[Ip-health] MSF: Paediatric AIDS Data Show Good Clinical, But Sub-optimal Virological Outcomes

Tue Jul 24 03:43:09 2007

New Paediatric AIDS Treatment Data Show Good Clinical Results=0D
                   But Sub-optimal Virological Outcomes=0D
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 Urgent need to get existing paediatric formulations to children who need=
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                                   them=0D
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Sydney, 24 July, 2007 =E2=80=93 New paediatric treatment data presented by =
the=0D
international medical humanitarian organization M=C3=A9decins Sans Fronti=
=C3=A8res=0D
(MSF) at the 4th International AIDS Society conference in Sydney=0D
demonstrate good clinical results but sub-optimal virological outcomes. The=
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results confirm concerns about the effectiveness of treating children=0D
without access to appropriate and adapted paediatric AIDS drug=0D
formulations.=0D
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MSF presented data on virological, pharmacological and adherence outcomes=
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for a cohort of children in rural Uganda at 12 and 24 months on treatment.=
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The probability of remaining alive and in care was good, with 91% and 86%=
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on treatment at six months and 12 months, respectively. However, viral load=
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results, which are a strong predictor of long-term survival, were not as=0D
encouraging.   A viral load of below 400 copies was achieved in only 59% of=
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children after 12 months and 33% after 24 months.  Of children identified=
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with a high viral load (over 1000 copies), 85% showed resistance to one or=
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more of the commonly-used first-line antiretroviral drugs.=0D
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=E2=80=9COur treatment outcomes in children are a reflection of how difficu=
lt it=0D
has been to treat children with drugs that aren=E2=80=99t designed for them=
,=E2=80=9D said=0D
Dr. Myrto Schaefer, Paediatric HIV/AIDS Advisor for MSF.  =E2=80=9CBecause=
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appropriate formulations have not been available for children, we=E2=80=99v=
e had to=0D
treat them by cutting adult tablets in two, or give them syrups that are=0D
hard to measure and swallow.  This approximate method of dosing and=0D
administration may be what is contributing to the less-than-ideal=0D
virological outcomes we are finding.=E2=80=9D=0D
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Over one year ago, several generic manufacturers launched the first=0D
fixed-dose combination tablets for children.  These three-in-one pills make=
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dosing easier and more accurate.  While WHO has endorsed the use of these=
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existing formulations, it still has not listed any of these products in=0D
their prequalification program.  This has the practical effect that=0D
children across the developing world do not have access to these products.=
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Because of these delays, MSF has internally validated the use of the=0D
paediatric fixed-dose combinations for use in its projects.=0D
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=E2=80=9CWHO has been moving far too slowly on paediatric AIDS drugs,=E2=80=
=9D said Karen=0D
Day, pharmacist with MSF=E2=80=99s Campaign for Access to Essential Medicin=
es.  =E2=80=9CIt=0D
is unacceptable that now that these products finally exist, WHO is not=0D
doing what is necessary to approve the drugs they recommend so that they=0D
become more widely available.  Children have had to wait five years longer=
=0D
than adults for a three-in-one AIDS drug, and they shouldn=E2=80=99t have t=
o wait=0D
any longer.=E2=80=9D=0D
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MSF is currently treating 100,000 patients with HIV/AIDS in more than 30=0D
countries, 7,000 of whom are children. MSF has been caring for people=0D
living with HIV/AIDS in developing countries since the mid 1990s, and first=
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began providing antiretroviral treatment in 2000 in Thailand and South=0D
Africa.=0D
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Contact:    Sheila Shettle:   043.943.2436 or  + 41.79.293.0270=0D
            James Nichols:    040.752.5700=0D
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+++++++++++++++++++++=0D
Sheila Shettle=0D
Senior Communications Officer=0D
M=C3=A9decins Sans Fronti=C3=A8res=0D
Campaign for Access to Essential Medicines=0D
Rue de Lausanne 78=0D
1211 Geneva, Switzerland=0D
+ 41.22.849.8403=0D
+ 41.79.293.0270 (m.)=0D
www.accessmed-msf.org=0D
+++++++++++++++++++++++=0D
SIGN MSF'S 'DROP THE CASE' PETITION=0D
=0D
Millions of people around the world today rely on affordable medicines=0D
produced in India.  Pharmaceutical company Novartis is taking the Indian=0D
government to court to force a change in the country's patent law.  If=0D
Novartis wins, a major source of affordable medicines for millions of=0D
people across the globe could dry up.=0D
=0D
MSF is urging Novartis to DROP THE CASE.=0D
=0D
Find out more and sign up to our petition:=0D
http://www.msf.org/petition_india/international.html=0D
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