HIV treatment drugs.
Experts have proposed new treatment modes for older people with HIV. The new treatment does not cause the health-threatening side effects found in the existing drugs.
Experts at the ongoing International Aids Society Conference on HIV Science in Rwanda said older people above 60 years are never given enough attention when it comes to the
war against HIV, yet they are at more risk of other medical conditions like kidney
disease, diabetes, hypertension and osteoporosis (a bone disease that weakens
bones and makes them more susceptible to fractures).
Presenting the research findings in the forum, Dr Loice
Ombajo, an infectious disease specialist and Co-Director at the Centre for Epidemiological Modelling and Analysis (Cema), reiterated that
older people are often ignored when it comes to research and implementation of
research findings related to HIV, putting them at more risk.
Three studies, B/F/TAF, Sungura
and Twiga research, were done to fill this gap.
“The B/F/TAF is a study focused on people aged 60
and above living with HIV. It helps us understand how ageing, HIV and chronic
illnesses intersect in African settings. With the right partnerships and
investment in research and development, we can deliver HIV treatment that is
not only effective, but also safe, acceptable and better suited for older
adults,” she said, according to a statement from Cema.
Dr Ombajo (pictured) noted that the B/F/TAF study (short for
Bictegravir/Emtricitabine/Tenofovir Alafenamide for the Elderly) involved 520
people living with HIV who were 60 years and older and had been on
antiretroviral treatment for over 10 years.
These participants were randomly
assigned to continue with the national standard regimen (TLD – Tenofovir
disoproxil fumarate, Lamivudine, and Dolutegravir) or switch to a newer
combination called B/F/TAF (Bictegravir, Emtricitabine, and Tenofovir
alafenamide). Over 96 weeks of follow-up, those on B/F/TAF showed strong viral
suppression along with improved bone and kidney health outcomes.
She, however, said that they faced a new dilemma at the end of
the study since B/F/TAF was not yet available in Kenya’s national programme. This
prompted them to return participants to TLD, which has potential harm to bone
and kidney function, hence medically problematic, which forced them to now embark
on the Sungura and Twiga studies.
The Sungura study followed up on 197 participants from the
BFTAF study who continued on a simplified two-drug regimen—Dolutegravir and
Lamivudine (DTG/3TC). In this study, the researchers examined whether dual
therapy can be just as effective as traditional three-drug treatments,
especially for older adults dealing with multiple chronic illnesses.
Preliminary results from Sungura at 24 weeks were promising.
There were no cases of virologic failure or participant drop-out, and all
participants maintained viral suppression. These findings support growing
global evidence that dual therapy can be effective and safer for select
populations.
The third study, Twiga, is an ongoing five-year
observational study tracking comorbidities in both HIV-positive and
HIV-negative individuals aged 60 and above. It was initiated to better
understand how HIV influences ageing, especially in relation to comorbidities,
medication burden and long-term organ function.