ARV: Treatment as prevention

In 2007, the government of Botswana and the U.S. Center for Disease Control and Prevention launched a clinical trial to evaluate if the drug Truvada and antiretroviral (ARV) therapy could prevent HIV infection among healthy adults who were at risk of acquiring the disease.

The idea behind the study didn’t come completely out of left field. Researchers already knew that giving ARV treatment to monkeys before exposing them to SIV (the monkey version of HIV) protected most monkeys against infections. Furthermore, researchers and health workers had success in reducing HIV transmission in infants when they gave ARVs to newborns exposed to the disease. 

Now, in the days leading up to the 6th International AIDS Society conference on HIV Pathegonesis, Treatment, and Prevention (IAS 2011), the BOTUSA study as well as another study, Partners PrEP, have been released. Each evaluates using ARV treatment as prevention. The studies cite that high active antiretroviral therapy (HAART) goes beyond the realm of treatment; it prevents the transmission of AIDS. The new studies show that the use of antiretorival drugs by uninfected people to prevent HIV infection can cut the risk of HIV acquisition by between 62 and 78 percent. 

Providing ARVs to uninfected individuals prior to HIV exposure, or pre exposure prophylaxis (PrEP), made headlines in November of 2010 when an IPrEX study revealed that ARV treatment could be used to prevent transmission in men who have sex with men. This is the first evidence that PrEP works in heterosexuals.
“Today’s news is encouraging and provides clear evidence that PrEP can substantially reduce the risk of HIV infection,” said Dr. Rajiv Shah, Administator of USAID. “The next step is to determine how these scientific findings can be put to use in real world settings.” 

Further details about the studies will be released at the IAS conference which will be held in Rome from July 17-20.