Children living with HIV/Aids in the region will soon benefit from a new antiretroviral formulation that medical workers say is easier to administer and has a “friendly” taste.
Medics also hope the formulation, developed by pharmaceutical company Cipla, in collaboration with the Drugs for Neglected Diseases Initiative (DNDi) and was approved for use by WHO in 2015, will address the treatment gaps that currently exist as a result of challenges resulting from the way the current drugs are stored.
The formulation, containing the antiretroviral drugs Lopinavir and Ritonavir, will be in oral pellets and will replace the syrup form of the same drug, which is the current formulation in use for treating paediatric HIV. The syrup formulation has a bitter taste, which usually makes it difficult for children to take consistently every day.
The newly developed pellets can be administered by being mixed with soft foods given to children, including porridge, yoghurt and breast milk.
“We still have challenges addressing treatment gaps for children living with HIV, and this largely has to do with the current form of the medication — both in terms of the taste and storage,” said Dr Cordelia Katureebe, the national co-ordinator for paediatric and adolescent HIV care at Uganda’s Health Ministry.
“With the syrup, one has to store it under refrigeration with a specific temperature and after two months it is usually not suitable for use,” she added.
Because the syrup requires refrigeration at all times, it becomes challenging for poor families who cannot afford fridges or those in rural areas where such facilities are non-existent.
But with the oral pellets, Dr Katureebe said, they are heat-stable and are considered safe under normal temperatures.
The bitter taste of the paediatric HIV drugs also means some children and caregivers abandon treatment altogether. “That is why this new formulation will help us retain those on treatment but also reach out to more children as it will be easy to administer and store the medication in all settings,” noted Dr Katureebe.
A two-year study to evaluate the acceptability and use of the new formulation among 250 children started in May in Uganda at five sites including three run by the Joint Clinical Research Centre in Kampala, Gulu and Fort Portal districts and two others at EPI in Mbarara district and Baylor Uganda at Mulago Hospital.
Dr Olawale Salami, project manager for the paediatric HIV project of DNDi, said a similar study is already underway in Kenya, with plans to expand the initiative to other East African countries.
Dr Victor Musiime, the principal investigator of the study at the Joint Clinical Research Centre in Kampala said the study will focus on how the children are responding to the new drug, its acceptability and how easy it is for parents and caregivers to administer it.
“The advantage of the new formulation is that it does not require refrigeration so we are hoping that caregivers will find it more acceptable and that the patients will also like it. This will help us solve the challenge of treating children living with HIV,” noted Dr Musiime.
The WHO estimates that about 3.2 million children under the age of 15 are living with HIV/Aids, mostly in sub-Saharan Africa. Although progress has been made in the elimination of mother-to-child-transmission of HIV, even in poor African countries, the same progress has not been made in ensuring all those living with the virus receive effective treatment.
About 800,000 children under the age of 15 are currently enrolled on and receiving antiretroviral therapy (ART) in low and middle-income countries globally. According to Dr Katureebe, Uganda has about 95,000 children under the age of 15 living with HIV/Aids. Of these, 60,000 are currently on ARV treatment.