A new paediatric HIV treatment could be a breakthrough for parents  struggling to administer medication for their young children.

The treatment, created by Cipla, in partnership with Drugs for Neglected Diseases Initiative (DNDi), could improve children’s adherence to antiretroviral treatment.

The drug is a fixed-dose four-in-one combination of abacavir, lamivudine, lopinavir, ritonavir  for infants and children under the age of three. The medication also meets the World Health Organisation (WHO) guidelines. The South African Health Products Regulatory Authority has also approved the medication, says Cipla.

The innovative formulation is packaged as capsules containing strawberry flavoured granules. The granules are about the size of granulated sugar and can be stirred into food or milk.

“The treatment is specially made for children aged 0–14 years living with HIV with little or no access to treatment,” Paul Miler, Cipla South Africa CEO, said in an email to Health-e News.

The drug company is prioritising optimal child-friendly antiretroviral formulations for children living with HIV (CLHIV). They are particularly focussing on treatment for children and infants who are at the highest risk of dying without access to treatment.

Parents’ experiences

Health-e News spoke to parents who know the struggle of giving a child an HIV medication.

Dorris Moloi*, a grandmother from Bohlokong in Bethlehem in the Free State, welcomed the new medication. She says children won’t even notice that they are receiving medication.

Moloi takes care of her five-year-old granddaughter, and adds that administering the child’s HIV medication has been a difficult journey.

“For me as her guardian it’s difficult to give her the syrup because I know what is it for. She hasn’t questioned me about it because she is still young,” Moloi says. She worries about what will happen as the child grows and has to switch to the tablet form of medication.

“When they switch her to tablets she is obviously going to question about swallowing a pill every day.

Thandeka Nkomo* still manages her 17-year-old daughter’s antiretroviral medication. The new medication, she believes, will make it easier for parents and their children to adhere to the treatment regimen.

Nkomo tested positive for HIV when she fell pregnant in 2002 and started attending antenatal care at a mobile clinic. The clinic near Mkhuphula village in Tugela, Kwa-Zulu Natal, was not well resourced and did not have the treatment to prevent mother-to-child infection.

“We didn’t have a clinic in my village so we had to go to a mobile clinic to seek healthcare services,” she says. “They tested me and found that I was HIV positive but because I wasn’t given nevirapine, my daughter was born HIV positive as well.”

When her daughter was ill soon after her birth, the child was also diagnosed with HIV and received antiretroviral treatment.

“At first she would cry or throw up when I was giving her medication which came in a syrup form,” says Nkomo, who now lives in Tembisa. She eventually got used to it until she had to change to pills as she grew older. Even with the pills it was a struggle for her to get used to them. Sometimes she would refuse to swallow them.” — Health-e News

*Not their real names.