Shortage Of Combination Drugs Puts HIV Patients In A Quandary

Chennai, 6 Aug 2019:

There is a shortage of first-line anti retroviral therapy (ART) regimen — Zidovudine-Lamivudine (ZL) combination drugs — across Tamil Nadu. Persons living with HIV/AIDS, who are on this drug regimen, are getting doses for a week instead of the recommended one month due to short supply.

Officials said the combination drug is in short supply across the country. A majority of patients are on the Tenofovir-Lamivudine-Efavirenz (TLE) drug regimen in the State. This accounted for nearly 80% of patients. The remaining are on Zidovudine-Lamivudine-Nevirapine or Zidovudine-Lamivudine-Efavirenz (ZLE) regimen, officials said.

A doctor, on condition of anonymity, said there was a shortage of ZL combination drug in the city for approximately a month. “We are managing the crisis. As of now, TLE is the universal regimen, but a group of patients is dependent on Zidovudine-Lamivudine regimen. They may not have been fit for TLE owing to reasons such as renal diseases or would have been on the regimen for several years,” he said.

Last week, Daisy David, founder of Tamil Nadu Network for People Living with HIV/AIDS, received a week’s supply of the drugs from the ART centre at Rajiv Gandhi Government General Hospital.

“I have been on this regimen for 10 years. Usually, I get medicines for three months due to compliance. Due to the shortage, I got medicines only for a week. It seems there is a problem in supply of raw materials for the manufacturer. How did the National AIDS Control Organisation (NACO) not predict this,” she said.

ART centres were disbursing the drugs for a week or 10 days and were asking patients to come back for the next batch of supply, she said. A State-level positive network member alleged that in a few places, patients were switched to TLE without proper information.

Officials and members of positive networks are worried that the shortage could lead to problems in adherence to medication.

K. Senthil Raj, project director of Tamil Nadu State AIDS Control Society, said 80% of patients are on TLE. “Those who cannot take this combination are on ZL combination drug. There is a country-wide shortage in supply for the adult regimen. The NACO has told us to locally purchase the drugs and assured us that we will get the supply by August-end. It gave us contingency fund that has been granted for the ART medical officers,” he said.

He said that they had ordered 1.50 lakh doses from a Hyderabad pharmaceutical company. “We have received the order and this is sufficient for this month,” he added. The Hindu