HIV
The clinical team conducting the study at Aga Khan University Hospital Nairobi displays the injectable ARV medication under study led by Professor Reena Shah (left), Infectious Diseases Specialist.

Kenya has joined other nations across the world in a clinical study on injectable antiretroviral (ARVs) medications in a collaborative trial involving the Aga Khan University Hospital, Kenya.

The first patient in Kenya was injected with antiretroviral medication on March 31.  The study is also being carried out in Uganda and South Africa and the results will inform antiretroviral policy, especially in Africa.

Patients opting for the survey will have the option of either starting the injection straight away or taking the tablet form of RPV and CAB for one month before starting injections. This will allow observing if they can safely take these new drugs.

Each randomized patient will be followed up for 24 months, with viral loads being monitored every six months to determine if they are responding well to treatment. In addition, the study will be monitored for side effects very closely to see that the drugs are safe.

At the moment, most HIV drug regimens consist of three different medications that need to be taken orally daily.

The studies that led to this licensing were mostly done in Europe, the Americas and Asia whose populations and socioeconomic backgrounds significantly differ from African populations.

“Successful treatment of HIV leads to control of viral multiplication. This success relies on people taking their drugs regularly. The way someone takes their drugs may depend on several factors that include the number of drugs taken, the ease of swallowing them, the number of times they are taken, their taste, as well as the associated side effects among other factors,” said Prof Rena Shah, an infectious disease expert at the hospital who is leading the study.

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Prof. Reena added that “this study is looking at using a different way of taking the HIV medicine; using injections of two medicines given once every two months. These injected medicines have worked well in previous studies done in the USA, Europe, and South Africa but have not yet been evaluated in the rest of Africa.”

It is thought that taking medicine by injection will improve people’s lives because they no longer have to orally take medicines every day as well as deal with the risk of forgetting to take them.

HIV treatment, now commonly known as Antiviral therapy (ART) has been in use since the first drug Zidovine (AZT) was discovered in 1987.

Improvements in the treatment have aimed at improving drug effectiveness through combining drugs and the current regimes commonly containing three drugs.

These combinations, however, frequently result in side effects from the drugs and numerous pills cause pill burden. Subsequent efforts from 2020, therefore, have aimed at reducing: the number of pills taken per day, the number of drugs in the combinations to reduce pill burden, and the number of side effects.

Since its discovery in the early 1980’s the HIV/AIDS pandemic has gone on to affect over 37 million people globally in 2020.

Findings of the Kenya Population-based HIV Impact Assessment 2018 indicated that Kenya’s HIV prevalence was at 4.9 percent.

The studies, therefore, tended to have more Caucasians, more males proportionately, and significantly better health systems.

Additionally, the trial setting was overly regulated with intense laboratory testing which is not the case in the public health sector in Africa.

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