An antiviral pill, consumed daily by thousands of men in Sydney and other parts of Australia, has led to a worldwide unprecedented reduction in new HIV infections, demonstrating that a more focused preventative approach is progress in ending the AIDS epidemic
Cases of HIV among gay and bisexual men fell nearly one third to the lowest since the beginning of the study to reduce the impact of the Truvada pill by Gilead Sciences Inc. on reducing the AIDS-causing virus in a large population to eat. The findings, released Thursday in the medical journal Lancet HIV, could pave the way for other states and countries to stop transmitting the virus with a treatment called PrEP.
"The speed of the decline seen in new HIV infections among gay and bisexual men is a world first," said study leader Andrew Grulich, head of HIV epidemiology and prevention at the Kirby Institute, University of New South Wales. "These numbers are the lowest since the beginning of HIV surveillance in 1
Advances in the fight against AIDS over the past 15 years have prompted UN member states to end the epidemic by 2030, globally falling to 1.8 million in 2017, from more than 3 million a year in most of the world 1990s. Although the study results do not suggest similar efficacy in heterosexual populations, they show that PrEP is "very cost-effective" in certain risk groups, Grulich said in a telephone interview.
New HIV infections occurred in 102 gay and bisexual men in the state of New South Wales in the first year of study compared with 149 infections in the 12 months prior.
"While we have been at least three or four years ago, the effectiveness of PrEP at an individual level has shown worldwide that policymakers are restraining the introduction of PrEP to some extent, as the impact on the population has not been demonstrated – and that's what they wanted we do, "said Grulich.
At the end of June, around 180,000 people in the US accepted Truvada for PrEP, said Robin L. Washington, Gilead's Chief Financial Officer, in a July teleconference.
The blue, oval pill is a fixed-dose combination of the drugs tenofovir, Disop Roxil and emtricitabine. Generic versions of Truvada from Mylan, Cipla and Teva Pharmaceutical Industries have made the drug available at a lower cost.
"We are seeing the beautiful steady growth of Truvada for the use of PrEP," said John F. Milligan, chief executive officer of Gilead's Morgan Stanley Global Health Care conference last month. Areas in the US where PrEP was most ingested have achieved some of the best reductions in HIV infection, he said.
"I am now more confident that policymakers are thinking very innovatively about how to increase access to PrEP," Milligan said. "So next year we'll be working on a number of things that could really increase the number of patients on PrEP and could do a great deal to prevent the infection, and of course, good for our business."