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UCLA researchers suggest unconventional approach to control HIV epidemics
Date:12/7/2011

A new weapon has emerged to prevent HIV infection. Called pre-exposure prophylaxis, or PrEP, it is a strategy of providing medications to at-risk people before they are exposed to the virus. Having shown great promise in recent phase 3 clinical trials, PrEP may soon be rolled out for public use.

Because PrEP is based on the same drugs used to treat HIV-infected individuals, the big public health fear is that the dual use of these drugs will lead to skyrocketing levels of drug resistance. But in a new study, UCLA researchers say the exact opposite is likely to happen.

Sally Blower, director of the UCLA Center for Biomedical Modeling and a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues used sophisticated computer modeling to determine that a PrEP prevention program used alone, or current HIV treatment programs used alone, could indeed, separately, increase drug resistance. But if used together, the researchers say, resistance is likely to decrease.

Their findings appear in the current online edition of the peer-reviewed journal Scientific Reports, published by Nature Publishing Group.

"This was a very big surprise," said Blower, the study's senior author. "We found that this counterintuitive effect will only occur if adherence to the PrEP prevention program, where individuals have to take a daily pill, is very high. This counterintuitive effect occurs when the beneficial effect of PrEP in preventing infections is so great that it overcomes both its own detrimental effect on increasing resistance and the detrimental effect of current HIV treatments on increasing resistance."

Africa is ground zero for HIV and AIDS, a continent where the death rate is simply "awful," Blower said. Since the country of Botswana was one of the sites for the PrEP drug trial, Blower and her colleagues chose it for their modeling. Botswana has the best health care system in Africa, th
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Contact: Mark Wheeler
mwheeler@mednet.ucla.edu
310-794-2265
University of California - Los Angeles
Source:Eurekalert

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