SEATTLE — Monthly shots of HIV drugs worked as well as daily pills to control the virus that causes AIDS in two large international tests, researchers reported Thursday.
If approved by regulators in the United States and Europe, the shots would be a new option for people with HIV and could help some stay on treatment. Instead of having to remember to take pills, patients instead could get injections from a doctor or nurse each month.
“Some people will be thrilled” at the convenience, said Mitchell Warren, executive director of AVAC, an AIDS advocacy group.
Condoms remain the most widely available and inexpensive form of HIV prevention. Pills taken daily can keep HIV levels so low the virus is not transmittable to sex partners, but not everyone takes them as prescribed.
The shots could improve how well some people stick to treatment, perhaps helping those who have trouble remembering to take daily medicine to keep infection at bay.
There are other potential benefits. Getting shots at a clinic can lend more privacy to patients worried about the stigma of filling an HIV prescription at a pharmacy, said Dr. Susan Swindells of the University of Nebraska Medical Center in Omaha, who presented results Thursday at an HIV conference in Seattle.
Cost will be an issue “to make sure that everyone has access to this medication,” said Dr. Hyman Scott of the San Francisco Department of Public Health, who was not part of the study. It’s not clear how much the shots would cost. HIV pills can cost a patient up to thousands of dollars monthly, depending on the drug combination, insurance coverage, rebates and discounts.
And there will be concerns about patients missing a monthly shot, which could lead to drug-resistant strains of the virus. It will be “a good option for some people,” Scott said.
Whether monthly shots will also work to protect users’ sex partners hasn’t been studied yet, but there is reason to think they will, said experts at the conference.
The shots are a long-acting combo of two HIV drugs — rilpivirine, sold as Edurant by Johnson & Johnson’s Janssen, and ViiV Healthcare’s experimental drug known as cabotegravir.
ViiV Healthcare paid for the research. The drug makers are seeking approval later this year in the United States and Europe.
One study included 616 people who were taking pills to treat their HIV infection. The other study enrolled 566 people who hadn’t yet started treatment, so they first got pills to get the virus under control.
In each of the studies, half the participants switched to the shots while the rest stayed on pills. After nearly a year, 1 to 2 percent of people in both groups had traces of virus in their blood, whether they got shots or pills. That shows the shots worked as well as the standard pill therapy. A few people withdrew from the studies because of pain after the injections.
The studies were done in Europe and North America and in nations including Argentina, Australia, Russia, South Africa, South Korea, Sweden, Japan and Mexico.
“We don’t have experience rolling out an injection in the real world,” said Warren, the AIDS advocate. He said the next challenges will be how to deliver the shots and whether patients will remember to come back monthly. “These are big questions.”
— Carla K. Johnson
I would love to go to the once a mo shot, I dont do pills well I forget them or I just dont wenmt them but a shot would also help me keep track or my overall health by seeing the nurse..
Where this looks most attractive is traveling. I’ve always worried about traveling and having to carry all my pills with me, especially my HIV medication, and adhere to it/them on the road and the possibility of losing any. I take a lot of pills (diagnosed in ’85) but my HIV meds are my most important. If I could just take one shot and have a month not have to worry about it that’d be great. If I miss one dose of anything else it can be a drag, but if it I miss one dose of my HIV meds it can be disastrous.
Monthly injections won’t cut it. Yearly or perhaps semi-yearly injections may work. Why in the world would I need to schedule a monthly injection at my local clinic when I can swallow a pill every morning with my vitamins? Perhaps those who are unable to pop a pill daily due to addiction, lifestyle or mental issues might benefit. But for the majority of HIV+ persons, who adhere to a one-pill-a-day regiment, this would be a hindrance.
Monthly injections are not attractive to me. Maybe bi-monthly or once every 3 months would work. Ive taken a pill everyday for 15 years if it was a problem it certainly isnt a problem taking them now. Besides if I took a monthly injection they would likely require me to do it Mon-Fri between 8am to 5pm. Id have to miss work every month. And if for some reason I missed my injection Id be totally screwed.
I’m sure it’s a matter of choice, if you want pills fine, if you want shots good, don’t say won’t cut it and generalise for everyone.
I think the monthly shots would be wonderful tho, considering that tests say the same dosage is good as for 2 months, whichever works for anyone.
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