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Pre-exposure prophylaxis does work for women, two studies find
Gus Cairns, 2011-07-19 00:50:00
Two studies of the use of oral pre-exposure prophylaxis (PrEP) in heterosexual people show that oral PrEP will protect women against HIV.
The 6th International AIDS Society Conference in Rome heard the additional data from two trials of pre-exposure prophylaxis in heterosexuals yesterday. First results from these trials, the Partners PrEP trial and the TDF2 trial, were announced on Wednesday, 13 July. This was when the placebo arm of the Partners trial was closed well in advance of the planned ending date as it was realised that there were many more infections in this arm than in people taking antiretroviral PrEP.
The new data on PrEP in men and women were keenly anticipated because another study of PrEP in women, FEM-PrEP, had closed recently after finding zero efficacy for Truvada, and it had been theorised that oral PrEP might not work for women because drug concentrations in the genital tract were too low.
The results of the TDF2 trial were planned to be announced at the IAS conference, but in the event were released at the same time as the Partners PrEP results, while a special session was convened at the conference to include more data from both studies.
The Partners study compared tenofovir and tenofovir/FTC (Truvada) versus placebo as PrEP in serodiscordant couples (one person HIV-positive, one negative) in Kenya and Uganda, while the TDF2 study compared Truvada versus placebo in heterosexual men and women in Botswana.
In brief, the Partners study found that tenofovir had an efficacy of 62% in preventing HIV infection and Truvada an efficacy of 73%; there was no statistical difference between the efficacy of Truvada and tenofovir. In the TDF2 study, Truvada had an efficacy of 63%, but was 78% efficacious in patients who had last received study drugs less than a month ago and who therefore had pills available.
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