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Fixed-dose ART tablets for children with HIV show promise
Survey in India revealed high acceptance rate.
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Physicians and caregivers in India involved in pediatric HIV/AIDS treatment reported that pediatric fixed-dose combination antiretroviral therapy tablets were easy to manage and administer, according to a study presented at the XVII International AIDS Conference, held in Mexico City.
India provides free ART to adults and children, but access for children is often limited. It is estimated that only 1,800 of the approximately 100,000 children with HIV/AIDS in India received appropriate treatment as of October 2006.
The India Pediatric AIDS Initiative was launched in November 2006 to combat the disparity between the number of children with HIV/AIDS and the number of children receiving treatment. Use and assessment of pediatric fixed-dose combination ART tablets were key features of the initiative.
Researchers in India sent questionnaires to 120 ART distribution centers. They also conducted interviews and focus-group discussions involving six ART centers. These sessions involved doctors, counselors, pharmacists, pediatricians, caregivers and children with HIV. The goal was to assess a variety of issues related to the fixed-dose treatment, including counseling, acceptability and logistic matters such as stock management. Respondents also were asked to compare syrup formulations with the fixed-dose combination tablet.
Favorable patient acceptability levels for the pediatric version of the tablet were reported by 94.7% of the 78 doctors who responded and by 87.5% of the 48 pharmacists who responded. The treatment was well tolerated, according to 93.3% of the doctors and 79.2% of the pharmacists. There were 64 counselors surveyed, 85.9% of whom reported better adherence to the fixed-dose combination tablet than to syrup combinations. Most pharmacists (81.3%) agreed that adherence to the fixed-dose combination tablet was superior to that of the syrup combinations.
Pharmacists (79.2%) also reported that the tablet was easy to dispense and administer. Also, 70.8% responded that the tablets led to improvements in stock management and forecasting. However, difficulty in breaking the tablets, difficulty in dispensing the tablet to newborns and lack of accurate dosing based on body weight or body surface area were reported by a small number of doctors, according to the findings.
A small percentage of children and their caregivers reported complaints, which included difficulty in cutting tablets, changes in number of tablets according to weight, pill burden, and absence of syrup formulation for newborns and palatability. – by Rob Volansky
For more information:
- Pensi T, Purohit V, Chan P. Pediatric fixed dose combination tablets simplifies administration of antiretroviral treatment for children in India. Presented at: the XVII International AIDS Conference; Aug. 3-8, 2008; Mexico City.