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Thousands of New HIV Infections could be Prevented over Next 20 Years with Once-a-Week Capsule


Photo By Michael Moloney via Shutterstock

 

It would soon be easier for HIV patients to stick to their strict schedule of dosing for the drug cocktails they take to fight the virus. Massachusetts Institute of Technology researchers developed a capsule that a patient has to take only once a week to deliver the week’s worth of HIV medication in one dose.

The drug will gradually release throughout the week. It could also be taken by people at risk of HIV exposure to help prevent them from being infected. The weekly pill will help solve one of the main barriers to the treatment and prevention of HIV which is adherence.

Clinical trial

Also contributing to the study are researchers from Brigham and Women’s Hospital and Lyndra, Giovanni Traverso, a research affiliate at MIT’s Koch Institute for Integrative Cancer Research, said. Lyndra was launched to develop the technology and is now working to hold a clinical trial that will deliver the system.

The capsule has a star-shaped structure with six arms which can be loaded with drugs. It is folded inward and encased in a smooth coating. When the capsule is swallowed, the arms will unfold and gradually release its load. Traverso said it is like placing a pillbox in a capsule in which there are chambers for every day of the week on a single capsule.

The system was initially used to deliver ivermectin, a malaria drug. It can remain in the stomach for up to two weeks. The researchers adapted the capsule to deliver HIV medication. They tested it on pigs and found that the capsule successfully lodged in the stomach and released three different HIV drugs over one week. After the release of the entire drug, the capsule disintegrates into smaller components which can pass through the digestive tract.

There are several large clinical trials that evaluated if antiretroviral drugs can prevent healthy people from being infected with HIV. But the trials have mixed success, and researchers identified the difficulty of making people take the necessary pills daily as a major obstacle to preventive treatment.

By shifting from a daily dose to weekly dose, scientists expect to improve the efficacy of HIV preventive treatment by about 20 percent. They incorporated the figure into a computer model of HIV transmission in South Africa which showed that 200,000 to 800,000 new infections could be prevented over the next 20 years.

New HIV vaccine study

It was in South Africa where an HIV vaccine was tested and targeted to enroll several thousands of participants, Live Science reported. The research is the first in seven years to test how effective a vaccine is against HIV, according to the National Institutes of Health which funded the study.

South Africa was chosen as a pilot area because over 1,000 people acquire HIV daily. The last time an HIV vaccine was tested was in 2003 in Thailand. They found it effective by 31 percent at preventing HIV infection over 3.5 years. The one tested in South Africa was similar to the one tried in Thailand, but it was modified to provide greater and longer-lasting protection.

The NIH said it wanted to enroll 5,400 sexually active men and women ages 13 to 35 who are not HIV infected. The results of the trial are expected to be out in 2020.

Stop the HIV/AIDS pandemic

Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease, said that a longer-acting, less invasive oral formulation could be one vital part of their future arsenal to stop the HIV/AIDS pandemic.

He pointed out that progress has been substantially made to advance antiretroviral therapies that enable a person who has HIV to enjoy a nearly normal lifespan and reduce the risk of acquiring HIV. But failure to adhere to daily therapeutics for people who are infected with the virus and pre-exposure prophylaxis for uninfected but at-risk people remain a key challenge. 

Fauci said that new and improved tools for HIV treatment and prevention and a wider implementation of novel and existing approaches are needed to end the HIV pandemic. Studies like the one held by MIT and BWH help in moving closer to reaching the goal.

The researchers are now working to adapt the technology to other ailments that could benefit from the weekly drug dosing. Kirtane said that putting other drugs onto the system is significantly easier because the core system remains the same. All they need to do is to change how slowly or quickly the cargo will be released.

Meanwhile, IOL reported that another HIV study was launched on Wednesday in East London. The focus of the research is HIV prevalence in transgender women in South Africa. The Human Sciences Research Council will lead the integrated biological and behavioral survey, initiated by the US Centers for Disease Control and Prevention. The study will be held in Cape Town, Johannesburg, and Buffalo City Metro in the Eastern Cape in the latter part of January.


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