Breaking the Cycle: Gilead’s Efforts to Improve HIV Treatment for Children
Dr. Eva Natukunda, a pediatric HIV specialist at the Joint Clinical Research Center in Kampala, Uganda, often hears from adolescents and young adults living with HIV that they are exhausted. Eva has been monitoring many of these patients since they were born and has found that by the time they reach adolescence, children who have grown up with HIV are tired of taking 4 to 6 pills every day because single-tablet regimens are not available everywhere for children. Some who stop taking their medication experience a resurgence of the virus and risk having children with HIV, perpetuating the epidemic to another generation of babies.
Eva is determined to break this cycle. She is one of many clinicians worldwide who are collaborating with Gilead scientists to develop more advanced and accessible treatments for the approximately 1.7 million children worldwide living with HIV, 90% of whom are in sub-Saharan Africa.
“Medications for children have historically lagged behind those for adults,” said Kathryn Kersey, Executive Director of Gilead’s Virology Clinical Development.
“I think it’s fair to say that children living with HIV have been left behind and there’s a need to close the gap between treatment options available for adults and children.”
According to the World Health Organization’s 2020 data, only 54% of children with HIV are receiving antiretroviral therapy, compared to 74% of adults. Eva explains that there are several reasons for the gaps in medication for children. Limited research on young people results in limited drug options, and adherence can be difficult due to regimens that require multiple doses of different therapies. Additionally, medications can be unpalatable and difficult for children to take.
“In some parts of the world, drug availability is the obstacle,” said Kathryn. “And stigma also still deters some parents from seeking care for their children.”
Gilead has been at the forefront of helping transform the treatment and prevention of HIV for decades, and it is also focused on helping speed the development and accessibility of new medications for children. Last year, it opened the global Pediatric Centre of Excellence in Dublin to coordinate and optimize the execution of pediatric clinical trials.
“The goal is to develop innovative therapies and have them approved sooner so they can reach children across the globe that much faster,” explains Kathryn.
At the center, over 100 employees are working on developing and researching new treatments for HIV, hepatitis, and COVID-19. Scientists have also started exploring new pediatric cancer treatments and will soon begin studies on treatments for childhood inflammatory conditions.
Kathryn explains that children are not simply smaller versions of adults when it comes to medication. There are many factors to consider, such as how their bodies metabolize medication and the impact on developing organs. There are also practical considerations for conducting clinical studies in children, such as obtaining informed consent and even routine matters like drawing blood samples. Additionally, children may have difficulty taking large or bitter-tasting pills.
To address this challenge, Gilead is collaborating with the Clinton Health Access Initiative and the Penta ID network to develop dispersible medications that can be dissolved in water to make them more palatable for children. This partnership, announced earlier this month, aims to improve treatment and adherence rates among children living with HIV in low- and middle-income countries.
Kathryn notes that new single-pill regimens can also improve adherence but are not approved for use in the pediatric population in most low- and middle-income countries. In the future, she envisions medications being tested for children at the same time as they are tested for adults to prevent delays in availability for adolescents. One of the most promising approaches is long-acting injectable medications, which could help young people and their caregivers manage their medication routines.
“Injections could potentially make a big difference in the lives of teenagers. They are clamoring for this,” said Eva.
“If the HIV treatment gap between children and adolescents can be closed, we can stop the cycle,” said Kathryn.
Eva is determined to break this cycle. She is one of many clinicians worldwide who are collaborating with Gilead scientists to develop more advanced and accessible treatments for the approximately 1.7 million children worldwide living with HIV, 90% of whom are in sub-Saharan Africa.
“Medications for children have historically lagged behind those for adults,” said Kathryn Kersey, Executive Director of Gilead’s Virology Clinical Development.
“I think it’s fair to say that children living with HIV have been left behind and there’s a need to close the gap between treatment options available for adults and children.”
According to the World Health Organization’s 2020 data, only 54% of children with HIV are receiving antiretroviral therapy, compared to 74% of adults. Eva explains that there are several reasons for the gaps in medication for children. Limited research on young people results in limited drug options, and adherence can be difficult due to regimens that require multiple doses of different therapies. Additionally, medications can be unpalatable and difficult for children to take.
“In some parts of the world, drug availability is the obstacle,” said Kathryn. “And stigma also still deters some parents from seeking care for their children.”
Gilead has been at the forefront of helping transform the treatment and prevention of HIV for decades, and it is also focused on helping speed the development and accessibility of new medications for children. Last year, it opened the global Pediatric Centre of Excellence in Dublin to coordinate and optimize the execution of pediatric clinical trials.
“The goal is to develop innovative therapies and have them approved sooner so they can reach children across the globe that much faster,” explains Kathryn.
At the center, over 100 employees are working on developing and researching new treatments for HIV, hepatitis, and COVID-19. Scientists have also started exploring new pediatric cancer treatments and will soon begin studies on treatments for childhood inflammatory conditions.
Kathryn explains that children are not simply smaller versions of adults when it comes to medication. There are many factors to consider, such as how their bodies metabolize medication and the impact on developing organs. There are also practical considerations for conducting clinical studies in children, such as obtaining informed consent and even routine matters like drawing blood samples. Additionally, children may have difficulty taking large or bitter-tasting pills.
To address this challenge, Gilead is collaborating with the Clinton Health Access Initiative and the Penta ID network to develop dispersible medications that can be dissolved in water to make them more palatable for children. This partnership, announced earlier this month, aims to improve treatment and adherence rates among children living with HIV in low- and middle-income countries.
Kathryn notes that new single-pill regimens can also improve adherence but are not approved for use in the pediatric population in most low- and middle-income countries. In the future, she envisions medications being tested for children at the same time as they are tested for adults to prevent delays in availability for adolescents. One of the most promising approaches is long-acting injectable medications, which could help young people and their caregivers manage their medication routines.
“Injections could potentially make a big difference in the lives of teenagers. They are clamoring for this,” said Eva.
“If the HIV treatment gap between children and adolescents can be closed, we can stop the cycle,” said Kathryn.
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