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New Hope for Women in the Fight Against HIV

JUL 26, 2016 | KRISTI ROSA

Effective Protection Against HIV Transmission 

Despite the news on P. bivia, recent findings suggest that there is hope for pregnant women who are infected with HIV. The study shows that HIV-infected mothers with strong immune systems can prevent the transmission of the virus to their children by taking a three-drug antiretroviral regimen during breastfeeding, according to the Promoting Maternal and Infant Survival Everywhere (PROMISE) study funded by the National Institutes of Health. Started in 2010, PROMISE is a multi-component study whose goal is to determine the safest and most efficient way to reduce risk of HIV-transmission from mother to infant.
 
Between June 2011 and October 2013, PROMISE enrolled 2,431 pairs of infected mothers with their HIV-uninfected infants at sites in South Africa, Malawi, Tanzania, Uganda, Zambia, Zimbabwe, and India, in an effort to compare the effectiveness of two antiretroviral regimens for preventing HIV transmission from mother to child. The researchers found that three-drug antiretroviral therapy for the mother, combined with doses of nevirapine for the infant, offered protection against mother-to-child transmission.
 
Protocol Chair Mary Glenn Fowler, MD, MPH said in the news release, “The PROMISE team and the PROMISE mothers were gratified with extremely low rates of infant infection and excellent infant survival with the use of maternal antiretroviral therapy. These results show the importance of mothers continuing to take antiretroviral therapy to reduce risk of mother-to-child transmission during breastfeeding.”
 

New HIV Prevention Study 

Similar to the results of ART therapy use, a new analysis of data from the ASPIRE study found that the use of a monthly vaginal ring that releases an anti-HIV drug called dapivirine, reduces the risk of HIV infection in women by at least 56%. Where the ASPIRE study provided answers related to the level of protection the ring supplies, a new clinical trial called the HOPE (HIV-Open Label Extension) study will delve deeper into the relationship between adherence and protection through the examination of the rings returned by the women in the previous study, and will gather new data on the ring’s extended use.
 
Elizabeth R. Brown, MD, the principal investigator of the Statistical and Data Management Center of the Microbicide Trials Network (MTN) that conducted ASPIRE will continue to conduct HOPE. Dr. Brown explained in a press release, “We did these new analyses to better understand the potential degree of protection the dapivirine ring could provide. These results are encouraging, finding that protection could be significant with consistent use.”
 
The HOPE trial will be open to all 2,614 women who had previously participated in the ASPIRE study who are not infected by HIV. Participants will be provided with a dapivirine ring to be placed in the vagina each consecutive month for a year. The women will attend monthly visits where they will have the chance to hand in their ring for a new one. Ring adherence will be determined through examination of residual dapivirine levels.
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