Preventive treatment may lower HIV transmission

	Tweet

Treatment with two antiretroviral drugs before exposure to HIV may significantly reduce the risk of acquiring the infection. Specifically, pre-exposure prophylactic (PrEP) regimen of tenofovir and emtricitabine has the potential to substantially reduce the lifetime risk of HIV transmission in high-risk populations, a new study indicates.

While the strategy is “unlikely to confer sufficient benefits to justify the current costs of tenofovir-emtricitabine,” the researchers say, it could become cost-effective if prices were lower or efficacy higher.

A multicenter team, led by Dr. David Paltiel of Yale School of Medicine in New Haven, Connecticut, performed a computer simulation of HIV transmission, detection and care to assess the efficacy and the cost of the PrEP regimen of tenofovir and emtricitabine among men who have sex with men and who are at high risk of HIV infection. 

The average patient age as 34 years and high risk was defined as a 1.6 percent average annual incidence of HIV infection. The researchers defined acceptable PrEP efficacy as 50 percent. The monthly cost of the tenofovir-emtricitabine regimen was estimated to be $753.

“PrEP reduced lifetime HIV infection risk from 44 percent to 25 percent and increased average life expectancy from 39.9 to 40.7 years, Paltiel and colleagues report in the current issue of Clinical Infectious Diseases.

The average lifetime treatment costs increased from $81,100 to $232,700, the investigators estimate, “indicating an incremental cost-effectiveness ratio of $298,000 per quality-adjusted life-year gained.”

Still, Paltiel told Reuters Health, “We find that even small improvements in efficacy, pricing, and targeting to a younger, higher-risk population would make PrEP as cost-effective as many other widely accepted public health and medical interventions.”

He continued, “I don’t think anybody believes that PrEP is ready for prime time. We’re still in the research phase. But there are significant policy steps to be taken today.” These include making sure ongoing PrEP efficacy trials succeed, and planning what to do with the trial data.

Overall, Paltiel concluded, “In the face of the many recent disappointments PrEP shows promise as a strategy that could help contain the epidemic.”

SOURCE: Clinical Infectious Diseases, March 15, 2009.

RELATED STORIES:
FDA Advisory Panel Approves Home HIV Test Kit   FDA Approves New In-Home HIV Test   Home HIV test advances   Survey Reveals Support for Over-the Counter HIV Testing   F.D.A. Panel Weighs Preventive Use of H.I.V. Drug   Stem Cell Therapy Shows Promise in Fight Against HIV   Progress against HIV thwarted by patients’ unmet needs   California to test pill for HIV prevention   Mechanism of HIV spread has potential for future drug therapy   Seeking HIV treatment clues in the neem tree   HIV Prevention Pill’s Value Varies by Target   Using AIDS drugs to prevent infection: a bargain?

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]