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These are the third and fourth widely reported studies of Gilead's treatments.
The first was announced last year, involving gay men in Peru, Ecuador, Brazil, South Africa, Thailand and the United States (San Francisco and Boston). Truvada lowered the chances of infection by 44 percent, and by 73 percent or more among men who took their pills most faithfully.
Experts celebrated. The CDC advised doctors on prescribing the pill along with other prevention services for gay men, based on those encouraging results.
But momentum seemed to stall in April, when an interim analysis of a study of 3,900 women in Kenya, Tanzania and South Africa did not show a benefit from Truvada. Scientists can't explain the failure in that study but one theory is that the women did not take the pill as often as they should have, said Dr. Lynn Paxton, who has coordinated the federal agency's HIV prevention research.
Gilead Sciences is a major producer of AIDS drugs. On Tuesday, United Nations health officials announced the company had agreed to allow Truvada, Viread and two other drugs to be made by generic manufacturers, potentially increasing their availability in poor countries.
That was seen as good news, but something short of a major coup.
"I wouldn't expect an immediate dramatic effect on the generic availability" of those drugs in Africa, said Tido von Schoen-Angerer, executive director for Doctors Without Borders' campaign for access to essential medicines. The agreement limits the number of additional countries that can produce the drugs, he said.
Officials say they will have to determine how much of the medicine can be produced and how much it will cost, and priorities will have to be set when it comes to who would get the drugs for prevention.
A 30-day supply of Truvada costs about $900 in U.S. pharmacies, and the same amount of Viread costs about $600. Prices charged in developing countries are much lower, but still can be hard to shoulder.
"Countries need to identify which populations could benefit the fastest and at the lowest cost," said Cate Hankins, chief scientific adviser at the United Nations' AIDS agency.
"There has to be some soul-searching about the costs of current drugs," she added.
Without WHO or UNAIDS guidance on how to roll out the prevention regimens, experts say it's unlikely any countries will take serious steps to do that. UNAIDS said they hoped that guidance would be ready next year.
Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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