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Why HIV is becoming a death sentence again

 ARV drugs

More than 13,000 Kenyans on HIV medication are staring at what doctors say are preventable deaths due to treatment failure.

In a survey done at Médecins Sans Frontiers' (MSF) 200 bed hospital in Homa Bay County, the charity noted that half of the patients are no longer responding to treatment.

"Up to 40 per cent of these are dying, a third of them within 48 hours of admission," MSF told the ninth IAS Conference on HIV Science in Paris, France last week.

Most of those dying are on ARVs, according to Charlotte Morris of MSF UK, unlike 20 years ago. In Kenya, ARVs were introduced 15 years ago, turning a previously death sentence into a manageable condition. But doctors say this is changing as ARVs lose their effectiveness against HIV.

"In Homa Bay, where anti-retrovirals have been available for years, half of the patients hospitalised with Aids show signs of treatment failure," says MSF's David Maman.

Totally untreatable

In April, the Ministry of Health, University of Amsterdam, The Netherlands, the Kenya Medical Research Institute, and the US Centers for Disease Control and Prevention reported the emergence of totally untreatable HIV patients in Kenya.

"Our findings indicate that nearly one in four patients in Kenya fail second-line treatment and this has completely exhausted the available anti-retrovirals," said their report in the Journal of Aids.

Ministry of Health statistics indicate that 900,000 Kenyans are on ARVs while about 180,000 are taking second-line drugs. MSF says 75 per cent of HIV patients being admitted to their facilities with advanced HIV have been on ARVs.

"This suggests that they may have either inherited a resistant form of the virus or their care providers have failed to notice their patients were not responding to treatment," it said.

MSF says these deaths can be prevented. Kenya is planning a survey on children later this year. Recently, the Ministry of Health launched the ARV drug Dolutegravir, described as safer and less likely to be resisted by HIV. 

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