The NHS has been given the green light to offer people living with HIV the first ‘long-acting injectable’ to keep the virus at bay.
Charities have hailed the ‘incredible news’ which offers an alternative to adults living with HIV who have to take daily antiretroviral drugs.
Many people living with HIV can keep the virus at very low levels by taking antiretroviral tablets each day.
These drugs keep the number of virus particles in the blood – also known as the viral load – so low that it cannot be detected or transmitted between people.
But now an estimated 13,000 people will be eligible for the injectable treatment in England which means they no longer need daily treatment but will have two injections every two months.
This means they can reduce the days they receive treatment from 365 to six per year.
Charities have hailed the ‘incredible news’ which offers an alternative to adults living with HIV who have to take daily antiretroviral drugs (file photo)
The National Institute for Health and Care Excellence (NICE) said that cabotegravir (also called vocabria and made by Viiv Healthcare) with rilpivirine (also called Rekambys and made by Janssen) can be offered to adults who have managed to keep HIV viral load to a low level through daily antiretroviral medicines.
Clinical trial results show that cabotegravir with rilpivirine is as effective as oral antiretrovirals at maintaining a low viral load, NICE said.
Meindert Boysen, deputy chief executive NICE, said: ‘Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment.
‘However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle.
‘We’re pleased therefore to be able to recommend cabotegravir with rilpivirine as a valuable treatment option for people who already have good levels of adherence to daily tablets, but who might prefer an injectable regimen with less frequent dosing.’
Many people living with HIV can keep the virus at very low levels by taking antiretroviral tablets each day (file photo)
Why is HIV so hard to cure?
In 1995, researchers discovered why HIV manages to come back even when it seems to have been defeated.
The virus buries part of itself in latent reservoirs of the body, lying dormant as ‘back-up’.
In 1996, it was discovered that anti-retroviral therapy (ART) could suppress the virus, and prevent it from resurging, if the medication was taken religiously.
But once that blanket is lifted, the virus swiftly rebuilds itself.
Despite decades of attempts, experts still don’t know how to get at those hidden parts of the virus.
The most promising approach may well be a ‘shock and kill’ technique – awakening the virus out of its hiding place then blitzing it.
But researchers don’t yet know how to wake it up without harming the patient.
A handful of HIV-infected patients who also had cancer have been left in long-term remission after undergoing a risky stem cell transplant.
The so-called ‘Berlin patient’ Timothy Ray Brown was the first to undergo the life-threatening procedure 13 years ago, which gave him a bone marrow transplant from a donor with HIV-resistant genes that wiped out his cancer and the virus in one fell swoop.
Commenting on the news, Debbie Laycock, head of policy at Terrence Higgins Trust, said: ‘It’s incredible news for people living with HIV in England and Wales that they will be able to access the first long-acting injectable treatment on the NHS as an additional treatment option.
‘We have incredibly effective treatment which means HIV is now a manageable virus, however, it is lifelong so it is important that taking treatment is as easy as possible.
‘HIV unfortunately remains a stigmatised condition. Although we’re working hard to tackle the stigma surrounding HIV, this new injectable treatment option could help people in house-shares for example who do not wish to share their HIV status and will no longer have to worry about hiding their medication.
‘Pill fatigue is also an issue for some people living with HIV who struggle with the idea of taking antiretroviral drugs every day.
‘Long-acting injectable treatment is also a better option for those who have difficulty swallowing medication. Therefore, the institute’s approval provides a welcome additional treatment option for people living with HIV across England and Wales.
‘This is a great step forward as we work towards ending new cases of HIV by 2030. The institute’s decision brings great potential for HIV prevention including long-lasting PrEP in the future.’
Deborah Gold, chief executive of National Aids Trust, said the charity was ‘delighted’ with the news, adding: ‘The voice of people living with HIV is clear: they want this technology available as part of a range of treatment options. It won’t be right for everyone but, for some, monthly injections are highly preferable to daily pills.
‘Innovations that can make it easier for people to stick to their treatment plans both improve the wellbeing of people living with HIV and bring us one step closer to the goal of ending transmissions by 2030.’
Dr Jonathan Stoye, from the Francis Crick Institute, said: ‘Drug treatment of HIV-1 has been one of the great successes of modern medicine.
‘While HIV-1 was once a virtual death sentence from AIDS, combination therapy now allows an essentially normal life span.
‘However, almost all treatments require taking medicines at least once a day. This is inconvenient and brings with it the risk of missing doses essential for virus control.
‘The approval by NICE of a long-acting injectable treatment must therefore be warmly welcomed.’
Woman, 30, diagnosed with HIV eight years ago may be CURED ‘because her immune system has naturally cleared the virus’
A woman who battled HIV for years is now clear of the virus despite not taking any medication, doctors revealed this week.
The unidentified 30-year-old, of Argentina, is only the second person ever recorded whose immune system has naturally rid their body of the virus.
The ‘Esperanza Patient’, as she is known, was first diagnosed with HIV in 2013 — but now has undetectable levels of the virus in her body.
For the first eight years after being diagnosed she received no medication except for six months when she was pregnant, to ensure her baby would be healthy.
Researchers say the discovery brings a potential cure closer for the 38million people living with the AIDS-causing infection worldwide.
The unidentified 30-year-old is only the second person ever recorded whose immune system has naturally rid their body of the virus. Only one other person has also naturally cleared the virus. Loreen Willenberg’s (pictured) story was first revealed last August. The 67-year-old, of San Francisco, was diagnosed with HIV 30 years ago.
The unidentified 30-year-old, of the Argentinian city of Esperanza, is only the second person ever recorded whose immune system has naturally rid their body of the virus
A group of Harvard-based medics announced the discovery at a major international meeting of HIV experts in March.
Medics then revealed the patient, whose ex-boyfriend died of AIDS, had no disease-causing or ‘intact’ virus.
The findings have now been confirmed in the Annals of Internal Medicine.
Dr Xu Yu and colleagues found no intact traces of the virus in the 1.5billion blood and tissue cells they analysed.
No other details of the woman are currently public but doctors at the time called her ‘athletic and beautiful’ and revealed she had a boyfriend and a newborn baby, both of whom were HIV-negative.
Only one other person has also naturally cleared the virus. Loreen Willenberg’s story was first revealed last August. The 67-year-old, of San Francisco, was diagnosed with HIV 30 years ago.
Academics claimed she could be ‘added to the list’ of cured HIV patients, next to the ‘Berlin patient’ Timothy Ray Brown and the ‘London patient’ Adam Castillejo.
Both Mr Brown and Mr Castillejo had cancer and received a bone marrow transplant from a donor with HIV-resistant genes to wipe out the disease and the AIDS-causing virus in one fell swoop.
But neither Ms Willenberg — or the Esperanza patient — had the risky treatment.
The two women are examples of elite controllers, a rare group of people who have never taken antiretroviral therapy but show no signs of the virus in their blood.
Normally, when a person gets infected with HIV, the virus attaches to their immune cell’s DNA and reproduces from there.
Anti-retroviral therapy can help prevent the replication process but cannot eliminate HIV in the body altogether, meaning people need to take daily treatment to suppress the virus.
Adam Castillejo, 40, was the second person in the world to be cured of HIV. Earlier this year he revealed he was the ‘London patient’
‘Berlin Patient’ Timothy Ray Brown was successfully cured of the HIV virus 12 years ago
But for one in 200 people, the elite controllers, most of the virus settles into inactive parts of the genome, known as ‘gene deserts’, causing no harm. The remaining virus is cleared up by the body’s immune system.
Dr Yu, based at the Massachusetts General Hospital, said: ‘These findings, especially with the identification of a second case, indicate there may be an actionable path to a sterilizing cure for people who are not able to do this on their own.
‘We are now looking toward the possibility of inducing this kind of immunity in persons on ART through vaccination, with the goal of educating their immune systems to be able to control the virus without ART.’
Writing in the journal Annals of Internal Medicine, the researchers added: ‘The person described here is originally from the city of Esperanza, Argentina.
‘In line with her wishes, we propose to refer to her as the ‘Esperanza patient’ to send a message of hope for finding a cure for HIV infection.’