Is there 'magic pill' to prevent HIV?

Houston advocates believe positives outweigh drug's drawbacks

By Robert Arnold - Investigative Reporter

HOUSTON - The Food and Drug Administration is considering a final decision of a breakthrough drug to prevent HIV. If approved, for the first time a medicine would be used to prevent people from contracting the virus that causes AIDS.

"What the FDA is considering is that we might actually get to a place where we are ending HIV," said Nike Blue, director of preventive services with AIDS Foundation Houston

Yes, Blue said ending HIV. 

The drug is named Truvada. It's made by Gilead Sciences.

Blue said he believes Truvada could be a game-changer in keeping healthy people from contracting HIV and the misery of AIDS.

"I've lost many friends and even family to HIV," said Blue. "This drug is inspiring. It's amazing just seeing the look on the faces of those with HIV when they realize we're going to be getting to a place where there won't be any new infections because now we have enough tools in our toolbox to prevent HIV."

Truvada targets the areas of the body HIV infects and kills the virus before it starts. It's a pill patients must take once a day -- for life.

Blue said it would allow couples where one person is HIV positive, and the other isn't, to have unprotected sex.

"It's an opportunity for couples to have one more tool to continue loving their partner," said Blue. 

With Truvada, women with an HIV-positive partner could now get pregnant without a medical procedure. The preventative drug would also be targeted to men who have sex with other men. Prostitutes and drug addicts, who often spread HIV, could also benefit from the pill. It would also allow some women at-risk to take a preventative measure on their own and not rely on sex partners to use condoms.

"We're not talking about passing this out to young teens or young adults, but to the folks who are putting themselves at risk," said Blue. "For them, this may be their only means of protection."

While people who have HIV are living longer, the virus is still being spread at dangerous rates, including in Houston. The Centers for Disease Control and Prevention reports around 50,000 people nationwide get HIV every year. That number has stayed roughly the same for 15 years. 

Could Truvada be the key to dramatically changing that?

"It's not going to be the end to AIDS," said Dr. Tom Giordano, a physician at Baylor College of Medicine. "It's not a magic bullet. But it could improve the situation if it's used properly."

Giordano is also medical director of the Thomas Street Heath Center just north of downtown Houston. It's a Harris County Hospital District clinic devoted entirely to treating patients with HIV and AIDS. Thomas Street treats more than 5,000 HIV-positive patients and counting.

"This (Truvada) is the first potentially new tool to try and decrease the number of HIV-positive patients in a long time," Giordano said.

However, Giordano said Truvada isn't 100 percent effective. If it's not taken every day, it doesn't work.

One concern is that someone gets HIV while just periodically using the drug. That could lead to a more drug-resistant strain of HIV. Giordano said studies examining Truvada have looked at the concern. 

"Fortunately, there has not been much of a signal that people develop a resistant strain while they're taking this," Giordano said. "But it could be a serious concern." 

The other worry is once patients take the pill, they may quit doing all the other things to help stop the spread the virus --  like using condoms and limiting the number of sex partners.

Truvada isn't cheap. An estimated cost for a year's worth of treatment is $14,000. Giordano said the county clinic could receive discounts for its patients. Blue said accessibility could become another eventual concern.

While Truvada may not be the "magic bullet" to preventing HIV, both Giordano and Blue said, for certain people, the drug could become a powerful tool. 

"I see this as one tool in the tool box that already has a bunch of tools in it," Giordano said. "But we still need more, and there are more coming down the road."

The FDA is expected to announce its final decision on Truvada's approval in September.

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