Slow-Release Pill Could Address HIV Drug Adherence Issues

Once-weekly pill has the potential to prevent 20% of new HIV infections.

One of the biggest issues facing pharmacists is medication adherence. Whether a patient has an acute or chronic disease, adhering to a prescribed drug regimen is crucial for outcomes.

Adherence remains a significant issue in fighting the HIV/AIDS epidemic. Combination therapies can successfully manage HIV and reduce the likelihood of adverse events, however, clinical trials suggest that only 30% of patients adhere to their treatments.

A study published in Nature Communications demonstrates how a mini pill box can stay in the stomach for up to 1 week and deliver a consistent dose of HIV antiretroviral therapy.

“These slow-release dosage systems perform equal or better than the current daily doses for HIV treatment in preclinical models,” said C. Giovanni Traverso, MB, BChir, PhD.

The researchers developed a capsule that unfolds into a star-shaped structure in the stomach that is too large to exit, but allows food to pass through. The capsule contains polymers and other compounds that allow the HIV drugs to be slowly released.

Notably, the star-shaped pill can deliver multiple drugs at a time, which would be beneficial for patients with HIV who often take more than 1 antiretroviral, according to the authors.

In the new study, the authors investigated the pill’s ability to deliver dolutegravir, rilipivirine, and cabotegravir for prevention among HIV-negative models and viral suppression among HIV-positive models.

The researchers tested the doses for each drug in a pig model and measured the amount of each antiretroviral for 1 week.

The investigators also used mathematical modeling to project what would happen if a patient missed a dose of the therapy. They also explored how to potentially improve prevention strategies.

The simulated viral dynamics and adherence patterns suggested that the novel pill would be able to lower the risk of therapeutic failure, according to the study.

The authors said that the new system may also be able to mitigate thousands of new HIV cases. Transitioning patients from a daily dose to a weekly dose of pre-exposure prevention could drop new infections by 20%, according to the study.

A model population in South Africa demonstrated that using the new pill has the potential to prevent 200,000 to 800,000 cases of HIV over the next 2 decades, a significant reduction.

The team of researchers are currently working to validate their results and translate these findings to patients, according to the study.