Foilized pouches can prevent the transmission of HIV from mother to child using multi-drug therapies

Robert Malkin

Department of Biomedical Engineering, Duke University, Durham, USA.

DOI: 10.4236/jbise.2014.71007                

Abstract

Children can become HIV positive (HIV+) from their mother during home birth. If the infant ingests antiretroviral (ARV), medications immediately after birth, the risk of transmission can be dramatically reduced. We have previously proposed the use of foilized, polyethylene-lined pouches to store ARV’s. Using the pouch, the mother receives the medication at an antenatal care visit, months before delivery, and if she delivers at home, tears open the pouch and drips the medication into her child’s mouth. In this work, we extend the use of the pouch to store a modern ARV, Lamivudine (3TC), often used in multi-drug regimens. Under laboratory conditions, pouches were filled with 3TC and stored at 25?C/60% relative humidity (RH) for twelve months. We found that the 3TC was stable throughout the year (maximum 5.6% of labeled concentration change). The preservatives were somewhat degraded by the act of repackaging the medicine, but sufficient preservatives remained to maintain the medication. The same impurities were identified in the 3TC stored in the pouches and the samples removed from the bottles indicating that the pouches do not introduce new impurities (impurities that are not already introduced by the bottle). We conclude that the pouch can preserve this modern ARV for up to twelve months.

Keywords

PMTCT; HIV; AIDS; Anti-Retroviral Preservation; Home Birth

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	WHO (2009) PMTCT strategic vision 2010-2015: Preventing mother-to-child transmission of HIV to reach the UNGASS and Millennium Development Goals. WHO, Geneva. http://www.who.int/hiv/pub/mtct/strategic_vision.pdf
[2]	WHO, UNAIDS, UNICEF (2009) Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress report 2009. WHO, Geneva, 112. http://www.who.int/entity/hiv/pub/tuapr_2009_en.pdf
[3]	WHO (2009) Rapid advice: Antiretroviral therapy for HIV infection in adults and adolescents. WHO, Geneva. http://www.who.int/hiv/pub/arv/rapid_advice_art.pdf
[4]	UNFPA (2007) The Prime Minister of Tanzania calls on regional leaders to increase health spending to 15 per cent of national budgets and to strive for achieving health MDGs. Press release. http://www.unfpa.org/public/News/pid/308
[5]	Berman, A. and Brooke, S. (2006) Sourcing guide: The Nevirapine infant-dose pouch for use in prevention of mother-to-child transmission of HIV/AIDS programs. Version 1. PATH, Seattle, 2. http://www.path.org/publications/files/TS_update_pkg_nvp.pdf
[6]	FDA (1999) Guidance for industry: Container closure systems for packaging human drugs and biologic. Section III.F.1.
[7]	Malkin, R.A. and Howard, C. (2012) A foilized polyethylene pouch for the prevention of transmission of HIV from mother to child. The Open Biomedical Engineering Journal, 6, 92-97.
[8]	Malkin, R.A. (2013) A pouch may be prevent the transmission of HIV from mother to child. Journal of Biomedical Engineering Research, 2, 66-70.