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IPREX pre-exposure prophyaxis study results

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Gus Cairns
Member
Posts: 257
IPREX pre-exposure prophyaxis study results
Posted on: November 23 2010, 02:28 pm

Taking HIV drugs prevents HIV - IF you take them.

Bottom-line finding was that Truvada reduced HIV infections is a group of HIV-negative gay men by 44%, even though only 50% of them actually took the pills they were supposed to.

http://www.aidsmap.com/news/Anti-HIV-drugs-prevent-HIV-infection-trial-shows-if-you-take-them/page/1553857/

In a nutsehell:
44% efficacy, lower bound of confidence interval 15%
Three different measures of adherence
1) by pill count alone: if over 90% adherence then 74% efficacy, but no efficacy if under this figure
2) By pill count and self report: If adherence over 50%, then 50% efficacy, but no efficacy if under this figure
3) Participants CLAIMED c. 90% adherence BUT drug level monitoring in a sample suggested only 50% adherence.  If you assume that true adherence was 50% then, as Bob Grant said, 50% would be the MAXIMUM efficacy we could get: therefore after adjustment the ‘true’ efficacy with 100% adherence would be in the 92% - 95% range
So there’s 2 major stories:
1) PREP works better even than the animal models suggested (NB the higher-risk men had better adherence and results than the lower-risk men)
2) Getting people to adhere will be really hard, and this is what the rollover study will concentrate on.

Gus

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