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Simulation Tool Predicts Efficacy of PrEP for HIV

June 15, 2018

Recent research demonstrated a new simulation modeling framework to predict how effective certain pre- and post-exposure prophylaxis will work to prevent HIV infection.

The study, published in PLOS Computational Biology, aimed to build a mathematical simulation in order to help streamline development of pre-exposure prophylaxis (PrEP) drugs. The researchers noted that though current PrEP treatments significantly decrease infection risk, they are not 100% effective and can be costly.

The researchers found that their innovative model could accurately predict how experimental PrEP regimens will perform.

“Using the mathematical framework we developed, it is now possible to evaluate the clinical efficacy of any PrEP regimen prior to conducting any confirmatory trial,” Max von Kleist, PhD, of the Freie Universität Berlin, said in a press release.

Using their tool, the researchers determined that 50mg of oral dolutegravir is equally as effective as Truvada (emtricitabine/tenofovir disoproxil fumarate; Gilead) when used as a pre-exposure treatment. They also determined that this regimen may be more effective than Truvada when taken as a post-exposure prophlaxis treatment.

The researchers were also able to use the tool to determine the blood concentration of dolutegravir needed for the regimen to be 90% effective at preventing HIV infection.

“The cost of PrEP is a major burden to its broad implementation, particularly in sub-Saharan Africa, which is hit hardest by the epidemic,” Dr von Kleist said. “The next step for this research is to evaluate the potential of extremely cost-efficient regimens that are currently neglected in drug re-purposing programs for PrEP.”

Additionally, Dr von Kliest and colleagues noted that this model could evern be used to predict the efficacy of HIV vaccines.

“By adapting the pharmacokinetics model, the framework can easily be used to predict the prophylactic utility of other candidate drugs currently under development, such as oral maraviroc, and raltegravir, long-acting injectable rilpivirine or cabotegravir, or it may be adapted to predict vaccine efficacy,” they concluded.

David Costill

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