[afro-nets] Anti-Retroviral Drugs Resistance

Anti-Retroviral Drugs Resistance
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Experts Express Concern over Rising Cases of Drug-Resistant HIV
Strains

(1) INDISCRIMINATE use of anti-retroviral drugs (ARV). Commonly
called Acquired Immune Deficiency Syndrome (AIDS) drugs, in the
developing world is being blamed for the rising cases of drug-
resistant Human Immuno-deficiency Virus (HIV) strains that
causes AIDS.

The findings of the study were published in the British Medical
Journal by a team of researchers from the London School of Hy-
giene and Tropical Medicine.

The study shows that uncontrolled prescription of ARV is wide-
spread and rising in Africa and Asia, and urges governments and
international agencies to deal with the problem. Worried by the
prospect of unregulated supply of AIDS drugs accelerating the
development of drugs-resistant HIV, the Federal Ministry of
Health (FMH) recently completed a pilot (clinical) study on
ARV’s imported for people living with HIV/AIDS (PLWHAs).

The problem, according to reports, is compounded because of the
worsening economic realities in developing countries where the
state sector cannot or will not provide drugs, leaving patients
who can afford them to naturally purchase where they can from
doctors, pharmacies, market sellers, or relatives abroad.

However, HIV experts insist that the drugs are meant to be pre-
sented and their resistance monitored.

The leader of the team, Dr. Ruairi Brugha, observes that pa-
tients often do not take their drugs as recommended. He said:
“These drugs are not being used according to the correct regi-
mens. For instance, monotherapy just giving one ani-retroviral
drug is definitely bad practice. And we see evidence of that
both from Zimbabwe and Uganda, and I am sure it is happening in
other countries too.” The study also noted that in some places
patients are changing medication frequently, taking the wrong
dose, or stopping treatment in periods when they cannot afford
it.

Commenting on the study, the chairman National Action Committee
on AIDS (NACA) professor Babatunde Osotimehin regretted that the
misuse of AIDS drugs which has become common in Africa is pre-
cisely the set of conditions under which a virus quickly becomes
drug resistant.

Osotimehin, however, noted that the National ARV programme is
making sure that only those who need the drugs get it and at
recommended doses. He said: “There are set procedures before a
PLWHA is recruited into the ARV programme. We have made adequate
provision for the recommended dosage.”

According to reports, HIV also is becoming resistant to estab-
lished ARVs in the rigid treatment patterns of the so called de-
veloped nations. The study cautions that governments and health
authorities cannot afford to wait for more dangerous resistance
to emerge in the developing world. It reads: “Doctors and clin-
ics need treatment guidelines, supplies of drugs need to be sta-
ble, and the public sector needs to compete more effectively in
providing the services that people want.” (ICEHA) The director-
general of the Nigerian Institute of Medical Research (NIMR)
Yaba, Lagos, Dr. Oni Idigbe, who heads the pilot centers told
the Guardian that drug resistant strain of HIV is set to emerge
if the ARV drugs are not used according to the strict guide-
lines.

“We are doing everything possible to ensure that this problem
does not jeopardize the ARV programme and the commitment of the
Federal Government to provide treatment for PLWHA,” Idigbe said.
Meanwhile, American Food and Drug Administration (FDA) has ap-
proved the sale of a new 625-mg table of nelfinavir. People liv-
ing with Human Immuno-deficiency Virus (HIV) that causes the Ac-
quired Immune Deficiency Syndrome (AIDS) taking the new formula-
tion now only need to take two tables twice daily.

The report published in (ATIE ­ News: Bite ­ sized HIV/AIDS
treatment news bulletins) notes that the new formulation of
nelfinavir is as effective as the old formulation.

By Asaha Udom (Director)
mailto:okugod@yahoo.com

Anti-Retroviral Drugs Resistance (2)
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I read the article of drug resistance with great interest. I
have just realized my CD4 cell is 90 and that is not good news
for me. Under these circumstances realizing fully well if I de-
lay to commence I might deteriorate and will be difficult to get
myself back together. I am forced to look for drugs and in these
desperate circumstances which has forced many people to start
treatment which eventually they will not be in position to sus-
tain in the long run.

The other reason especially for Zimbabwe, Harare in particular,
a lot of people were displaced by the clean up operation which
made a lot PLWHA not to access their drugs at all. While I might
not have figures I can give you here I have some of my own sup-
port group members who have missed doses because of this exer-
cise. The other factor has been drug costs: currently in Zim-
babwe per month you need not less than 1.5 million Zimbabwe dol-
lars and each household in town per month are not even getting
anything near that. So really we have a number of challenges
that affect adherence which later leads to resistance.

Believe Dhliwayo
Vital Hope Support
9 Newport Road Greencroft
Harare, Zimbabwe
Cell: +263-23-693-050
Tel.: +263-4-333-917
mailto:vitalhopes@comone.co.zw

Vital Hope Support Group is a Registered Support Group of The
National Network For People Living With HIV & AIDS in Zimbabwe
ZNNP+ (PVO 2/99) This is a People Living With HIV & AIDS Commu-
nity Based initiative involved in Treatment Literacy & Wellness
Programs, in The World of Work and Resource Limited Settings.

Anti-Retroviral Drugs Resistance (3)
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Dear Believe,

I thought the ARV were free to those who have them unless they
prefer and can afford to pay! At least this is the case here in
Tanzania. I am wondering how one can help but will get in touch
as soon as I have something concrete. The CD4 of 90 is already
too low NOT to be on treatment! However I understand the dilem-
mas you are facing.

Redempta Mbatia
MD, MSc EPI (UK), DLSHTM
Health Expert & Technical Adviser
RFA Kilimanjaro and Tanga
GFA Medica
P O Box 3002
Moshi, Tanzania
mailto:gfa.moshi@iwayafrica.com