Zim ART pa­tients over­dosed, sci­en­tist re­veals

Chronicle (Zimbabwe) - - Front Page - Paidamoyo Chipunza

MORE than 20 per­cent of Africans tak­ing Efavirenz — a first line an­tiretro­vi­ral drug used in the man­age­ment of HIV and Aids could be tak­ing an over­dose — a lo­cal sci­en­tist, Pro­fes­sor Collen Masimirem­bwa, has re­vealed.

In an in­ter­view on his lat­est sci­en­tific de­vel­op­ment aimed at as­sess­ing the safety and ef­fec­tive­ness of medicines in African pop­u­la­tions, Prof Masimirem­bwa who is the pres­i­dent and chief sci­en­tific officer with the African In­sti­tute of Bio­med­i­cal Sci­ence and Tech­nol­ogy (AiBST) said re­search had shown that the con­cen­tra­tion of Efavirenz in Africans was higher com­pared to Euro­peans tak­ing the same medicines.

“Over 20 per­cent of pa­tients in Zim­babwe and in Africa for that mat­ter, are over­dosed when they are be­ing given the cur­rent stan­dard dose.

“We’ve now re­alised that the dif­fer­ence is be­cause of the ge­netic make-up of African peo­ple where they have a vari­ance which re­duces their ca­pac­ity to re­move the drug from the body once given the stan­dard dose. Cau­casians on the other hand, have a vari­ance that quickly breaks down the drug (Efavirenz) in their bod­ies faster than in Africans,” said Prof Masimirem­bwa.

He said the high con­cen­tra­tion of resid­ual Efavirenz in Africans causes more side ef­fects in them com­pared to their coun­ter­parts.

He said this is the rea­son why most HIV pos­i­tive peo­ple tak­ing Efavirenz ex­pe­ri­ence mul­ti­ple side ef­fects com­pared to oth­ers in some parts of the world.

Prof Masimirem­bwa said AiBST had come up with a ge­netic test to as­cer­tain the pos­si­bil­ity of re­duc­tion of Efavirenz dose in the prod­uct to match with the African ge­netic make-up to re­duce the side ef­fects.

Some of the drug’s side ef­fects are di­ar­rhoea, skin rash, nau­sea, dizzi­ness, lack of con­cen­tra­tion, headache, fa­tigue, vom­it­ing, and anorexia.

“The ge­netic tests and the dos­ing al­go­rithm of how to re­duce the dose will have a huge im­pact be­cause it will mean peo­ple will be treated safely, which is the most im­por­tant part of treat­ment,” said Prof Masimirem­bwa.

He said their re­search on Efavirenz was pre­cip­i­tated by reports of peo­ple liv­ing with HIV who were ex­pe­ri­enc­ing side ef­fects to the drug.

“Many peo­ple were com­plain­ing of side ef­fects, then we said why is it that way? When we mea­sured the con­cen­tra­tion, we re­alised that it was high,” he said.

He said in re­sponse to that, AiBST, in part­ner­ship with the Gov­ern­ment and Harare City Coun­cil has set up a re­search unit at Chi­tung­wiza Cen­tral Hos­pi­tal meant to as­sess the safety and ef­fec­tive­ness of medicines in African pop­u­la­tions be­fore they are in­tro­duced into the mar­ket.

He said once ac­cred­i­ta­tion and the other pa­per­work is fi­nalised, all clin­i­cal tri­als will be con­ducted at Chi­tung­wiza Cen­tral Hos­pi­tal. Sam­ples will be sent to Wilkins Hos­pi­tal in Harare, which houses AiBST lab­o­ra­to­ries.

“In­deed, there is clear ev­i­dence that the dif­fer­ence in the ge­netic make-up can af­fect a num­ber of drugs, but not all drugs, that is why this project is ex­tremely im­por­tant.

“We’re now say­ing with a clin­i­cal trial unit, those phar­ma­ceu­ti­cal com­pa­nies can work with us at an early stage to make sure that their prod­ucts are safe and ef­fec­tive for African pop­u­la­tions,” he said.

Pro­fes­sor Masimirem­bwa said one such com­pany is Swiss-based No­var­tis.

No­var­tis is also as­sist­ing AiBST with tech­ni­cal and fi­nan­cial sup­port to set up the re­search units and en­sure that they are of in­ter­na­tional stan­dards.

So far, the phar­ma­ceu­ti­cal com­pany has do­nated re­search equip­ment worth $2 mil­lion to aid in re­search pro­cesses and is as­sist­ing with train­ing of staff who will be con­duct­ing the re­search.

No­var­tis’ head of global sci­en­tific de­vel­op­ment Mr Marcelo Gu­tier­rez said his or­gan­i­sa­tion part­nered with AiBST af­ter re­al­is­ing that med­i­cal needs across the globe were di­verse.

He said in Africa, they were also work­ing with sim­i­lar in­sti­tu­tions in Nairobi, Ghana, South Africa and Tan­za­nia to un­der­stand the needs of dif­fer­ent pop­u­la­tions.

“We re­alised that there is a huge di­ver­sity of pa­tients world­wide and in order for us to un­der­stand this di­ver­sity, we’ve to part­ner with sci­en­tists from di­verse back­grounds in order to help us un­der­stand var­i­ous dis­eases. We can only do that by part­ner­ing with in­sti­tu­tions like AiBST to help us pro­vide safe and ef­fec­tive medicines as quickly as pos­si­ble,” said Mr Gu­tier­rez.

Lo­cal phar­ma­ceu­ti­cal com­pa­nies are send­ing their sam­ples to In­dia or Ger­many for safety as­sess­ment.

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