Pvt physicians giving wrong medication to HIV patients

MEXICO CITY: Getting treated for HIV from your neighbourhood doctor could be seriously putting your life in danger. A first-of-its kind study, conducted by WHO for Indias National AIDS Control Organisation estimates that nearly 10,000 HIV infected people – being treated by private physicians in India – were following irrational drug combinations and faulty regimens.

This was making them resistant to the first line anti-retroviral (ART) drugs faster than usual. The study, presented at the 17th International AIDS Conference here, made another startling revelation – some Indian pharma companies were delivering the highly toxic ART drugs directly to the homes of HIV patients to overcome the patients reluctance to visit pharmacies, in fear of stigma and discrimination.

The survey, conducted in Delhi and Kolkata over three months from October 2007, also found that more than 1,500 patients being treated by private physicians had already been put on the second line ART. Around 17% of the drugs being recommended by these private practitioners to hapless patients were single ingredient drugs, while the standard international protocol to treat HIV patients is to give them a triple drug combination therapy.

Also, due to high cost of ART drugs, patients purchase them usually for 7-10 days before discontinuing treatment.

Kountenya Sinha, for TNN

Further probing revealed that a majority of private physicians were prescribing ART drugs based on the information given to them by representatives of drug companies.

Nacos director general K Sujatha Rao told TOI in Mexico City, "It is vital for the drug controller generals office to ensure that ART drugs arent sold over the counter – a trend which has now been noticed in India. Policies being followed by some pharma companies to directly deliver ART drugs to patients is illegal.

"This is one area the government has to strengthen regulatory powers. The number of drug inspectors have to be increased tremendously to save lives."

Dr B B Rewari, Naco’s ART consultant, told TOI, "At present, 1.56 lakh HIV patients are on first-line ART in Nacos 174 centres. The private sector treats about 40,000 HIV patients. Normally, only 5% of those who follow the proper drug regimen and are on the right combination therapy develop resistance at the end of three years on treatment.

Irrational use of such drugs, like the ones being practised by most of India’s prvate doctors, can make patients resistant in just six months time."

According to Dr Rewari, most of the private doctors don’t have enough time to counsel their HIV patients, resulting in lack of treatment adherence.

Naco officials say the HIV/AIDS Bill presently lying with the law ministry for approval stipulates that only those trained in prescribing ART drugs can do so. Globally, 25 drugs are used as part of ART out of which 17 are available in India.

Naco now plans to engage the private physicians and teach them how to treat HIV patients. "It is most important that ART drugs are given in proper dosage and combination for it to be efficacious because every drug has a half life after which the serum concentration in the blood falls, making it ineffective," Dr Rewari added.



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