Real World Evidence Shows Antiretroviral Treatment Reduces HIV Transmission
A “real world” HIV drug study in China has confirmed the value that antiretroviral (ARV) pharmaceuticals offer HIV-positive patients and their uninfected partners.
The project, recently reported in the Lancet, studied 24,000 Chinese couples, half of which had received ARV medication, and highlighted that a tangible impact could be seen from such treatment. The real world study confirmed that ARV therapy for HIV-positive patients living with uninfected partners reduced HIV transmission rates across China. The authors believe this means that such an approach is a viable public health prevention strategy that could potentially be developed at a national level.
Clinical trials have previously shown a potential for the use of such pharmaceuticals and that ARV treatment can significantly reduce the rate of transmission. However latest studies, a perfect example of "real world evidence" in action, have boosted findings and potentially opened the door for public health programmes to take place on a major scale.
Whilst the impact was less than seen in the clinical trials, it was still significant enough to be of value. The report states: “We calculated a 26% relative reduction in HIV transmission in the treated cohort. The reduction in transmission was seen across almost all demographic subgroups and was significant in the first year, and among couples in which the HIV-positive partner had been infected by blood or plasma transfusion or heterosexual intercourse, but not among couples in which the HIV-positive partner was infected by injecting drugs.” The clinical trials showed a difference of 89%.
The World Health Organization (WHO) believes that whilst the number of new HIV infections and fatalities from related illnesses are slowing down, the levels are still too high with 2.5 million new infections in 2011. As a result there is an urgent need for effective pharmaceuticals.
WHO’s focus is now on ensuring the 7.5 million people who require ARV treatment can get this medication and that improving availability of these drugs is the solution to cutting rates further. The WHO has set a target of providing 15 million HIV-infected people with ARV by 2015.
Dr Gottfried Hirnschall, Director of the World Health Organization’s HIV Department, believes that the focus must be on ensuring full access to ARV treatment for HIV sufferers: “The challenge now is to ensure that global progress is mirrored at all levels and in all places so that people, whoever they are and wherever they live, can obtain antiretroviral therapy when they need it.”
As a result of this latest research the WHO is recommending that ARV therapy is given to HIV-positive partners, regardless of the strength of the immune system, to “reduce the likelihood of HIV transmission to the uninfected partner.” This has important implications for the pharma industry to continue “real world trials” and to ensure ARV therapy is readily available on a global scale.