From Dennis Thompson
TUESDAY, 11 June 2019 (HealthDay News) – According to a highly influential panel of experts, a daily pill that can block the transmission of HIV should be prescribed to people at high risk of developing the AIDS-causing virus.
The treatment – called pre-exposure prophylaxis (PrEP) – has proven to be very effective in preventing HIV spread in clinical trials, a study of the burden of proof by the U.S. Preventive Services Task Force (USPSTF) concluded.
The task force gave PrEP its advice at the highest level, an A-score, which means that the potential benefit of the treatment is considerable and is supported by strong medical evidence.
The drug, better known as the two drugs combopil Truvada (emtricitabine-tenofovir), prevents HIV from causing a permanent infection in people exposed through sex or using injection drugs, according to the US Centers for Disease Control and Prevention.
"Although HIV is not as often in the media as it used to be, it is still a major public health problem in the US, with nearly 40,000 people getting HIV every year," said USPSTF president. Doug Owens. "These are pretty effective interventions that can help reduce new HIV infections."
An estimated 1.1 million people in the United States are living with HIV and more than 700,000 have died of AIDS since the first cases were reported in 1981, the Task Force said.
The class A recommendation should increase the insurance coverage of the expensive medication and get it into the hands of those who need it, experts said.
The USPSTF regularly publishes evidence-based guidelines on preventive health practices, and the Affordable Care Act (also known as "Obamacare") requires insurance companies to take preventative measures that receive strong recommendations for working groups.
"We have seen first-hand at our clinics how the scaling up of PrEP can dramatically lower the rates of new HIV infections and improve the quality of life for those who have access to this intervention," said Dr. Antonio Urbina. He is associate professor of infectious diseases at the Icahn School of Medicine on Mount Sinai in New York City.
"In addition to an almost perfect protection against HIV, PrEP is a good gateway for young adults to access preventive and primary care services," Urbina added.
With the "daring" recommendation from the task force, "the elusive goal of ending the HIV epidemic in the US now seems possible," Urbina said.
But obstacles remain. The only drug approved by the US Food and Drug Administration for PrEP, Truvada, currently costs $ 20,000 a year, Dr. said. Rochelle Walensky, a specialist in infectious diseases at the Massachusetts General Hospital in Boston.
"The real challenge with PrEP is not how well it works once you've got it," Walensky said. "We know it is more than 90% effective in people taking the medicine."
Instead, people who should take PrEP are faced with a number of barriers, not the least of which are the costs, she said.
"The challenge with PrEP & # 39; s value in HIV prevention is the number of people coming in and getting it, the number of prescribers willing and able and knowledgeable to give it, and the ability of people to take it reliably once they've prescribed it, "said Walensky.
The task force emphasized that PrEP is not for everyone. Groups with a high risk of HIV infection who should be on PrEP include:
- Men who have sex with other men and have a relationship with a HIV positive person; who use inconsistent condoms; or who have had a sexually transmitted disease in the past six months.
- Heterosexual women or men whose sex partner is HIV positive; who use condoms that are inconsistent with a partner whose HIV status is unknown; or who have contracted syphilis or gonorrhea in the past six months.
- People who inject drugs and regularly share needles.
PrEP recipes are usually written in the Northeast and the West, & we also know that the epidemic is in the South & Walensky said.
Southern states are the least likely to have extended Medicaid under Obamacare, preventing access for many insureds, and people with high HIV risk in the South also face social stigma when looking for PrEP, she added.
"This is really a bold and wonderful step forward that should be welcomed, but I don't think we can disappoint a guard at all to say that this will be the answer," said Walensky. "It probably doesn't do all the hard work for the patients who need it the most."
The recommendation for the task force was published online on 11 June in the Journal of the American Medical Association.
Copyright © 2019 HealthDay. All rights reserved.
SOURCES: Doug Owens, M.D., M.S., Chairman, U.S. Pat. Preventive Services Task Force; Antonio Urbina, MD, associate professor of infectious diseases, Icahn School of Medicine at Mount Sinai, New York City; Rochelle Walensky, M.D., M.P.H., infectious disease specialist and co-director, Medical Practice Evaluation Center, Massachusetts General Hospital, Boston; June 11, 2019, Journal of the American Medical Association, online
Means to stay good
. (tagsToTranslate) American expert panel supports HIV prevention pill for people at high risk