Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Aids: A Single-Tablet Generic Tritherapy Tested Successfully In Cameroon

05.07.2004


WHO’s objective is to enable 3 million people living with HIV to have access to antiretroviral treatments by 2005. The development of simple and inexpensive generic fixed-dose combined therapies appears the most suitable solution for making possible this access to treatments in developing countries with meagre resources.



The tritherapies that associate two different classes of antiretrovirals (two inverse transcriptase nucleoside inhibitors and a non-nucleosidic inhibitor of this same viral enzyme), used as a basic treatment, are effective and well tolerated. Their combined form in a single tablet, developed by a firm producing generic drugs, encourages better treatment compliance by the patient and simplifies management of orders and storage of the medicines. Their cost is much lower than that of tritherapies of patented medicines (2).

Consequently, these combined generic forms provide the possibility of treating more subjects infected with HIV. However, although prequalified by WHO and available in many developing countries, at present some international aid agencies involved in programmes of access to antiretrovirals do not recognize them. The main reason cited is the absence of full clinical studies that could allow assessment of their effectiveness, safety and quality.


Researchers from the IRD and their partners (1) have just shown, by means of a clinical trial performed in Cameroon, that the generic fixed-dose antiretroviral tritherapy currently most commonly used in Africa satisfied these criteria. This treatment uses a combination of a dose of nevirapine, one of stavudine and one of lamivudine in a single tablet.

The trial was conducted by means of a pilot project of access to the antiretroviral medicines initiated in Yaoundé, the capital of Cameroon. For six months, 60 adults infected by HIV-1 were treated with one tablet twice a day, in two of the city’s hospitals. Clinical and biological monitoring of these infected subjects kept a close check on their health status with time and evaluated the effectiveness, the tolerance and treatment compliance. The appearance of resistance and the quality of the different batches of medicines administered as part of the trial were also investigated.

At the end of six months of treatment, the viral load was undetectable (below 400 copies/ml) in 80% of patients The T CD4 lymphocyte count was increased by 83 cells/µl, indicating a satisfactory level of immunity restoration. The treatment applied thus turned out to be as effective as conventional tritherapies. According to patients’ accounts, in 99% of cases the medicines were taken in compliance with prescriptions. This very good compliance with treatment was confirmed by regular measurement of blood concentrations of each of the three antiretrovirals. Out of 60 people in the study, only one case of intolerance was found, necessitating a modification to the treatment. The researchers moreover observed two cases of resistance, one in a person who had not properly followed his prescribed treatment, the other in a woman who, before the start of trial, had received nevirapine in prevention treatment against mother-child HIV transmission.

In parallel, analysis of several tablets from each of seven boxes of generic medicines distributed to patients in the trial verified that these tablets effectively contained the active agents for which they were put on the market, in the expected doses (3).

These results showed that the generic fixed-dose tritherapy studied is at once effective, well tolerated and of high quality. They provide arguments in favour of its use as basic treatment in the developing countries.

The study is currently being continued with the aim of finding long-term confirmation of the results obtained. These are the subject of a publication and discussion in the journal The Lancet of 3 July. They will be presented at the international conference on Aids, to take place in Bangkok, in mid July.

(1) The main institutes participating are the IRD, the National AIDS Control Programme (Yaoundé), the Central hospital and the Military hospital of Yaoundé (Cameroon), Médecins sans frontières (Geneva, Switzerland). The study was financed by the ANRS (Paris, France).
(2) In Cameroon, this generic fixed-dose tritherapy contained in a tablet comes to 20 dollars per month, as against 35 for a conventional tritherapy.
(3) 96% of the expected dose for nevirapine, 89%
for stavudine and 99% for lamivudine.

Marie Guillaume | alfa
Further information:
http://www.paris.ird.fr

More articles from Health and Medicine:

nachricht Fast-tracking T cell therapies with immune-mimicking biomaterials
16.01.2018 | Wyss Institute for Biologically Inspired Engineering at Harvard

nachricht Dengue takes low and slow approach to replication
12.01.2018 | Duke University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

Im Focus: Room-temperature multiferroic thin films and their properties

Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.

Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...

Im Focus: A thermometer for the oceans

Measurement of noble gases in Antarctic ice cores

The oceans are the largest global heat reservoir. As a result of man-made global warming, the temperature in the global climate system increases; around 90% of...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

White graphene makes ceramics multifunctional

16.01.2018 | Materials Sciences

Breaking bad metals with neutrons

16.01.2018 | Materials Sciences

ISFH-CalTeC is “designated test centre” for the confirmation of solar cell world records

16.01.2018 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>