Based on new evidence assessing benefits and risks, the use of the HIV drug dolutegravir (DTG) is recommended as the preferred first-line and second-line treatment, the World Health Organization said in a statement on Monday.
This include pregnant women and those of childbearing potential especially in Sub-Saharan Africa, the WHO said.
The move comes after latest scientific findings have revealed that a new, low-cost, generic, fixed-dose antiretroviral therapy (ART) combination containing tenofovir, lamivudine, and dolutegravir was being introduced in many countries in sub-Saharan Africa.
Initial studies had highlighted a possible link between dolutegravir and neural tube defects (birth defects of the brain and spinal cord that cause conditions such as spina bifida) in infants born to women using the drug at the time of conception.
According to the Lancet magazine, one of the the world’s leading independent general medical journal, the combined benefits of wider dolutegravir use would offset small increases in predicted neural tube defects.
As for any medications, informed choice is important. Every treatment decision needs to be based on an informed discussion with the health provider weighing the benefits and potential risks, the UN agency said.
WHO also stresses the importance of providing information and options to help women make an informed choice.
To this end WHO has convened an advisory group of women living with HIV from diverse backgrounds to advise on policy issues related to their health, including sexual and reproductive health.
Reports indicate that scaling up antiretroviral therapy (ART) in sub-Saharan Africa represents a major achievement, with ongoing challenges, including increasing transmitted drug resistance, poor coverage of viral load monitoring and low numbers of people who have fulfilled the criteria for failure of first-line ART switching to second-line regimens.
WHO now recommends use of the integrase inhibitor dolutegravir with tenofovir and lamivudine in people initiating ART and, potentially, in those currently on first-line ART if they have a recent viral load measurement less than 1000 copies per mL.5, it said.
Despite the fact that sub-Saharan Africa contains only about 11 percent of the Earth’s population, the region is the world’s epicenter of HIV/AIDS, according to official estimates.
According to UNAIDS, all the worst affected countries (with prevalence rates over 20 percent) are contiguous to one another in the lower part of the continent including South Africa, Lesotho, Swaziland, Botswana, Namibia, Zambia, and Zimbabwe.
Botswana, Lesotho, Swaziland, and Zimbabwe have prevalence rates above 30 percent, reports said.
CU/as/APA