Single daily pill boosts HIV battle
Durban - From April 1, HIV-positive people on antiretroviral (ARV) therapy will be able to take one pill a day, instead of three pills twice a day.
Pregnant women with HIV will also be put on this “triple fixed-dose combination” pill, no matter how strong their immune systems (CD4 count), for the duration of pregnancy and breast-feeding, to protect their babies from HIV.
The single pill is thanks to a new government contract that comes into effect next month for a generic that combines into one pill the three first-line ARVs, Tenofovir, Emtricitabine and Efavirenz.
Three ARVs are needed to keep HIV in check effectively and to prevent patients from developing drug resistance.
Health Minister Aaron Motsoaledi said the government had moved over to fixed-dose combination treatment because “it is much easier for patients to take their ARVs”.
“We are prioritising new patients and pregnant women for the fixed-dose combination pill treatment,” he said. “For those who (have been receiving) antiretroviral therapy, we will leave it to their doctors to decide whether to change them over.”
Describing the fixed-dose combination pill as “excellent news for patients”, Médecins Sans Frontières spokeswoman Kate Ribet said it would “improve adherence and thus reduce the risk of treatment failure and drug resistance”.
“It is easier to plan, order, prescribe, dispense and monitor adherence of one combination drug than three separate ones. This is critical, given the history of stock-outs and the lack of pharmacists and pharmacist assistants,” said Ribet.
Welcoming the single pill, the SA HIV Clinicians’ Society said it reduced the risk of incorrect dosing due to patient misunderstanding or prescribing or dispensing errors.
Patients would also be unable to default on single drugs to avoid certain side-effects. For example, some patients independently discontinue Efavirenz because of dizziness or drowsiness. “For me, the best thing about the fixed-dose combination is that it will not be possible to run out of one of the three antiretroviral drugs,” society president Dr Francesca Conradie said.
Vuyiseka Dubula, the general secretary of the Treatment Action Campaign, said the combination tablet would mean a reduction in the “pill burden” for people and improve the likelihood of people taking their treatment.
“About 70 percent of people in South Africa who have HIV have tuberculosis and have to take treatment for both illnesses at the same time. This means many of us take far too many pills, and that (causes) some not to take them.”
Dubula said not everyone would get the new single pill, as some patients were on different regimens and the government also had prioritised access.
“The most important thing is that we need to take our medication regularly without interruptions.” – Health-e News Service