New Orleans ranks third among U.S. cities in HIV case rates, according to the most recent National HIV Surveillance report from the Centers for Disease Control and Prevention (CDC). However, New Orleans also is the site of research for a promising new drug that could prevent HIV infections. The Tulane National Primate Research Center, GlaxoSmithKline, ViiV Healthcare and the Aaron Diamond AIDS Research Center collaborated on a study of the new drug. Dr. Rudolf Bohm, associate director and chief veterinary medical officer at the Tulane National Primate Research Center, discusses the drug and its implications.
What is this new drug?
It is an injectable formulation and is related to an approved antiviral drug. This drug is highly protein-bound, which means it stays in circulation longer. There are similar, related drugs on the market that are shorter-acting.
What were the results of the study?
We found that we could prevent infection in 100 percent of animals receiving the drug. These findings demonstrate that individuals in high-risk populations could receive an injection of this drug once every three months, achieving blood levels of the drug that prevented the animals in our study from becoming infected. This study could have a significant impact on the approach to the prevention of new HIV infections.
So essentially, a person would get a shot every three months and be protected from HIV. What makes the new drug different from related drugs on the market?
There are a number of oral medications used to treat HIV infections, and usually they need to be dosed at least once a day or several times a day. Missed doses decrease efficacy, or the ability to prevent infection. The drug we tested would improve adherence, since it is an injectable form that would be administered once every three months. While one would have to see a health care provider for the injections, our thoughts are that compliance will improve.
Would you expect to see fewer new cases of HIV?
Our hypothesis is that a longer-acting antiviral drug that decreases the frequency of dosing will increase adherence, thereby increasing efficacy in preventing HIV infection. In 2012, there were a reported 2.3 million new cases of HIV infection around the world. The use of this long-acting drug formulation or similar drugs could have a significant impact in reducing new infections.
When would this new drug be available?
That's a difficult question, because Phase 2 clinical trials in humans have not yet begun and the drug approval process is complicated. I can't comment on that with any certainty. It could take a couple years or more. All we know is that the drug will be going into Phase 2 clinical trials. It seems to be a very safe drug in the human trials that have been done up to this point.
New Orleans is an epicenter of the AIDS/HIV epidemic. How could this drug benefit our population in particular?
Because the New Orleans area has a high rate of new infections, our population is likely to benefit from this drug (being) used as pre-exposure prophylaxis when it goes on the market. Any population in an area where the rate of new infections is high would see a benefit. Those who are already infected may benefit indirectly from the resulting increased knowledge of how these drugs work and from development of more effective compounds that not only prevent infection, but also treat existing infections.