Diabetes summit: Alarm raised about Aids drug


d4T drugInternational diabetes experts warn that one of South Africa's most commonly used anti-Aids drugs could, in the long term, send the country's diabetes rates spiralling.

The concern has prompted a local HIV and Aids expert, who referred to the drug as "the villain" among first-line treatment, to call on pharmaceutical companies to make alternatives more affordable.

Dutch diabetes expert Professor Peter Reiss raised the alarm on the second day of the World Diabetes Congress currently on in the city.

But he warned that the toxicity of d4T should not be used as an argument for withholding lifesaving treatment.

The drug is one of three in the standard cocktail for South Africans living with Aids.

Reiss stressed that it was "an important risk factor for the development of insulin resistance and diabetes".

According to an editorial in the latest issue of JEMDSA, the official journal of the Society for Endocrinology, Metabolism and Diabetes in South Africa, about eight percent of black women in urban areas have diabetes.

A study of the prevalence of diabetes among coloured people in the Western Cape showed an 11 percent prevalence, rising to a startling 30 percent in people over 65.

Reiss said the direct effects of d4T on the glucose pathways in the body had been identified just four weeks after the start of therapy.

The drug, he said, was the cheapest available. It may still be the only option for sub-Saharan regions.

"But it may be good to move away from these regimens as soon as possible," said Reiss.

Dr Linda-Gail Bekker, of the University of Cape Town's Desmond Tutu HIV Centre, told delegates that adherence was extremely high because HIV-positive South Africans were acutely aware of the lack of options available to swop drug regimens.

The second-line treatment was not only at least three times more expensive, but was also the final option in South Africa, where no third-line help was available.

More than 70 percent of local patients, after three years of treatment, were still taking the first-line cocktail, which included d4T.

They had, however, substituted d4T in cases where women weighed more than 75kg.

"The reason d4T is here and the reason we are using it is because it is very cheap. We need activism to bring down the price of alternatives, and we urgently need the alternative Tenofivir to be licensed in this country," she said.

Bekker suggested that women with high body-mass indexes should not be considered for d4T.

"South Africa has the enormous task ahead of 1,5 million people who we'd like to get on to ARVs in the next few years, and this is an experiment of mammoth proportions.

"At this stage we are just trying to save lives, and haven't really begun to grapple with the metabolic issues," she said. 

source IOL 

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This page contains a single entry by ID Admin published on December 7, 2006 2:54 PM.

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