In a major relief to HIV-positive patients who have developed resistance to second-line treatment, the government has decided to provide free-of-cost third-line antiretroviral (ART) treatment to such
In a major relief to HIV-positive patients who have developed resistance to second-line treatment, the government has decided to provide free-of-cost third-line antiretroviral (ART) treatment to such patients.
The government will launch the new initiative on January 29, which is in accordance with the WHO 2013 ART recommendations. With some patients showing resistance to second line drugs, the technical resource group at National AIDS Control Organisation (Naco) has recommended to provide third line ART. The group also recommended to use a combination of three drugs — Darunavir (600 mg), +Ritonavir (100 mg) with Raltegavir (100 mg) — as the preferred third-line regimen.
According to government estimates, there could be only 250 such patients but drugs have been procured for 1,000 such patients over the next one year as it is expected that more patients could be taking these drugs privately and once the programme is launched by the government they will eventually come to the national programme due to cost factor. Since there is no further line of treatment, experts recommend a “cautious” use. Significantly, the patients will be put on treatment after a lengthy and carefully designed screening process whereby “those patients who have already been initiated on second-line ART will be tested for viral load monitoring every six months.
However, those found with non suppressed viral load additional intensive adherence counselling will be given along with viral load testing on a three-monthly basis and if the patient is found as a case of virological failure then the patient will be provided third-line ART,” said a senior official in the health ministry. Those found in need of third-line treatment will be examined by a trained team of experts, which will then sent the report to the national clinical expert panel at the Naco for review and approval.
The doctors have been also given special training as these drugs are new and doctors are not familiar with them. Accordingly, 3-4 doctors from the 10 centres of excellence in HIV care have been trained by the WHO on these protocols.
The drugs will be available only at these centres of excellence. The patient will have to take a total of six tablets daily in third-line ART.
As per the health ministry, the per patient cost of these drugs will be Rs 1,18,000 for one year. On the other hand, the cost for first-line and second-line drugs are Rs 7,700 and Rs 15,000 for one year.
