The new three-in-one HiV drug, Dolutegravir, is not necessarily as effective against HiV

A new study has found that the new three-in-one HiV drug, Dolutegravir, is not necessarily as effective against HiV as previous first line antiretroviral treatments. Professor Francois Venter of Wits University weighs in on the matter.

So this drug has been rolled across tens of millions of people um what the report slightly got wrong was actually it wasn’t that the drug didn’t perform it’s that the old drug performed really really well so the new drug just when you compare it to the old that you know did slightly outperform it but not to the degree we thought simply because the first one did

So well so in some ways it’s actually quite good news um we the one thing that is of concern is that we are seeing people gaining a great deal of weight um on the new regimen but even that’s been really really um complicated because it actually might be that they they are just south africans are very prone to becoming obese anyway and it does a lot of people are

Arguing quite persuading me certainly that in fact it is just this return back to our normal diet that just puts us on a normal trajectory but i think the bottom line is that the war against hiv in terms of finding new therapies is still there and we need to be looking for better drugs and perhaps we should start by taking a step back um what spurred this new

Study on um i mean were you seeing signs that created some kind of concern around this new drug so no the old the old drug was actually the reason we did it just expensive it had side effects a lot of people had messed with your sleep it made you feel dizzy and then there were metabolic changes that messed with your glucose and your your your cholesterol and a

Few other things and and the other thing is it’s very easy to break to get resistance to it is is very easy the new drug didn’t have any of those things it also didn’t have drug interactions with the new drug didn’t have drug interactions with um with contraceptive with um you know sort of oral contraceptive tablets so there were lots of benefits on paper when

We started comparing it the the old drug did really well so you know with that it’s part of the problem with fast tracking new drugs is that you pick up the side effects in local populations it’s very important to remember a lot of these drugs were tested in gay white males in north america and europe the moment we stopped extrapolating that our own population

This is why it’s so important for us to do research in our own populations we started seeing the side effects particularly amongst black women so it’s again you know we must be pushing very hard for these drugs when they’re going to be rolled out in our in our local population that the studies get done here first so that we have that information to give to our

Patients before they start um taking new drugs i would have imagined that what happens on any other case but nonetheless i mean outside of the weight gain what are some of the adverse effects of this new drug that you found pretty much that’s it it was the only real side effect we saw we were you know in other countries patients also can plan the best of their

Sleep we actually didn’t see that our patients actually tolerated very very well um the the everything else looked exactly the same that it was slightly safer for bones and for kidneys compared to the old drugs um and that was less dizziness so in fact this drug was wonderful it was just the simple thing around the weight gain that that messed with us oh okay

And your comments about why are these not done locally and that’s actually why we did this study is we were very worried that people can push this drug and yeah we only pick it up later which is exactly what happened we picked up the side effect which was not reported until we came along how concerned then should we be about patients who are taking this new drug

In the absence of the knowledge that you’ve just presented now in other words are these effects in the greatest scheme of the fight against hiv detrimentally enough for us to renege back to the old drug or is it just a matter of being aware of it and perhaps changing things like your diet so yeah that’s i think that’s one of the great medical secrets is that diet

Changes do very very little for weight gain it’s the same as exercise i know anyone who’s tried to lose weight it’s a uphill battle it’s one of the hardest things you can possibly do it’s actually probably harder than giving up smoking and a whole range of other things that medicine often has very poor track record in terms of offering so it’s definitely better

Than the old drug um in the sense that you know not everybody gains weight for instance men don’t tend not to gain that much weight so for me and for instance if you all women who are not gaining weight in the new drug they can carry on with their lives what we’re battling with is we don’t have a good alternative except for the old drug for the patients who um

Who who are actually gaining weight so it’s a real headache at the moment so you simply say a lot of our patients are saying we love this new drug then they start gaining weight they say no we still want the new drug it becomes kind of a tipping point where you’re replacing your entire wardrobe with people suddenly saying actually this is uncomfortable i want

Something else and at this stage we don’t have much to offer then we have nothing yeah yeah certainly drives home a point you’ve already made that you know the fight against hiv and getting to a point where we have suitable treatment is far from over that’s the time we have for this conversation this morning thanks very much for weighing in certainly appreciate

Your update on this issue professor francois fenter is director of essentia research group adverts university sounding the alarm there over this new hiv three-in-one drug which is now found to be contributing to weight gain especially among black women in south africa what does this mean i guess for those patients especially as we also deal with the added issue

Of the covet 19 pandemic watching that closely for you

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The new three-in-one HiV drug, Dolutegravir, is not necessarily as effective against HiV By Newzroom Afrika