Drug tested for HIV prevention in Baltimore

As effective vaccines against HIV remain elusive, Johns Hopkins researchers have completed the first tests to see if a drug already used to treat HIV infection might one day be used to prevent sexual and blood-borne transmission of the virus that causes AIDS.

Reported in the March 7 issue of the journal AIDS (available online now), the 12-week study of nevirapine in Baltimore is believed to be the first in the United States to evaluate a pre-exposure, drug-based prevention strategy for adults at high risk, say the researchers. Previous strategies have focused on behavioral changes such as condom use and clean needles.

"This is a new concept for prevention of HIV infection," says J. Brooks Jackson, M.D., M.B.A., director of pathology and leader of the study. "A combination of drugs is used to treat HIV infection, but we want to see if long-term, low doses of one of these drugs can prevent new HIV infections in people at high risk. HIV infection rates are fairly steady in the United States, but skyrocketing elsewhere. We can't afford to wait for a vaccine."

When taken twice a day, nevirapine is one part of routine anti-retroviral therapy to keep HIV infection from resulting in AIDS. In small, one-time-only doses, the Johns Hopkins researchers already have proven -- overseas -- that nevirapine cuts in half the risk an HIV-infected mother will pass the virus to her baby during childbirth.

The new study tested the safety of three different doses of nevirapine all just a fraction of the treatment dose in 33 people at high risk of contracting HIV because of sexual practices or injection drug use. No serious adverse side effects related to nevirapine were seen in any participants, and none contracted HIV during the study period, the scientists report.

"This study wasn't designed to test whether nevirapine could in fact prevent HIV transmission, but it would have been bad for the future of this effort if we'd detected

Contact: Joanna Downer
Johns Hopkins Medical Institutions

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