Drug Reduces HIV In Men, New UNC-CH Study Shows

July 07, 1997

CHAPEL HILL -- Treating men infected with HIV, the virus that causes AIDS, with a drug called delavirdine and other antiretroviral medications cuts the amount of virus in semen and blood by about 90 percent, according to a new study. The virus became undetectable in some volunteers, and even a year after treatment, virus levels in patients remained roughly 50 percent below what they were before treatment, the research showed.

"This is the first prospective study that suggests we might be able to decrease the probability of transmission of HIV using antiretroviral drugs," said Dr. Bruce L. Gilliam, who led the research at the University of North Carolina at Chapel Hill.

"Because the AIDS virus doesn't transmit very well, in the United States it is thought that there is about one transmission for every 1,000 exposures, and we might be able to reduce that further."

Still, people should never rely on such treatment to avoid contracting or spreading the virus, he cautioned. Abstinence remains the best way to avoid the illness, and using condoms is second best.

Gilliam directed the investigation while a fellow in infectious diseases at the UNC-CH School of Medicine. He now is a research physician at the Henry M. Jackson Foundation for the Advancement of Military Medicine in Rockville, Md.

A report on the findings appears in the May 1 issue of the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, published today (Monday, July 7).

The study involved collecting semen and blood from 11 HIV-positive men before they were given what's called reverse transcriptase inhibitor therapy with delavirdine, zidovudine and didanosine. Researchers measured virus particles in those specimens and then counted them in new samples eight to 18 weeks after treatment began and again in five patients at least a year later. For comparison, the scientists also measured the AIDS virus in 11 men not receiving delavirdine and the other drugs or whose treatment had not changed for at least two months before the study started.

No significant change was observed in virus levels in the control group volunteers, who were monitored for up to 26 weeks. In the treatment group, however, levels dropped markedly, and in eight of the 11 subjects, HIV could not be detected at all. Similar results were found in blood samples.

"This study provides the first convincing evidence that reverse transcriptase inhibitor therapy effectively reduces shedding of HIV-1 in semen and may therefore reduce the spread of infection within populations," Gilliam said.

Besides Gilliam, UNC-CH authors include Drs. John R. Dyer, Susan Fiscus, Myron S. Cohen and Joseph J. Eron Jr. and registered nurse Cheryl Marcus. Other authors are Drs. Susan Zhou of the Jackson Foundation and Lynne Wathen and William W. Freimuth of the Pharmacia & Upjohn Co. of Kalamazoo, Mich.

Pharmacia & Upjohn manufactures delavirdine, Glaxo-Wellcome Pharmaceuticals produces zidovudine and Bristol-Myers Squibb makes didanosine.

"This work confirms what many AIDS researchers thought would be the case, but no one had looked at in a prospective way before," Gilliam said. "Because it also resolves the uncertainties of several earlier studies with conflicting results, we think the response will be very positive."

In the United States and Europe, antiretroviral therapy holds promise for slowing the AIDS epidemic, but also increases the possibility of transmitting resistant strains of HIV, he said. Such therapy would not be practical in Africa and the Far East because countries there and most people cannot afford the drugs.

Because the study population was small, the scientists were not able to determine which of the antitretroviral drugs was most effective in curtailing the virus.

The National Institutes of Health's General Clinical Research Centers Program and Pharmacia & Upjohn Co. supported the research.

- 30-

Note: Gilliam can be reached at (301) 217-9410, Ext. 1055 (w) or 947-8004 (h). His beeper number is (301) 215-1035. Cohen's numbers are (919) 966-2536 (w) and 933-9434 (h).

University of North Carolina at Chapel Hill

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.