Decisively deal with ARVs side effects, Sikika urges govt

A man who is living with HIV & AIDS, in Mtwara Region, allegedly experienced a body transformation where he began developing breasts like a woman as a result of ARV use.


The discovery, at the Centres for Disease Control (CDC) on June 5, 1981, of pneumocysitis pneumonia, a very rare condition, in five gay men in Los Angeles, marked a turning point in the history of this world as it gave birth to a new disease that would be called AIDS.

But the 30-year story of HIV/AIDS remains severely truncated. The HIV story typically starts from the first diagnosis of AIDS but ignores where, when and how the virus originated. This might be attributed to scientists labouring in vain in search of a solution to the problem.

However, the introduction of antiretrovirals (ARVs) came as a relief as people living with the virus were given a shot in the arm as these medicines prolong lives. Though the drugs provided hope at a time humanity was facing extinction, the honeymoon became short-lived as thousands of ARV users are battling serious side effects.

In Tanzania, cases of people suffering serious side effects have been on the increase and it is against this background that Sikika, a non governmental organisation dealing with health issues recently urged the government to decisively tackle the problem.

Through a press release, Irenei Kiria, the organisation's executive director, urged the Ministry of Health and Social Welfare (MoHSW) to identify and phase out all ARVs that are causing serious side effects to people living with HIV & AIDS in the country while adequate education should be provided for proper use of these drugs to patients to minimize the problem.

Cases of people suffering serious body deformities allegedly after using ARVs have been increasing in the country. Recently, the media reported a sad case, which occurred in Mtwara region whereby, a man who is living with HIV & AIDS experienced a body transformation where he began developing breasts like a woman as a result of ARV use. When he reported the case to the doctor, he was told that is a normal reaction to people who have been on ARV medication for a long period of time.

“Sikika discovered that although people living with HIV (PLHIV) have reported the side effects they get as a result of ARV use, still some of the health service providers have not taken any action, such as changing of the ARV’s for the PLHIV, or considering any other types of treatment,” said Kiria.

He went on to highlight that interviews (conducted by Sikika) with ARV users and healthcare providers revealed that some of the side effects encountered by patients as a result of ARV use include; loss of body weight, weariness of the body, numbness of the hands and legs, body rashes, nails becoming dark colored and even the transformation of body parts after the use of the drugs. It has also been noted that it may take up to six months before a new dosage is prescribed to them from the moment they report the side effects experienced as a result of ARV use. In most cases, when the PLHIV report the side effects they experience as a result of these drugs, and the answer they get is that, the side effects are a normal reaction and that they will disappear.

“Sikika has also discovered that most of the Care and Treatment Centers (CTCs) do not have CD4 count machines. This equipment is important as it makes it easy to know the health progress of a patient, what type of counseling needs to be done and the type of medication that needs to be prescribed to the PLHIV. This problem has been persistent especially in the rural areas where PLHIV are forced to walk long distances to get checked up for their CD4 count.

“This issue has been evident in the districts of Kondoa and Mpwapwa where some health care facilities do not have CD4 count machines. The facilities are Kisese, Hamai, Sondolo, Busi and Kwamtoro in Kondoa district and Kibwake, Rudi, Mima and Pwaga in Mpwapwa district. The absence of this equipment contributes to the PLHIV having to continue using medication which may not be proper considering the number of CD4s in their body,” he added.

Kiria went on to recommend that serious action be taken to persuade health service providers to adhere to their professional ethics and must swiftly address the problem of ARVs side effects as soon as they receive complaints. The Ministry of Health and Social Welfare should also be responsible and assist the victims to alleviate their suffering.

“PLHIV must follow doctors’ prescriptions without faltering to avoid such incidences. At the same time Sikika urges the government to make sure that ARVs are readily available to patients when needed as failure to access the drugs leads to faltering.

“Furthermore, the government should provide CD4 count machines to counseling and testing centres (CTCs) that are operating without the machines, and make sure that machines that are out of order are repaired to avoid and reduce such cases,” he said.

The problem of side effects is not a preserve of this country alone as the World Health Organisation revealed that it is a problem affecting the whole world.

It was discovered that certain antiretroviral (ARV) drugs commonly used in the developing world may be responsible for premature ageing, according to the authors of a new study published in the journal, Nature Genetics. Newer, less toxic but more expensive ARVs are more commonly used in the Western world.

Nucleoside analogue reverse-transcriptase inhibitors (NRTIs) - including Zidovudine, Lamivudine and Abacavir - have enabled millions of people living with HIV to prolong their lives. The UN World Health Organization has recommended that countries phase out Stavudine, an NRTI commonly used in Africa, due to long-term, irreversible side effects.

"We noticed that people in their 40s who had been on NRTIs for the past several years had signatures of ageing in their muscles commonly found in healthy people in their 70s and 80s," said Prof Patrick Chinnery of the University of Newcastle in the UK, one of the study's lead authors.

The researchers studied skeletal muscle from 33 HIV-infected adults, all aged 50 years or under, and 10 uninfected control subjects of comparable age. They found that in patients on NRTI treatment there was an expansion in mutations of mitochondrial DNA - the energy-producing part of the cell - similar to the mutations found in healthy older individuals.

"What we saw in our study is similar to patterns described by people who have been on ART [antiretroviral therapy] for a long time," said Chinnery.

Studies have found that despite a significant drop in mortality, people living with HIV are often affected by an increased risk of non-AIDS complications, including osteoporosis and heart attacks, which undermine their life-expectancy.

"The findings suggest that we need to look carefully at the effects of these drugs because some of the diseases caused by the abnormalities - diabetes, heart failure and so on - are serious and can cause progressive disability," Chinnery noted.

"But at the same time, clearly the patients need their drugs in order to keep them alive... but our study suggests that it may be beneficial to move to newer classes of drugs."

Chinnery said there was a need to conduct prospective studies on the likely effects of long-term use of different ARVs in order to catch and address potentially harmful side effects.