Preventing the spread of HIV with a pill

Elizabeth Reddy, MD, leads Immune Health Services at Upstate. PHOTO BY SUSAN KAHN.

Elizabeth Reddy, MD, leads Immune Health Services at Upstate. PHOTO BY SUSAN KAHN.

Infectious-disease experts in the early 1980s were trying to make sense of clusters of gay men with unusual infections and failing immune systems. It was the beginning of the AIDS epidemic. Soon researchers identified the human immunodeficiency virus as responsible, and attention turned to finding a cure, or at least a vaccine.

Now, 35 years later, a pill exists that can halt the spread of HIV.

Truvada is a medication that is commonly paired with other medications to treat HIV infection. It is also being used — together with safe sex practices — to help reduce the risk of becoming infected. Used this way, the therapy is called pre-exposure prophylaxis, or PrEP.

“If people taking PrEP take the medicine regularly and it is detectable in their system, they have about a 90 percent reduction in acquisition of HIV. So it’s highly effective,” said Elizabeth Reddy, MD, medical director of Upstate’s Immune Health Services.

Just taking Truvada is not enough to protect someone from getting HIV, however. Condom use is important, as is limiting exposure by limiting the number of sex partners.

Gilead Sciences, the maker of Truvada, cautions that Truvada can cause serious liver problems, or a buildup of lactic acid in the blood, which would be a medical emergency. It can also worsen hepatitis B symptoms if a person suddenly stops taking Truvada. The medication can also cause kidney problems including kidney failure, bone problems that may make one prone to fractures, changes in body fat and changes to the immune system.

Reddy said that “for the most part, Truvada is extremely well tolerated. It has no side effects in most people.” Most side effects, including headache, abdominal pain and decreased weight, subside within a few weeks.

Truvada is designed for people who are healthy, uninfected, free of kidney disease and at high risk for HIV transmission. Those at highest risk in America are young men having sex with men, Reddy said.

With the proportion of new HIV infections in the United States increasing. Reddy said infectious disease experts believe Truvada is a crucial new weapon in the public health arsenal. If its use can reduce the number of people who become infected, we may finally begin to see the end of the epidemic.

How to obtain Truvada

Upstate’s  Immune Health Services is prepared to prescribe Truvada. Call 315-464-5533 for an appointment. Also, some primary care doctors in Central New York will prescribe the drug.

Before a person receives pre-exposure prophylaxis, a blood test must confirm that they are not infected with HIV. People taking Truvada for prevention are supposed to be tested regularly for HIV and other sexually transmitted diseases, which can increase a person’s risk for HIV.

Hear Reddy’s radio interview about Truvada. This article appears in the spring 2015 issue of Upstate Health magazine.

 

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