More fantastic news: HIV and TB drugs make a wonder pair

Two new life-saving drugs, one to prevent tuberculosis and an HIV wonder drug, work together, despite fears that they would interact badly.

This means a new TB-prevention drug can be given to high-risk HIV-positive South Africans to ensure they don’t contract the lung disease, which remains the country’s biggest killer. 

Dr Yogan Pillay, deputy director-general of the national department of health, said: “People being successfully treated for HIV are now dying from TB in high numbers, and that’s unacceptable. These new findings will allow us to prevent many of these deaths.”

Johannesburg-based Aurum Institute and the US-based Johns Hopkins University conducted the research in SA.

The results were announced on Wednesday at the annual Conference on Retroviruses and Opportunistic Infections in Seattle.

Aurum Institute CEO Prof Gavin Churchyard, who co-led the research, said: “We now have two game-changing drugs that can stop South Africans dying of TB when they are living with HIV.”   

Local HIV patients at high risk of TB infection are currently prescribed an antibiotic called Isoniazid, as TB-prevention therapy, for between six to 36 months.

This is a long time to take a medicine, with possible side effects, for an illness one does not have. 

“We’ve known for some time that preventive therapy for TB is a critical component of any effort to control the epidemic,” said Churchyard. 

“But current treatment options take too long and are potentially more toxic.”

A new TB-prevention drug called 3HP has to be taken for only three months, has fewer side effects and is more effective. 

But scientists did not know if it worked with the new ARV Dolutegravir, often described as a “wonder” drug.

Dolutegravir, which has few side effects, will form part of SA’s new three-in-one ARV pill later this year.

To get an answer, researchers enrolled 60 adults with HIV, who received Dolutegravir and other ARVs for eight weeks and then began a three-month course of 3HP for TB prevention.

The combination of drugs was safe.

“These are the results we have all been waiting for,” said Unitaid executive director Lelio Marmora.

The research findings will allow SA, 11 other African countries and Unitaid to make 3HP available soon to between 400,000 and 600,000 people.

President Cyril Ramaphosa and other presidents made a commitment to provide preventative TB treatment to at least 30 million people, reaching six million people by 2022, at a meeting at the UN in September.

Better TB preventative therapy gives hope that scientists will reduce the annual 10 million TB infections, which cause about 1.6 million deaths.

According to the World Health Organisation, TB is one of the top 10 causes of death globally.

“Preventive therapy, including 3HP, is one of the best ways to keep individuals and families safe from TB,” said Dr Paul Davis, chairperson of the Aurum Institute. “The 3HP regimen gives us hope that by using a find, treat and prevent TB strategy, we will finally end the epidemic.”