A New Easy-to-Take HIV Medicine Could Be the Ticket to Saving More Kids

No need for a spoonful of sugar—the drug comes in the form of tiny pellets that can be mixed with food.

(Photo: Dorian Gray/Getty Images)

Jun 30, 2015· 2 MIN READ
David McNair is an award-winning reporter and editor based in Charlottesville, Va. He runs the hyper-local news site The DTM and his fiction has appeared in Virginia Quarterly Review.

It’s a situation any parent can relate to: Try to give medicine to a child, and the episode can often end in tears and tantrums. It’s not much different in some of the most troubled parts of the world—except the stakes are higher when children are affected by HIV and AIDS and need to take lifesaving medicine.

But that could soon change, thanks to an announcement from UNAIDS and UNICEF that the U.S. Food and Drug Administration has tentatively approved an antiretroviral medication in pellet form that can be mixed with food, making it quick and easy for children to consume.

“Treatment innovations such as this that replace unpleasant and bad-tasting medicines are a real breakthrough, accelerating access to treatment for children and keeping our youngest healthy,” Michel Sidibé, executive director of UNAIDS, a United Nations program to fight HIV and AIDS around the world, said in a statement. Only 24 percent of children living with HIV have access to antiretroviral medicines, he said, calling the situation “unacceptable.”

The pellets, manufactured by Indian generic medicines manufacturer CIPLA, are heat-stable and deliver a mixture of lopinavir and ritonavir, a fixed-dose combination of drugs approved by the FDA in 2000 to battle HIV infection. The size makes it much easier to deliver to children three years old and younger. Previously, the only available combination of the drugs came in a harsh-tasting syrup containing alcohol that needed to be refrigerated (a challenge in countries where electricity and modern appliances are not easy to come by). In more developed parts of the world, antiretrovirals can come in a variety of forms, including tablets and powders, but research into more palatable formulations is still under way and is often expensive, according to HIV/AIDS nonprofit Avert.

Batches of the new pellets will first make their way this month to Kenya, part of a larger plan to deliver the medicine throughout sub-Saharan Africa, according to News Medical. The drug manufacturer is also developing new four-in-one fixed-dose combinations of HIV-fighting medicines that will be even easier for children to take than the pellets.

So, Why Should You Care? Resisting critical HIV medication can be fatal, especially for children. Once someone is infected, the virus can progress rapidly, and it is one of the leading causes of child mortality in developing countries. Without treatment, one in three children who become infected with HIV will die before the child's first birthday, and half will die before their second, according to UNICEF. Despite efforts by organizations such as UNAIDS and UNICEF to provide children access to HIV treatment, fewer than 800,000 of the 3.2 million children infected with the virus had access to antiretroviral medicines in 2013.

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The sooner antiretroviral treatment is administered, the greater the increase in survival rates among infants and young children, according to the World Health Organization. Because of the lack of heat-stable and palatable medicines for young children, several countries have found it challenging to follow this recommendation.

“This new formulation is a step in the right direction toward saving more lives of children living with HIV,” said Craig McClure, UNICEF’s chief of HIV and AIDS. “We expect it to greatly improve treatment access for many more children and support UNICEF’s equity-focused programming aimed at reaching the most disadvantaged children throughout the world.”