Pill that may be able to prevent HIV

leonidas83

http://www.nydailynews.com/life-style/health/scientists-founded-pill-appears-safe-effective-prevention-hiv-works-a-daily-basis-stresses-scientists-article-1.1074505

Daily HIV pill Truvada can help healthy people avoid contracting the virus that causes AIDS

FDA to decide if the pill should be approved for people who are at high risk of contracting disease

Federal drug regulators on Tuesday affirmed landmark study results showing that a popular HIV-fighting pill can also help healthy people avoid contracting the virus that causes AIDS in the first place. While the pill appears safe and effective for prevention, scientists stressed that it only works when taken on a daily basis.

The Food and Drug Administration will hold a meeting Thursday to discuss whether Truvada should be approved for people who are at risks of contracting HIV through sexual intercourse. The agency's positive review posted Tuesday suggests the daily pill will become the first drug approved to prevent HIV infection in high-risk patients.
FDA reviewers conclude that taking Truvada pre-emptively could spare patients "infection with a serious and life-threatening illness that requires lifelong treatment."
Despite the positive results, reviewers said that patients must be diligent about taking the pill every day. Adherence to the medication was less than perfect in clinical trials, and reviewers said that patients in the real world may forget to take their medication even more than those in clinical studies.
First announced in 2010, Truvada's preventive ability was hailed as a breakthrough in the 30-year campaign against the AIDS epidemic. A three-year study found that daily doses cut the risk of infection in healthy gay and bisexual men by 44 percent, when accompanied by condoms and counseling. Another study found that Truvada reduced infection by 75 percent in heterosexual couples in which one partner was HIV infected and the other was not.

Sounds great on paper, hopefully this pill will become a realistic option for people at high risk from HIV. Getting it up the sh** pipe need not to be a worry anymore for peeps

Augmerson

Who'd take it? Actors in the porn industry?

galwayrush

Cyanide would be pretty effective as well..

Bluesphere

yes! €5 ride off a junkie here i come!

hatrickpatrick

In before "NO!!! We will NOT STAND for this! You're interfering in God's will to punish sodomites and unmarried fornicators!!!!!" -- The Catholic Church

bnt

And, of course, the people who need it the most - such as women in sub-Saharan Africa - won't be able to afford the $30+ per day that it costs. The article also suggests that women may need a higher dosage for it to work on them.

seamus

Chris Rock was right!

Pushtrak

Considering

1) How many people currently have HIV.
2) How many people are really going to take a daily dose, with the costs associated for something the majority will assume they'd never contract.

I'd rather see more in the treatment camp than this. I know, there is that whole prevention is better than cure, but in this form... You just know these drugs will be very expensive, and I really can't see people en masse taking this as if it were some vitamin.

Still, though, not to be a naysayer, any progress towards finding cures (treatments) are good things. In fact, my naysayer attitude may be actually excessively naysayer. It may be that such constant treatments are about as good as we are likely to get. I say this because I'd actually like to hear opinions on the subject.

Jester252

10% of anglo saxon men are immune to HIV
rooster teeth

The Irish Riddler

44% less likely when used in conjunction with condoms

special k helps lose weight in conjunction with a healthy balanced diet

pr1cks

Stinicker

HIV/Aids is not a worry once you have a bit of sense and practice safe sex and use condoms. Herpes and Warts now they are two dirty doses that I'd like to see science get working on ASAP. HIV is killing millions in the developing world and actually doing humanity a favour if you want to take a very dim darwinist type view on it.

Overthrow

Stinicker wrote: »

HIV/Aids is not a worry once you have a bit of sense and practice safe sex and use condoms. Herpes and Warts now they are two dirty doses that I'd like to see science get working on ASAP. HIV is killing millions in the developing world and actually doing humanity a favour if you want to take a very dim darwinist type view on it.

Herpes isn't a big deal at all. 25% of adults have it.

Chuck Stone

It's weird.

Surely it would be cheaper to give high risk people free condoms and/or clean needles if they taking drugs intravenously?

I don't get it.

Chamone MF

Stinicker wrote: »

HIV/Aids is not a worry once you have a bit of sense and practice safe sex and use condoms. Herpes and Warts now they are two dirty doses that I'd like to see science get working on ASAP. HIV is killing millions in the developing world and actually doing humanity a favour if you want to take a very dim darwinist type view on it.

Thats the ironic tragedy about it, life is damn cruel sometimes.
Africa is a fked up continent and thats also where aids is at its worst.
Finding a cure would just mean more children living a life in squalid poverty and THEN dying rather than just not surviving birth.
And population would shoot up in barely civilized countries.

1ZRed

44% less likely when used in conjunction with condoms/Quote]

Just 44%. I'm going to be wrapping it up regardless so why would I care to pay €30 a day?
44% would not entice me to bareback!
Dat butt secs be whay too riskay girrr!:p

Giselle

Pushtrak wrote: »

I'd rather see more in the treatment camp than this.

Treatment for HIV is excellent. Very few Westerners with access to the correct meds will go on to develop Aids, and most will have a near-normal life expectancy.

The poor sods in the developing world face a much, much, grimmer future though.

The treatment is there, its the cost of that treatment thats the major issue.

RichieC

Does it bring Freddie back? no. complete bollocks.

Giselle

RichieC wrote: »

Does it bring Freddie back? no. complete bollocks.

Freddie wouldn't be coming back no matter what he died from.

RichieC

Giselle wrote: »

Freddie wouldn't be coming back no matter what he died from.

:mad:

The Irish Riddler

The best form of protection is absintince.

Being pale and ginger is helpful also.

1ZRed

The Irish Riddler wrote: »

The best form of protection is absintince.

Not entirely sure about that...

smellslikeshoes

I guess maybe the implication of this is less about what this pill can do currently to prevent it and more about what going in this direction could possibly do in the future. Maybe in 10 years they will have improved on percentage chance of infection, maybe in 20 they will have made a dose once every year possible etc.

Giselle

1ZRed wrote: »

Not entirely sure about that...
http://www.google.ie/search?tbm=isch&source=mog&hl=en&gl=ie&client=safari&tab=wi&q=abstinence%2099.9%20effective&sa=N&biw=320&bih=416#i=5

The Virgin Mary was HIV+?

So thats two big cover ups the Church is responsible for.

RichieC

The Irish Riddler wrote: »

The best form of protection is absintince.

Being pale and ginger is helpful also.

Yea, and starvation is the best protection against food poisoning.

LH Pathe

Please, no there'll be an outbreak of scatmunchers god gave us aids for a reason.. well; gave you lot aids.

Jesus Wept

bnt wrote: »

And, of course, the people who need it the most - such as women in sub-Saharan Africa - won't be able to afford the $30+ per day that it costs. The article also suggests that women may need a higher dosage for it to work on them.

They need education mostly, a lot of them just don't wear condoms because they think condoms give you aids.

Christ on a bike.

mickgotsick

Andy Carroll wrote: »

They need education mostly, a lot of them just don't wear condoms because they think condoms give you aids.

Christ on a bike.

I thought it was more Christ on his bike going around telling them not to use condoms?

Cianos

Chamone MF wrote: »

Thats the ironic tragedy about it, life is damn cruel sometimes.
Africa is a fked up continent and thats also where aids is at its worst.
Finding a cure would just mean more children living a life in squalid poverty and THEN dying rather than just not surviving birth.
And population would shoot up in barely civilized countries.

This isn't true. Poverty, disease and population (over)growth are all interlinked. Removing one does not mean the others will continue along the same trajectory they were going in beforehand. Poverty stricken people tend to have more children, people are poorer where disease is rampant. If the population was healthier, education would shoot up in value, peoples overall quality of life and prospects would improve, the population growth would slow down, not speed up.

edit: To follow, people shouldn't be reluctant towards 3rd world aid because of the idea of the population exploding if it were healthier. Many people seem to actually view it this way and it's very simplistic. Africa is very capable of being a food surplus continent with correct infrastructure etc.

Pushtrak

Pushtrak wrote: »

1) How many people currently have HIV.
2) How many people are really going to take a daily dose, with the costs associated for something the majority will assume they'd never contract.

I'd rather see more in the treatment camp than this. I know, there is that whole prevention is better than cure, but in this form... You just know these drugs will be very expensive, and I really can't see people en masse taking this as if it were some vitamin.

Well as it's already been said there is more in the treatment camp than this (in fact meds aside I heard about a possible cure - there was an example of a HIV+ person getting a bone marrow transplant from a HIV immune person and they were cured completely - obviously this isn't a viable cure though, and even if it was, it's hardly suitable for clinical trials).

It's true, this is hardly going to become commonplace in developing countries, but consider a situation in the developed world where one person in a couple was HIV+ and the other was clear, I'm sure they'd be willing to pay the expense and be as vigilant as possible taking it. Or what about the possibilities for pregnant women who are HIV positive, it must have some applications there.

bnt

Cianos wrote: »

edit: To follow, people shouldn't be reluctant towards 3rd world aid because of the idea of the population exploding if it were healthier. Many people seem to actually view it this way and it's very simplistic. Africa is very capable of being a food surplus continent with correct infrastructure etc.

For more on this idea, folks should read a bit about Demographic Transition theory: the way improvements in people's economic status have been correlated* with lower birth rates. Different parts of the world are at different stages. The theory is evolving to include recent birth rate increases in Ireland and some European countries, and there are exceptions such as France, which never had the kind of population boom Ireland had before the Famine.

One reason I mentioned women in sub-Saharan Africa is that, in many cases, they are genuine victims in the HIV crisis. They might want to practice safe sex with condoms, but it's often the men who refuse to cooperate and use force to get what they want. There's also a lot of superstition and wishful thinking on the topic e.g. some bright male spark came up with the idea that having unprotected sex with a virgin would cure his AIDS. Result: two people with HIV instead of one.

When I read about the pill, that's the first thing I thought of, since women could take the pills without risk or reprisals. However, the cost means that, even if they were given out, they would be sold rather than taken.

* remember: correlation is not causation.

Nothingbetter2d

Augmerson wrote: »

Who'd take it? Actors in the porn industry?

Porn stars

Junkies using needles

Blood Transfusion / Organ Recipient Patients

Staff in Prisons/Hospitals

Aid Workers in High Risk countries

Chamone MF

Chamone MF wrote: »

Thats the ironic tragedy about it, life is damn cruel sometimes.
Africa is a fked up continent and thats also where aids is at its worst.
Finding a cure would just mean more children living a life in squalid poverty and THEN dying rather than just not surviving birth.
And population would shoot up in barely civilized countries.

Cianos wrote: »

This isn't true. Poverty, disease and population (over)growth are all interlinked. Removing one does not mean the others will continue along the same trajectory they were going in beforehand. Poverty stricken people tend to have more children, people are poorer where disease is rampant. If the population was healthier, education would shoot up in value, peoples overall quality of life and prospects would improve, the population growth would slow down, not speed up.

edit: To follow, people shouldn't be reluctant towards 3rd world aid because of the idea of the population exploding if it were healthier. Many people seem to actually view it this way and it's very simplistic. Africa is very capable of being a food surplus continent with correct infrastructure etc.

Whats not true?

Africa is a fked up continent (true)

and thats also where aids is at its worst (true)

Finding a cure would just mean more children living a life in squalid poverty

[ more would survive/not die as there would be a cure and a cure would mean less deaths, they'd live a life in poverty, and procreate and then die later] .......(true)

And population would shoot up in barely civilized countries. (true)

[there would be more people around due to less people dying ....who would in turn have children]

given the high rate at which kids die of aids in African countries this would be a 'shoot/leap up'. (Obviously true)

opinion guy

true-or-false wrote: »

Well as it's already been said there is more in the treatment camp than this (in fact meds aside I heard about a possible cure - there was an example of a HIV+ person getting a bone marrow transplant from a HIV immune person and they were cured completely - obviously this isn't a viable cure though, and even if it was, it's hardly suitable for clinical trials).

Why is this obviously not a viable cure and why is it not suitable for clinical trials ?

They do this kind of thing all the time in leukemia patients. In fact the reason this guy got the bone marrow transplant was that they had cancer of some sort.

seamus

Even with rampant disease, population control is still an issue in "barely civilised" countries. They're a lot like Ireland of 80+ years ago where mothers would have so many children, they would commonly list how many they've had in terms of:
1. Pregnancies
2. Born alive
3. Currently Alive

Curing aids would barely make any difference to population growth in developing nations because it currently well outstrips the death rate as it is. You also have to consider that in many cases a child/parent who has contracted aids likely exists in the lowest socio-economic grouping and so if they weren't killed by AIDS, they stand a fairly strong chance of being killed by something else.

Curing AIDS is far from a panacea, but neither is the syndrome itself any kind of effective population control mechanism or Darwinian necessity. If AIDS could be tackled easily and cheaply, it frees up resources to deal with other problems.

The primary issue with Africa is not necessarily disease, poverty or education. It's primarily that the countries most suffering with these issues can't climb out of them because they're being run by corrupt despot dictators (like Mugabe) who maintain a stupid population to avoid losing power, or because there is basically no effective government and much of the country is run by warlords and militias, who again have no interest in anything but their own power.

Stiffler2

How does one actually spell hiv ?

opinion guy

opinion guy wrote: »

Why is this obviously not a viable cure and why is it not suitable for clinical trials ?

They do this kind of thing all the time in leukemia patients. In fact the reason this guy got the bone marrow transplant was that they had cancer of some sort.

Well I can't say I'm in any way qualified to comment, so take this with a pinch of salt, I might be wrong.

A bone marrow transplant is a big thing to commit to, it's not like giving blood, it's quite invasive. You would need to find a match that is both a viable marrow match but also HIV immune, which is a small percentage of people of a certain genetic background (if I remember right it's mainly europeans, and it's also a recessive gene so you need two copies, and also I think I heard it's dying out too). So the pool of donors is small, far smaller than a regular bone marrow transplant, which itself is usually quite difficult to manage, usually it's a family member.

Now considering AIDS is most common in Africa, and the immunity gene is most common in Europe, and the fact that most bone marrow transplants are between family members, it seems far-fetched to think that we could find corresponding donor-patient pairs on any sort of scale to perform enough trials to make a definitive conclusion, never mind offering it as a cure on a substantial scale. Adding to that the fact that not all carriers of both sets of the gene would be willing to participate, how would they manage it?

Even if you tested the bone marrow of every person in Europe, the eventual pool of willing matches would be small. If it managed to get past trial, I'm sure that family members or friends of HIV positive people would be willing to be tested, but it would be like looking for a needle in a haystack.

I'd be surprised if there isn't a huge number of people researching a way to make it work though, and for all I know there have been advances in the bone marrow approach since the discovery.

opinion guy

true-or-false wrote: »

Well I can't say I'm in any way qualified to comment, so take this with a pinch of salt, I might be wrong.

A bone marrow transplant is a big thing to commit to, it's not like giving blood, it's quite invasive. You would need to find a match that is both a viable marrow match but also HIV immune, which is a small percentage of people of a certain genetic background (if I remember right it's mainly europeans, and it's also a recessive gene so you need two copies, and also I think I heard it's dying out too). So the pool of donors is small, far smaller than a regular bone marrow transplant, which itself is usually quite difficult to manage, usually it's a family member.

Now considering AIDS is most common in Africa, and the immunity gene is most common in Europe, and the fact that most bone marrow transplants are between family members, it seems far-fetched to think that we could find corresponding donor-patient pairs on any sort of scale to perform enough trials to make a definitive conclusion, never mind offering it as a cure on a substantial scale. Adding to that the fact that not all carriers of both sets of the gene would be willing to participate, how would they manage it?

Even if you tested the bone marrow of every person in Europe, the eventual pool of willing matches would be small. If it managed to get past trial, I'm sure that family members or friends of HIV positive people would be willing to be tested, but it would be like looking for a needle in a haystack.

I'd be surprised if there isn't a huge number of people researching a way to make it work though, and for all I know there have been advances in the bone marrow approach since the discovery.

It doesn't require a HIV immunity gene - with a bone marrow transplant such as this you completely wipe out the recipients immune system and marrow stem cells. Therefore you eradicate HIV from there body - along with their immune system. You then give them new immune system with the bone marrow transplant. All it requires is that the donor doesn't have HIV. Of course there are complications and side effects. I suppose it is more risky than taking pills. And you are correct in saying finding donors is a challenge.

cartell_best

Why not the old fashioned way? Use protection? stop the infection!

1ZRed

The thing with HIV is that it's so unstable as a virus. If I remember correctly the virus uses two different types of proteins to 'break into' a cell and change its function. The only reason why the HIV medication works is because it inhibits just one of these proteins but not the other. The latter being very random and so, near impossible to find an inhibitor for it because it keeps replicating its self but it does it wrong nearly all the time so its ever changing (Similar to the flu virus) This is why HIV in these people seldom develops into AIDS but isn't cured either.
A while ago scientists sent out a protein simulator and asked gamers to try and build the HIV virus and after a few weeks someone managed to do it. This could lead to a HIV cure in about 15-20 years because they now might know its fundamental structure.
It's still going to be a push to cure it but in a way, the scientists are half way there already. Its just that no major breakthrough has been made since the 90s.

But all of this doesn't matter to these Africans because up or down, they won't see the cure for years and years even if we got it tomorrow.

1ZRed

cartell_best wrote: »

Why not the old fashioned way? Use protection? stop the infection!

I completely agree!:)

opinion guy

opinion guy wrote: »

It doesn't require a HIV immunity gene - with a bone marrow transplant such as this you completely wipe out the recipients immune system and marrow stem cells. Therefore you eradicate HIV from there body - along with their immune system. You then give them new immune system with the bone marrow transplant. All it requires is that the donor doesn't have HIV.

Are you sure? I thought it was only ever the one accidental case where a person who had gotten a transplant had been cured of HIV and on further inspection they found that the donor was immune?

Edit: Actually, I read it in the Metro Herald a year or two ago, so I'll take your word for it..

opinion guy

true-or-false wrote: »

Are you sure? I thought it was only ever the one accidental case where a person who had gotten a transplant had been cured of HIV and on further inspection they found that the donor was immune?

Edit: Actually, I read it in the Metro Herald a year or two ago, so I'll take your word for it..

Well you may be right:
http://www.foxnews.com/health/2010/12/14/doctors-claim-hiv-positive-man-cured-stem-cell-transplant/

I hadn't heard that detail before. i shall see if I can track down the case report

seamus

opinion guy wrote: »

It doesn't require a HIV immunity gene - with a bone marrow transplant such as this you completely wipe out the recipients immune system and marrow stem cells. Therefore you eradicate HIV from there body - along with their immune system. You then give them new immune system with the bone marrow transplant. All it requires is that the donor doesn't have HIV. Of course there are complications and side effects. I suppose it is more risky than taking pills. And you are correct in saying finding donors is a challenge.

HIV attaches to host lymphocytes which are continually present in the blood stream. Replacing the bone marrow will have the short-term effect of destroying the immune system because no new white blood cells are produced, but as the donor marrow replaces the white blood cells, they will just be cross-contaminated by the existing infected lymphocytes. There is no effective way to "clean" someone's blood of the infected white blood cells before performing the transplant.

The case you're referring to was a marrow transplant from an HIV-immune donor. This was still exceptionally risky and probably wouldn't have been undertaken if the patient didn't also have leukaemia.

opinion guy

opinion guy wrote: »

Well you may be right:
http://www.foxnews.com/health/2010/12/14/doctors-claim-hiv-positive-man-cured-stem-cell-transplant/

I hadn't heard that detail before. i shall see if I can track down the case report

From what it says here, the donor had the two copies of the immunity gene, but the transplant would have killed most of the virus and using an immune donor was more of a "let's see what happens if we try this". It then goes on to say that actually it was a miracle it worked at all, and that for a while he was in a coma because of it.

http://blogs.scientificamerican.com/guest-blog/2011/08/10/the-berlin-patient-may-not-be-the-answer-as-hiv-research-progresses-toward-a-cure/

opinion guy

I found the guys website - the patient I mean.

Well worth a read:
http://timothyrbrown.com/

Chamone MF

seamus wrote: »

Even with rampant disease, population control is still an issue in "barely civilised" countries. ...Yes it is, but thats entirely beside the point. This is like saying 'I have a sore back now, but hey, my back was sore a week ago anyway'.

Curing aids would barely make any difference to population growth in developing nations because it currently well outstrips the death rate as it is. - What? I think you'll find those numbers add up to a substantial total.

You also have to consider that in many cases a child/parent who has contracted aids likely exists in the lowest socio-economic grouping and so if they weren't killed by AIDS, they stand a fairly strong chance of being killed by something else.

Yes...cruel irony. (sound familiar) They'd live in squalid poverty and procreate and THEN die.

Curing AIDS is far from a panacea, but neither is the syndrome itself any kind of effective population control mechanism or Darwinian necessity. If AIDS could be tackled easily and cheaply, it frees up resources to deal with other problems. hmm, Problems like an inevitable spike in population for example?

In any case, its a no win cruel situation, if they don't die young from aids they get to live a sht life in poverty and then die having endured a life of hardship and will likely taken the time to introduce some poor newborn to the same rotten existence.

I call a place where walking tens of kilometers under the risk of death to get some water "barely civilised". What do you call it? High quality lifestyle?