All Aboard

 In 2010 an estimated 5 million people were taking antiretroviral medication to manage their HIV. In the U.S., those who are diagnosed early and start drug therapy upon diagnosis carry a near-zero chance of passing the virus on to a sexual partner. And while much more of the global population has access to medication than ever before, the levels of care vary widely. With that disparity comes varied levels of concern for the safety of HIVers on antiretroviral therapy.

A study published in July and funded by the Bill and Melinda Gates Foundation found that more oversight is crucial on matters such as inappropriate use, drug interactions, toxicity, and substandard drugs, given the broadening pool of antiretroviral medication recipients.

The Forum for Collaborative HIV Research — which studies topics including drug side effects, new clinical trial designs, and how to make HIV testing universally available — had the task of advising drugmakers, government agencies, and others how best to assure safety and proper use of antiretrovirals.

“Loss of confidence in the safety of [antiretrovirals] could lead to poor adherence and the emergence of drug resistance, reduced demand for therapy, or inappropriate switching to more toxic or expensive medicines,” researchers noted in the report. In other words, if HIVers can’t be certain their meds are safe, they’re less likely to take them in the most effective manner.

The forum’s message is clear: Health officials, regardless of nation, need to be heard on how to properly maintain antiretroviral effectiveness.

“Many stakeholders with substantial interests are still not routinely at the table. Most prominently, the pharmaceutical industry, both innovator and generic, are not included,” researchers noted. Given their multibillion-dollar investment in the war on HIV, drug companies need to play a greater role in ensuring that medications are taken safely and properly. Such vigilance is “inextricably intertwined” with HIV research on a global scale, they wrote.