One of the deadliest infections in the world, affecting close to 36.9 million people globally, the HIV (Human Immuno Virus), is yet to get a cure. Amidst news that human trials may soon start, with a vaccine being developed by Chinese scientists receiving a green signal, the WHO has recommended the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential suffering from HIV.
Here's everything you need to know:
∙ While initial studies had highlighted a possible link between DTG and neural tube defects in infants born to women using the drug at the time of conception, new data from two large clinical trials comparing the efficacy and safety of DTG and EFV in Africa have now expanded the evidence base.
∙ Turns out, the risks of neural tube defects are significantly lower than what the initial studies may have suggested.
∙ Notably, safety concerns on DTG were first reported in May 2018 from a study in Botswana that found 4 cases of neural tube defects out of 426 women who became pregnant while taking DTG.
∙ Following the revelation, a number of countries advised pregnant women and women of childbearing potential to take efavirenz (EFV) instead.
∙ According to WHO, DTG is a drug that is more effective, easier to take and with fewer side effects than alternate drugs that are currently being used.
∙ Furthermore, DTG has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and nevirapine-based regimens.
∙ In 2019, 12 out of 18 countries surveyed by WHO reported pre-treatment drug resistance levels exceeding the recommended threshold of 10 per cent. These findings resulted in the decision to update the 2019 guidelines.
∙ 82 low and middle-income countries have reported that they would be transitioning to DTG-based HIV treatment regimens and the newly updated recommendations aim to help even more countries improve their HIV policies.
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