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Medicine Science

In New Study, HIV Prevention Pill Truvada Is 100% Effective 226

An anonymous reader writes: A study published in the journal Clinical Infectious Diseases details the recent trial of a drug named Truvada, which researchers think might excel at preventing HIV infections (abstract). The scientists administered the drug to 657 people at high risk for contracting HIV, including users of injected drugs. At the end of the study, every single subject was still free of the virus. This is encouraging news in the fight against AIDS, though it shouldn't be taken to mean the drug is perfectly effective. Since researchers can't ethically expose people to HIV, we don't know for sure that any of the subjects were definitely saved by the drug. Other studies have also had to be stopped because it was clear subjects who were on a placebo were suffering from noticeably higher rates of infection. Leaders in the fight against AIDS say this new study closes a "critical gap" in existing research by demonstrating that Truvada can work in real-world health programs.
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In New Study, HIV Prevention Pill Truvada Is 100% Effective

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  • by frank_adrian314159 ( 469671 ) on Friday September 04, 2015 @04:47PM (#50459637) Homepage

    How long until resistance is developed? Or how does this drug prevent it?

  • by quantaman ( 517394 ) on Friday September 04, 2015 @04:48PM (#50459639)

    The scientists administered the drug to 657 people at high risk for contracting HIV, including users of injected drugs. At the end of the study, every single subject was still free of the virus.

    Can anyone who can view more than the abstract tell me how many they would normally expect to contract HIV?

    • by quantaman ( 517394 ) on Friday September 04, 2015 @04:52PM (#50459659)

      The scientists administered the drug to 657 people at high risk for contracting HIV, including users of injected drugs. At the end of the study, every single subject was still free of the virus.

      Can anyone who can view more than the abstract tell me how many they would normally expect to contract HIV?

      Nevermind, buried in the NYT article:

      That amounts to 388 “person years” of observation.

      By contrast, in a 2014 clinical trial among gay men in England, participants who received a placebo instead of Truvada had nine infections for every 100 person years of observation, said Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases.

      So assuming similar populations 388 * 9 / 100 = ~35, of course I'm too lazy to compute the confidence intervals.

      • by Solandri ( 704621 ) on Friday September 04, 2015 @06:42PM (#50460201)
        At a 9% incidence rate (p=0.09), a 95% confidence interval would be 1.96 * sqrt( p*(1-p) / n ) = 1.96 * sqrt(.09*.91/388) = 0.02847, or 2.8%.

        So you would have expected 35 +/- 11 cases.

        A 99% confidence interval would be 3.7%, or 35 +/- 14.5 cases. So these are very promising results. Though converting 657 people to 388 person-years may be a bit suspect. Maybe HIV isn't detectable in some people after just a half year post-infection? And I'm not sure how the fact that a person can only be infected once skews the distribution (e.g. a sample of 2 people for 100 person-years has a maximum of 2 infections, while a sample of 200 people for 100 person-years has a maximum of 200 infections.)
  • by FizzyP ( 3891957 ) on Friday September 04, 2015 @04:57PM (#50459693)
    Yay! If we could squash HIV maybe we can finally stop using it as a weak excuse for circumcision. (Don't get me wrong, obviously HIV is a bigger problem than circumcision but it'd be a nice side effect)
  • by willworkforbeer ( 924558 ) on Friday September 04, 2015 @05:09PM (#50459739)
    100% of participants also did not get lap dances from a Kardashian.

    Causation, correlation, or conspiracy? Choose your own adventure.
    • by TWX ( 665546 )

      100% of participants also did not get lap dances from a Kardashian.

      We cannot be sure of that. In fact, if her highly public behavior is any indication of her private behavior, the odds may be better than anyone realizes, depending on the length of the study.

    • 100% of participants also did not get lap dances from a Kardashian.

      Causation, correlation, or conspiracy? Choose your own adventure.

      Or just good luck.

  • by jklovanc ( 1603149 ) on Friday September 04, 2015 @05:21PM (#50459799)

    Headline;

    In New Study, HIV Prevention Pill Truvada Is 100% Effective

    Summary;

    This is encouraging news in the fight against AIDS, though it shouldn't be taken to mean the drug is perfectly effective.

    Slashdot needs new editors.

    • Those statements aren't necessarily contradictory. The drug has been perfectly effective in the study - nobody who was on it got infected. At the same time this might not be sufficient to claim that the drug is perfectly effective in general. It's possible that the test group was just lucky or there are people for whom the drug won't work, but they didn't get into the test.

    • OK let me explain it for you:

      "In new study, pill is 100% effective"

      No one studied got HIV when taking the pill.

      "It's not perfectly effective"

      Just because it worked for those 650 people doesn't guarantee it would work for everyone always.

  • Great.

    Now, let's get mandated to be covered as preventative care, or at least part of the tier-1 formularies, under the ACA. As it is, many health care plans refuse to provide Truvada at all. Or, in some cases where they do, they ignore the FDA's approval and claim its use in PrEP to be "off-label" and classify it at their highest tier (non-preferred and brand-name) and highest co-pay; making it prohibitively expansive for many people.

    • Case in point, I just checked my own health plan's website, and if I wanted to go on Truvada, it would cost me $1762.61 for a 90-day supply.

      Rounding to make the math simple... $600 a month is a car payment, for a fairly expensive car. In some places, that could be an entire rent check or even mortgage payment. That's overtly extortionate for a life-saving preventative treatment. And I, at least, would have *some* coverage for it. According to drugs.com, retail pricing runs about $1500 per 30-days. That

      • Case in point, I just checked my own health plan's website, and if I wanted to go on Truvada, it would cost me $1762.61 for a 90-day supply.

        Rounding to make the math simple... $600 a month is a car payment, for a fairly expensive car. In some places, that could be an entire rent check or even mortgage payment. That's overtly extortionate for a life-saving preventative treatment. And I, at least, would have *some* coverage for it. According to drugs.com, retail pricing runs about $1500 per 30-days. That rises up to a C. Montgomery Burns level of inhumanity.

        Want to keep your luxury car, then spend $5 on a pack of condoms instead.

        • Want to keep your luxury car, then spend $5 on a pack of condoms instead.

          You don't have to buy a two year supply of them you insensitive clod!

      • When sold in Africa, or procured by other organizations, it can be acquired for about 24 cents per pill (International Drug Price Indicator Guide [msh.org]).

        Without getting into the dark world of drug pricing, it's clear that $18.58 a pill, which nearly a 75x markup, is probably a wee bit too high, particularly for a drug whose two components aren't exactly on the cutting edge of anti-retroviral therapies.

        • You are quoting prices where the patent has expired and a generic is available. Similar prices will be available in the United States when the patent expires in 2021.

      • I looked up the price and got $3978 for a 90-day supply. Which seems like a reasonable price when a new drug costs over one billion dollars to develop.

        http://www.manhattan-institute... [manhattan-institute.org]

        Rather than complaining about the drug companies you should be complaining about the high costs the FDA imposes on drug companies in order to obtain FDA approval.

        BTW, a generic will be available in 2021.

  • Does the US government have the means and the will to get this drug into the hands of all of the public. Is it cheap to make? We could eliminate AIDS in the US if this stuff works.
    • by BigDish ( 636009 )

      It already is. It has been approved by the CDC since May, 2014 for about a year as a preventive (for HIV) drug. I've actually been on it for about a year (I'm in the US).

  • ...sent another second-rate punishment to kill off all them gays. Poor ol' geezer appears to be losing his mojo.

    Either that or the ignorant morons who insisted AIDS was god's way of punishing homosexuals for being, um, homosexual, yet again proved to be full of shit.

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