[Ip-health] JAMA: Effort Launched to Adapt HIV/AIDS Drugs for Children

Rachel M. Cohen rachel.cohen72 at gmail.com
Tue Aug 9 13:59:55 PDT 2011



August 10, 2011

Medical News & Perspectives

JAMA 2011;306(6):597


Effort Launched to Adapt HIV/AIDS Drugs for Children

Rebecca Voelker


A nonprofit research and development organization has launched a new program
to adapt HIV/AIDS medications for safer, more effective pediatric use.


The Drugs for Neglected Diseases initiative (DNDi), which is based in
Geneva, Switzerland, announced the new effort in July. The program will
build on the DNDi's work in developing and delivering new treatments for
such neglected diseases as sleeping sickness, leishmaniasis, and Chagas


HIV infection nearly has been eliminated in infants and children in
developed countries because of effective treatment to prevent
mother-to-child transmission of the virus. But the same preventive methods
are not widely available in low-income countries.


“Children with HIV/AIDS in low- and middle-income countries . . . are absent
from the HIV research and development agenda, and this is largely because
they are poor and voiceless and do not represent a lucrative market,” said
Bernard Pécoul, MD, MPH, executive director of the DNDi, in a statement.


After discussions with experts in endemic countries and officials from
government health agencies in the United States and Europe, the DNDi has set
as its first goal the development of an improved first-line protease
inhibitor–based regimen for children younger than age 3 years, regardless of
prior exposure to antiretroviral drugs.


The World Health Organization (WHO) recommends antiretroviral therapy for
children with HIV infection who are younger than age 2 years. However, the
safety and correct doses of key drugs have not been established for very
young children and formulations have not been specifically adapted for


According to the DNDi, its pediatric HIV therapy has to be easy to
administer, better tolerated by children than current drugs, heat stable,
and dosed once daily or less. New formulations also should be durable
against drug resistance, compatible with tuberculosis drugs, and affordable.


The WHO has reported that more than 2.5 million children younger than age 15
years currently are living with HIV infection. Some 2.3 million of these
children live in sub-Saharan Africa.


According to the Joint United Nations Programme on HIV/AIDS, only 28% of
children in immediate need of antiretroviral therapy have access to
treatment. Without treatment, one-third of children born with HIV will die
before their first birthday, 50% will die before they are aged 2 years, and
80% will die before they are aged 5 years.


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