New and Better Drug Regimens

This week Siyayinqoba Beat It! looks at new and better drug regimens. Generally, new and better drugs to treat HIV are developed all the time and earlier this year Government introduced Tenofovir (TDF) to replace Stavudine which is also known as d4T.

One of the people who started taking Tenofovir this year is Nothembisile Mfunda (57).  In 2001 Nothembisile was losing weight and had started to develop sores in her mouth. Although she wasn't sick she decided to test for HIV and the results came back positive. After having lived nine years with HIV, Nothembisile, who stays in Dengwane Village in Mount Fletcher, started losing weight again and her health became poor. As a result she asked to put on ARVs, "I started treatment on 1 June. I take Tenfovir (TDF), 3TC and Stocrin," Nothembisile explains. "I haven't had any problems since I started with the treatment. I got my strength back and I am healthy."

At the Duncan Village Day Health Centre, Dr Lindelwa Cindi talks about the new protocols that include Tenofovir, "This new drug replaces Stavudine (d4T). The main difference is that it only has to be taken once a day. It also has a much better side effect profile. It is a safe and easy drug to take," she says. "Stavudine has many side-effects including peripheral neuropathy (damage to the nervous system), hot or cold feet, pins and needles. It can also lead to the lactic acid in our blood to increase. It usually is at a low level. When, however, it increases, you lose weight, have diarrhoea, feel nauseous, or experience difficulty breathing. This can be dangerous, so it is important to consult a doctor or nurse and change the drug immediately." Tenofovir is available for adults but not used for children. While it is prescribed to adults starting their first line treatment, it is also possible to take as second line.

The new drug is a great relief for patients experiencing side-effects. For those, however, who have been taking Stavudine (d4T) for years without experiencing on-going side-effects, d4T is the right treatment to continue taking.  Vuyiswa Ndleleni from De Doorns is one such person. "I have been taking Stavudine, Lamivudine and Efavirenz since 2006. When I first started I had some side effects, rashes and itching. After six weeks I was fine. I have had no side-effects since and have stayed on the same treatment". Vuyiswa knows that she is lucky as many people suffer various side effects such as swollen stomachs and painful feet when they take d4T. During a check up at Eben Donges Hospital in Worcester, Doctor Anri Wenteler explains, "both Stavudine and Tenofovir have the same success. So people who have been on Stavudine for a long time will stay on it. Only people who have had problems will change".

For patients who experience side-effects taking Stavudine, Tenofovir is the better option as it has very few side-effects and only has to be taken once a day. However patients need to have a blood test to check whether their kidneys are healthy first before starting on it and once on Tenofovir they should keep having their kidneys checked.