http://www.monitor.co.ug/artman/publish/health-and-living/Trials_on_ARVs_in_preventing_HIV_transmission_start_74815.shtml

A new clinical trial to test whether the use of antiretroviral drugs could reduce the risk or prevent HIV transmission to a negative partner in a discordant relationship has started in Uganda.

Discordance is a situation whereby one partner has HIV, the virus that causes Aids, and the other does not. In Uganda, about 50 per cent of HIV positive people are living in discordant relationships putting negative partners at a high risk of infection.

The trial known as Pre Exposure Prophylaxis (PrEP) will involve HIV negative partners in discordant relationships orally taking either one antiretroviral drug called tenofovir or in combination with another drug, Truvada as a preventative drug on a daily basis according to The Aids Support Organisation (Taso).

The trial under Taso will begin in Mbale and Tororo while the same trial will also be carried out in Bushenyi at the Kabwohe Clinical research Centre, and at the Infectious Diseases Institute’s trial site in Bukoto under different auspices. However, even while on the drug, the couples will be provided with risk reduction counselling, condoms and family planning requirements to further protect them from getting the virus.

Speaking to journalists at the Taso headquarters last week, the Executive Director, Mr Robert Ochai said that the trial was an effort to find out whether negative partners could be protected from contracting the virus while still with their partners. “PrEP is an effort to find out whether there is a way we can protect the negative partners from getting HIV. If found to be effective, it will have enormous implications in the fight against Aids,” Mr Ochai said.

He added that, “We know that as a country, there is a discordance phenomenon. If nothing is done, with time, the one without the HIV virus will also pick it. We are now searching for solutions.”
According to one of the researchers for the trial, Dr Jonathan Wangisi, the new potential HIV prevention strategy if successful, would be used in combination with already existing preventive measures like condoms and male circumcision among others even for those not in discordant relationships.

Dr Wangisi said that trials would involve 3,900 HIV negative men and women between the ages of 18 and 65 in discordant relationships. “We shall be recruiting people in the next two years. In Mbale and Tororo, we shall recruit 500 to 800 couples,” he said. Adding that, “it will be a five year study and the earliest we can have results is in 2010 or when there is early evidence that it works or not.”

Uganda has been involved in a number of HIV clinical trials, some of which have been successful. These include Nevirapine, a drug that prevents the mother to child transmission of HIV and use of Septrine and clean water to reduce opportunistic infections in people living with HIV/Aids among others. PrEP studies are being conducted in other African countries like Kenya, Botswana, Malawi, South Africa and Tanzania supported by The University of George Washington, Bill and Melinda Gates foundation, Centres for Prevention and disease control (CDC Atlanta and Uganda) and Taso Uganda.