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Unfortunately, it is difficult for children to take multiple medicines every-day.2a However, children living with HIV can now benefit from newer, easy-to-take, child-friendly formulations of medication that have been developed.3a Learn all about these improvements here.
UNDERSTANDING THE CHALLENGES OF MEDICATIONBack to top
“Children living with HIV have been neglected for too long, with the recommended treatment for years consisting of a bitter-tasting syrup with high alcohol content.”3b
Dr Bernard Pécoul, Executive Director of DNDi.
Some antiretrovirals (ARVs) for children require refrigeration, making storage of these medicines difficult for families without necessary living conditions suited to this.3b
Infants and young children are at the highest risk of dying if they do not receive treatment.3b
It is estimated that:
THE NEED FOR ADAPTED AND BETTER TASTING FORMULATIONSBack to top
Medicines that are designed specifically for infants and young children should encourage adherence.3b
There have been major improvements in the types of medicines available for treatment of HIV in very young children.4a Medicines are more pleasant tasting, heat-stable and easier-to-use. There are also now fixed-dose combinations (up to 4 medicines in one formulation) which will replace older medicines.3a
GRANULE-FILLED CAPSULESBack to top
- Combines 4 medicines in 1
- Strawberry flavoured granules
- Parents and caretakers are able to administer the medicine to children by sprinkling the granules on soft food or milk
- Does not require refrigeration therefore provides convenient transport and storage
- Easy to administer to infants and children of different weights and ages
PELLETSBack to top
- Combines 2 medicines in 1
- Can be mixed into foods such as porridge or milk
- Easier to administer to children than liquids
- Improved adherence to treatment
- No refrigeration required
Improved formulations can lead to better treatment outcomes.4c Many children have to take three or more pills or a combination of pills and liquids, every day, twice a day.2c Fixed-dose combinations improve treatment adherence by lessening the pill (or liquid) burden.4d
WHAT ARE THE CAUSES OF POOR ADHERENCE (BARRIERS) TO TREATMENT AMONG CHILDREN?Back to top
- HIV regimens for infants and young children often require taking multiple daily doses of multiple pills or liquids, some of which are extremely unpalatable.5a
- A struggle when administering medicine adds to the burden that caregivers experience when providing care to their HIV-infected children.2e
The lack of child-friendly formulations seems to be the biggest contributing factor in poor adherence among children.2b
The main obstacles preventing good adherence to treatment in children are:
The development of child-friendly formulations makes it easier for caregivers to administer HIV medications and easier for children to take medications.2f
↑ ADHERENCE ↑ SUCCESSFUL LONG-TERM THERAPY ↑EXTENDED LIFE2d
- Global HIV and AIDS Statistics. 2020 fact sheet. Available from: https://www.unaids.org/en/resources/fact-sheet Last accessed August 2020.
- Schlatter AF, Deathe AR and Vreeman RC. The Need for Pediatric Formulations to Treat Children with HIV. AIDS Research and Treatment http://dx.doi.org/10.1155/2016/1654938.
- The Drugs for Neglected Diseases initiative (DNDi). HIV treatment for children to be produced for under one dollar a day [November 29, 2019]. Available at: https://dndi.org/press-releases/2019/
- Cipla News. Cipla working to end neglect of paediatric HIV [Online]. Available from: https://www.cipla.co.za/cipla-news/cipla-working-to-end-neglect-of-paediatric-hiv/ Last accessed August 2020.
- AIDSINFO, National Institutes for Health (NIH). HIV Treatment: The Basics [Last reviewed March 2, 2020]. Available from: https://aidsinfo.nih.gov/guidelines/html/2/pediatric-arv/83/adherence-to-antiretroviral-therapy-in-children-and-adolescents-living-with-hiv Last accessed August 2020.
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