In what could eventually become a milestone for HIV prevention, very preliminary tests of an implant containing a new drug suggest that it may protect against infection for a full year.
The research was described on Tuesday at an international AIDS conference in Mexico City.
New HIV prevention methods are desperately needed. About 75 million people have contracted the lethal virus since the AIDS epidemic began. Even now, about 1.7 million people are infected each year — despite decades of promotion of condoms and abstinence, and years of efforts to get people to take a daily pill that prevents infection.
“If — and I’m emphasising if — if it pans out in a larger trial that it delivers a level of drug that’s protective for a year, that would be a game-changer,” said Dr. Anthony S. Fauci, director of the National Institute for Allergy and Infectious Disease and a leading expert on AIDS.
Dr. Robert M. Grant, a researcher at the University of California, San Francisco, who led the landmark 2010 trial that proved that a daily pill could thwart HIV, said he had expected a breakthrough based on the powerful new drug used in the implant.
The device “seems ideal in many respects,” he added. “It can be removed if there are side effects or HIV infection.”
Merck’s innovation is to deliver its new antiretroviral drug, islatravir, with a proven technology long used for birth control: a matchstick-sized plastic rod inserted just under the skin of the upper arm that slowly releases tiny doses of the medication.
Many people at risk of HIV infection, particularly women in Africa, are desperate for prevention methods that are easier to use, and easier to conceal, than a bottle of pills.
Islatravir has “some remarkable attributes,” said Dr. Roy D. Baynes, Merck’s chief medical officer.
It is 10 times as potent as any previous HIV drug, he said, so tiny amounts are effective, which lowers the risk of side effects. The drug lingers in the body for a relatively long time — after five days, half of the dose remains — so it can be given less often that other HIV medications.
Unlike some HIV drugs, islatravir is absorbed into anal and genital tissues, which is where most infections start.
The Washington Post
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