Drugs May Offer AIDS Prevention

FlipFlopSnowMan writes "There is an interesting article on MSNBC about the possibility of preventing AIDS using the same pills that are currently used to fight the virus in affected individuals." From the article: "The drugs are tenofovir (Viread) and emtricitabine, or FTC (Emtriva), sold in combination as Truvada by Gilead Sciences Inc., a California company best known for inventing Tamiflu, a drug showing promise against bird flu. Unlike vaccines, which work through the immune system -- the very thing HIV destroys -- AIDS drugs simply keep the virus from reproducing. They already are used to prevent infection in health care workers accidentally exposed to HIV, and in babies whose pregnant mothers receive them."

Cash cow?

[Tx]

Q. How to make more money from expensive AIDS drugs?

A. Obvious - sell it to people who don't have AIDS as well as people who do.

As I understand, these drugs are very expensive, and personally I can't see any justification for using them prophylactically.

Same hype as with Tamiflu?

[Opportunist]

Tamiflu is an overhyped, not really effective anti-flu drug. Not more. It would be a bomb in the budget of Roche if we didn't "suddenly" (read: 3 years after it was first detected) get "washed over" (read: Every couple of days we find a dead bird somewhere on the planet) by the "epidemic" (read: Umm... yeah, somewhere in the Far East a handful of people died who pretty much washed their hands in infected bird blood).

Now everyone's crazy to get their hands on Tamiflu. Is it me or does it smell like a well placed marketing hype that the media picked up all too eagerly, since there's nothing else going on that would make people buy their news?

Re:Ah, man..

[dario_moreno]

"odds are 1 in 10000"...rather 1 in 1000, and even more for receptive sex, and if you do it once a day, you get almost a 1 in 2 chance of catching it after 500 days. Check Chad Douglas on google...always on top, positive after 5 years, dead after 15.

Ummm...

[spaztik]

This is all well and good but...

In the United States, wholesale costs are $417 for a month of tenofovir and $650 for Truvada.

Who is going to be able to afford this stuff?

Terrific Idea

[scrub76]

The evidence that AIDS drugs can prevent infections comes not only from exposed health care workers, but also monkey studies. If monkeys are given AIDS drugs up to 48 hours before exposure to SIV (the causitive agent of simian AIDS), they fail to become infected. That has been known since the late 90s. There is some data suggesting that the drugs can't always protect against multiple exposures to SIV, but those studies used only one drug at a time (not a cocktail of pills, like you would take if you had HIV).

As an HIV researcher myself, I realize that we are not going to have a highly effective, preventative vaccine for HIV any time in the near future. There are no clear 'winners' in the pipeline right now, and even if a vaccine looked effective right now, it would be years (and millions of new infections) before it clears human testing and it broadly available. Issues like viral resistance to the vaccine, incomplete protection from infection, potential side effects, and a false sense of security would plauge any vaccine that is developed -- and these are many of the same issues confronting the use of drugs as HIV preventatives.

One major hurdle to testing these drugs in populations highly affected by HIV is to convince them that this intervention is not a magic bullet. There will be problems, some of which we probably can't predict. There will be breakthrough infections in people taking the drugs. And the long-term health consequences aren't known. So far, these concerns have led to the abandonment of several trials of PrEP (using tenofovir in HIV-, high-risk populations) around the world. Hopefully the new data (using multiple drugs together works better than tenofovir alone) will encourage vulnerable populations that the potential benefits may outweigh the risks.

Re:Cash cow?

[Saulo Achkar]

...personally I can't see any justification for using them prophylactically. Get AIDS and you will find a justification....

Re:Resistance

[Andrzej Sawicki]

Perhaps that is the point. Got to keep the business going, no? (Too bad this is only partially a joke.)

Re:Cash cow?

[Anonymous Coward]

Um, how about not use them and then get AIDS? As a gay man, the cost of these drugs would be justified. You obviously have never had an HIV scare; it's NOT fun.

Re:Cash cow?

[PrescriptionWarning]

If you are a gay man who has unprotected sex, or are an IV drug user, then these drugs are a good idea.

i hope you are only using these as an example, because straight people can get AIDS too ya know, and not just from going to see a prostitute.

of course if someone is having sex with so many different people they fear that they need such a drug, well maybe instead they should think about changing their lifestyle, they might actually be happier

Go for prevention!

[barefootgenius]

Yes folks! The next time you want to do the wild thing with one of those crazy ladies of the night. Go for prevention. Its simple its easy and its cheap.

1- Navigate to the My Video folder.

2- Click on one of your numerous porn clips.

3- Wank!

See folks. Stopping the spread of AIDS is easy...and its on your hands*.

*-Three sessions of thirty seconds per day recommended. Lubricants, may apply.

Re:Canadians

[SSCGWLB]

Somebody has to pay for the R&D on all those drugs the rest of the world takes for granted/steals. Those companies spend billions developing, testing, and getting FDA approval on a single drug. Then, after that, they have to bear the legal liability if there are unintended side effects (Vioxx anybody?). I don't even begrudge them making money, that's why these corporations exist (gasp!). Personally, I am glad I live in the best country in the world that has the innovation and R&D infrastructure to develop a drug like this. That way, if I get sick, they may have developed a drug to cure me!

Thanks for playing,
~nate

What to expect.

[sammy baby]

Expect immediate, heavy resistance from the ultra-right wing, Christian conservative political forces in the US. Experience has shown that if there's a disease that increases the potential negative consequences of having sex, especially those which disproportionately affect women, they will oppose efforts to provide treatment. (Women in heterosexual relationships carry an increased risk of HIV transmission when compared to men, although they have a decreased risk in homosexual relationships. The reasons I leave as an exercise for the reader.)

Case in point: the human papilloma virus, or HPV. Now here's the thing with HPV: it's sexually transmitted, condoms don't protect against it, and doctors believe that it's responsible for seven out of ten cases of cervical cancer later in life. So, if we could develop a vaccine against it, that would be a huge strike against cancer, right?

Well... sure. But ultra right groups like the Family Research Council oppose such a vaccine, even though pharmaceutical companies have already conducted successful clinical trials. Why? Because they want to scare people into not having sex.

"Giving the HPV vaccine to young women could be potentially harmful," Bridget Maher of the Family Research Council told the British magazine New Scientist, "because they may see it as a license to engage in premarital sex." [thenation.com]

If this is the reaction an HPV vaccine (or, for that matter, condoms) gets, how do you think they're going to react to a cure to something which disproportionately affects gay men?

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[account_deleted]

Comment removed based on user account deletion

face the facts

[penguin-collective]

what if one of the various "environmental factors" models is right rather than the "single pathogen" model?

That's just not a serious possibility anymore; here are just some basic observations:

• While clinical diagnosis relies on symptoms, HIV infection has been followed in minute detail from initial transmission to death numerous times, in the presence and absence of treatment, in individuals with completely different histories, at the molecular level, at the tissue level, and at the clinical level.
  
• The epidemiology of HIV has been studied extensively: the disease is clearly transmissible and no other factor than an existing HIV infection is associated with transmission.
  
• Drugs specifically targeted at HIV have increased survival rates tremendously, while changes in lifestyle have had limited effect.
  
• The molecular mechanisms of resistance to HIV infection (found in a few percent of the population) are well understood.
  

Single pathogens are sexy for epidemiologists.

Yes, and they are also the rule for infectious diseases. While susceptibility and severity of a disease may vary with environmental factors, for infectious diseases, there is usually a well-defined, clearly characterizable pathogen responsible.

Re:MOD PARENT UP

[Mr2001]

AIDS diagnosis as it is practiced today assumes HIV-AIDS causation.

Which makes sense, because the evidence as it is observed today indicates HIV-AIDS causation. See the sibling of your post for details. There's no more reason to believe AIDS is caused by anything besides HIV than there is to believe the moon landing was faked.

Re:Save the melodramatic crap

[tbone1]

In 1990, over 5 million people worldwide, practically all of them children, were dying of diarrhea. But did you see Bono appear at the Grammy Awards with a brown ribbon on his lapel?

Re:Save the melodramatic crap

[hey!]

Ummm. You may be right if you go by infections. But if you go by mortality statistics, HIV kills more people than any identifiable infectious agent. Period.

In 2002, 3.9 million people died from "lower respiratory infections", 2.8M from HIV, 1.8M from miscellaneous diahrreheal illnesses, 1.6M from TB, 1.2 from Malaria, and 0.6M from Measles, according to the 2003 WHO World Health Report.

Furthermore, one of the major reasons TB is becoming harder to keep ahead of is HIV. The 2005 World Bank Annual Report say of TB: "The disease is the most common opportunistic infection associated with HIV, increasing the number of people with tuberculosis in many countries in Africa."

Re:Ah, man..

[LanimilbusLE]

The wikipedia entry for Chad Douglas does not confirm your point. It is not even know if the man is dead or if he ever even contracted HIV. Furthermore he did NOT use condoms in his movies according to the article. http://en.wikipedia.org/wiki/Chad_Douglas [wikipedia.org]