press conference attended by Dr Kajit Chupanya, a former deputy Bangkok city clerk who heads the research project, and US Ambassador Kristie Kenney.

Kajit said the risk of infection with the human immunodeficiency virus (HIV) dropped by 74 per cent among those taking tenofovir every day.

"This is the first evidence of pre-exposure prophylaxis among injecting drug users," he said. The findings from the research project were published in the online medical journal The Lancet.

Started in 2005, the project covers 2,413 participants. In this random, double-blind, placebo-controlled trial, some participants were given tenofovir. They have had a much lower rate of HIV infections, the project found.

"We will continue to give tenofovir to the project's volunteers for one more year after the project is completed," Kajit said.

He said the research project was a collaboration between the US Centres for Disease Control and Prevention (CDC) and Thailand's Public Health Ministry.

Dr Supak Wanichsenee, a chief coordinator of the research project, said tenofovir was a prescription drug available in Thailand. One tablet costs about Bt40.

"This medicine has been imported from the US," she said.

Kajit said he would consult with the CDC further as to whether the project should be expanded in Thailand.

Deputy Bangkok city clerk Dr Perapong Saichua said it was good news that there was now a way to reduce the risk of HIV infections. However, he said one sure way to lower the risk was to get people to stop injecting drugs.

"Some participants have decided to quit narcotics after the project's staff educated them about the negative impacts of abusing drugs," Perapong said.


-- The Nation 2013-06-14

[lowushatin]

they been giving Truvada, a once-daily combination of the mentioned tenofovir with something else. they also give it as post-exposure prophylaxis. I wonder if the news is about Truvada or it's really only a standalone tenofovir.

[Chris Lawrence]

Don't they experiment on rats first to produce the data?

A lot of drugs used to treat some virus's have considerable side effects. I know with HCV. interferon and ribavirin treatment can knock your white blood cell count which opens the body to other infections. These infections become very hard to treat while on this combination treatment. One gentleman I know ended up with an infected tooth, which eventually got him inintensive care unit in hospital while on this treatment.

Imagine getting the placebo and still committing risk behaviour. How did they get that thru the ethics committee?

I wonder if the drug company funded the study? I have seen a few drug companies fund such studies which to me becomes a bias.

[swifty5x5]

I don't get it. If your taking an aids drug you already have HIV so they want non HIV drug users to take a drug they don't need in case they get HIV. Why don't they just supply clean needles to injecting drug users?

[steveromagnino]

Basically, there is ample research to show 'day after' medicine works; this is essentially taking a permanent 'day after' medicine commonly referred to as PEP, as long as it is taken within less than 72 hours of exposure after which is ceases to be effective. You take this when you have been exposed to HIV in the hope of stopping the disease in its tracks completely before the body 'seroconverts' and accepts the disease as permanent:

http://www.catie.ca/en/treatmentupdate/treatmentupdate-152/anti-hiv-agents/study-finds-pep-not-100-effective-preventing-hiv

One would hope that it is not single line therapy, but since Viread/Tenofovir seems to perform and stand up pretty well to mutation/resistance except for the K65R mutation, and is relatively well tolerated, I guess if there was a single line this would be it. Still makes more sense to run with a single halflife dual therapy at least; TDF/3TC or TDF/FTC; adding a 3rd drug would start to add presumably more side effects.

Truvada isn't the nicest stuff for the liver from memory, but is also used to treat hepatitis and a few other things. Given the choice of a chronic brutal disease which gradually destroys the body, mind and health meds with side effects seem like a better option than death. The number of elite controllers able to personally resist the spread of the disease via their immune system only with the A/E strain prevalent in Thailand is very, very low compared to the strains in other parts of the world (HIV is not the same strain worldwide).

One would hope the researchers have looked at the risk of a bunch of parttime take sometimes forget sometimes people creating a new series of drug resistant HIV strains.

[belg]

simply: never start with any drugs and always were a condom on your willy

[Emdog]

swifty 5X5 has it right: supply needles to drug users. Seems like a no brainer, so that idea should be within grasp of policy makers. Any strong drug is going to do all sorts of things to your system. We call them side effects. Another duh. And the idea that this can help protect the user may lull them into more risky stupid behavior. More profit to be made selling drugs than in supplying needles. Where do these people come up with these poorly thought out "solutions"?

[BlackJack]

as there are over 100 kinds of HIV can they tell us what particular virus the pills were effective against

sounds like big pharma wants people to take a daily does of something to help prevent something that may or may not exist

[steveromagnino]

actually about 90% of HIV in Thailand is either type A/E or type B (from memory), and most of the drugs work for most of the HIV type 2 strains (HIV type 1 I think is the one in Africa, or it might be the other way around).

PEP is needed for needlesticks, hospital workers etc, but indeed, condoms and no shared needles is a major saving factor....however knowing the state of msm in Thailand I'd guess that for some....that thought isnt' going to fly.

[doctorproc156]

I don't get it. If your taking an aids drug you already have HIV so they want non HIV drug users to take a drug they don't need in case they get HIV. Why don't they just supply clean needles to injecting drug users?

That should be done in conjunction with this, having centers where clean needles and this drug are distributed free for anyone to take and use. Or have a supervised injection site which ensures the safety of the drug users as well as sign them up for rehabilitation if they decide to use the injection services. This could also be given free to people working in the sex industry to reduce the risk of HIV infection. Prolonged use of this drug and program can eradicate HIV and AIDS if done extensively and properly.

[steveromagnino]

It cannot eradicate, it can only reduce transmission rates (which is in itself a good thing).

[Bagwan]

"A side-effect of using the drug is nausea." And what about the side effects killing the immune system and in the end the user? Pharmaceutical fairy tales.

Thank you for your contribution to medical research. Where can I read more about your claim that the drug "kills" the immune system? Do you understand how the drug molecule works? It is specific to an enzyme.

How is it that none of the Hepatitis B and HIV-1 patients treated with the drug have any recorded indications of the drug "killing" their immune systems? In this specific 6 year study, nothing of the sort was recorded. Drugs do have side effects, but in this case, there is nothing to even remotely support your allegation, which is quite simply, ignorant.

Do you have an alternative viable solution to the current health crisis, or are you just content to offer up statements that demonstrate an absence of understanding on how viruses replicate?

GK I see we have a common interest :_)

The AIDS myth believers are out in force on this one!

Obviously the drug cocktail does not 'kill' the immune system any more than treating any other disease with a proven treatment. The CD4, white blood cell, anecdotal evidence, fatality rate, opportunistic infection stats all say....the cocktail works. The charity I help with the last kid they lost was in about 2009, prior to HAART they were more like a hospice, since the advent of the cocktail, even low grade high side effect treatments like the generic GPO and first generation protease inhibitors the decision to take or not take for almost everyone is a no brainer. Even insurers are starting to accept HIV+ applicants...slowly but surely. It's not a death sentence, just as diabetes and other chronic conditions now can be treated.

What they are now learning, though, is even with the cocktail, somehow the immune system is in a permanent state of inflammation, and now we are starting to see what happens when people with HIV age like a normal person rather than passing away after 8-12 years; they are more susceptible to certain diseases (separated out from the lipodystrophy buffalo hump, etc symptoms from taking certain meds and in some cases from HIV itself) such as dementia, heart issues, digestive issues, cholesterol issues, etc.

We see a lot of this in the kids, who for the most part seem to suffer more so from fat loss, stunted growth and some seem to have some memory issues which might be part and parcel of the meds. I am sure their nutrition and health suffers, because Thai diet is high in starch, whereas the best defense seems to be lower carbs higher protein diet.

I've tried the meds once, the easiest to handle meds, to see what it was like for a day. Similar to a massive hangover and nausea which lasted for a couple of days; and that's one day. I presume you get used to it taking it every day (the kids don't even think about it when they take their meds) but to accept this nausea by choice....I'd rather bag it and not share needles if that's what it took to avoid it.

To suggest that a bit of nausea and the other side effects is worse than dying. Well, I guess all the evidence in the world cannot refute 'a mate at a pub'.

Still question the benefits of preventative meds, when the alternative is an outbreak of resistant strains if people don't have the fear of god to make sure they take everyday. Different if some of the trials for single dose multi day drugs ends up becoming a reality.

My wife was infected 22 years ago. She was been treated for it only in the past 12 years. After two years taking GPO-VIR her medication was changed by a more knowledgeable doctor than the one who has been attending her. She has never had any side effects from medication and her CD4 count is no longer of interest to the doctor. Her viral load is a mere 20 copies per cml and the virus hides away in her glands rather than swan around in her blood. The T cells which form part of the CD4 element of her white blood cells have done their job.

The type of HIV that is prevalent in Thailand is no longer a killer. The killers are ignorant doctors who do not have the honesty or the balls to admit that they are not equipped to deal with sufferers and refer patients onwards, and the Thai Government who stand by while private hospitals rake in the money by charging big money thus putting treatments out of reach for the vast majority.

[Bagwan]

Using drugs and introducing them to the body intravenously equates to a suicide wish in my book. People have free will. If they want to use drugs after all the warnings and in contravention of the law then so be it. Let them kill themselves. Such an attitude may save a lot of innocent people from being infected. Why waste precious and costly resource on those who knowingly have put themselves at risk. You can't stop people being stupid so why try?

In UK hospitals I understand that it is standard practice in A & E is that those who have injured themselves through their own mindless lack of thought and consideration are sent to the back of the queue for treatment. Harsh you might think, but you reap what you sow.