QUAD PILL: The HIV adherence booster

By Meluse Kapatamoyo

Adherence to medication is critical for people living with HIV. However, the number of tablets a patient is required to take on a daily basis makes it difficult to stick to a regular time-table, a situation which can lead to drug resistance.



Clemetine Mumba

For people like Clementine Mumba, who has been on anti-retroviral therapy (ART) for the last 12years, she soon may no longer have to worry about the number of pills she would have to take on a daily basis.

A recent US study has revealed “Quad pill” tablet which combines four HIV drugs into a single daily treatment. The four in one pill is intended to make it easier for patients to stick to their medication, improving the effects of their treatment.

Mumba was diagnosed with Tuberculosis in 1998 and immediately commenced treatment but tested HIV positive eight months later.

In the year 2000, she started the antiretroviral therapy (ART) but had to discontinue due to prohibitive cost of Antiretroviral (ARVs) drugs at the time. The drugs cost K1.5 million per month (U$300).

“The stress of taking so many drugs was too much and as if that was not enough, storage of (Kaletra) was also difficult for me, especially when I was travelling.  I used to move with a small cooler box all the time when I was travelling out of my base.

I remember one time, my friend lost her father in Mpulungu (Northern Zambia) and I escorted her for a funeral in the village where there was no electricity and no refrigerator.  I would buy ice water at the market and put it in the small cooler box just to keep my drugs cool.”

Though Mumba restarted her treatment two years later, she had already developed resistance to the drugs.

In 2005 after becoming resistant to first-line treatment, Mumba was put on 2nd line drugs and started taking Aluvia and Truvada which she says require her to take fewer tablets daily.

Instead of the earlier 7 tablets, she now only takes 5 (2 Aluvia tablets, twice daily and 1 Truvada tablet daily)

The Quad pill is said to be the first multi-pill to include a type of anti-HIV drug known as an integrase inhibitor, which stops the virus from replicating.

Researchers say the solitary once a day pill was found to be faster acting and had fewer side-effects compared to two widely used drug regimes.

Mumba says “for me taking one pill a day would make a great difference in my life, it will christmax, especially that it has fewer side effects.  Some of the drugs that I have taken have left me with fatal side effects which are physically irreversible.

So the news of one pill, once per day and fewer side effects, will be truly good news for a woman like me, who has come a long way from taking so many TB drugs, so many ARV drugs to one tablet only once per day.”

According to the World Health Organisation (WHO), standard ART consists of the combination of at least three ARV drugs to maximally suppress the HIV virus and stop the progression of HIV disease.

An estimated 34 million people are currently living with HIV worldwide. At the end of 2011, over 8 million people living in low- and middle-income countries had access to ART, reported the WHO and UNAIDS organisations.

While access of ARVs by infected people remains vital, finding a lasting solution to drug resistance, that would ensure patients take their medication daily and on time is equally important.PYM