A Shot Taken Every 2 Months Could Prevent HIV

August 20, 2020

In a large clinical trial, an HIV-prevention shot outperformed a prescription drug usually taken for the same purpose, The New York Times reported.

The injectable drug, taken once every two months, could provide an “attractive new option” for HIV prevention, compared to having to be taken daily, Dr. Monica Gandhi, a researcher at the University of California, San Francisco, told the Times.

Currently, pharmaceutical company Gilead Sciences makes the only two HIV prevention pills on the market, Truvada and Descovy. pills offer what’s called pre-exposure prophylaxis (PrEP), meaning a person taking it to prevent infection should they become exposed to HIV. But PrEP pills must be taken daily to keep blood levels of the drug high enough to block the virus, according to the U.S. Centers for Disease Control and Prevention (CDC). Taking PrEP pills daily can reduce the chance of contracting HIV by about 99 percent – but that’s only if people stick to a daily regimen.

Truvada and Descovy also carry a high price tag, which could limit widespread use of PrEP, especially in poorer countries, according to the New York Times. Without insurance, a 30-day supply of any of the pills can cost between $1,600 and $2,000, though some people qualify for the drugs for free or at reduced cost in the U.S., the PBS NewsHour reported.

But soon, people may be able to choose a new injectable drug called cabotegravir to protect themselves from HIV. According to the Times, a large clinical trial showed that the needle was about 66 percent more effective than Truvada in preventing HIV infection in real-life situations. The findings presented at the AIDS 2020 virtual conference were “revolutionary,” Harvard researcher Dr. Rochelle Walensky told The New York Times.

The trial was conducted by a scientific collaboration called the HIV Prevention Trials Network, which included nearly 4,600 same-sex men who have sex with men and transgender women from seven different countries. According to the New York Times, ViiV Healthcare, the pharmaceutical company that developed cabotegravir, ensured that at least half of the participants from the United States were black men who have sex with men, representing the group most affected by HIV/AIDS in the country.

The trial had two groups: one group received cabotegravir and the other took Truvada. the study was blinded, so those in the Truvada group got a placebo injection, while those in the cabotegravir group took a placebo pill, and neither the participants nor the trial conductor knew who was getting what, according to ClinicalTrials. gov. while 13 participants who received cabotegravir were infected with HIV and 39 who took Truvada were infected.

In addition, in a sample of 372 people who took Truvada, blood tests showed that only 75 percent continued to take the pills. Cabotegravir is still relatively effective in preventing infections when compared to only those who took Truvada exactly as prescribed. While cabotegravir still requires patients to stick to a schedule, Gandhi suggested that health care providers could offer only short appointment slots for the shots, which could also be given at a pharmacy or from a mobile van, according to the Times.

Cabotegravir is also being tested among women in sub-Saharan Africa, but it will take longer to recruit participants, according to the Times. The drug has not yet been tested in transgender men.

If cabotegravir is approved by the U.S. Food and Drug Administration in the next year or two, the drug could compete with a generic version of Truvada, which is expected to be launched in 2021, Walensky noted. With that in mind, ViiV Healthcare should set their prices very low, as rival drugs are likely to get cheaper, she said.

“Having another pharma company in the PrEP portfolio is exciting,” Walensky told the Times.” It will create competition and ideally drive costs down.”