Easy-to-take medicine better at suppressing HIV in children

Date:

Dispersive drug for infants. Credits: Picturing Health, picturinghealth.org

A low-cost, easy-to-take, once-daily antiretroviral drug is also more effective in controlling HIV than standard treatments, according to a global study led by UCL researchers.

Research published today New England Journal of MedicineFound that the dolutegravir-based regimen, which is already widely used in the treatment of adults, reduces the likelihood of treatment failure in adolescents aged 3 to 18 years by about 40% compared to standard treatment.

The findings were based on a randomized controlled trial called ODYSSEY, which included more than 700. Children Dolutegravir or standard antiretroviral drugs were randomly administered from 29 clinical centers in Africa, Europe, and Asia and followed for at least 2 years.

The results of this trial, sponsored by the Penta Foundation and funded by ViiV Healthcare, provided information on new guidance from the World Health Organization and recommended that children use dolutegravir-based treatments.

Professor Diana Gibb (UCL’s MRC Clinical Trials Unit), Principal Investigator for the ODYSSEY Trial and one of the senior authors of the paper, said:

“Treatment for children is often significantly delayed compared to adults due to the need for individual prescriptions and studies. ODYSSEY evidence using simplified dosing has narrowed the treatment gap and countries have children. We hope that we can quickly expand our access to the treatment globally. “

Lead author Dr. Anna Turkova, UCL’s MRC Clinical Trials Unit, said: With large tablets that are difficult to swallow.

“Dolutegravir is usually given in small tablets once a day, and baby pills can be dispersed in water, making it easier for young children to take. This facilitates treatment adoption and long-term compliance. Importantly, only about half of the children living with HIV are currently being treated, and untreated children are at high risk of weakened immunity and poor health. . “

An easy-to-take drug that is excellent for controlling HIV in children

Dr. Abbas and the patient, the principal investigators of the trial in Mbarara, Uganda. Credits: Picturing Health, picturinghealth.org

In this study, researchers found that 14% of children who received dolutegravir experienced treatment failures in two years, compared to 22% of children who received standard treatment. Treatment failure was considered to have occurred if the virus became measurable in the blood, that is, if it was not completely suppressed, or if the child had symptoms of HIV-related health problems. Such failures may be due to the drug not being taken and the drug not functioning.

Evidence from adults shows that dolutegravir has a high genetic barrier to resistance. This means that the virus is unlikely to become resistant over time. This was reproduced in the ODYSSEY trial, with much less resistance occurring between children and adolescents receiving dolutegravir-based treatment.

Previous studies have suggested that dolutegravir may be associated with weight gain in adults, but researchers found that those who received dolutegravir gained 1 kg, 1 cm, and abnormalities in 2 years. He said the new discoveries are reassuring for children, as they show better growth rather than heavy weight gain. Children in the dolutegravir group had a better lipid profile, which reduced their risk of cardiovascular disease in the long run.

In the main study, all children weighed over 14 kg and most were over 6 years old. The efficacy of treatment was also examined between infants and babies weighing less than 14 kg who were enrolled in another group in the study. The results have not been published yet.

Exam participants were enrolled in Uganda, Zimbabwe, South Africa, Thailand, the United Kingdom, Spain, Portugal and Germany. Most of the participants were based in sub-Saharan Africa, where most children live with HIV.

Early findings from the ODYSSEY trial show that children weighing 20 kg or more can safely take adult dolutegravir tablets, announcing WHO dosing guidance and a new license for the drug in the United States and Europe in 2020. Contributed to.

Dr. Cissy Kityo of Uganda’s Collaborative Clinical Research Center, which enrolls most children in ODYSSEY, said: Dolutegravir For the majority of children living with HIV. It greatly simplifies the procurement of national health care systems in low- and middle-income countries and reduces costs. “

Dolutegravir is an integrase inhibitor. In other words, it suppresses HIV by inhibiting integrase, an enzyme required for the virus to replicate.


Gender / gender disparity in dolutegravir intake persists despite WHOOK for women of reproductive age with HIV


For more information:
Anna Turkova et al, “Odyssey: Dolutegravir for Primary and Secondary HIV Treatment in Children”, New England Journal of Medicine (2021).

Quote: An easy-to-take drug with excellent HIV control in children (December 29, 2021) https: //medicalxpress.com/news/2021-12-easy-to-take-medicine-suppressing-hiv- to 2021 Obtained on December 29, 2014. children.html

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The post Easy-to-take medicine better at suppressing HIV in children appeared first on California News Times.

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