HIV carriers at risk if they don't follow anti-Aids drug regime, experts warn

Faithful adherence to antiretroviral drug regime by HIV carriers is essential to keep the deadly disease at bay, researchers warn

PUBLISHED : Sunday, 01 December, 2013, 6:14am
UPDATED : Sunday, 01 December, 2013, 6:14am

It is World Aids Day today and while the disease may not arouse the fear it did a few decades ago thanks to the development of antiretroviral therapy, it remains a death sentence for many.

Despite the availability of treatment for the human immunodeficiency virus, which attacks the immune system and can lead to Aids, a patient only needs to miss a few doses of retroviral drugs to render them useless.

"The antiretroviral drug used by most low-income countries is not the optimal drug, and it is very unforgiving," said Dr Annette Sohn, an Aids researcher.

"It means the virus in the carrier's body develops resistance towards the drug if they skip their medication, even if only a few times," she warned.

The drugs have to be taken twice a day every day to contain the virus. Without at least 95 per cent adherence - meaning people can only skip their medication fives out of 100 times - the treatment can fail.

Sohn, vice-president and director of Therapeutics Research, Education, and Aids Training in Asia, said the problem was a threat to global efforts to control HIV.

"Most drug users, from children to adults, try really hard to stick to the routine. But they are not perfect people and it is a very high bar to achieve. The drug is too harsh on them and puts them under a lot [of] pressure."

According to the World Health Organisation, there are 35.3 million people living with HIV globally, with 2.3 million new cases every year.

China has 780,000 HIV carriers, with about 48,000 new infections each year. Only half of them have access to medical treatment and, of those, just 200,000 remain on the retroviral therapy.

Some of those who stop taking the medication, or whose course of drugs has become interrupted, have developed resistance towards the drugs, Bangkok-based Sohn said.

Others may have difficulty returning to the clinic to get the medicine; some may have given up because of side effects or fear of discrimination.

If the first-line medicine fails, doctors should issue a second-line drug, which is usually more costly, she said.

Hong Kong sees a better drug-adherence rate than many Asian countries, according to Dr Patrick Li, chief of medicine at Queen Elizabeth Hospital.

He said the public hospital in Kowloon saw 10 per cent of patients with HIV develop resistance towards first-line medicine. "But those people who reach the second line need to be very careful, it means the red light is already on. Patients are really at risk if the medicine fails to contain the virus again, as there is not much choice left."

For World Aids Day today, 25 years after the initiative for the first ever global health day was launched, the WHO has issued its first guidelines for HIV testing, counselling and care for adolescents living with HIV, which health workers hope will help tackle the challenge.

Video: How an expat lives in Hong Kong… with HIV