There are few positive stories about HIV, but Truvada is undoubtedly one of them. The once-a-day pill has been shown dramatically to reduce the rate of infection in those at the highest levels of risk of exposure to the virus. Final results from the latest study, called “Proud” and published this week in the medical journal The Lancet, show it cut infections among gay men judged at high risk by 86 per cent.
In a study in San Francisco, published two weeks ago, not a single person became infected among 600 high-risk individuals – mostly gay men – given the pill and followed for two-and-a-half years. The drug, providing “pre-exposure prophylaxis”, was 100 per cent effective.
Such findings have, quite rightly, been met with cheering at conferences. This pill marks a major breakthrough in the prevention of the disease which was a death sentence less than three decades ago. Now experts involved in the Lancet study, led by the highly respected Professor Sheena McCormack, of the Medical Research Council and University College London, say the NHS cannot afford to ignore the overwhelming evidence of the drug’s success.
A key concern has been that Truvada would become a “party drug”, used instead of condoms to prevent infection, thereby having the unwanted side-effect of increasing the risk of passing on other sexually transmitted infections. But this, it turns out, has not been the case – there was no significant increase in other STDs recorded during the Lancet trial.
Truvada currently costs £4,300 a year and it is estimated that one case of HIV could be prevented for every 13 men taking the prescription. Estimates suggest that, over 80 years, prescribing the drug to 7,000 men at highest risk – defined as those who have had unprotected sex with five partners in the past year – could save the NHS £500m. However, to be cost effective the price of Truvada must come down.
A decision on who should have access to the drug is expected from NHS England early next year. From both a human and financial perspective, it would be folly to miss this opportunity to roll back the epidemic.
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