HIV drugs may help protect women

By Maggie Fox, Health and Science Correspondent

TORONTO (Reuters) – Doctors are finding new uses for HIV
drugs, with one study showing they might safely protect women
at high risk of infection and a second showing that people can
safely skip the most toxic pills.

Research to be presented at the 16th International
Conference on AIDS, which opens on Sunday, shows new benefits
from drugs that help suppress the fatal and incurable virus.

The human immunodeficiency virus that causes AIDS infects
close to 39 million people globally. Since the virus started
spreading globally in the 1980s it has killed 25 million people
and orphaned millions more.

There is no vaccine and no cure. Only condoms and complete
sexual abstinence have been shown to prevent infection.

Family Health International tested an experimental approach
called pre-exposure prophylaxis or PrEP using a drug called
tenofovir. Researchers believe the drug, made by the
California-based Gilead Sciences Inc. under the brand name
Viread, could keep healthy people from getting HIV.

The researchers gave either the pill or a placebo to 936
high-risk women in Cameroon, Ghana and Nigeria.

They were not able to tell if the pills actually prevented
infection with the AIDS virus but tested the women’s kidney and
liver function to make sure taking the drugs was safe. They
also wanted to see if the women would take the drugs
consistently.

“The encouraging news was in regard to safety,
acceptability

and risk,” Ward Cates, who helped lead the study, said in a
telephone interview.

One worry was that the women would feel protected by the
drug and would fail to use condoms, or have sex more often. But
this did not happen during the trial, Cate said.

The women, all recruited because they were sex workers, or
had sex frequently with different men, all got counseling and
condoms at every visit.

Several women got pregnant — at a rate of about 40 per 100
women per year — suggesting that the women did not always use
condoms, Cate noted.

“In general, access to condoms is limited in many of these
resource-poor settings,” Cates said.

“This approach is not intended for people who are in the
general population but only for people in very high-risk
settings for whom no other HIV prevention approach is
available.”

SAFER COMBINATIONS

In some countries, HIV drug cocktails can keep patients
healthy. There are more than 20 drugs available now and it is
not always clear which combination is best. Some drugs cause
more side-effects than others.

A team led by Dr. Sharon Riddler of the University of
Pittsburgh School of Medicine at the University of Pittsburgh
tested some of the combinations to see if patients could skip
the oldest class of HIV medications, called nucleoside reverse
transcriptase inhibitors, also known as NRTIs or “nukes.”

They can cause intolerable side effects in some patients,
ranging from diarrhea to hepatitis.

Their test of 753 volunteers at 55 centers showed that
using two drugs in the NRTI class with a drug called efavirenz,
a non-nucleoside reverse transcriptase inhibitor, suppressed
the virus in more people than a more widely used combination.

“Now that we’ve completed the trial, there should be little
doubt that patients can benefit from this ‘nuke’-sparing
treatment regimen when NRTI side effects are a problem,” Ridley
said in a statement. For more stories related to the
International AIDS Conference, please go to

http://today.reuters.com/news/globalcoverage.aspx?type=aids&src=

GLOBALCOVERAGE_wire)