New ARV drug a game-changer for HIV pa­tients

The Star Early Edition - - NEWS - AMY GREEN

THE MUCH-AN­TIC­I­PATED an­tiretro­vi­ral (ARV), do­lute­gravir, will be in­tro­duced as the first-line treat­ment for the HIV in­fected in South Africa as early as April, Health Depart­ment deputy di­rec­tor-gen­eral Dr Yo­gan Pil­lay said at the 9th In­ter­na­tional Aids So­ci­ety (IAS) con­fer­ence on HIV Sci­ence in Paris this week.

A do­lute­gravir-based reg­i­men will be a “game-changer” for South Africa and peo­ple liv­ing with HIV be­cause it has fewer side-ef­fects and is cheaper than ex­ist­ing treat­ments, ac­cord­ing to Pro­fes­sor Fran­cois Ven­ter from the Wits Re­pro­duc­tive Health and HIV In­sti­tute.

Ini­tially planned to en­ter the South African mar­ket in Oc­to­ber next year, Pil­lay said that the tim­ing would de­pend on when sup­pli­ers reg­is­ter the fixed-dose-com­bi­na­tion (FDC) ver­sion with the Medicines Con­trol Coun­cil.

“Dur­ing this con­fer­ence, I’ve been meet­ing all the sup­pli­ers to find out when they will reg­is­ter. We think that def­i­nitely two, most likely three, will reg­is­ter this year and if they reg­is­ter we can start ear­lier,” he said.

ARV ther­apy re­quires tak­ing three drugs a day, ev­ery day, for life, but treat­ment is made eas­ier when all the drugs are com­bined into one pill – an FDC.

He said that cur­rent treat­ment based on the drug efavirenz had side-ef­fects that can be se­vere and make the med­i­ca­tion dif­fi­cult to take for pa­tients. These in­cluded men­tal health and liver prob­lems.

Do­lute­gravir’s side-ef­fects are milder and much less com­mon and could make tak­ing treat­ment for life much eas­ier.

Ac­cord­ing to a Jan­uary pa­per pub­lished in the South African Med­i­cal Jour­nal, a do­lute­gravir-based reg­i­men could trans­late into ini­tial cost-sav­ings of 20% of the coun­try’s an­nual ARV bud­get. When vol­umes are met, when the ma­jor­ity of pa­tients have been switched to the reg­i­men, cost sav­ings could reach 50%. Ven­ter said this was largely due to the price of the raw ma­te­ri­als used to man­u­fac­ture the drug. The cost sav­ings are highly sig­nif­i­cant as South Africa runs the largest ARV pro­gramme in the world and spends roughly R10 bil­lion a year on procur­ing the medicines for lo­cal pa­tients. Do­lute­gravir could also solve the coun­try’s ARV-re­sis­tance prob­lem, said Ven­ter.

He said reports in­di­cated that at least 10% of pa­tients on treat­ment had de­vel­oped re­sis­tance to first-line ARVs.

HIV-drug re­sis­tance oc­curs when in­di­vid­u­als do not take their medicines as pre­scribed.

RE­LIEF: Dr Yo­gan Pil­lay PIC­TURE: ADRIAN DE KOCK

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