Study optimises second line ARV therapy

normal lives, but on medication daily.
In Anti-Retroviral Therapy, adherence is of paramount importance as lack of it can lead to serious health problems leading to the mutation of the virus in the blood thereby resulting in one failing to recover even when taking the medicine. Not everyone who reacts badly to some ARVs would have defaulted, for some, they could just have not been compliant with the medication.
There are a few people who have encountered problems with ART and some of them have unfortunately died. One such case was reported in the media in February, which brought to the fore that some people have reacted severely to ARVs.
The woman in this instance had been on Stalanev for two years and had not experienced any problems. She had in fact recovered, but her health took a sudden turn and she began experiencing swollen feet and a severe headache.
She had “pins and needles” and failed to walk in no time.
She also complained of a splitting headache among a host of other complications. Continuing on the drug for a patient who is reacting can have fatal consequences, as the drug would not be serving the required task of getting one healed.
It would be even toxic and causing one to get worse instead of getting better. She was admitted at Parirenyatwa Hospital where for a full month tests for meningitis were run and she was found not to have that. She unfortunately died before the country had embarked on any clinical trials to see why some people reacted badly to ARV medication.
It is for those who have reacted severely that the EARNEST Study – UZ CRC launched clinical trials.
For some who have been lucky they have been enrolled on the clinical trials for people who have had severe side effects to ARVs.
The EARNEST trial is the world’s largest trial investigating the best options for individuals whose first combination of anti-HIV medicines is no longer working.
The main aim of the trials is to find out whether in African HIV treatment programmes, a new anti-HIV medicine, raltegravir (currently registered for HIV treatment in Western countries) can be combined with a standard anti-HIV medicine called aluvia (lopinavir/ritonavi) to benefit people who need to change their HIV treatment.
This means they have to switch to second line therapy, which should be more effective and could bring recovery to those affected. In a report released recently the EARNEST clinical trials reached a milestone after a year on Friday, April 29, 2011 when 1 200 HIV positive individuals for the project were recorded.
“The 1 200 participants were enrolled at 14 sites in five African countries, namely Uganda, Malawi, Kenya, Zambia and Zimbabwe. In Zimbabwe, 330 HIV positive individuals have been recruited at the University of Zimbabwe Clinical Research Centre (UZ-CRC) in Harare,” said the report.
The trial is being conducted in partnership with the United Kingdom Medical Research Council, the Institute of Tropical Medicine in Belgium, the Istituto Superiore di Sanita and CINECA in Italy, the Hospital La Paz in Spain and the University College Dublin in Ireland.
The European Union is funding programmes with medicines for the trial having been donated free of charge by various pharmaceutical companies including Merck and Abbott.
“Now that trial recruitment has been completed and all EARNEST participants have commenced on the second combination of anti-HIV medicines.
“The focus of the EARNEST trial will be on collecting important information about the health of the participants as well as important information about their quality of life, social functioning and financial status.
“The trial will provide final results in early 2014. The findings of this African trial will inform future international HIV treatment guidelines such as those of the World Health Organisation, and are eagerly awaited around the world,” said the report. The participants are assured of continued support even after the trials.
Wild rumours are associated with clinical trials as people speculate that after being made guinea pigs patients would be abandoned to die. This is not the case as the organisation makes follow up and assist in the health needs of all the participants. For most HIV patients, lack of cash to travel to the clinics and centres and at times the long distances covered have made adherence impossible. This special clinical trial helps those who are not able to meet their transport needs as defaulting is not an option.
Meanwhile, the world of science has reached a milestone and promised a vaccine for Aids within a year. This should be a relief, as it would mean a new chapter in the fight against the pandemic.
Dr Bette Korber is dedicated to finding an HIV vaccine after losing two of her friends to the pandemic. In a report on the Daily Mail, Dr Korber who is based at Los Alamas National Laboratory in New Mexico has worked for the past 20 years in the evolutionary lane studying HIV when most people believed it an exercise in futility.
The Mosaic vaccines act in that it stimulates the immune system to recognise naturally occurring amino acids in the virus’ proteins.
The HIV virus is made of largely of proteins, cause Aids, a disease that targets the body’s immune system making a person vulnerable to a host of infections and foreign tumours. The mosaic vaccines are believed to provoke very strong immune responses in monkeys and mice and should be the best thing to happen in the research to a vaccine. For all people living positively, 15 years ago, testing positive in Zimbabwe was a death sentence. Even in the developed world anti-HIV medicine was very expensive and only the rich could afford it. Then only brand names were produced and ranged from US$10 000 to US$12 000 per year for one which was not affordable to the majority.
Thanks to the Indian firms which are dubbed third world pharmacies as they have made medication affordable by manufacturing generic medicine for so little. Even developing countries can now afford to buy the generic medicines. People living positively must be aware that cross infections are a major risk to their health and no matter what the world of medicine brings, cross infections is digging one’s grave.
Today, people on ART have a new lease of life, and like any lease, if you default on the terms of the contract it is cancelled. May concern is for HIV positive people who inspite of their condition think that no more harm can be done to their systems. They have this warped thinking that: “I already have it so what.”
This is being foolish as they keep getting a host of other infections they did not have. In the process they acquire TB, pneumonia, herpes, meningitis etc whereby one ends up suffering from all the communicable disease when in the first place one only was afflicted with one, how sad.
In instances where one had HIV-1 on falling sick and being retested they are found to have HIV-3 which is a cross infection type. How unfortunate. With such behaviour, ARVs are bound to fail too. Not to even talk of the vaccine in a year or less which should go on trials, behaviour change is called in such people. Do not be reckless and have your lease terminated. ARVs are not the miracle drug, behaviour change and adherence to medication are.
In all you endeavour to get, may you get understanding. Till then, God bless.
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