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The Kirby Institute Level 6 Seminar Room Wallace Wurth Building UNSW Australia Sydney NSW 2052
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Rata Joseph +61 (0)2 9385 0900 rjoseph@kirby.unsw.edu.au
The Kirby Institute is pleased to present:
Dr Dianne Carey-Clinical Project Leader- Therapeutic Vaccine Research Program, Kirby Institute
"Dose reduction as part of antiretroviral treatment optimisation."
Abstract:
By the end of 2013, approximately 12.9 million people globally were receiving antiretroviral treatment, 11.7 million of these in low- and middle-income countries. However, this 11.7 million represents about a third of the estimated 33 million with HIV infection in these countries. Expanding treatment to all infected individuals and their retention in long-term care poses enormous challenges as significant increases in investments are required at a time when donor funds and health care resources are either unchanged or decreasing.
Antiretroviral drugs costs have decreased in low- and lower-middle income countries over recent years assisted by continuing expansion of treatment programmes, greater predictability of demand, improved manufacturing methods and increased competition between manufacturers. While treatments are now more affordable, drug costs remain substantial. Expanding treatment towards universal access will increase total drug costs significantly. Dose reduction provides a means of further decreasing costs.
Although several antiretroviral agents have shown no difference in virological suppression rates across several dosages in phase II studies, the highest tolerated dose was taken into phase III registration trials. Several dose optimisation trials which compared the virological efficacy of a reduced dose versus standard dose of an antiretroviral drug have completed recently. However, changing the dose of a drug necessitates robust evidence from well-designed, long-term clinical trials and timely review of the emergent data by international regulatory agencies to ensure the research findings are translated into updated treatment guidelines.
Bio:
Dianne Carey is a Clinical Project Leader in the Therapeutic Vaccine Research program and has been involved in a number of HIV clinical trials, most recently ENCORE1. Dianne completed her PhD at UNSW; her thesis focused on assessment, prevention and management of HIV lipodystrophy and associated metabolic toxicities with the aim of ensuring long-term antiretroviral adherence and optimised clinical benefit. Prior to joining the Kirby, Dianne was an HIV clinical pharmacist at St Vincent’s Hospital. She has Batchelor of Pharmacy and Master of Public Health degrees from the University of Sydney.