Un nouvel espoir dans la lutte mondiale contre le VIH.
La Food and Drug Administration des États-Unis a approuvé lundi 20 décembre une injection destinée à prévenir l’infection par le virus responsable du sida, la première de ce type au monde.
“Nous avons approuvé aujourd’hui le premier traitement injectable à utiliser chez les adultes et les adolescents à risque (…) pour réduire le risque de contracter le VIH par voie sexuelle”, indique l’agence.
Le cabotégravir (CAB-LA), un médicament qui a terminé ses essais cliniques de stade en novembre 2020, a montré un résultat encourageant pour éviter l’infection, selon les différents essais cliniques.
Une dernière étude a montré qu’il était 66 % plus efficace pour prévenir les infections au VIH que les pilules quotidiennes traditionnelles.
Une étude antérieure menée par ViiV Healthcare, une société pharmaceutique spécialisée dans le développement de thérapies contre le VIH, a révélé que le traitement sur un échantillon de femmes était jusqu’à 89 % plus efficace que d’autres médicaments actuellement utilisés par voie orale.
Selon l’entreprise, l’essai avec des femmes a suivi un autre test chez des hommes ayant des rapports sexuels avec des hommes et des femmes transsexuelles qui a également montré que les effets étaient supérieurs aux pilules quotidiennes que des millions de personnes dans le monde consomment actuellement pour éviter de tomber malade du sida. .
Contrairement aux traitements actuels, qui obligent les personnes à prendre une pilule tous les jours, le cabotégravir est injectable et s’administre tous les deux mois.
Auparavant, l’Organisation mondiale de la santé avait célébré ” l’innocuité et l’efficacité du médicament ” et expliqué que les essais avaient été interrompus prématurément par le comité de surveillance car les résultats montraient qu’il était ” hautement efficace ” pour prévenir le sida.
Le Dr Jeffrey D. Klausner, expert en VIH et professeur d’épidémiologie et de maladies infectieuses à l’Université de Californie – qui n’était pas lié à l’étude de l’entreprise pharmaceutique, mais a eu accès aux données -, a assuré à BBC Mundo il y a quelques mois qu’il s’agit d’un résultat prometteur.
“C’est très encourageant, cela double presque la protection contre le VIH quand on compare l’injection tous les deux mois avec les pilules quotidiennes”, déclare-t-il.
Un nouveau médicament
Actuellement, plusieurs sociétés pharmaceutiques distribuent des complexes antirétroviraux connus sous le nom de prophylaxie pré-exposition (PrEP), qui se sont avérés efficaces pour prévenir le VIH.
Klausner explique que maintenant, d’un point de vue pharmacologique, il s’agit d’un traitement différent.
“Le médicament fonctionne différemment des pilules de PrEP actuelles. Deuxièmement, il s’agit d’une injection qui dure deux mois ! Au lieu de devoir prendre une pilule tous les jours”.
Le Dr Víctor García-Martínez, expert en maladies infectieuses à l’Université de Caroline du Nord à Chapel Hill, a déclaré que, bien souvent, les traitements tels que la PrEP ont cessé d’être efficaces parce que de nombreuses personnes oublient de prendre la pilule chaque jour.
“Depuis le début des études sur la prévention du Sida, nous nous sommes rendu compte que les participants ne respectaient pas les indications sur la manière et le moment de prendre les médicaments. Ainsi, de nombreuses personnes ont été infectées parce qu’elles n’ont pas pris les médicaments”, explique-t-il à BBC Mundo.
“Donc ce qui change maintenant, c’est qu’au lieu de prendre une pilule tous les jours, les gens reçoivent une injection toutes les huit semaines. Ainsi, les gens n’ont pas besoin de prendre des médicaments tous les jours et cela peut aider énormément”, ajoute-t-il.
Selon l’OMS, cela pourrait être particulièrement bénéfique pour les femmes dans certaines régions du monde où les niveaux d’infection sont élevés, comme en Afrique, où il est difficile pour beaucoup de maintenir une routine quotidienne pour consommer le médicament.
“Certaines femmes ont du mal à prendre une pilule quotidienne et l’utilisation irrégulière de la PrEP orale réduit l’effet de prévention. Une formulation injectable à longue durée d’action a le potentiel de renforcer l’effet de prévention sans dépendre de l’adhésion à un régime quotidien de PrEP orale. “, indique l’OMS.
García-Martínez a déclaré que le nouveau médicament pourrait également accroître l’accès des femmes aux nouvelles thérapies , étant donné que certains traitements actuels de pré-exposition, comme celui appelé Descovy, ne sont accessibles dans certains pays qu’aux hommes ayant des relations sexuelles avec d’autres hommes.
Mme Klausner a expliqué que le fait qu’il s’agisse d’une injection facilite également la prise du médicament, et que la personne peut s’injecter elle-même ou demander à quelqu’un de le faire au lieu de se rendre dans une clinique ou une pharmacie.
Espoirs et mises en garde
Les experts consultés par BBC Mundo se sont montrés optimistes quant à ce nouveau traitement, même si, comme pour tous les médicaments, ils recommandent également la prudence.
Selon l’étude, comme le médicament reste longtemps dans le sang, s’il est arrêté, ces petites quantités pourraient ne pas suffire à protéger contre le VIH, ce qui pourrait entraîner le développement d’un virus résistant au médicament. .
L’OMS a également averti que des études de sécurité chez les femmes enceintes et allaitantes sont encore nécessaires et que des recherches supplémentaires devraient être envisagées pour comprendre “les approches de mise en œuvre les plus efficaces et les plus acceptables.”
Klausner souligne à cet égard qu’il serait également nécessaire de tenir compte de la capacité de production et de distribution du médicament.
” L’impact qu’il aura sur le VIH au niveau mondial dépendra de la manière dont il sera disponible et de la rapidité avec laquelle il le sera . Nous constatons encore plus d’un million de nouvelles infections par an, la plupart en Afrique subsaharienne et chez les jeunes femmes”, dit-il.
Selon l’expert, rendre ce type de traitement accessible aux femmes de cette région du monde peut devenir décisif pour contrôler la pandémie de sida.
“J’aimerais voir un programme de planification familiale et de prévention du VIH facilement accessible dans toute l’Afrique australe. Garder les jeunes femmes en bonne santé et faire en sorte que la grossesse soit un choix plutôt qu’un accident est l’un des meilleurs moyens d’autonomiser les femmes et de construire des économies prospères qui sortiront les sociétés de la pauvreté”, affirme-t-il.
* Cette note a été publiée en 2020 et est maintenant mise à jour après approbation par la FDA américaine.
source:bbc
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