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New ARV injections to replace daily pills, reduce defaulters

 

Ugandan HIV activists Barbara Kemigisa shows Antiretroviral (ARV) packagings and tablets in an art design encouraging people infected with HIV to use the ARVs and fight against stigmatisation during the Nairobi Summit on ICPD25 at KICC. [David Gichuru, Standard]

Local medical experts have welcomed the approval of an ARV injection which will replace the daily pills for people with HIV.

Use of Antiretroviral (ARV) drugs cabotegravir and rilpivirine jabs was approved by the National Institute for Health and Care Excellence (NICE) in England and which published the findings indicating injections were as good as convectional ARV drugs in keeping the virus at bay.

Currently, across the globe, treatment for HIV?1 is via taking lifelong antiretroviral tablets daily to keep viral load low, so that it can neither be detected nor transmitted between people.

NICE notes that the two drugs are administered as two separate shots every two months after an initial oral (tablet) lead-in period meaning it will reduce the number of drug defaulters.

According to NICE Deputy CEO Meindert Boysen for some people “daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle.”

Cabotegravir and rilpivirine are manufactured by Viiv Healthcare and Janssen, respectively, and are recommended for patients with HIV-1 infection.

“Clinical trial results show that cabotegravir with rilpivirine is as effective as oral antiretrovirals at keeping the viral load low,” reads part of the finding in parts.

Patients on the jabs should also have no evidence to suspect viral resistance or previous failure of other anti-HIV-1 drugs called nonnucleoside reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (INIs).

Scientists in the study documented stigma as an issue that negatively impacts on health and relationships of HIV patients “who might prefer an injectable regimen with less frequent dosing,” said Boysen. If approved, NICE will publish final guidance on use by January 2022.

The ARV injections will be tested on 13,000 eligible people in England before treatment is rolled out globally.

Kenyan scientists have welcomed the findings with Pharmaceutical Society of Kenya CEO Dr Daniella Munene, saying the injections will mean a higher quality of life for those living with HIV as daily uptake of tablets comes with stigma and leads to defaulting.

“The injection regimen is indicated for those who have already suppressed their viral load through the regular regimen,” said Dr Munene. 

Meanwhile, Kenya is facing an acute shortage of rapid HIV testing kits, risking mother to child transmission.

The most affected are pregnant mothers who are now delivering without undergoing mandatory tests as per the HIV prevention guidelines.

National AIDS and STIs Control Programme (Nascop) head Dr Catherine Ngugi admitted there has been a shortage of kits.

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