•DTG not given to women of child-bearing age
•National Aids Control Council says it will not remove restriction until WHO clears drug
Young HIV-positive women will wait longer to access the powerful DTG antiviral drug.
DTG (Dolutegravir) is the preferred first-line ARV in Kenya, but not recommended for women aged 15-49 because it can deform the spines of unborn babies.
A modelling study published in the latest Lancet HIV Journal, however, suggests that the benefits of making DTG available to all women of childbearing age substantially outweigh risks.
Pointing to this study, several local lobbies now want the government to lift the restriction.
But the National Aids Control Council yesterday said it would not change this recommendation unless the World Health Organisation clears the drug.
“From a health perspective, it’s better to be more reserved than put people at risk. We always want to look at the science involved and this is really a recent study, so we have to wait for more,” NACC boss Nduku Kilonzo said in Machakos.
Last year, Medical Services director Jackson Kioko instructed that women of childbearing age be given the first-line treatment Efavirenz drug. He said the restriction on DTG was “due to limited safety data".
Nairobi-based National Empowerment Network of People living with HIV-Aids in Kenya (Nephak) is among the lobbies advocating to have all women access the drug.
“It should be noted that from the outset, Kenya opted for DTG from the time the generic version became available. The concern only came up after a study in Botswana detected a significantly higher rate of neural tube defects in infants of mothers who had been taking Dolutegravir at the time of conception, compared to other antiretroviral therapy regimens,” Nephak CEO Nelson Otuoma said.
He noted the DTG is cheaper, has few side effects, is highly potent and has a high barrier to the development of resistance. A study supported by the WHO is underway in several countries, including Kenya, to determine the extent of the risk to unborn babies.
The new Lancet study shows that in 20 years, the deaths of women denied the new drug would double.
“Because of the greater potency of dolutegravir and better viral suppression, the rate of mother-to-child transmission would be lower under a universal dolutegravir policy than if all restrictions applied,” it says.