HIV drugs in Nigeria
Drug management is one of the treatment, care and support modalities of people living with HIV/AIDs in Nigeria. Drug treatment of people living with HIV/AIDs in Nigeria is known as anti retroviral therapy.
What is anti retroviral therapy?
This is the type of treatment for HIV or AIDs. It is not a cure but it can stop people living with HIV from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of your life. The drugs which work against HIV infection itself by slowing down the reproduction of the virus in the body are referred to as anti retroviral drugs (ARV), anti – HIV drugs or HIV antiviral drugs. Most of these HIV drugs in Nigeria are highly subsidized by the federal government. Hence, they are provided free in most health institutions or you may be required to pay for them.
What are ” Combination Therapy” and HAART in Nigeria?
For antiretroviral treatment to be effective for a long time, more than one antiretroviral drug needs to be taken at a time. This is what is known as “Combination Therapy”. If one drug is taken on its own, it has been found that, over a period of time, the drug stops working. HIV reacts to the drug in your body and changes, so that the virus is no longer affected by the drug. The virus then starts to reproduce itself the same way as before. This is known as the virus becoming resistant to the drug. If two or more antiretrovirals are taken together it will reduce the rate at which resistance develops. The term Highly Active Antiretroviral Therapy (HAART) is used to describe a combination of three or more anti- HIV drugs.
Classes/groups HIV drugs in Nigeria
There are 4 main groups of anti-retroviral drugs in Nigeria. They are the following:
1) Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)- table below showing the generic and brand names of NRTIs. Lamivudine, zidovudine and stavudine being the most popular ARVs in Nigeria. Stavudine was banned by NAFDAC because of its fatal side effects
2) Non-nucleoside reverse transcriptase inhibitors (NNRTIs). Check table below. Efavirenz and nevirapine are the most commonly used in Nigeria.
3) Protease inhibitors (PIs). Table below showing the generic names and brand names of HIV drugs in Nigeria. These groups of ARVs are known as protease inhibitors. Indinavir is the most popular of these drugs.
4) Fusion or entry inhibitors. New drug in town
There are currently more than 20 NAFDAC approved HIV drugs in Nigeria. As you can see above, the drugs are referred to by their research or chemical names and less often in their brand names, for example AZT (zidovudine). The second name of the drug is the common name for all the drugs with the same chemical structure, for example AZT is also known as Zidovudine. The third name of the drug is the brand name given by the pharmaceutical company; in Nigeria, one of the brand name of zidovudine is Retrovir. Lastly, an abbreviation of the of the common might also be used such as ZDV, which is the fourth name given to zidovudine.
Getting medications, where to get ARVs in Nigeria
In Nigeria, out of the 3.4million persons living with HIV, only 750,000 are on antiretroviral therapy(ART). This is partly due to ignorance as most persons do not know that HIV treatment in Nigeria is FREE or infected persons do not know where to get the drugs.
Right now, increasing number of drugs are now being licensed by NAFDAC for treatment of HIV and opportunistic infections. In Nigeria, antiretroviral drugs are available on prescription in hospital pharmacies, community pharmacies and some religious houses. Apart from cost related issues, better sources of these drugs are all Federal Teaching Hospitals, Federal Medical Centres and PEPFAR (USA/Nigeria Partnership for HIV/AIDs Relief) project centres. Currently, the following hospitals provide free antitetroviral drugs under the PEPFAR project:
1. Charles Boromeo Hospital, Anambra State, Nigeria
2. Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra state
3. General Hospital, Calabar , Cross River state
4. University of Calabar Teaching Hospital, Calabar, Cross River state
5. University of Benin Teaching Hospital, Benin city, Edo state
6. Central Hospital Benin City, Edo state
7. Gwagwalada General Hospital, Abuja, Federal Capital Territory
8. National Hospital, Abuja, FCT
9. Wuse General Hospital, Abuja, FCT
10. Massey Street Children’s Hospital, Lagos, Lagos State
11. Island Maternity Hospital, Lagos, Lagos state
12. Mainland Hospital, Ebutte-Metta, Lagos state
13. Aminu Kanu Teaching Hospital, Kano, Kano state
14. Infectious Disease Control Hospital, Kano, Kano state
15. Muritala Mohammed Hospital, Kano, Kano state.
In Lagos, Edo, Anambra, Adamawa states, HIV drugs are available free of charge. But for some hospitals listed above, one month supply of the drugs is available for patients at #1,000 naira. Buying HIV drugs in pharmacy shops that is not under PEPFAR is very expensive.
HIV/AIDS medications and dietary supplements in Nigeria
Although many people with HIV take dietary supplements, vitamins or herbal remedies in the hope of boosting or protecting their immune systems and general health, evidence that these have any beneficial effect is somewhat thin. It is important to to know that that certain supplements, such as large doses of garlic, can stop some anti- HIV drugs from working properly. Large doses of vitamin A can cause liver and bone damage, as well as vomitting and headache. Vitamin C doses above 1,000mg per day can cause kidney stones, diarrhoea and hardening of the arteries, and reduce the concentration or effectiveness of indanavir (crixivan). Vitamin E supplements should not be taken with amprenavir (agenerase). Above 75mg per day of zinc can cause the shortage of red and/or white blood cells. Large doses of selenium can suppress your immune system and excess doses of vitamin B6 cause painful nerve damage. Please watch the supplements!
cost of HIV drugs in Nigeria
The Nigerian government policy to provide antiretrovirals freely as part of HIV programs at the country’s health facilities has greatly improved the uptake of treatment. Excellent policy, but free drugs for HIV patients is not enough. It is well known that HIV/AIDS increases a persons vulnerability to opportunistic infections, persons living with HIV in Nigeria often incur other expenses like non-antiretroviral drugs e.g antibiotics, non-routine tests, medical consultations, transportation, food, admission and hospital stay. These cost are not covered by government programs. Most of the patients are not on health insurance, so they do out of pocket treatment for these diseases. This makes treatment of HIV in Nigeria very expensive making most citizens seek the alternative (herbal ‘cure’).
Kudos to Anambra, Lagos, Edo, and Adamawa states that pay part of the treatment for opportunistic infections.
Please note the HIV/AIDS is NOT a death sentence. Get tested and treated.
HIV/AIDS information for the Nigerian Community