ARVs in our water are 'harmless'

But antiretroviral and other medication in drinking water are an increasing risk over time

- Sheree Bega

The presence of antiretroviral (ARV) residues in drinking water may be “harmless” but prolonged exposure to the broader population may lead to antimicrobial resistance, according to the Water Research Commission (WRC) and the department of water and sanitation.

Last week, the Mail & Guardian reported on a study at the North-West University, which found that significant concentrations of ARVs have been detected in South Africa’s water sources, particularly downstream of wastewater treatment plants.

Current wastewater treatment processes are inadequate for removing these bioactive compounds, underlining the need for technological advancements, the authors said.

The drugs most frequently detected were lopinavir and efavirenz, with concentrations at some sites far exceeding global norms. South Africa has the most extensive HIV treatment programme of its kind in the world.

Aquatic ecosystems and wastewater management systems were affected. Bacteriophages — viruses critical to controlling bacteria in wastewater treatment — were significantly affected.

Such disruptions could lead to bacterial blooms and reduced water quality, the authors said.

"The consumption of any type of exogenous drug by any organism in sufficient quantities may intervene with the regulation of metabolic systems and bring about adverse effects," said the study, warning that the presence of antiretrovirals in water "can be considered a hidden or latent risk".

"Humans are also exposed to these compounds via drinking water, and at concentrations exceeding calculated hazard quotients," the authors said. "Although not found in this study, humans and other organisms may potentially ingest antiretrovirals and their breakdown products via aquatic organisms such as fish."