Optimised paediatric antiretroviral treatment to achieve the 95-95-95 goals
- PMID: 34691769
- PMCID: PMC8517773
- DOI: 10.4102/sajhivmed.v22i1.1278
Optimised paediatric antiretroviral treatment to achieve the 95-95-95 goals
Abstract
While the progress towards reaching the UNAIDS 95-95-95 targets in South African adults seems promising, the progress in the paediatric population is lagging far behind; only 79% percent of children living with HIV know their status. Of these, only 47% are on treatment, and a mere 34% of those are virally suppressed. Thus, virological suppression has been attained in only 13% of children living with HIV in South Africa. Multiple factors contribute to the high treatment failure rate, one of them being a lack of paediatric-friendly antiretroviral treatment (ART) formulations. For example, the Lopinavir/ritonavir syrup, which is the current mainstay of ART for young children, has an extremely unpleasant taste, contributing to the poor tolerability and lack of adherence by children using the formulation. Furthermore, the lack of appropriate formulations limits the optimisation of regimens, especially for young children and those who cannot swallow tablets. Switching from syrups to dispersible tablets will improve ease of administration and adherence and result in cost-saving. Despite the approval of simplified paediatric-friendly formulations internationally, including other sub-Saharan African countries, unnecessary delays are experienced in South Africa. Clinician groups and community organisations must speak up and demand that approvals be expedited to ensure the delivery of life-changing and life-saving formulations to our patients as a matter of urgency.
Keywords: 95-95-95 goals; ART; HIV/AIDS; PMTCT; paediatric.
© 2021. The Authors.
Conflict of interest statement
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
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References
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- Joint United Nations Programme on HIV/AIDS (UNAIDS) . UNAIDS Data 2020 [homepage on the Internet]. [cited 2021 June 17]. Available from: https://www.unaids.org/en/resources/documents/2020/unaids-data
-
- Woldesenbet SA, Jackson DJ, Lombard CJ, et al. . Structural level differences in the mother-to-child HIV transmission rate in South Africa: A multilevel assessment of individual-, health facility-, and provincial-level predictors of infant HIV transmission. J Acquir Immune Defic Syndr. 2017;74(5):523–530. 10.1097/QAI.0000000000001289 - DOI - PMC - PubMed
-
- FDA Approved Drugs . ABACAVIR Sulfate and Lamivudine No. 202381 [homepage on the Internet]. [cited 2021 June 17]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/pepfar/202381PI.pdf
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