June 12th, 2013
06:01 PM ET
Antiviral drugs help prevent HIV infection in IV drug users
Treating intravenous drug users with antiviral drugs may reduce their chances of HIV infection, according to a new study published Wednesday in the British medical journal The Lancet.
The Bangkok Tenofovir Study was done in Bangkok, Thailand, from 2005-2013. It was run by the Centers for Disease Control and Prevention in collaboration with the Thailand Ministry of Public Health.
Researchers recruited more than 24,000 people at 17 sites. Half took the pill tenofovir - an antiretroviral drug - daily, while the other half got a placebo. Participants were followed for about four years. Researchers found those taking the drug cut their chances of infection by 49% almost in half - approximately 49%.
This is not the first study to prove that PrEP - pre-exposure prophylaxis - is effective in reducing HIV transmission in high risk groups. Studies have already been done in heterosexuals as well as gay and bisexual men. But according to the CDC, this is the first study of its kind to prove effective in reducing rates among those who inject drugs.
“This study completes the picture of PrEP efficacy for all major HIV risk groups," said Dr. Michael Martin, chief of clinical research for the Thailand Ministry of Public Health-CDC collaboration. "We now know that pre-exposure prophylaxis can be a potentially vital option for HIV prevention in people at very high risk for infection, whether through sexual transmission or injecting drug use.”
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said, "The real important advance here is the proof of concept that in yet another high risk group - IV-drug users - pre-exposure prophylaxis can work if the individuals adhere to taking the drug."
The study found that the reduction rate for those who took their daily dose routinely was even higher - 74%.
“Adherence was a key factor determining efficacy in our trial among people who inject drugs, as it has been in previous PrEP trials examining sexual transmission,” said Martin. “These results underscore the importance of helping people using pre-exposure prophylaxis achieve effective levels of adherence.”
It can often be difficult to directly attribute the antiviral drug's protective effect on people who get infected by injecting drugs, said Salim Karim, professor and director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) at the University of KwaZulu-Natal in Durban, South Africa. That's because, he says, some IV drug users engage in risky behavior such as prostitution to support their drug habit.
“Even though questions remain about the extent to which PrEP can be effective in preventing either of the routes of transmission in this group, the overall result is that daily tenofovir does reduce HIV transmission in injecting drug users," Karim said. "The introduction of PrEP for HIV prevention in injecting drug users should be considered as an additional component to accompany other proven prevention strategies like needle exchange programmes, methadone programmes, promotion of safer sex and injecting practices, condoms, and HIV counseling and testing.”
UNAIDS, the Joint United Nations Programme on HIV/AIDS, called the study results a complement to other PrEP trials released over the past few years.
“Piece by piece, scientific advances are paving the way to the end of the AIDS epidemic,” said Michel Sidibé, UNAIDS executive director. “The full potential of antiretroviral therapy in keeping people alive and well and in preventing new HIV infections is becoming apparent. The results of this study are important, and if used effectively in HIV programming, could have a significant impact in protecting people who inject drugs from becoming infected with HIV.”
So far, all evidence suggests PrEP is safe and effective for reducing the risk of HIV infection in high-risk populations, and there have been no concerns regarding its use daily, the CDC says.
About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
Pills are not the answer.
There hasn't been a workable solution yet.
No, but cutting the infection RATE in high risk groups means they will not spread it as often to other groups (typically through sexual activity), thereby lowering the infection rate for every other group as well. It will also help those not at risk, by lowering the cost (in terms of medicine and lost productivity) of HIV infection in the general population – the net cost to the government for giving out free pills is probably very much in the black.
Not doing drugs is a workable solution.
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So drug users get HIV by using drugs (dumb) and sharing needles and syringes (dumber). So now we expect these Einsteins to go spend hundreds of dollars to take other shots to prevent the HIV that could have been prevented by just buying a 50 cent syringe?
I hope this study had some other purpose and benefit. Otherwise it should have been a victim of sequestration.
These drugs will be paid for by the taxpayer and distributed for free.
Once infected, paying for long-term HIV care is much more costly than prevention measures.
Why do we keep interfering with evolution?
unless you die in a car accident, you will likely being dying of some disease.... colon cancer, heart disease, TB...... One may argue all of that is for evolution. Doesn't mean we shouldn't try to help.
What about you then, for being so evil? We can genetically engineer out the bad genes from drug users. But I dunno if you're worth it.
The world has over 6 billion people. Most of them are trying to live productive lives. They help themselves, their families, their friends and their communities. Given that we have limited resources to help them, I see know reason to spend any of these resources on people who choose to use drugs and are stupid enough to share needles. No reason at all. Every dollar we spend on somebody who CHOSE to ruin his life is a dollar denied to someone who wants to make something of themselves.
You mourn for the drug addict. I mourn for the poor child who never had a chance because we wasted resources on those that choose to throw their lives away.
Let them die, survival of the fittest.
I bet that's why your kids never get vitamins or vaccines or antibiotics. After all, those treatments only serve to allow the weak to survive infection.
...or does 'survival of the fittest' only apply to undesirable groups? That is either lack of critical thinking on your part or hypocrisy – take your pick.
Why would you want to limit HIV among IV drug users?
Yes! People who I find morally objectionable deserve to get sick and die. I do not want to help, but only jeer as they perish in the gutter.
Because they can spread it to NON-USERS.
Maybe your daughter/sister/mother/brother etc. will have sex with a drug user someday, with or without knowledge of their drug use. With this treatment perhaps the user won't have HIV and thus give it to someone you DO give a dam about.
Do you ever think things through or just jump to biased conclusions?
Ummmm, because IV drug users don't live on a secluded planet away from the rest of society. They interact with others in society, hence spreading the disease around. IV drug users aren't just junkies sleeping in their own p e e in dark alleys. They're people who have friends, possibly girlfriends/boyfriends or kids. They're people who interact in society on a daily basis heightening the risk of others getting the disease through some of their actions. And some of them even manage to kick the drug habit and become better people and productive members of society again. Do you want your next drug-rehabilitated coworker to be HIV positive?? Stop being so selfish and superior.
I hope one day all of you will experience the sheeer BLISS that is intravenous drug use. Meth, heroin, ketamine, etc. If you've got it, put it in a needle and slam it!
It is so gratifying that we will be able to help the drug user to continue sharing needles while preventing the transmission of a deadly disease. I don't suppose that this discovery will help those who contract HIV through no fault of their own.
Just like providing Viagra to prison inmates. Stiffen their tool so they can bonk each other. Medical science marches on.
That's just it! It very well could "help those who contract HIV through no fault of their own", as I explained in a couple comments above yours. But for your benefit I'll cut & paste...
Maybe your daughter/sister/mother/brother etc. will have sex with a drug user someday, with or without knowledge of their drug use. With this treatment perhaps the user won't have HIV and thus give it to someone you DO give a dam about.
Sounds to me like you guys could use some IV Heroin.
@ Edwin: You've got it. By definition, an undesirable is one the group doesn't want. Allowing nature to take it's course by removing the undesirables, their cohorts, sympathizers & enablers, means the group will eventally have to deal with fewer undesirables & less objectionable behavior – all without taking intervening action.
I love slamming heroin. No greater feeling in the world. All you people who are bashing drugs should just TRY it once, you'll change your tune.
Yeah and those withdrawals are probably the most wonderful feeling in the world too!
im rich. i dont get withdrawals, because i never run out of dope. its called an inheritance.
@ trilly3807: Maybe your mother/brother/sister should refrain from having indiscriminate sex without knowing their partners well, for long periods of time and without a indisoluable commitment.
I just did a big shot of heroin and fentanyl. I feel AMAZING.
@ trilly3807: Maybe your mother/brother/sister should refrain from having indiscriminate couplings without knowing their partners well, for long periods of time and without a indisoluable, divine commitment.
The world must make so much sense to you.
This pill is crap. As an HIV positive IV heroin user, one of my favorite things in life (besides mainlining dope) is spreading my infection and sharing needles with unsuspecting people. That gets me rock hard.
@ trilly3807: Maybe your mother/brother/sister should refrain from having indiscriminate couplings. People who are hetero, monogamous, faithful and discriminating in choice of life partners don't end up with this problem.
@ trilly3807: Maybe your mother, brother & sister should refrain from their current practices. People who are hetero, monogamous, faithful and discriminating in choice of life partners don't end up with this problem.
@ trilly3807: Maybe your mother, brother & sister should refrain from their current practices. People who are properly oriented, monogamous, faithful and discriminating in choice of life partners don't end up with this problem.
@ trilly3807: Maybe your mother, brother & sister should refrain from their current practices. People who are properly oriented, faithful and discriminating in choice of life partners don't end up with this problem.
How about we save the people who actually contribute to our society instead of junkies? HIV in junkies, does anybody really care?
how about you blow me?
Sorry, but we REALLY don't need to be finding ways to keep addicts alive. I just made a comment to a friend yesterday that drugs are obviously not that potent, these days. They simply aren't killing enough people.
In other news, has anybody had any luck with clip-on sunglasses? I tried a pair at Walgreen's yesterday but they seemed clunky and heavy.
great it would be nice to see a pill to stop cancer is useful humans that pay taxes not maintain a high risk life style!
"...reducing HIV transmission in high risk groups..." Drug dealers should dispense this medicine with their person-destroying substances. The longer the addict lives, the more money the drug dealer makes.
something some of you short sighted might be able to grab on to. Virus mutate all the time they recombine genetic traits and come back thousands of times faster than humans can evolve. This research could easily lead to understanding that may someday save the entire human race. Dont ever trade knowledge for prejudice its a bad bet.
what no celibate sober self righteous judgmental HIV negative high school graduates have any comments. Maybe if you could catch a deadly virus from drinking beer, it would be ok to develop a treatment.
Treat dem wid cyunide/
People, before you get your underwear all in a bundle, this was a *study* to test the effectiveness of this particular method of preventing HIV infection. And thank you to those who dared mention that these very addicts might be out there passing HIV infection to others who are unaware that they are IV drug users or perhaps to their babies through birth. So yes, you should really care even if you don't care about the addicts themselves (Rush Limbaugh, Brett Favre?, half the baseball hall of fame used IV drugs). This study was done to add to the body of knowledge of HIV prevention and treatment and was not solely done simply to treat IV drug users. Please, before you spit your flamin hot cheetos out of your nose, take some time to understand science.
bravo an IQ above room temperature. The flamin hot cheetos was priceless
Well, obviously Congress needs to ban that pill immediately! The last thing we want is for IV drug users to live any longer. They're supposed to get sick and die! That's how we make room for the new generation of drug users.
just replace the words drug user with consumers and you will have touched on the truth of modern society
what makes anyone think you can get an addict to pay for or take a pill even if it were free? why should we have to pay for this? it feels like we're enabling their reckless behavior. we can't fund schools well, we can't feel hungry kids, we can't fix the homeless problem but we're eager to help willful drug users who would shun societies demands they stop using and hurting us?
obviously you know nothing about addicts or addiction. your ignorance astounds me. go die.
Actually, we can fund schools well, and we can fix the homeless problem.
We just haven't been willing to live with the tax rates and diminished military spending those solutions would require.
supplying clean needles and make people aware of the risks of dirty needles is much cheaper.
supplying clean needles and at the same time make people aware of the dangers of used needles is much cheaper.
HIV is a disease/sickness that can mess up a Person in such ways that i reckon that, if you have a human heart you can weep even for a sworn enemy who is in the final stages of the disease. My Country Botswana experienced the devastation 1st hand in the early to mid nineties before the introduction of ARV's. The governmennt did a lot, it really fought hard. Unfortunately some of us Folks can be such unbelievable idiots!!! Imagine a Person whisked out of deaths door through the help of ARV's only for them to engage in risky behaviour further risking re-infection and spreading the virus! What do you do with such?
Sometimes i feel sad when you People behave and fight like wild souls. Talk without fighting please!
People will always do drugs. But stopping the spread of HIV is very important to global health. The cost of preventative action is far less than the care necessary for those who have already contracted HIV. Plus, no one deserves to die from such a horrible disease. Additionally, drug users aren't just the junkies you see begging for money on the streets. As someone who worked in a needle exchange program, drug users come from all walks of life. We had many rich, BMW driving white men coming in for exchanges. I think this is an excellent study and hopefully the results can be implemented into meaningful actions to help halt the spread of HIV around the world.
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