Cost of HIV treatment in Kenya to rise

December 15, 2009 12:00 am

, NAIROBI, Kenya, Dec 15 – The cost of HIV treatment is set to rise by up to 140 percent after the World Health Organisation (WHO) issued fresh guidelines to phase out Stavudine, the ARV treatment that is currently in use.

National Aids and STI Control Programme Head of Treatment and Care Dr Ibrahim Mohammed said on Tuesday that the cost of treating a single patient with the new regimen would cost up to Sh17,000 annually.

“This will be a gradual process, it will not be done overnight. Our initial budget will be high but then there will be subsequent savings because when we start treatment earlier, some patients will not develop opportunistic infections fast and in that way we will be decreasing cost of treating opportunistic infections like TB,” Dr Mohammed said.

Dr Mohammed said 70 percent of the 320,000 people on ARV treatment were using Stavudine and this would be phased out gradually over a period of three to five years.

WHO has recommended that patients who are on Stavudine and have developed complications be put on Tenofovir (TDF) which is the most expensive while those who have not developed any complication yet should be treated with Zidovudine (AZT) which costs Sh11,700 for a single patient annually.

“Tenofovir will especially be for those who develop side effects from Stavudine. Such patients cannot use AZT because it is like to develop the same side effects,” said WHO Kenya Director Dr David Okello.

According to the Director of Medical Services Dr Francis Kimani, Stavudine can cause disfigurement through destruction of fat in various parts of the body and it may also cause numbness on the fingers and legs.

“One may appear as if they have dips and depressions like if there is destruction of the fat on the thigh that area sinks down like somebody who is punched,” he said.

But Dr Okello said such side effects were experienced by people who had used the medication for more than three years which is termed as a long time.

He said about 44,800 patients had already developed the side effects and added that it was crucial for Kenya to change the treatment as advised in the new guidelines to cut on the cost of treatment for side effects.

The guidelines also require governments to put persons living with HIV on anti retroviral treatment when their CD4 count falls to 350, an increase from the previous CD4 count of 250.

The CD4 count is a type of cell that protects the body from infection and is found in the immune system.

The Human Immuno-deficiency virus (HIV) normally attacks the CD4 cells and uses them to produce more of the virus and this weakens the immune system making it unable to protect the body from opportunistic infections.

A HIV negative person is required to have about 700 CD4 cells while those living with HIV are supposed to have above 500 CD4 cells in a drop of blood.

The Director of Medical Services said this could raise the number of people on ARV treatment from the current 320,000 to 650,000.

“The people who have not been started on treatment may not have much problem but what we will first ensure that those who are already on treatment do not stop.  Then we will go to the others selectively in such a way that although we are going to start very early, they don’t all come at the same time and they don’t get diagnosed at the same time,” he said.

In the new guidelines, medics would also be required to use the viral load to diagnose treatment failure.


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