Kenyan patients are crying out for injectable ARVs. Will a trial backed by KEMRI, Aga Khan and Ampath be a game changer?
Health care providers are at it again. When on March 31, 2022 the first HIV patient in Kenya was injected with antiretroviral (ARV) medication after being enrolled in a study being conducted at The Aga Khan University Hospital (AKUH), Nairobi, many thought getting people to join the clinical trial would be a big challenge.
But a team carrying out the study, dubbed “Cabotegravir And Rilpivirine: Efficacy and Safety – CARES”, and backed by Janssen Pharmaceuticals, a division of Johnson & Johnson, say things are going according to plan. In their latest review, the doctors said objective was to ensure accessibility of injectable ARVs to developing countries especially in Sub-Saharan Africa where there is heavy burden of HIV disease.
“The study is moving smoothly,” says Dr. Cissy Kityo, executive director Joint Clinical Research Centre, Uganda. “We have recruited 512 (participants) and we are doing follow-up… we have patients who have reached month 15.”
Injected medicines, according to Ms Kityo, have worked well in previous studies done in the USA, Europe and South Africa but are yet to be evaluated in the rest of Africa. She says the trial is not only being carried at Kenya’s Agha Khan University Hospital, Kenya Medical Research Institute in Kericho and Ampath (Uasin Gishu), but also in Uganda and South Africa.
The next stage, she adds, is registering the injectable drugs (Cabotegravir and Rilpivirine) and engaging stakeholders such as the United States President’s Emergency Plan for Aids Relief (PEPFAR) and Global Fund to ensure that the two HIV regimens are approved and adopted. Botswana and South Africa are the first African countries to embrace the injectable ARVs for HIV treatment.
“Patients will now chose between taking a tablet a day, or being given injections. It is like the female contraceptives; some women like to take tablets everyday, others prefer injections, and there are some who prefer implants. It is just an option for the patients,” says Prof. Reena Shah, principal disease investigator at AKUH.
“Remember being a research, we want them to be in a hospital setting. We don’t want to go to their houses to do it until we are confident with the medication, and from what we’ve seen I’ll tell you that now we are very confident with the medication… You get two separate injections every two months instead of having a pill everyday. So you get six injections a year instead of taking 365 pills in a year,” says Shah.
