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LONDON: In what is being called a game changer, British scientists have confirmed that a daily pill cuts the risk of HIV infection among gay men by 86%.
Results of a major UK trial of pre-exposure prophylaxis (PrEP) have been described as “extremely exciting”.
The study shows that pre-exposure prophylaxis among gay men at high risk of contracting the disease is highly protective.
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Researchers from the medical research council and public health England presented results of the PROUD study conducted in partnership with 12 NHS trusts in England.
The study looked at whether offering daily HIV Pre-Exposure Prophylaxis (PrEP) to men who have sex with men (MSM) was a reliable way to prevent them from becoming infected if exposed to the virus.
The researchers concluded that PrEP offers a major new opportunity to curb newly acquired HIV infections in MSM in the UK, of which there were an estimated 2,800 in 2013.
The sexual health research clinics that took part in the PROUD study were able to integrate PrEP into their routine HIV risk reduction package with ease.
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The drug used in the trial – the anti-retroviral Truvada (usually used to treat HIV) – was already known to reduce the incidence of HIV infection in placebo controlled trials.
The study was launched in 2012, enrolling 545 participants at 13 sexual health clinics in England. The study randomized participants to receive PrEP immediately or to receive PrEP after a period of 12 months, allowing researchers to compare those on PrEP versus those not yet on PrEP.
Of the 545 participants who joined the study, 276 were randomized to the group who received PrEP immediately and 269 to the group who received PrEP after a deferred period of 12 months.
There were 22 HIV infections among participants in their first year in the study, with 3 in the immediate group giving an HIV incidence of 1.3 per 100 person-years, and 19 in the deferred group giving an incidence of 8.9 per 100 person-years.
The 86% protection from daily (Truvada) PrEP reported by the study, is the highest reported from a randomized controlled trial of PrEP to date.
Adherence to the daily drug regimen appears high in the study.
Sheena McCormack from the MRC Clinical Trials Unit at UCL said, “These results are extremely exciting and show PrEP is highly effective at preventing HIV infection in the real world. Concerns that PrEP would not work so well in the real world were unfounded. These results show there is a need for PrEP, and offer hope of reversing the epidemic among men who have sex with men in this country. The findings we’ve presented today are going to be invaluable in informing discussions about making PrEP available through the NHS”.