Non-availability of specific ARV drug type increases risk to HIV patients

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Non-availability of ARV drug type increases risk to HIV patients

Aditi Tandon

Tribune News Service, Chandigarh,

April 5. State AIDS Control Societies (SACS) in most parts of India, especially

north, have been doing without one of eight vital combinations of antiretroviral

(ARV) drugs. Stavudine 40 mg two-drug combination, the ARV drug type

administered to people living with HIV/AIDS (PLHAs) who are over 60 kg in

weight, has been out of stock at many antiretroviral therapy (ART) centres for

about a month.

In North India, especially, the problem is grave, considering the region has a

large number of PLHAs who are more than 60 kg in weight. The shortage has left

the patients with no option but to buy the drugs privately at a cost that can

range between Rs 1000 to Rs 1200 per month.

Several patients, being poor, have had to go without the drug type over the

period of its shortage as they have been unable to afford the cost of treatment.

The problem still persists and continues to disturb the HIV experts’ mandate of

ART drug adherence for HIV infected.

Non-adherence to any drug combination for any reason defeats the purpose of ART

as it increases the patient’s chances of developing resistance to the HIV virus

- something which regular ARV drug treatment fights. In this particular case,

the fear of patients developing resistance to the virus holds good, with even

doctors administering ART drugs admitting that the shortage has proved very

disturbing to the HIV treatment strategy.

“The shortage should not have been allowed to exist. It should have been

addressed in advance, especially when AIDS control societies all over the

country, including the one at Chandigarh, have been sending repeated reminders

to National AIDS Control Organization (NACO) to fill the gap,” a source said.

Another problem is that NACO prohibits local state AIDS control societies from

procuring the out-of-stock drugs locally for issues of quality control and

testing. Last year when a similar problem of non-availability of drugs had

arisen, Chandigarh SACS and societies at other centres had purchased the drugs

at local level to ensure that treatment did not suffer.

However, they were soon prevented from doing so through a circular that NACO

issued. Sources in NACO, meanwhile, said non- availability of Stavudine 40 mg

two-drug type had been caused due to error in the assumption of patients

requiring such a combination. “We had expected a certain number of patients to

seek this drug combination. But we ended up getting more than expected.

We are in the process of procuring drugs from a Bangalore-based company. The

supply order had been delayed. We will send the drugs within the next four

days,” said a top NACO official, adding that the other drug combinations were in

regular supply.

http://www.tribuneindia.com/2007/20070406/cth3.htm#4

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Yashwinder Singh <yashwinder_80@...>