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. 2019 Apr;22(4):e25267.
doi: 10.1002/jia2.25267.

Pursuing use of optimal formulations for paediatric HIV epidemic control - a look at the use of LPV/r oral pellets and oral granules

Christine Y Malati  1 , Rachel Golin  1 , Lisa O'Brien  2 , Nandita Sugandhi  3 , Meena Srivastava  1 , Chris Larson  4 , Benjamin R Phelps  1
Affiliations

Pursuing use of optimal formulations for paediatric HIV epidemic control - a look at the use of LPV/r oral pellets and oral granules

Christine Y Malati et al. J Int AIDS Soc. 2019 Apr.

Abstract

Introduction: Despite a significant reduction in mother-to-child transmission of HIV, an estimated 180,000 children were infected with HIV in 2017, and only 52% of children under 15 years of age living with HIV (CLHIV) are on life-saving antiretroviral therapy (ART). Without effective treatment, half of CLHIV die before the age of two years and only one in five survives to five years of age.

Discussion: Over the past four years, the United States Food and Drug Administration tentatively approved new formulations of lopinavir/ritonavir (LPV/r) in the form of oral pellets and oral granules. However, the slow uptake of the aforementioned formulations in the low- and middle-income countries with the highest paediatric HIV burden is largely due to three challenges: limited manufacturing capacity; current unit cost of the pellets and granules; and slow uptake of these new formulations by policy makers and health care workers.

Conclusions: Solutions to overcome these barriers include ensuring availability of an adequate supply of LPV/r oral pellets and oral granules, considering all programmatic and clinical factors when selecting paediatric ART formulations, and leveraging current resources to decrease paediatric HIV morbidity and mortality.

Keywords: HIV infections; antiretroviral therapy; children; infants; lopinavir/ritonavir; optimal regimens; protease inhibitor.

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References

    1. UNAIDS . Global HIV & AIDS statistics 2018 fact sheet. Geneva: UNAIDS; 2018. [cited 2018 Sep 15]. Available from: http://www.unaids.org/en/resourcse/fact-sheet
    1. Boerma RS, Boender TS, Bussink AP, Calis JCJ, Bertagnolio S, Rinke de Wit TF, et al. Suboptimal viral suppression rates among HIV‐infected children in low‐ and middle‐ income countries: a meta‐analysis. Clinical Infect Dis. 2016;63(12):1645–54. - PubMed
    1. Nasuuna E, Kigozi J, Babirye L, Muganzi A, Sewankambo NK, Nakanjako D. Low HIV viral suppression rates following the intensive adherence counseling (IAC) program for children and adolescents with viral failure in public health facilities in Uganda. BMC Public Health. 2018;18(1):1048. - PMC - PubMed
    1. Palumbo P, Lindsey JC, Hughes MD, Cotton MF, Bobat R, Meyers T, et al. Antiretroviral treatment for children with peripartum nevirapine exposure. N Engl J Med. 2010;363:1510–20. - PMC - PubMed
    1. Boerma RS, Sigaloff KC, Akanmu AS, Inzaule S, Boele van Hensbroek M, Rinke de Wit TF, et al. Alarming incrase in pretreatment HIV drug resistance in children living in sub‐Saharan Africa: a systematic review and meta‐analysis. J Antimicrob Chemother. 2017;72:365–71. - PubMed

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