Based on new evidence assessing benefits and risks of antiretroviral (ARV) drugs, the World Health Organisation (WHO) has recommended the use of dolutegravir (DTG) as the preferred first-line and second-line treatment based on its effectiveness, adequacy and a high genetic barrier to resistance. The drug has been declared safe for all populations, including pregnant women and those of childbearing potential.

DTG was formerly feared to cause birth neural tube defects, a defect of the brain and spinal cord in infants born from women using the drug at the time of conception. A potential safety concern about the drug was reported in May 2018 when a study carried out in Botswana found four cases of defects out of 426 women who were pregnant while taking the drug. In regards to these preliminary findings, many countries advised pregnant women and women of childbearing potential to take efavirenz (EFV), another type of ARVs.

However, new results from two clinical trials comparing the efficacy and safety of DTG and EFV in Africa have shown that the risk of neural tube defects is significantly lower than what the initial studies reported.

An advanced study conducted by a research group from the University of the Witwatersrand, Johannesburg which will be completed next year shows that DTG is an effective and well-tolerated antiretroviral drug. The study which will continue for 96 weeks, presented its 48-week results at the International AIDS conference in Mexico City.

Rwanda will also start an evaluation on the effectiveness of the drug. According to the Rwanda Biomedical Centre, Rwanda will host a scientific meeting next month on the use of the drug, and recommendations concerning it will be made at the meeting.

At the moment, a new drug and method of blocking infection are being studied. This new method offers hope that the obstacle to combating HIV could be overcome by keeping people on medication.

The approach uses a small implant the size of a matchstick, inserted in the upper arm. This implant slowly releases the medication which blocks the virus for a year or more. If it is proven safe and successful in larger studies, this method could be a major improvement for people at high risk of contracting the virus. It will also provide a more flexible option for those who have trouble adhering to the once a day pill regimen and other methods used currently.

It is important to know that out of the 34 million HIV-positive people worldwide, 69 percent – which accounts for 23.8 million people – live in Africa. Also, 91 percent of the world’s HIV-positive children live in Africa. While more than one million adults and children die every year from HIV/AIDS in Africa alone.


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