29 May 2018

Ministry of Health and Wellness has cautions the public about potential safety issues related to the use of antiretroviral medicine called Dolutegravir (DTG). The drug has a potential to affect neural tube development during early conception.

Neural tube entails development of the spinal cord, the brain and the bone surrounding tissues that takes place within 28 days of conception (one month).  

Dolutegravir is one of the antiretroviral drugs offered to HIV infected people, and was introduced in Botswana in 2016 because it is better tolerated and leads to faster and sustained viral suppression.

In an interview, Ministry of Health and Wellness public relations officer, Ms Doreen Motshegwa said health experts and researchers were working on the safety issues related to uptake of the medication and that the findings were currently circumstantial.

She said data was very limited at this time and it suggested that potential issues arise from a woman’s exposure to DTG only at the time of conception. “This is when the neural tube fails to completely form,” she stated.

Ms Motshegwa said currently, monitoring with regards to the uptake of the medication was continuing because only four cases of neural tube defects have been identified out of the 426 women who were taking DTG before they became pregnant from an ongoing study that is conducted by Botswana Harvard Partnership.

She, however, noted that despite the findings, the drug has proven to be a highly effective both in Botswana and around the world.

She stated that the ministry continues to monitor the use of DTG among women of childbearing age and will inform the public appropriately about any new developments. 

Meanwhile, a news release from the Ministry of Health and Wellness advises HIV infected women to use DTG with caution and with advice from their clinicians.

The release further advises the public that HIV positive women who desire pregnancy, or are currently taking the medication, should inform healthcare providers for appropriate advice.

It states that HIV women who are pregnant and have conceived while on DTG should alert their healthcare providers so they can be advised appropriately.

Neural tube defects maybe related to folate deficiency, other medications, obesity or genetic factors.

The release states that to date, more than 2 500 women who began taking DTG after the time of  conception have not reported any cases of neural tube defects and that there has been no infant born with a neural tube defect from women who started DTG after their first three months of pregnancy. ENDS