New drug with reduced dosage side effects can help to increase treatment adherence among HIV

  Approximately 1.5 to 2.0  lakh people are living with HIV and AIDS in Andhra Pradesh andTelangana out of 21 lakh in India

  Studies show that non-adherence to treatment in HIV in infection leads viral resistance and drug failure

With India reporting 3rd largest number of high number of HIV cases in the world, the new drug with reduced dose of Efavirenz that has been approved by the top drug regulatory in the country recently has brought cheer among the medical fraternity with doctors highlighting that the new drug with reduced side effects can help to curb non-adherence to treatment, which has reportedly become one of the major reasons for treatment failure.

“Adherence plays a key role in HIV treatment success. Present HIV drugs were reported to have various side-effects such as vivid dreams including nightmares, nocturnal dizzininess, depersonilalization which many times lead to patients to sticking to not following the treatment,” said Dr.M Satyanarayan, HIV Physician, Aswini Diabetic and HIV Clinics Hyderabad.

It has been reported that Efavirenz at the dose of 600mg is associated with aforementioned effects and can be a major hindrance in ensuring good adherence among HIV infected people. A research funded by Bill & Melinda Gates Foundation and conducted by Australia’s University of New South Wales had suggested that a reduced dose of 400 mg Efavirenz is not only non-inferior to the standard dose of 600 mg in terms of efficacy but can also significantly reduces the efavirenz related Central Nervous system side effects.

The Drug Controller General of India (DCGI) has recently approved the marketing of antiretroviral (ARV) drug TLE400 (Tenofvori Disoproxil Fumarate 300mg/Lamivudine 300mg/ Efavirenz 400mg) in India as an alternative first-line treatment for HIV-AIDS affected people.

Even though the adult HIV prevalence at national level has shown steady decline since 2003, India remains one of the worst HIV-affected countries in the world, with has approximately 25 lakhHIV infected people. Approximately, 6.3% of the infected individuals are children and 40.5% are women. The number of infected patients continues to grow every year.

Although various government and non-government organizations have dedicated awareness programs focusing on preventive and curative measures in HIV, the outreach to the affected population has been moderately effective.

 “Government efforts along with active participation from NGOs and hospitals have made a significant impact as we see today a steady decline in adult HIV prevalence from an estimated peak of 0.38% in 2001–2003 to 0.26% in 2015,”said Dr. Meka Satyanarayana. However, adding that the situation still remains challenging, he said: “As per the latest data, approximately 86,000 new HIV infections were reported in 2015, with expected trends may follow in 2017 and 2018.”

Dr. Meka Satyanarayana also elaborated that “ a huge section of HIV infected population are from low socio economic sections of the society. Hence, the high cost of HIV drugs is an important concern.”

The new drug reportedly has been launched at reduced prices in comparison with other first-line antiretroviral drug, which can have significant impact in ensuring adherence. He further said, “Along with government measures in scaling awareness programmes to reach the last HIV patient with combined efforts from NGOs, doctors, and hospitals, affordable drugs with low side-effects will help the mission to eliminate HIV in a from society”

Awareness campaigns with the support of such drugs will help enforce better medical adherence in targeted groups like pregnant mothers, migrant workers, prisoners, truck drivers, sex workers, injecting drug users, and others. “This is of major significance, especially for states like Telangana, Andhra Pradesh, Maharashtra, and Karnataka, Gujrat and Goa which has the highest people living with HIV numbers in 2016,” Dr. Meka Satyanarayana concluded.