{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T01:12:03Z","timestamp":1775265123836,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,12,13]],"date-time":"2018-12-13T00:00:00Z","timestamp":1544659200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Heat\u2010stable lopinavir\/ritonavir (<jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r) oral pellets were developed to overcome challenges with administration and storage experienced with previously available tablet and syrup forms of <jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r prescribed to paediatric <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> patients. We report on the adoption of <jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r pellets for infants living with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> in the public sector antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) programme in Zimbabwe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Infants aged three months to three years who had been prescribed a <jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r\u2010based regimen (including <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>\u2010na\u00efve patients) in fourteen facilities across the country were eligible to receive the pellets. Caregivers were counselled on the new formulation and provided with administration guides. A caregiver questionnaire was administered three to four months after the child initiated on pellets. Data were also extracted from patient <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>One hundred and fifty\u2010seven children were enrolled (median age: 21\u00a0months; interquartile range 11.8 to 29.4). Survey data from 74 caregivers were included for analysis. Eighty\u2010one per cent of the caregivers preferred pellets while 19% preferred the syrup formulation. Eighty\u2010nine per cent assessed their child's response to taking the pellets as good or very good. Overall, 46% did not report any challenges while 54% reported one or more challenges with using the pellets. Difficulties with administration included: poor taste (36%; 26 participants); swallowing pellets (16%; 12 participants); finishing the dose (14%; 10 participants); and opening the capsule (10%; seven participants). Caregivers who were not confident to instruct others on pellet administration were 5.64 (95% confidence interval 1.45 to 21.95, <jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.013) times as likely to experience a challenge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A large proportion of caregivers preferred pellets to other formulations of <jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r and reported a good response to pellets; however, they also reported challenges with administration. Counselling should focus on ensuring that caregivers can confidently administer pellets and are able to instruct others, to ensure high uptake and good adherence to treatment. <jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r pellets may be an acceptable substitute for other available forms of <jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r for eligible children under three years if they are currently on or in need of <jats:styled-content style=\"fixed-case\">LPV<\/jats:styled-content>\/r\u2010containing regimens; however, challenges with administration still highlight the need for improved drug formulations for paediatric <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25214","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T07:28:57Z","timestamp":1544772537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Assessing the adoption of lopinavir\/ritonavir oral pellets for <scp>HIV<\/scp>\u2010positive children in Zimbabwe"],"prefix":"10.1002","volume":"21","author":[{"given":"Briony","family":"Pasipanodya","sequence":"first","affiliation":[{"name":"Clinton Health Access Initiative \u2013 Country Team Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudo","family":"Kuwengwa","sequence":"additional","affiliation":[{"name":"AIDS and TB Unit The Ministry of Health and Child Care Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret L","family":"Prust","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Inc. Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethany","family":"Stewart","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Inc. Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Chakanyuka","sequence":"additional","affiliation":[{"name":"The World Health Organization \u2013 Country Office Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tonderayi","family":"Murimwa","sequence":"additional","affiliation":[{"name":"The United Nations Children's Fund \u2013 Country Office Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Brophy","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Inc. Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olawale","family":"Salami","sequence":"additional","affiliation":[{"name":"Drugs for Neglected Diseases \u2013 Africa Regional Office Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Mushavi","sequence":"additional","affiliation":[{"name":"AIDS and TB Unit The Ministry of Health and Child Care Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsitsi","family":"Apollo","sequence":"additional","affiliation":[{"name":"AIDS and TB Unit The Ministry of Health and Child Care Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,13]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"UNAIDS.Fact sheet \u2013 World AIDS Day 2017. [cited 2018 Feb 25]. Available from:http:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_en.pdf"},{"issue":"2","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s40272-016-0210-4","article-title":"Challenges and opportunities in the development of HIV medications in pediatric patients","volume":"19","author":"Gueorgui D","year":"2017","journal-title":"Pediatr Drugs"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001333"},{"key":"e_1_2_9_5_1","volume-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection Recommendations for a public health approach","author":"World Health Organisation","year":"2016"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw488"},{"key":"e_1_2_9_7_1","volume-title":"Updated recommendations on first\u2010line and second\u2010line antiretroviral regimens and post\u2010exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidance","author":"World Health Organisation","year":"2018"},{"key":"e_1_2_9_8_1","unstructured":"Inter\u2010Agency Task Team (IATT) for Prevention and Treatment of HIV Infection in Pregnant Women Mother and Children.Fact sheet on lopinavir and ritonavir (LPV\/r) oral pellets. [cited 2018 Feb 25]. Available from:http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/193543\/FactsheetIATT_WHO_UNICEF_lopinavir_eng.pdf?sequence=1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000135"},{"key":"e_1_2_9_10_1","first-page":"1654938","article-title":"The need for pediatric formulations to treat children with HIV","volume":"2016","author":"Schlatter AF","year":"2016","journal-title":"AIDS Res Treat"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0036186"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-1740"},{"issue":"3","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"e014528","DOI":"10.1136\/bmjopen-2016-014528","article-title":"Understanding the acceptability and adherence to paediatric antiretroviral treatment in the new formulation of pellets (LPV\/r): the protocol of a realist evaluation","volume":"7","author":"Giralt AN","year":"2017","journal-title":"BMJ Open"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25214","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25214","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T13:31:47Z","timestamp":1694698307000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":12,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1002\/jia2.25214"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25214","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]},"assertion":[{"value":"2018-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25214"}}