New Kid-Friendly Drugs for Children Living with HIV Could be a Game Changer
By Michelle Betton | June 17, 2014
Anyone who’s tried to force a kid to eat vegetables knows it can be an uphill battle to get children to swallow things that don’t taste very good.
But what do you do when a child’s health, and sometimes life, is on the line, and you can’t get them to take their medicine?
This was the question facing many of the attendees at the 2013 International Conference on AIDS and STIs (ICASA), where researchers and health workers discussed the challenges of getting HIV-positive children to take pediatric formulations of antiretroviral drugs (ARVs).
Because many infants and young children cannot swallow pills, pediatric ARVs come in liquid or syrup form. These often are sticky, difficult to administer, and they frequently taste bitter.
“Caretakers already have a hard time getting infants and young children to take liquid medicines, and when it tastes bad, children are more likely to spit it out or refuse to take the drugs,” said Mary Pat Kieffer, senior director of technical leadership development, program innovation, and policy at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).
“When kids do not get the proper dosage of their ARVs, they can develop resistance to the drugs, which has serious consequences for their health.”
Studies show that only 60 percent of doses are actually swallowed by 1-month-olds.
Fortunately, pediatric AIDS researchers have been working to develop new formulations of these lifesaving medications that are more palatable for children.
The organization Drugs for Neglected Diseases Initiative (DNDi) pays special attention to HIV/AIDS and works with pharmaceutical companies to develop better HIV medications for children. DNDi creates granulated drugs that can be added to any food. They brought samples of the medications to ICASA and encouraged participants to try them.
The white powder-like drug was completely tasteless.
Several of their formulations are ready to be field-tested. If approved, caretakers will be able to easily add these granules to liquid or food, overcoming longstanding challenges with packaging and taste.
They’re also creating a granulated form of pediatric HIV medication that is a fixed-dose combination (3-4 drugs combined). Dosing will be based on a child’s weight, with changes controlled by simply increasing the number of capsules as a child grows. A third type of medication under development will be a tablet that dissolves in water.
“New innovations like these could help make it easy for families with children living with HIV to administer the lifesaving medication,” Kieffer said. “With more children actually swallowing the medications, not only will there be more survivors, but fewer children will have to move to second-line drugs, which are used when initial medications stop working.”
These innovations represent very important progress in the fight to end AIDS in children.