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

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: Nonstop Tranport of Cargo in Nanomachines

Max Planck researchers revel the nano-structure of molecular trains and the reason for smooth transport in cellular antennas.

Moving around, sensing the extracellular environment, and signaling to other cells are important for a cell to function properly. Responsible for those tasks...

Im Focus: UNH scientists help provide first-ever views of elusive energy explosion

Researchers at the University of New Hampshire have captured a difficult-to-view singular event involving "magnetic reconnection"--the process by which sparse particles and energy around Earth collide producing a quick but mighty explosion--in the Earth's magnetotail, the magnetic environment that trails behind the planet.

Magnetic reconnection has remained a bit of a mystery to scientists. They know it exists and have documented the effects that the energy explosions can...

Im Focus: A Chip with Blood Vessels

Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.

Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...

Im Focus: A Leap Into Quantum Technology

Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.

In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...

Im Focus: Research icebreaker Polarstern begins the Antarctic season

What does it look like below the ice shelf of the calved massive iceberg A68?

On Saturday, 10 November 2018, the research icebreaker Polarstern will leave its homeport of Bremerhaven, bound for Cape Town, South Africa.

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Optical Coherence Tomography: German-Japanese Research Alliance hosted Medical Imaging Conference

19.11.2018 | Event News

“3rd Conference on Laser Polishing – LaP 2018” Attracts International Experts and Users

09.11.2018 | Event News

On the brain’s ability to find the right direction

06.11.2018 | Event News

 
Latest News

Nonstop Tranport of Cargo in Nanomachines

20.11.2018 | Life Sciences

Researchers find social cultures in chimpanzees

20.11.2018 | Life Sciences

When AI and optoelectronics meet: Researchers take control of light properties

20.11.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>