News / Africa

Treating HIV Positive Women

Samples of Nevirapine, an antiretroviral AIDS drug used since the 1990s, are displayed at the National Institutes of Health in Memphis, Tenn.  (AP Photo/APTN)Samples of Nevirapine, an antiretroviral AIDS drug used since the 1990s, are displayed at the National Institutes of Health in Memphis, Tenn. (AP Photo/APTN)
x
Samples of Nevirapine, an antiretroviral AIDS drug used since the 1990s, are displayed at the National Institutes of Health in Memphis, Tenn.  (AP Photo/APTN)
Samples of Nevirapine, an antiretroviral AIDS drug used since the 1990s, are displayed at the National Institutes of Health in Memphis, Tenn. (AP Photo/APTN)
Joe DeCapua
New research shows that a combination of inexpensive antiretroviral drugs can be very effective in treating HIV positive women in developing countries. In fact, new research shows the treatment is just as effective as a much more expensive drug combination. However, the study also shows the cheaper drugs can carry a greater risk side effects.

Antiretroviral drug treatment has proven effective in suppressing the AIDS virus and saving lives. The drugs have changed the prognosis of the disease from one of certain death – usually within 10 years – to a chronic illness.

In 2010, the World Health Organization recommended that treatment of HIV infected women in poor areas should include the drug navirapine. It’s inexpensive and is often used in preventing the transmission of HIV from mothers to their newborns.

Research at Brigham and Women’s Hospital in Boston shows navirapine, in combination with other antiretrovirals, is just as effective as another combination that costs a lot more. Dr. Shahin Lockman led a study of 500 HIV infected African women who were in advanced stages of HIV/AIDS.

“There is very little known about the optimal regimen to use in persons living with HIV in resource-limited settings and in particular women living with HIV globally. The burden of HIV disease really is in resource-limited settings,” she said.

Resistance

Lockman is an associate professor of medicine at Harvard Medical School. She said the study of the navirapine-based combination looked at possible drug resistance. It’s known that when navirapine is given to women by itself – not part of a combination – resistance can develop.

“Many women are diagnosed with HIV and first enter the HIV care system when pregnant. And they are then offered often just one or two antiretroviral drugs to try and interrupt transmission of HIV to their baby. But these drugs, in particular single dose navirapine, which a woman takes during labor and gives one dose to her baby, while somewhat effective in reducing transmission to the baby, leaves three-quarters of the women with detectable drug resistant virus,’ she said.

The question is did that same drug resistance to navirapine occur when combined with several other antiretrovirals? The answer is no. But there was other good news, as well.

“In the women who had not previously taken single dose navirapine about 83 percent of women were able to suppress their virus and stay alive and well after starting the navirapine based regimen. So comparing that to the best first line regimens that we have here in the U.S., where the success rate is closer to 90 to 95 percent, 83 percent is not perfect, but it’s solidly good,” said Lockman.

However, while it was not as good as regimens here in the U.S., it was as good as a much more expensive regimen that is available in some developing countries. The downside of the navirapine combination, however, is the side effects.

“A reasonable number of patients had to switch off of navirapine treatment because of toxicity. And that was not particularly surprising. So about 14 percent of the women had to stop navirapine because of toxicity,” she said.

Navirapine can be toxic to the liver and skin. Lockman said if treatment is not stopped soon enough after symptoms appear, women can develop a “life-threatening drug sensitivity reaction.” Women in the study were closely monitored, though, and given a different drug regimen if necessary. But women not in such a study and not closely monitored could be at risk. Some may simply stop taking the drugs and forego treatment. And without treatment, Lockman said, they will die. She added that women deserve better.

“We really do need to push to get safer, better tolerated more effective treatment accessible so that even if you only have one or perhaps two lines of treatment the majority of people who start these can stay on them for life without toxicity,” she said.

She estimated millions of women need such treatment. She said PEPFAR - the President’s Emergency Plan for AIDS Relief - and the Clinton Global Initiative are some of best efforts to achieve that goal. 

The study was funded in part by the National Institute of Allergy and Infectious Diseases and the National Center for Research.

You May Like

Turkey: No Ransom Paid for Release of Hostages Held by IS Militants

President Erdogan hails release of hostages as diplomatic success but declines to be drawn on whether their release freed Ankara's hand to take more active stance against insurgents More

Audio Sierra Leone Ends Ebola Lockdown

Health ministry says it has reached 75 percent of its target of visiting 1.5 million homes to locate infected, educate population about virus More

US Pivot to Asia Demands Delicate Balancing Act

As the tumult in the Middle East distracts Obama, shifting American focus eastward appears threatened More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Natural Gas Export Plan Divides Maryland Towni
X
Deborah Block
September 21, 2014 2:12 PM
A U.S. power company that has been importing natural gas now wants to export it. If approved, its plant in Lusby, Maryland, would likely be the first terminal on the United States East Coast to export liquefied natural gas from American pipelines. While some residents welcome the move because it will create jobs, others oppose it, saying the expansion could be a safety and environmental hazard. VOA’s Deborah Block examines the controversy.
Video

Video Natural Gas Export Plan Divides Maryland Town

A U.S. power company that has been importing natural gas now wants to export it. If approved, its plant in Lusby, Maryland, would likely be the first terminal on the United States East Coast to export liquefied natural gas from American pipelines. While some residents welcome the move because it will create jobs, others oppose it, saying the expansion could be a safety and environmental hazard. VOA’s Deborah Block examines the controversy.
Video

Video Difficult Tactical Battle Ahead Against IS Militants in Syria

The U.S. president has ordered the military to intensify its fight against the Islamic State, including in Syria. But how does the military conduct air strikes in a country that is not a U.S. ally? VOA correspondent Carla Babb reports from the Pentagon.
Video

Video Iran, World Powers Seek Progress in Nuclear Talks

Iran and the five permanent members of the U.N. Security Council plus Germany, known as the P5 + 1, have started a new round of talks on Iran's nuclear program. VOA State Department correspondent Pam Dockins reports that as the negotiations take place in New York, a U.S. envoy is questioning Iran's commitment to peaceful nuclear activity.
Video

Video Alibaba Shares Soar in First Day of Trading

China's biggest online retailer hit the market Friday -- with its share price soaring on the New York Stock Exchange. The shares were priced at $68, but trading stalled at the opening, as sellers held onto their shares, waiting for buyers to bid up the price. More on the world's biggest initial public offering from VOA’s Bernard Shusman in New York.
Video

Video Obama Goes to UN With Islamic State, Ebola on Agenda

President Obama goes to the United Nations General Assembly to rally nations to support a coalition against Islamic State militants in Iraq and Syria. He also will look for nations to back his plan to fight the Ebola virus in West Africa. As VOA White House correspondent Luis Ramirez reports, Obama’s efforts reflect new moves by the U.S. administration to take a leading role in addressing world crises.
Video

Video Migrants Caught in No-Man's Land Called Calais

The deaths of hundreds of migrants in the Mediterranean this week has only recast the spotlight on the perils of reaching Europe. And for those forunate enough to reach a place like Calais, France, only find that their problems aren't over. Lisa Bryant has the story.
Video

Video Westgate Siege Anniversary Brings Back Painful Memories

One year after it happened, the survivors of the terror attack on Nairobi's Westgate Shopping Mall still cannot shake the images of that tragic incident. For VOA, Mohammed Yusuf tells the story of victims still waiting for the answer to the question 'how could this happen?'
Video

Video Militant Assault in Syria Displaces Thousands of Kurds

A major assault by Islamic State militants on Kurds in Syria has sent a wave of new refugees to the Turkish border, where they were stopped by Turkish border security. Turkey is already hosting about 700,000 Syrian refugees who fled the civil war between the government and the opposition. But the government in Ankara has a history of strained relations with Turkey's Kurdish minority. Zlatica Hoke reports Turkey is asking for international help.
Video

Video Whaling Summit Votes to Uphold Ban on Japan Whale Hunt

The International Whaling Commission, meeting in Slovenia, has voted to uphold a court ruling banning Japan from hunting whales in the Antarctic Ocean. Conservationists hailed the ruling as a victory, but Tokyo says it will submit revised plans for a whale hunt in 2015. Henry Ridgwell reports from London.
Video

Video A Dinosaur Fit for Land and Water

Residents and tourists in Washington D.C. can now examine a life-size replica of an unusual dinosaur that lived almost a hundred million years ago in northern Africa. Scientists say studying the behemoth named Spinosaurus helps them better understand how some prehistoric animals adapted to life on land and in water. The Spinosaurus replica is on display at the National Geographic museum. VOA’s George Putic has more.
Video

Video Iraqi Kurdistan Church Helps Christian Children Cope find shelter in churches in the Kurdish capital, Irbil

In the past six weeks, tens of thousands of Iraqi Christians have been forced to flee their homes by Islamic State militants and find shelter in churches in the Kurdish capital, Irbil. Despite U.S. airstrikes in the region, the prospect of people returning home is still very low and concerns are starting to grow over the impact this is having on the displaced youth. Sebastian Meyer reports from Irbil on how one church is coping.


Carnage and mayhem are part of daily life in northern Nigeria, the result of a terror campaign by the Islamist group Boko Haram. Fears are growing that Nigeria’s government may not know how to counter it, and may be making things worse. More

AppleAndroid