That HIV can develop resistance to the drugs used to treat it is nothing new, but results from recent studies reveal the emergence of resistance in subsets of people living with HIV to dolutegravir – an antiretroviral widely used in South Africa. Top HIV experts spoke to Elri Voigt about the new findings and what it means for people living with HIV in the country.
In December 2008, Dr Mark Blaylock left South Africa after a high-profile spat with then-Health MEC of KwaZulu-Natal Peggy Nkonyeni. The affair was sparked by Blaylock’s colleague Colin Pfaff being charged with misconduct for sourcing funding for antiretroviral drugs for pregnant women living with HIV. Four years later, Blaylock was back at Manguzi District Hospital in KwaZulu-Natal. Sue Segar chatted to Blaylock about his years outside of South Africa, returning to Manguzi, and how healthcare in KwaZulu-Natal has changed over the years.
In what is likely one of the largest treatment rollouts in South African history, well over four million people living with HIV have started taking the antiretroviral dolutegravir since its introduction around four years ago. Now, according to a recent study published in the Lancet medical journal, use of dolutegravir in South Africa is associated with more people staying on treatment and higher rates of viral suppression. Elri Voigt unpacks the study findings and assesses progress in the country’s switch to dolutegravir-based HIV treatment.
The 11th SA AIDS conference, recently held in Durban, highlighted the worrying fact that key HIV numbers such as treatment coverage are much lower in children than in adults. But as Elri Voigt reports, conference delegates also heard about new treatments and guidelines that will make life easier for kids and the exciting potential of several new long-acting experimental treatments.
A study published last year on an HIV variant that has been circulating in the Netherlands for the last 20 years reminded the public of the existence of viral variants beyond SARS-CoV-2. Elri Voigt unpacks what we know about the HI-virus, its variants, and the study’s findings.
New child-friendly formulations of several important antiretroviral medicines were recently approved by the South African Health Products Regulatory Authority. Thabo Molelekwa asks what this means for children living with HIV in South Africa and how long it will take for these medicines to become widely available.
In 2019, the Department of Health started providing the antiretroviral drug dolutegravir as part of HIV treatment in the public sector. Three years later, close to 3.2 million people in South Africa are taking dolutegravir every day. Even so, the rollout of dolutegravir hasn’t all been smooth sailing. Elri Voigt investigates how the massive undertaking of switching millions of people to a new drug has gone.
One of the biggest breakthroughs in HIV treatment in the 1990s came when three different antiretrovirals were used together, suppressing viral replication in multiple ways and preventing the development of drug resistance. Now, trials are showing that certain combinations of just two antiretrovirals might be as good as three, potentially bringing an end to a quarter of a century of triple therapy dominance. Elri Voigt reports.
Children living with HIV have to take multiple different antiretroviral pills or syrups twice a day, while most adults in South Africa have been offered one pill once a day regimens for around a decade. At the recent South African HIV Clinicians Society (SAHCS) conference, various speakers argued that better treatment regimens for kids are needed urgently. Thabo Molelekwa reports.
An antiretroviral injection administered every two months has been shown to be highly effective in preventing people from getting HIV in two large trials. Catherine Tomlinson asks what needs to happen before these injections become available to people in South Africa.
If South Africa is forced to go into a COVID-19 lockdown again, HIV support groups and adherence clubs should remain functional to make sure that everyone is supported, has regular access to information and treatment, and that people are motivated to adhere to treatment, argue Annah Maluleke and Solanga Milambo.
HIV medicines for children often taste bitter, pills are large, and for many children there is a lot of medication to take. This makes it hard to take treatment as prescribed. Tiyese Jeranji looks at the challenges with currently available HIV medicines for children, what innovations are in the pipeline, and how HIV treatment is being tailored to suit the needs of children.
