Researchers are attempting to improve the uptake of lifesaving HIV medication for infants and children by masking the traditionally bitter taste of the drugs.
In 2023, around 100,000 children under the age of 14 were HIV positive in sub-Saharan Africa, according to UNAIDS, the Joint United Nations Programme on HIV/AIDS. While antiretroviral drugs can be used to treat the condition, it can often be challenging to convince children to take the bitter drugs.
Researchers from the 吃瓜tv in Scotland and the in South Africa have teamed up to develop a novel method to disguise the taste.
Paediatric medicines
The standard conventional method involves adding sweeteners and flavouring agents for paediatric medicines, but this is often ineffective at masking strong bitterness and an unpleasant aftertaste can persist due to the short duration of the sweetener taste.
Instead, by using co-crystallisation 鈥搘here two or more different molecules are combined to create a new crystalline structure 鈥� the unpleasant taste can be reduced.
The research is in the Royal Society of Chemistry Pharmaceutics Journal.
Professor Katharina Edkins from the 吃瓜tv Institute of Pharmacy & Biomedical Science, who researches molecular interactions in pharmaceutical materials, said: 鈥淭aste plays a significant role in the development of pharmaceutical formulations, especially for paediatric and geriatric patients, as it directly affects whether patients stick to their treatment.
The preventative medication used for HIV tastes awful for children, and given they have to take this every day for the rest of their lives, it鈥檚 vital to ensure it鈥檚 something that鈥檚 palatable, as if they don鈥檛 take it, they will develop AIDS and die.
Professor Edkins and her team in collaboration with the research group led by Professor Marique Aucamp at the University of the Western Cape in South Africa focused on how the drug鈥檚 bitterness could be managed using co-crystallisation. This approach doesn鈥檛 just rely on making the medicine sweet, but on the interaction between the drug and the additional molecule. The stronger this interaction, the more effective it is in masking the unpleasant taste.
Professor Edkins added: 鈥淭he key factor isn鈥檛 the actual sweetness of the ingredients, but rather the interaction between the drug and co-former in solution. The stronger that interaction, the better the bitter taste is altered.鈥�
Electrical tasting
The researchers tested this method with nevirapine (NVP), a common antiretroviral drug. After creating five different co-crystal materials of NVP, they used an electrical tasting system to assess the results. The findings showed that co-crystallisation could significantly reduce the bitterness of the drug, making it much easier to take.
Professor Aucamp said: 鈥淭his is a 鈥榝ocus-shifter鈥� in pharmaceutical formulation. Typically, we would add a sweetener to improve the taste of children鈥檚 medication, but our study opened a whole new area for taste alteration of any medicine for any patient group.鈥�
The project was funded by the through their Future Leader in African Independent Research (FLAIR) collaboration grants, and the research group hope to secure additional funding for the next phase to widen this study to other antiretroviral drugs for HIV treatment, as well as move to drugs for tuberculosis treatment, and to move the taste testing into human taste panels.