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

EU Court Fines Poland for Hosting CIA 'Black Sites'

Ruling is first time a court has acknowledged suspects were held and tortured at the sites, under US program launched following the 9/11 terrorist attacks More

Migrant Issues Close to Home Spur Groups to Take Action

Groups placing water, food in the desert, or aiding detainees after release, have one common goal: no more deaths of migrants crossing illegally into the US More

Video At AIDS Conference, Prevention Pill Stirs Excitement

Truveda shows promise, spurring debate over access and other approaches More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Israel Targets Gaza Supply Tunnelsi
X
July 24, 2014 4:42 AM
The Israeli military has launched a ground operation in Gaza to destroy the myriad tunnels that may have been used to smuggle weapons to Hamas. VOA's Zlatica Hoke reports that could mean more hardship for the people of Gaza, who obtain some of their essential supplies through these underground passages
Video

Video Israel Targets Gaza Supply Tunnels

The Israeli military has launched a ground operation in Gaza to destroy the myriad tunnels that may have been used to smuggle weapons to Hamas. VOA's Zlatica Hoke reports that could mean more hardship for the people of Gaza, who obtain some of their essential supplies through these underground passages
Video

Video MH17's 'Black Boxes' Could Reveal Crash Details

The government of Malaysia now has custody of the cockpit voice and flight data recorders from Malaysia Airlines Flight 17, which was hit by a missile over Ukraine before crashing last week. As VOA's Carolyn Presutti reports, the so-called black boxes may hold information about the final minutes of the flight.
Video

Video Living in the Shadows Panel Discussion

Following a screening of the new VOA documentary, "AIDS - Living in the Shadows," at the World AIDS conference in Melbourne, a panel discussed the film and how to combat the stigma associated with HIV/AIDS.
Video

Video IAEA: Iran Turns its Enriched Uranium Into Less Harmful Form

Iran has converted its stockpiles of enriched uranium into a less dangerous form that is more difficult to use for nuclear weapons, according to the United Nations’ Atomic Energy Agency. The move complies with an interim deal reached with Western powers on Iran's nuclear program last year, in exchange for easing of sanctions. Henry Ridgwell reports for VOA from London.
Video

Video Relic of Saint Draws Catholics Worried About Immigration Issue

A Roman Catholic saint who is a figure of devotion for those crossing the border into the United States is attracting believers concerned about the plight of undocumented immigrants. Mike O'Sullivan reports from Los Angeles, where a relic of Saint Toribio has drawn thousands to local churches.
Video

Video US Awards Medal of Honor for Heroics in Bloodiest of Afghan Battles

U.S. combat troops are withdrawing from Afghanistan, on pace to leave the country by the end of this year. But on Monday, U.S. President Barack Obama took time to honor a soldier whose actions while under fire in Afghanistan earned him the Medal of Honor. VOA's Jeff Seldin has more from the Pentagon.
Video

Video Ukraine Rebels Surrender MH17 Black Boxes

After days of negotiations, a senior separatist leader handed over two black boxes from an airliner downed over eastern Ukraine to Malaysian experts early Tuesday. While on Monday, the U.N. Security Council unanimously demanded that armed groups controlling the crash site allow safe and unrestricted access to the wreckage.
Video

Video In Cambodia, HIV Diagnosis Brings Deadly Shame

Although HIV/AIDS is now a treatable condition, a positive diagnosis is still a life altering experience. In Cambodia, people living with HIV are often disowned by friends, family and the community. This humiliation can be unbearable. We bring you one Cambodian woman’s struggle to overcome a life tragedy and her own HIV positive diagnosis.

AppleAndroid