HIV PREVENTION TRIAL

This month the NHS will expand a trial of a controversial drug, which is hoped will represent a turning point in combatting the spread of HIV in the UK. With over 6,000 new diagnoses in 2015 alone and a predicted 101,200 people in the UK living with the disease, HIV/AIDS has been a major public health concern for over 30 years. The wider introduction of a new treatment, branded as Truvada, could hopefully reverse the trend.

 

A “transformative preventative medication”

Known medically as a pre-exposure prophylaxis treatment (PrEP), Truvada functions by preventing the HIV virus from replicating once it enters the body. This means that, even if a person comes into contact with the virus, it is unable to spread throughout the body and become permanent. Consequently, when taken as a daily pill, trials showed a decrease in the likelihood of contracting HIV by up to 92%.

 

Nationwide Trial

Over the next three years, 10,000 patients deemed at high risk of contracting HIV will be prescribed the treatment. Starting this month in clinics in London, Brighton, Manchester, Liverpool and Sheffield, the trial will expand nationally by April 2018. Scotland has already pledged to make the treatment publically available and Wales is conducting its own trial.

A small trial has already occurred in London showing promising results. Focusing on men who have sex with men (MSM), a known high-risk group, the study found a 32% decrease in new diagnoses across London and an 86% reduction for those involved in the trial. This occurred despite a 50% increase in the number of visits to the clinics.

This represented a significant change, labelled the “first downturn” in AIDS infections in the UK. For the five preceding years, new diagnoses in London had remained constant at around 900 but fell to 595 during the study.

 

Cost-effectiveness

Critics have raised questions over whether Truvada is a worthwhile use of NHS resources. In order to gain the maximum protection the pill must be taken daily. At £11.85 per pill, the three-year trial is expected to cost approximately £10million.

This cost could then increase to up to £20million a year to protect all those most at risk of contracting HIV.

However, aside from the ethical implications of denying preventative treatment to a large number of people, there is also a financial argument for introducing the drug. The lifetime cost of treating an HIV patient is approximately £360,000. With over 100,000 people in the UK already living with the virus and the infection rate having remained constant or increased in recent years, current treatments are also costly and have failed to limit the spread.

In addition, one study found that always using a condom (usually referred to as one of the most effective and cheapest forms of prevention) only prevented the spread of HIV 71% of the time in MSM groups and 80% in heterosexual partners.

Consequently, the forthcoming trial of an effective preventative treatment brings much cause for optimism.

Check out the NHS website for more information: www.nhs.uk/Conditions/HIV/