Last updated January 11, 2018 at 12:51 pm
Once an automatic death sentence, HIV is now a far more manageable disease. But its management depends on strict adherence to a dosing schedule of a cocktail of virus-fighting drugs – and only about 30 per cent of patients follow through on taking them.
But a new solution could change all that, require just a weekly dose of a capsule that acts like a mini pill box, slowly releasing the various drugs in the right proportions.
Proven effective in pigs, the treatment involves swallowing a capsule which unfolds into a rigid six-armed star shape when it reaches the stomach. It’s designed to lodge there while allowing food to pass through to the small intestine.
While the backbone of the star is made from a strong polymer, the arms can be modified as different drug-loaded polymers which release drugs at different rates. After the drugs are released, the structure breaks down and passes through the digestive system.
‘One of the main barriers to treating and preventing HIV is adherence. The ability to make doses less frequent stands to improve adherence and make a significant impact at the patient level.
These slow-release dosage systems perform equal or better than the current daily doses for HIV treatment in preclinical models,’ according to gastroenterologist and biomedical engineer Giovanni Traverso, a research affiliate at MIT’s Koch Institute for Integrative Cancer Research.
‘In a way, it’s like putting a pillbox in a capsule. Now you have chambers for every day of the week on a single capsule.’
Not only can this technique be used for viral suppression in infected patients, but it can also be effective for infection prevention.
The next step is to perform human clinical trials, and to look at ways to adapt the technique to different diseases.
“To put other drugs onto the system is significantly easier because the core system remains the same,” says one of the lead authors, MIT postdoc Ameya Kirtane. “All we need to do is change how slowly or how quickly it will be released.”
In Australia, the rates of HIV infection have remained stable for the last five years, with just over a thousand new cases each year. Globally, new cases have dropped from 3 million in 2000, to 1.8 million in 2016. 36.7 million people live with the disease.
The research was published in Nature Communications.