Run rings around HIV

Dis­creet vagi­nal in­sert se­cretes an­tiretro­vi­ral to cut trans­mis­sion chances

The Times (South Africa) - - NEWS - KATHARINE CHILD

IF YOU like it “put a ring on it” — but a ring con­tain­ing the an­tiretro­vi­ral drug dapivirine might be an even bet­ter idea.

Vagi­nal sil­i­cone rings im­preg­nated with dapivirine could re­duce the chance of women con­tract­ing HIV by about 30%.

NGO In­ter­na­tional Part­ner­ship for Mi­cro­bi­cides was told last week that the Euro­pean Medicines Agency had be­gun re­view­ing its ap­pli­ca­tion to regis­ter a dapivirineim­preg­nated ring for use in African coun­tries.

The NGO wants the ring ap­proved as a pre­ven­ta­tive drug for women at high risk of con­tract­ing HIV — in­clud­ing women in South Africa.

The ring, in­serted into the vagi- na, se­cretes the long-act­ing an­tiretro­vi­ral dapivirine. It needs to be changed monthly and can­not be felt by part­ners.

Tri­als took place in Malawi, Uganda and South Africa. Re­sults, an­nounced last year, showed the ring re­duced the risk of get­ting HIV by 30%.

Although this might not sound highly ef­fec­tive, in one trial women had 60% less chance of get­ting HIV.

Women un­der 21 did not get any pro­tec­tion from the ring in one study. It is thought they didn’t use it con­sis­tently enough for it to work.

The NGO said the ap­pli­ca­tion, lodged in Europe, was for ap­proval for African coun­tries.

“The ap­pli­ca­tion was submitted un­der ar­ti­cle 58. This al­lows the Euro­pean Medicines Agency, in co-op­er­a­tion with the World Health Or­gan­i­sa­tion, to pro­vide a sci­en­tific opin­ion on the safety, ef­fi­cacy and qual­ity of medicines mar­keted ex­clu­sively out­side the EU — specif­i­cally in lowand mid­dle-in­come coun­tries.”

NGO founder Dr Zeda Rosen­berg said: “If ap­proved, the ring could pro­vide women with an ur­gently needed long-act­ing and dis­creet method they can ini­ti­ate them­selves to pro­tect their health.

“End­ing the epi­demic will re­quire mul­ti­ple preven­tion op- tions to meet women’s needs.”

Right now South African women can pro­tect them­selves from con­tract­ing HIV dur­ing sex only with fe­male or male con­doms.

“Women across sub-Sa­ha­ran Africa lack the range of tools they need to stay HIV-free,” said Rosen­berg. The NGO said it would send its doc­u­ments to the SA Health Prod­uct Reg­u­la­tory Au­thor­ity, which reg­is­ters medicines, for­merly known as the Medicines Con­trol Coun­cil.

Euro­pean ap­proval for the ring, if granted, is ex­pected in early 2019.

If the ring is ap­proved, South African women will have one more way to re­duce the risk of con­tract­ing HIV.

South African women are at high risk of HIV and are twice more likely to con­tract HIV than men.

‘ Women lack the range of tools to stay HIV-free

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