Role of drugs in the management of HIV/AIDS in Nigeria
The classes of drugs most important
to people living with HIV/AIDS (PLWHA) are
·
Anti-infective
agents to treat or prevent opportunistic infection.
·
Anti-cancer drugs
to treat malignancies, such as Kaposi Sarcome and Lymphoma;
·
Palliative drugs
to relieve pains and discomfort, both physical and mental;
·
ARVS (Antiretrovirals
to limit the damage that HIV dose to the immune system by reducing Viral load.
Based on extensive field research, MSF (Medicines)
bans frontiers (doctors without Borders) asserts that the priority medicines
for resources poor setting are:
(1) Drugs
for the prevention of opportunistic infection particularly Isoniazide and
cotrimoxazole, which are recommended by WHO/UNAIDS;
(2) Palliative
drugs, such as analgesics and antidiarrheas, which have shown to improve the
well being of patients
(3) Antiretrovirals
(ARVS) which can act as preventives of opportunistic infections and help to
extend and improve the quality of live by reducing viral loads;
(4) ARVs
such as AZT and NVP, which can prevent MTCT and can be used as post-exposure
Prophylaxis (Perez –casas and Boulet, 2000).
The use of antiretroviral drugs in the
management of HIV infection in Nigeria.
There
are two main types of antiretroviral drugs:
* Nucleoside Reverse Transcriptase
Inhibitors (NRTIS)
* Non-nucleoside
Reverse Transcriptase Inhibitors (NRTIS)
(Colebunders, et
al…, 1997)
List
of NRTIS
|
Drug
|
Manufacturing company
|
|
AZT,Z
idovudide (Retrovir)
|
Glaxo
Smith Kline
|
|
ddI,
didanosine (VIdex)
|
Bristol
Myers Squibo
|
|
Ddc,
Zalcitabine (HIVid)
|
Roche
|
|
3TC,
Lamivudine (Epivir)
|
Glaxo
smith Kline
|
|
D4T,
Stavudine (Zerit)
|
Bristol
Myers Squibb
|
|
Abacavir
(Ziagen)
|
Glaxo
Smith Kline
|
|
Combine
pill of AZT &3TC(combivir)
|
Glaxo
Smith Kline
|
|
Combined
pill of AZT, 3TC and Abacavir (Trizivir)
|
Glaxo
Smith Kline
|
(UNA IDS/ Nigeria, 2001)
List
of NNRTI’s
|
drug
|
Manufacturing
company
|
|
Neuirapirie
(Varamune)
|
Boehringer
ingelheim
|
|
Efavirenz
(Sustiva)
|
DU
pont in the U.S; Stocrin-Merck in the nest of the world
|
|
Delavirdine
(REscripita)
|
Pharmacia
and upjohn
|
(UNAIDS/
Nigeria, 2001).
The
drugs selected for the survey in Nigeria, includes the following.
Antiretrovirals : delarvidine, Zindovudine CAZT, efavirenze, indinavir
(ddi), saquinavir, nelfinavir, stavudine, nevirappine, ritonavir, lamiivudine,
zalatabine, AZT/3TC combination.
Antibiotics: Amoxycillin /clavulanate, aproflaxacine,
cotrimoxazole, ceftrioxone, azithromicine antifundals: fluconazole,
ketoconazole, amphotericine B, Itraconazle.
Anti-TB:
ISonizide, Rifampicin, Pyrazinamide.
(UNAIDS
/ Nigeria, 2001).