Another disappointing result on HIV prevention front

The audio is in isiZulu. See the English summary below.

MABUTHO: Imiphumela engemihle yokuhlolwa kwalelikhambi iAcyclovir ifika esikhathini esingaphansi kwamasonto amane kusanda kumenyezelwa eminye imiphumela engemihle ye Carraguard microbicide nayo eyehlulekile ukubonisa ukuthi lelikhambi lingakwazi ukuvikela igciwane le HIV. Lelikhambi iAcyclovir belihlolwa ngaphansi kocwaningo olukhulukazi olwaziwa ngele HPTN 039 ukubheka ukuthi angeke yini likwazi ukuvikela igciwane le HIV kulabo abanegciwane iHerpes Simplex Virus-2. iHerpes Simplex Virus-2 igciwane elidala izifo ezifana nesifo socansi esaziwa nge genital ulcers, noma iherpes, okuyizilonda esithweni sangasese. Ukucwaningwa kwalelikhambi okwaqalwa ngonyaka ka 2003 bese kusesigabeni esibizwa ngo Phase III, okuyisigaba sokugcina ekuhlolweni kwekhambi ngaphambi kokuba lingathathwa njengelikulungele ukusetshenziswa. UProfessor Connie Celum wasenyuvesi yase Washington, eMelika, nguyena obehola ithimba lochwepheshe ebebehlola lelikhambi. Uthi bebenethemba elikhulu ngalelikhambi kodwa ke badumele ukuthi lehlulekile ukubonisa ukuthi lingakwazi ukuvikela igciwane le HIV.

Prof. CONNIE CELUM: We’€™re surprised because the epidemiologic and biologic data were so compelling. And we are definitely very disappointed. This is an important result for HIV prevention and tells us that this dose of Acyclovir is not going to prevent HIV acquisition.

MABUTHO: Lolucwaningo belwenziwa ezikhungweni eziyisishagalolunye emazweni ahlukene emhlabeni kubalwa iPeru, South Africa, US, Zambia kanye neZimbabwe. Kanti bebengu 3172 abantu ebebebambe iqhaza kulolucwaningo. Abavela emazweni aseAfrika bekungabesifazane, kanti abavela eMelika nasePeru bekungabantu abesilisa abalalanayo. Bonke bekudingakala ukuba kube ngabantu abanegciwane iHerpes Simplex Virus-2, kodwa bangabinayo iHIV. Ekugcineni imiphumela yalolucwaningo ibonise ukuthi lelikhambi alikwazi ukuvikela igciwane le HIV. Kodwa okungenani  libonisile ukuthi lelikhambi liyakwazi ukuthiba ama genital ulcers, noma iherpes, okuyizilonda ezivela esithweni sangasese eziphatha abantu abanegciwane iHerpes Simplex Virus-2 (HSV-2). UCynthia Kubheka ungomunye wabantu abanegciwane iHSV-2 ebebebambe iqhaza ekucwaningweni kwalelikhambi. Uthi uyaqonda ukuthi abacwaningi baphatheke kabi ngoba lelikhambi lehlulekile ukubonisa ukuthi lingakwazi ukuvikela igciwane le HIV. Uthi kodwa yena ngesingaye ukubamba iqhaza kulolucwaningo njengomuntu onama genital ulcers kumsizile ngoba selokhu eqale ukusebenzisa lelikhambi ebelihlolwa, iAcyclovir, ukhona umehluko awubonayo kulesisifo sakhe.

CYNTHIA KUBHEKA: It was a disappointment to researchers that Acyclovir does not prevent HIV ‘€¦.but to me it was not a disappointment because since I started using Acyclovir I do not have many outbreaks. Number two, since this study was initiated I now know more about HIV and my HSV-2 status. Now I know that I have herpes and I know how to behave sexually.

MABUTHO: Nakuba imiphumela yocwaningo ibonise ukuthi lelikhambi alikwazi ukuvikela igciwane le HIV uKubheka uthi usazoqhubeka nokubamba iqhaza kolunye ucwaningo lokuzama ukuthola ikhambi. Uthi ukusho lokhu ngoba kukhulu akufundile ngokubamba iqhaza ekucwaningweni kwalelikhambi obekubhekwa ukuthi lingakwazi yini ukuvikela igciwane le HIV.

CYNTHIA KUBHEKA: I will continue taking part in clinical trials. I will definitely continue because you learn a lot of things. I have learnt a lot of things.

MABUTHO: UDr Nomonde Xundu uyinhloko yomnyango wezempilo kuzwelonke ophikweni olubhekene negciwane le HIV. Oka Xundu uthi njengoba lolucwaningo lubonisile ukuthi lelikhambi alikwazi ukuvikela leligciwane kuzofanele iqhubeke imizamo yokuthola ikhambi lokuvikela iHIV.

Dr. NOMONDE XUNDU: We have to continue with research because now we know that suppressive therapy for herpes is not going to work to assist us with reducing acquisition of HIV, which we did not know previously. There was a theory that it might work, but this outcome is saying ‘€˜it actually does not work, look for other things’€™.

MABUTHO: Lelikhambi selingelesithathu kumakhambi ahlolelwa ukuvikela igciwane le HIV kuleli ukubonisa ukwehluleka ukuvikela leligciwane esikhathini esingaphansi kwezinyanga eziyisithupha. Ngenyanga ka September ngonyaka owedlule umkhankaso welinye ikhambi, elingumjovo, ebelihlolelwa ukuvikela igciwane le HIV, iHVTN 503, nelaziwa ngele ‘€œPhambili’€ lamiswa ukuhlolwa kuleli emva kokuba imiphumela yokucwaningwa kwalo eMelika nase Australia yabonisa ukuthi alikwazi ukuvikela leligciwane. Emasontweni ambalwa edlule kuye kwakhishwa imiphumela yelinye ikhambi ebelihlolwa kuleli iCarraguard microbicide, okunguketshezi olugcotshwa esithweni sangasese kumuntu wesifazane, obeluhlolelwa ukuvikela igciwane le HIV. Nalelikhambi nalo lehlulekile ukubonisa ukuthi lingakwazi ukuvikela igciwane le HIV. Lokhu kusho ukuthi ochwepheshe kusazomele baqhubeke neminye imizamo yokuthola ikhambi lokuvikela leligciwane elisalokhu liqhubeke njalo nokudla lubi ikakhulukazeni ezweni lase Ningizimu Africa njengoba ngokwezibalo zomnyango wezempilo kuzwelonke bebalelwa ku 5 million abantu abaphila naleligciwane kuleli.

See the English summary below.

Another disappointing result on HIV prevention front  

In just less than a month after the disappointing Carraguard microbicide results, a study using a genital herpes drug, Acyclovir, has proved that it does not reduce the risk of HIV infection among people with Herpes Simplex Virus-2.

‘€œWe’€™re surprised because the epidemiologic and biologic data were so compelling. And we are definitely very disappointed. This is an important result for HIV prevention and tells us that this dose of Acyclovir is not going to prevent HIV acquisition,’€ said Professor Connie Celum of the University of Washington when announcing the outcome of the study.

The study, which was conducted in nine countries, involved 3172 HIV-negative participants. But all had to have Herpes Simplex Virus-2 (HSV-2), a sexually transmitted infection commonly known as herpes. Half of the participants were heterosexual women from African countries such as Zambia, South Africa and Zimbabwe and the other half were homosexual men from the United States and Peru.

Although the final findings of the study show that Acyclovir does not prevent HIV infection in people with genital herpes, it did show that Acyclovir is effective in suppressing genital herpes. But despite the disappointing result that Acyclovir does not prevent HIV infection, Cynthia Kubheka, one of the women who participated in the study says she will ‘€œcontinue taking part in clinical trials’€ in the future because she ‘€œlearnt a lot of things’€.

‘€œIt was a disappointment to researchers that Acyclovir does not prevent HIV …but to me it was not a disappointment because since I started using Acyclovir I do not have many outbreaks. Number two, since this study was initiated I now know more about HIV and my HSV-2 status. Now I know that I have herpes and I know how to behave sexually,’€ said Cynthia Kubheka.

Dr Nomonde Xundu, a Chief Director in the TB and HIV/AIDS unit in the national Department of Health says the failure of Acyclovir to prove effective in preventing HIV means the quest for a solution to the HIV problem needs to be intensified.

‘€œWe have to continue with research because now we know that suppressive therapy for herpes is not going to work to assist us with reducing acquisition of HIV, which we did not know previously. There was a theory that it might work, but this outcome is saying ‘€˜it actually does not work, look for other things,’€ she said.

The Acyclovir trial is the third HIV prevention attempt conducted in the country, which has failed to prove effective in HIV prevention in less than seven months. In September last year, the clinical trial of the widely publicized HVTN 503 vaccine dubbed ‘€œPhambili’€ were stopped with immediate effect after its sister trials in the United States and Australia proved that it does not prevent HIV infection. Few weeks ago the results of Carraguard microbicide, a gel that is applied to a woman’€™s vagina also failed to prove effective.

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