Truvada to prevent HIV approved in Canada

Health Canada has approved a daily HIV prevention pill in combination with safer sex practices, the drug's manufacturer says.

Gilead Sciences Canada announced Monday its once-daily pill containing two anti-HIV drugs is approved in Canada to reduce the risk of sexual transmission of the virus.

"We are pleased to offer this important HIV prevention tool to at-risk populations in Canada," Norbert Bischofberger, the company's chief executive vice-president of research and development said in a release.

Taking medicines to reduce the risk of infection in HIV-negative people is called pre-exposure prophylaxis or PrEP, said Sean Hosein of CATIE, which calls itself Canada's source for HIV and hepatitis C information.

Health Canada approved Truvada together with:

• Testing for HIV before starting the drug.
• Screening for and, when necessary, treatment of sexually transmitted infections.
• Regular and frequent testing for HIV while using Truvada.
• Use of condoms.

Truvada costs about $1,000 per month.

"Now our insurance companies, our provinces and territories need to get on board with an HIV prevention strategy that includes Truvada," Hosein said. 

In a study published last year in the New England Journal of Medicine, use of the medication was associated with increased rates of nausea, vomiting and diarrhea and abdominal pain (14 per cent) compared with a placebo (5 per cent.) Kidney side-effects were also higher with the drug (18 per cent vs. 10 per cent.)

Demand for PrEP is high at anti-HIV clinics across Canada, said Dr. Isaac Bogoch, an infectious disease clinician and researcher at Toronto's University Health Network.

"There's no reason for people who  need HIV prevention care to be seen in a big referral hospital. This care should be done in the community and those settings," Bogoch said. 

The next step will be to broaden access, such as through family doctors, Bogoch said.

When physicians follow the guidelines about who they put on PrEP and how then those already infected with HIV will receive the full antiretroviral treatment that they need. Doing so reduces the potential for drug-resistant HIV, he said.