Health department monitors second line regimen of ARV treatment

THE Department of Health is closely monitoring the situation where a global shortage of lamivudine, a second line regimen of anti-retroviral (ARV) treatment has affected the availability of this ARV in health facilities in the country.

The first line treatment is widely available and there is no shortage of this product.

According to the Health Department, the majority of patients (over 90%) that are on ARV treatment receive the first line option which is a single dose fixed dose combination of Tenofovir/Emtricitabane/Efavirenz tablet.

Some patients (6%) are resistant or cannot tolerate the first line regimen and are then put onto the second line regimen of abacavir/lamivudine or zidovudine/ lamivudine,’ said department spokesperson Popo Maja.

The majority of patients are moved to the second line largely due to resistance and not tolerability.

The global shortage of lamivudine has affected the availability of abacavir/lamivudine and zidovudine/ lamivudine.

Pharmaceutical company Mylan is contracted to supply abacavir/lamivudine and zidovudine/ lamivudine, but they are affected by the global shortage and cannot supply the entire ordered quantities.

‘Due to the current supply constraints, we have advised provincial departments to closely monitor the distribution and rational use of these medicines until the supply is fully restored.

These measures include firstly, the redistribution of stock between facilities so there is no stock piling in any particular facility so that all patients receive treatment,’ said Maja.

Secondly, the department has alerted health officials that patients should be dispensed a lower quantity of stock than usual which may include issuing a month’s supply instead of the standard two or three-month supply.

Our clinicians have been informed that if implementation of the above two measures are unsuccessful and there is no treatment at a facility, the recommended therapeutic alternative is tenofovir (TDF) 300mg/emtricitabane (FTC) 200mg dual formulation tablet, with dose adjustments for renal impairment,’ said Maja.

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