While stocks last…

日期:2017-12-03 02:54:41 作者:席嗖远 阅读:

By Michael Day SOME African AIDS patients will soon have access to “triple therapy”, the life-prolonging combination of anti-HIV drugs that has so far largely been the preserve of clinics in developed countries. But at least one group of activists is unimpressed. The London-based AIDS Treatment Project says that the drugs cocktail on offer is regarded as second-rate by doctors in the developed world. Hoffmann-La Roche, the Swiss-based drugs giant, says it will donate its drugs saquinavir and ddC, plus supplies of AZT purchased from its rival Glaxo Wellcome, free to hospitals in Kenya, Tanzania, Uganda, Zimbabwe, Zambia, Malawi, Côte d’Ivoire and Cameroon. When the donation—worth more than £400 000—runs out, the drugs will be available at a discount. The firm is still negotiating with the countries over a price they can afford. However, the AIDS Treatment Project says that saquinavir tablets, which are poorly absorbed in the gut, are being replaced by a more effective orally administered soft-gel formulation. And ddC is used less than related drugs such as AZT and 3TC because it can cause nerve damage. The group describes Roche’s offer of these “two most problematic HIV products” as “dangerous and insulting”. Sandra Palleja, a medical officer at Roche’s US headquarters in Nutley, New Jersey, writing in the 10 September issue of The New England Journal of Medicine (vol 339, p 774), states that doctors should give their patients Fortovase gel formulation instead of saquinavir tablets. But Roche defends its decision to donate saquinavir and ddC to African hospitals. A unpublished study of 3500 patients, led by Hans-Jürgen Stellbrink of Eppendorf University Hospital in Hamburg, has shown that, compared with treatment with just AZT and ddC, half as many HIV-positive people develop AIDS if given saquinavir, ddC and AZT over a two-year period. Other experts say that some of the criticism levelled at Roche is unfair. “The AIDS Treatment Project’s position is a simplistic take on a very complex subject,” says Edward King, who runs a website called Clinical Care Options For HIV. “The donations are definitely a good thing because the situation in Africa is so urgent,” says Agathe Lawson, the UN AIDS programme’s country adviser for Côte d’Ivoire, based in Abidjan. She expects 4000 people in Côte d’Ivoire to benefit from either double or triple therapy, as a result of the donation. But Lawson adds that an estimated 840 000 people in the country are infected with HIV. Ian Weller, an AIDS specialist at University College London, says that the main problem would be to ensure that supplies are kept up and patients are properly observed. “How well is the safety going to be monitored, and what’s the compliance going to be like?