RESEARCH ARTICLE


A Foilized Polyethylene Pouch for the Prevention of Transmission of HIV from Mother to Child



Robert Malkin*, Caroline Howard
Department of Biomedical Engineering, Hudson 136, #90281, Duke University, Durham, NC 27708, USA


Article Metrics

CrossRef Citations:
6
Total Statistics:

Full-Text HTML Views: 609
Abstract HTML Views: 342
PDF Downloads: 148
Total Views/Downloads: 1099
Unique Statistics:

Full-Text HTML Views: 334
Abstract HTML Views: 235
PDF Downloads: 128
Total Views/Downloads: 697



Creative Commons License
© Robert Malkin; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Biomedical Engineering, Hudson 136, #90281, Duke University, Durham, NC 27708, USA; Tel: +1919-660-8266; Fax: 919-684-4488; E-mail: robert.malkin@duke.edu


Abstract

Many children become HIV+ due to mother-to-child transmission, a risk that can be largely eliminated if infants ingest antiretroviral (ARV) medications immediately after birth. As most mothers in Africa deliver at home, the ARV must be provided at their last antenatal visit, sometimes months before birth. No current drug delivery system allows the mother to store the medication at home long enough to be effective. We propose a preserving, foilized, polyethylene pouch to be pre-dosed and sealed by a pharmacist for later delivery to the newborn.

Pouches were filled with 0.6 ml of Nevirapine (NVP). Thirty-three pouches were immediately studied to measure the impact of medication handling (oxygen, light, filling and sealing the pouches). The remaining samples were stored for up to one year at three storage conditions (25°C/60%RH, 30°C/65%RH, and 40°C/75%RH). Every two months, moisture loss, preservative concentration, impurity concentrations and NVP concentration were measured. Flora and fauna challenges were conducted.

The pouch nearly eliminated moisture loss: pouches lost less than 0.7% of their weight over twelve months. As expected, exposing the medication to light, oxygen, and handling significantly affected the sacrificial preservative concentrations (Propyl paraben dropped 38%, Methyl paraben dropped 12% at time point zero). However, after the initial time point, preservative levels were stable in the package over twelve months under all storage conditions (4.1% average concentration drop), leaving sufficient preservatives to protect the medication. The concentration of NVP changed an average of only 1.3% over all storage conditions and times points (maximum 1.4%).

We conclude that the foilized polyethylene pouch can preserve NVP, and perhaps other ARV’s, for up to one year.

Keywords: HIV, PMTCT, anti-retroviral preservation, home birth..