Since the first Covid-19 case was reported in Wuhan, China, researchers from around the world have been working to find an elixir that will end the global pandemic. Although much attention seems to have been turned to the new coronavirus, scientists have made great strides in the fight against another gigantic disease: HIV and AIDS.
In the past few months, the world has marked three important milestones in preventing and treating a disease that has infected approximately 38 million people worldwide.
1. The vaginal ring
The use of oral pre-exposure prophylaxis (PrEp) tablets, the female condom and safe sex practices have, for decades, been the only options to protect women and girls from the risk of HIV infection.
Women and girls of reproductive age are generally more at risk of infection, with this population accounting for 60 percent of total infections in sub-Saharan countries.
Insert the Dapivirine Vaginal Ring (DPV-VR), the first HIV prevention option of its kind made for women since the female condom was approved almost 30 years ago. The flexible self-applied ring is made of silicone and is easy to bend and insert into the vagina. Once inside, he slowly releases an antiretroviral (ARV) medication called dapivirine into the vagina over time.
“DPV-VR is intended to be used to reduce the risk of acquiring HIV during vaginal sex for women 18 years of age or older who are most at risk for HIV, in combination with safe sex practices when pre-exposure prophylaxis oral (PrEP) is not used, cannot be used or is not available ”, says the World Health Organization.
2. Injectable PrEP
A historical study conducted in seven African countries, including Kenya, found that women taking injections of a drug called Cabotegravir had 89% less HIV infections than those taking daily PrEP pills. Although several studies have demonstrated the effectiveness of oral PrEP when taken as prescribed, the biggest challenge has been adherence to daily pills.
PrEP allows people to reduce the risk of becoming infected with HIV, especially during the periods of greatest risk in their lives. The new drug that will be injected once a month allows for discretion and helps discordant couples, sex workers and other populations at risk to overcome the social barriers that come with HIV.
Kenyans, however, will have to wait to receive the injection.
“It will certainly take some time before it is available in Sub-Saharan Africa, but the expectation is that it will be free, just like oral PrEP,” said Dr. Peter Cherutich, a public health expert.
3. monthly vaccine for HIV patients
The US Food and Drug Administration has approved a monthly injectable drug. The new drug – Cabenuva – is composed of Cabotegravir and Rilpivirine, which will only be administered to adults with suppressed viral load and who have no history of therapeutic failure.
Two studies involving about 1,100 patients from 16 countries found that the vaccine was as effective as daily pills in suppressing HIV over a 48-week study period. The injectable consists of two injections in the buttocks.
The monthly injection will remove the burden associated with taking daily pills, along with the discomfort of carrying medicine everywhere. It will also be a relief for patients who hide when using drugs due to the stigma associated with HIV.
Meanwhile, a phase one clinical trial testing a new vaccine approach to prevent HIV has produced promising results, showing success in stimulating the production of rare immune cells needed to start the process of generating antibodies to the rapidly mutating virus.
The study by IAVI and Scripps Research sets the stage for further clinical trials to create a safe and effective HIV vaccine.