By Alex Distefano
This week, the International AIDS Conference met in Washington, D.C., where thousands of scientists, philanthropists, politicians, lobbyists, researchers, activists, medical doctors and individuals living with the disease gathered to discuss the current world wide state of affairs of the epidemic that has killed over 30 million people.
Obviously, funding for research and treatment for both developed and Third World countries was a huge topic at the meeting. “The U.S. is committed and will remain committed to achieving an AIDS-free generation,” Secretary of State Hillary Clinton said during a speech on the first day at the conference.
Just two weeks ago, the FDA announced the approval of a new preventative treatment, using an already existing medication, for those not infected with the human immunodeficiency virus (HIV). The medication—trade name Truvada—is intended to prevent transmission of the virus and is being hailed as a landmark by many in the field of AIDS research.
“Truvada is actually a combination of two medications called tenofovir (TDF) and emtricitabine (FTC),” Dr. Cameron Kaiser, interim public health officer for the Riverside County Department of Public Health, tells the Weekly. “Both drugs are part of a class of medications called NRTIs [nucleotide reverse transcriptase inhibitors], which act as bogus raw materials to one of the enzymes of the HIV virus when it attempts to replicate. By interfering with the virus’ ability to replicate, this reduces the chance that the infection can take hold.”
This drug combo has been approved since 2004 as a treatment for those already infected with the HIV virus, and is often part of a “cocktail” of drugs that HIV patients take. But this is the first time the treatment has been approved for use on those who have not yet been infected with HIV, a treatment called pre-exposure prophylaxis, or PrEP. A medical study that led to FDA approval concluded that the risk of transmission among homosexual males decreased more than 40 percent when Truvada was used. The study also revealed a decrease by more than 70 percent in risk of transmission among heterosexual couples in which one person was infected with HIV, while the other was not.
However, Kaiser is quick to warn that this is not a cure-all and should not be treated as such when it comes to fighting the spread of HIV/AIDS, especially in high-risk patients.
“There is always the risk that people perceive any preventative medicine as a ‘magic pill,’” Kaiser says. “Truvada is not a magic pill, and there is a concern that people may let their guard down while taking it. At this time it is not possible to say what long-term ramifications this will have, so it is important for us as a health department to make these concerns known to the public as quickly as possible.”
In other words: Don’t retire the condoms just yet.
Kaiser stresses the importance of practicing safe se and getting tested regularly.
“The FDA, as well as myself and this department, regard Truvada as only part of a comprehensive HIV prevention strategy,” he says. Safe sex practices such as condoms and regular HIV testing remain the most important ways people can reduce their risk of contracting HIV.”
Not everyone thinks Truvada is great news.
Michael Weinstein, president of the AIDS Healthcare Foundation, a global organization involved in providing treatment to AIDS/HIV patients, criticizes the treatment of non-infected individuals as a detriment to efforts to slow down the AIDS epidemic and prevent more infections. Weinstein warns of the possibility of drug-resistant strains of HIV, and noted that Truvada’s side effects (harm to bones and kidneys, for example) might be worth the risk in people who are already infected, but not those who are otherwise healthy individuals.
“Today marks a catastrophe in the history of AIDS in America,” Weinstein told ABC News.
Kaiser also echoed Weinstein’s cautioning of Truvada’s potential side effects.
“Like any medication, the risks and benefits of Truvada prophylaxis as part of a comprehensive HIV risk reduction plan, including safer sex practices, need to be evaluated for every individual who is considering taking it,” he says.