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First two-drug combination pill for HIV treatment.

Before this landmark development, it was impossible for HIV patients to cover all of their needs through a single pill.

First two-drug combination pill for HIV treatment.

HIV treatment usually involves pills containing two inhibitors with important functions

Before this landmark development, it was impossible for HIV patients to cover all of their needs through a single pill. ViiV Healthcare recently introduced a new treatment option after successful trials.

One pill contains Integrase inhibitors

Integrase inhibitors (INIs) are kinds of  ARVs designed to block the function of integrase (a viral enzyme). Integrase is what inserts the HIV viral genome into host cells. Because this function is vital for HIV to replicate itself, blocking it halts further spread of the virus.

The other pill contains Nucleoside Reverse Transcriptase inhibitors

Nucleoside Reverse Transcriptase Inhibitors (NRTIs), though, were the first drugs available to treat HIV. Instead of inhibiting integrase, though, NRTIs inhibit something called reverse transcriptase. HIV cells heavily depend on reverse transcriptase for replication as well. Without this, the virus can’t copy itself at all.

‘Dovato’ – the new pill – now contains both inhibitors together

‘Dovato’, a new single-tablet antiretroviral regimen, now covers both functions. Manufacturer, ViiV Healthcare, is confident that this once-daily treatment application will help maintain a low viral load. ViiV is making it clear, though, that despite the medical revolution involved, this is not first-line therapy.

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So are ‘Dovato’ pills safe to use?

More than 1400 participants were involved in studies and trials, which resulted in approval being granted by the FDA. For surety, effects of traditional ARVs were included to compare against those only using ‘Dovato’. During 2018’s International AIDS Conference, reports surfaced that 91% of Dovato patients displayed an undetectable viral load. This means that the patients’ HIV RNA at 48 weeks in, couldn’t be seen in any tests whatsoever. Alarmingly, the response rates for patients with both high and low viral load were identical.

Both regimens were safe and well-tolerated. Fewer side effects were seen among ‘Dovato’ patients. Traditional ARVS still seemed to induce headaches, diarrhoea, nausea, insomnia and fatigue.

‘Dovato’ patients also displayed reduced signs of kidney- and osteo-related degeneration. But there is always another side to any medicine you use. ‘Dovato’ comes with clear warnings, like the fact that HIV patients using it while coping with Hepatitis B could develop drug resistance. Lamivudine, a key ingredient, acts against both viruses. This opens the door for a genetic mutation to occur, and likely cause drug-resistant HBV, just like when you don’t adhere to a TB treatment plan. Dug-resistant mutations worsen liver inflammation if treatment adherence doesn’t occur so HIV/HBV co-infection patients should consider adding HBV treatment or choosing an alternative HIV regimen.

Is the pill safe to use while pregnant?

For pregnant women undergoing PMTCT treatment plans, ‘Dovato’ is not recommended. Trials presented an association with neural tube defects in newborns to women using ‘Dovato’ in their first trimester. ‘Dovato’ should not be used at the time of conception through the first trimester of pregnancy, according to the FDA.

Despite these restrictions, ‘Dovato’ offers a safe, easy-to-use option for HIV patients.

Key benefit

HIV patients now have the option of taking a two-drug regimen in a single tablet. This eliminates additional toxicity and potential drug interactions from other ingredients.

Sources:

Highleyman, L. 2019. US regulators approve new two-drug combination pill for HIV. AIDSmap. 11 April. Available at: http://www.aidsmap.com/news/apr-2019/us-regulators-approve-new-two-drug-combination-pill-hiv [Accessed 30 July 2019].

US Department of Veterans Affairs. 2018. Nucleoside reverse transcriptase inhibitors (NRTIs or nukes). 9 February. Available at: https://www.hiv.va.gov/patient/treat/nrtis.asp [Accessed 30 July 2019].

We all have questions.

Below are some of the answers to the most common questions that you need to know.

What is usually the first sign of HIV?

After getting infected with HIV, most patients only experience moderate flu-like symptoms. Typically, the illness is sudden in onset and is characterised by fever, swelling of the lymph glands, a measles-like rash all over the body and ulcers in the mouth and sometimes on the genitalia.

What are the 4 stages of HIV?
  • Stage 1: Infection – Exposure to infected bodily fluids.
  • Stage 2: Asymptomatic – HIV quickly spreads and the patient becomes seropositive for HIV antibodies.
  • Stage 3: Symptomatic – The immune system is now engaged in a constant battle with the rapidly replicating virus.
  • Stage 4: AIDS – At this stage, the patient’s CD4+ count is 200 cells per mm3 or less.
How soon can HIV be detected by a blood test?

No test can detect HIV immediately after infection. The time between initial infection and a detectable viral load is called the window period. It can take anywhere from 2-12 weeks to after exposure detect whether you are HIV-positive or not, depending on which testing method is used.

How long does it take to show symptoms of HIV?

Following initial infection, there is a period of intense, unchecked viral replication that occurs. It usually takes two to four weeks after infection and can last about one to two weeks, after which there tends to be a slight recovery, and the infected individual is considered to be seropositive for HIV antibodies.

How is HIV transmitted?

HIV is transmitted from one person to another through the exchange of body fluids. The main method of transmission in South Africa is through unprotected sexual activity.

Does HIV test affect life insurance?

Being HIV-positive can affect standard life insurance policies, particularly if your status changes from HIV-negative to HIV-positive within a particular age range. That’s why AllLife covers all lives. Your HIV status doesn’t prevent you from getting cover with us.

Can HIV-positive women have children?

Yes, HIV-positive women can enjoy healthy pregnancies and give birth to healthy HIV-negative babies. Through the Prevention of Mother to Child Transmission (PMTCT) programme has been highly effective in reducing transmission risk to under 1%.

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