Khutso Kurhula embarks on groundbreaking research
26 August 2011
MEDIA ADVISORY: In a bid to improve adherence to antiretroviral treatment (ART) among children, the Anova Health Institute’s Khutso Kurhula (KK) project is embarking on a groundbreaking study of the side effects of ART in children.
Whilst a fair amount of research has been conducted on the side effects of ART in adults, considerably less is known about the side affects of treatment in children and young adolescents. This is only complicated further by children’s difficulty in effectively communicating their symptoms.
“As a result, side-effects in children often go undiagnosed”, study coordinator, Dr. Remco Peters explains. Peters believes that better understanding side-effects in children will help increase the likelihood of children and young adolescents adhering to their treatment. “This will allow them to lead long healthy and productive lives,” he adds.
Side effects differ from person to person and also depend on the type of antiretroviral drug (ARV). “This is why we have a range of regimens – so we can adjust treatment to minimize side effects,” says Peters. He is quick to add stress that these side effects are dramatically outweighed by the benefits of treatment: “…it is clear that ART works, and because of the treatment countless people living with HIV are living life to the full.”
The Anova study is currently taking place in public health facilities in the Mopani district of Limpopo and will include a sample of roughly 300 children between six months and 15 years of age.
Recognising that children’s symptoms are often miscommunicated, the researchers are directing questions about side effects directly to the children whilst examining them rather than their caregivers. This has resulted in more children reporting peripheral neuropathy than in the past.
So far reports from researchers are positive. The people of the rural Mopani district have given the study their stamp of approval by insisting their children are included in the research, with some even refusing to leave the clinic until their child is enrolled in the research.
The study was given the go ahead by the Limpopo department of health and ethics clearance was obtained through the University of the Witwatersrand’s ethics committee. It will focus particularly on hyperlactataemia but will also investigate other side effects of ART including lipodystrophy and peripheral neuropathy.
Hyperlactataemia occurs when lactic acid builds up in the body. The body’s cells produce lactate through normal metabolic processes, and produces more during strenuous exercise, making us feel stiff after a good workout. But in some cases, certain ARVs (known as nucleoside reverse transcriptase inhibitors, or NRTIs) can elevate the level of lactate in the body, causing extreme discomfort.
In adults symptoms of hyperlactataemia are known to include nausea and vomiting, weight loss and irregular heartbeat. Extreme cases of hyperlactataemia may result in potentially life-threatening lactic acidosis. However, the manifestations of hyperlactataemia in children are less well understood, something the Anovastudy hopes to rectify.
Khutso Kurhula is a project of the Anova Health Institute and is funded by PEPFAR through USAID.