June 14, 2017

Khayelitsha study offers hope for children with HIV who are failing treatment

Written by Ashleigh Furlong

Johnathan Bernheimer speaking at session

This post originally appeared on Ground Up.

Good news from a recent programme conducted in Khayelitsha on children and adolescents with HIV who were failing antiretroviral (ARV) treatment. It showed that most patients were able to suppress their high viral load within six months through continued adherence support.

Viral load is how much HIV is in your blood. A high viral load means that one is more infectious. Treatment failure is when ARVs are unable to prevent the virus from replicating. The virus then becomes detectable in the bloodstream again with standard viral load tests.

The results were particularly good for children and adolescents on a protease inhibitor regimen, which is a type of HIV drug.

These results were presented at the South African National AIDS Conference being held this week in Durban.

Dr Jonathan Bernheimer, from Medecins Sans Frontieres (MSF) in Khayelitsha and the Southern Africa Medical Unit (SAMU), found that 81% of patients achieved viral load suppression (which is when the virus is undetectable in the bloodstream) at least once during the intervention.

The intervention included clinical care, adherence support such as counselling and support groups, and changes of ARVs when needed.

Patients at first had to complete visits every two weeks and then monthly. To be discharged from the study, patients needed to have two consecutive suppressed viral loads. These viral loads were taken every three months.

“For a long time it was thought that paediatric patients did not suppress in a timely fashion, [however] we found differing data,” said Bernheimer.

174 children from the ages of 0 to 19 were enrolled in the intervention. All the patients had high viral loads and were failing treatment. 173 of the patients were infected at birth.

Bernheimer told GroundUp that “the vast majority of treatment failure is caused by poor adherence”. He said that the second biggest cause is probably resistance (i.e. the drugs actually are no longer effective against HIV because the virus has mutated) which can occur when a patient is poorly adherent.

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