Wales experts back HIV prophlyaxis, ahead of key meetings

A group of independent experts from Wales has become the latest to back Gilead’s Truvada as a way of slowing the spread of HIV, ahead of key decisions from Welsh and Scottish cost-effectiveness bodies.

The independent HIV expert group established by Public Health Wales concluded after an evidence review that Truvada (emtricitabine+tenofovir) was highly effective in HIV prevention among high-risk individuals.

This so-called pre-exposure prophylaxis (PrEP) use involves HIV-negative people taking the drug, which can prevent the virus replicating inside their bodies if they are exposed.

The experts reviewed the evidence ahead of a meeting of the All Wales Medicines Strategy Group, which is set to decide whether the drug is cost-effective in this use at the end of April.

Reviewers from the Scottish Medicines Consortium met earlier this month to discuss Truvada PrEP, and are due to make a decision on 10 April.

Dr Giri Shankar, Public Health Wales’ professional lead consultant for health protection, and chair of the expert group, said: “The review of evidence suggests that pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective clinically when used in the right client groups and in the right dose with appropriate monitoring.”

Patients already buy the drug themselves in Wales, Shankar added, saying that individuals using the drug needed to be aware of correct dosing regimens, potential side effects, interactions with other medication, and resistance that can develop.

PrEP proved controversial in England, after NHS commissioners gave the impression that they would fund the drug, before suddenly pulling the plug on a national programme last spring.

This led to a legal challenge from HIV campaigners, who eventually secured a ruling from the Court of Appeal that the NHS could legally fund PrEP.

NHS England had insisted that it was the responsibility of local authorities to fund the treatment, but eventually decided to fund a national PrEP programme through a 'large-scale' clinical trial.