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 Cholesterol-lowering drugs may fight infectious disease
22.08.2017 | Duke University

nachricht Once invincible superbug squashed by 'superteam' of antibiotics
22.08.2017 | University at Buffalo

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: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

Cholesterol-lowering drugs may fight infectious disease

22.08.2017 | Health and Medicine

Meter-sized single-crystal graphene growth becomes possible

22.08.2017 | Materials Sciences

Repairing damaged hearts with self-healing heart cells

22.08.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>