Re: Bill Gates' AIDS Drug for HIV-negatives (3)
- Julian Meldrum, UK
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Liliana Argueta is asking questions that can only be answered through
properly designed clinical trials and are therefore, in fact, an argument
in favour of running such trials.
It is certain that tenofovir will have some side effects: the question is
whether the particular side effects of tenofovir will be acceptable to
HIV-negative people at risk of HIV when set against any benefit that may
emerge from taking the drug.
However, there is no evidence that tenofovir on its own causes either
lipodystrophy or neuropathy. A review of what IS known about tenofovir can
be read on www.aidsmap.com at:
http://www.aidsmap.com/treatments/ixdata/english/50889255-9630-4c55-a136-18f3409aef9e.htm
(this URL may need to be repaired before it will work in a browser).
There are three main reasons why tenofovir has emerged as a focus of
research on using an ARV to prevent transmission between adults.
Firstly, there is evidence from animal studies that it can prevent SIV or
HIV transmission. (This evidence is stronger than for other drugs currently
used for post-exposure prophylaxis.)
Secondly, that HIV resistance to tenofovir seems to depend on several
mutations - in contrast to nevirapine, where a single mutation can make a
virus resistant to both nevirapine and efavirenz.
Thirdly, that it appears to have very low levels of side effects compared
to other ARVs (see above).
It is also likely that the side effects of tenofovir, taken as a single
drug at a relatively low dose by people without HIV, will be different from
and less severe than the side effects when it is combined with other drugs
as treatment and used by people with medical problems in addition to HIV
itself.
I agree with Marge Berer that additional medical options are needed for HIV
prevention. It is good news that the Gates Foundation is prepared and able
to fund this, alongside equally important work on microbicides and
preventive vaccines.
Gilead, the company which is developing tenofovir, has promised tiered
pricing for its use in Africa and elsewhere (also reported on
www.aidsmap.com). It is to be hoped that the cost, if the drug proves
successful, can be further reduced as the scale of production increases.
Julian Meldrum
International Editor, www.aidsmap.com
E-mail: [EMAIL PROTECTED]
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"Ivinicus factus sum veritabem diceus." ( I have become an enemy for speaking the truth ) St Paul!
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Mitayo Potosi
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