Antiretroviral drug shortage leaves persons living with HIV/AIDS in the dark

Certain antiretroviral drugs were in short supply across Tamil Nadu, according to Health Department soures. Representational image

Certain antiretroviral drugs were in short supply across Tamil Nadu, according to Health Department soures. Representational image

Rathna*, in her late 20s, has been feeling increasingly tired over the last two weeks. As a person living with HIV/AIDS (PLHA), a sudden change in antiretroviral therapy (ART) drugs by her doctor has left her with severe headaches, fatigue, pain in the hands and legs and difficulty walking. The reason for switching drugs: non-availability of stock.

“Nearly five years ago, I was shifted from the first-line to second-line antiretroviral regimen as the drugs did not work well for me. After initial struggles, my health condition improved until recently when the drug was suddenly changed. When I asked the doctor at a government hospital, I was told to take the drug for now as no stock was available at the moment,” she said.

As per records, Rathna, who was on tenofovir/lamivudine and atazanavir/ritonavir combination was put on a tenofovir, lamivudine and dolutegravir (TLD) combination drug.

Such drug changes are no longer uncommon in many parts of the State, according to members of the HIV positive networks and official sources in the Health Department. Some doctors and officials said certain antiretroviral drugs were in short supply across the State, including abacavir, lamivudine and dolutegravir.

A member of a HIV positive network, on condition of anonymity, said several PLHAs in the districts, including Erode, Karur, Namakkal, Salem, Tiruchi, Dindigul, Krishnagiri and Dharmapuri, were left clueless after their drugs were changed. “This raises the risk of drugs failing to work in patients. It also poses a risk to their health and life,” he said.

He added that the National AIDS Control Organisation (NACO) has stopped supplying drugs and has asked the State AIDS Control Societies to make local purchases. “The Tamil Nadu State AIDS Control Society is not taking up the purchase through the Tamil Nadu Medical Services Corporation that can ensure stock for six months,” he said.

“When a drug is changed, we need a liver function test, renal function test and check the glucose levels of patients. But here, medical officers are changing the drugs haphazardly. We are playing with the lives of people,” an official source said.

He added that some PLHAs, who were not educated, were confused after drugs of a different colour were given and were left wondering if they could take it. “ART treatment is a legal right for patients according to the HIV/AIDS (Prevention and Control) Act,” he said.

A senior doctor, who has been working in the field of HIV/AIDS, said the decision to change the drug regimen was at the discretion of the ART medical officer based on the clinical condition, laboratory parameters and presence of opportunistic infections in patients.

“The ART medical officer recommends to the State AIDS Clinical Expert Panel. Currently, there are stock outs of certain ART drugs in the country and even across the globe. When clinicians frequently switch regimens, and in the long term, there is a minimal chance that patients could develop drug resistance in the future,” he said.

“When the drugs are changed, it also causes confusion among patients who are not literate enough. Patients should be properly educated on the switching over of their regimens,” the doctor added.

A medical officer said there was a problem with the availability of drugs across the country. “It seems to be a national-level supply issue. NACO said the issue would be sorted out soon. If a drug is not available, we are allowed to make local purchases. Alternative regimens are being provided,” he said. Officials denied that there was any shortage of ART drugs in the State.

*name changed on request

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Printable version | Aug 5, 2022 10:53:11 am |