{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T17:30:48Z","timestamp":1779903048916,"version":"3.53.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T00:00:00Z","timestamp":1555286400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Despite a significant reduction in mother\u2010to\u2010child transmission of HIV, an estimated 180,000 children were infected with HIV in 2017, and only 52% of children under 15\u00a0years of age living with HIV (CLHIV) are on life\u2010saving 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>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\u2010 and middle\u2010income 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25267","type":"journal-article","created":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T08:11:48Z","timestamp":1555315908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Pursuing use of optimal formulations for paediatric HIV epidemic control \u2013 a look at the use of LPV\/r oral pellets and oral granules"],"prefix":"10.1002","volume":"22","author":[{"given":"Christine Y","family":"Malati","sequence":"first","affiliation":[{"name":"United States Agency for International Development Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Golin","sequence":"additional","affiliation":[{"name":"United States Agency for International Development Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-9864","authenticated-orcid":false,"given":"Lisa","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Independent Researcher Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandita","family":"Sugandhi","sequence":"additional","affiliation":[{"name":"ICAP at Columbia New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7424-8058","authenticated-orcid":false,"given":"Meena","family":"Srivastava","sequence":"additional","affiliation":[{"name":"United States Agency for International Development Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Larson","sequence":"additional","affiliation":[{"name":"United Parcel Service Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6297-1222","authenticated-orcid":false,"given":"Benjamin R","family":"Phelps","sequence":"additional","affiliation":[{"name":"United States Agency for International Development Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,15]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Global HIV & AIDS statistics 2018 fact sheet","author":"UNAIDS","year":"2018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw645"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5964-x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000931"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw463"},{"key":"e_1_2_8_7_1","unstructured":"World Health Organization.HIV drug resistance report. [Internet].Geneva:World Health Organization;2017[cited 2018 Sept 15]. Available from:https:\/\/www.who.int\/hiv\/pub\/drugresistance\/hivdr-report-2017\/en\/"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17140-7"},{"key":"e_1_2_8_9_1","unstructured":"U. S. President's Emergency Plan for AIDS Relief.Accelerating children's HIV\/AIDS treatment: promising practices and lesson learned implementation of the ACT Initiative[Internet].Washington D. C.:U. S. President's Emergency Plan for AIDS Relief;2017[cited 2018 Apr 19]. Available from:https:\/\/www.pepfar.gov\/documents\/organization\/270700.pdf."},{"key":"e_1_2_8_10_1","unstructured":"World Health Organization.Updated recommendations on first\u2013line and second\u2013line antiretroviral regimens and post\u2010exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidelines. Supplement to the 2016 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection.Geneva:World Health Organization;2018[cited 2019 Jan 13]. Available from:https:\/\/www.who.int\/hiv\/pub\/guidelines\/ARV2018update\/en\/"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2018.1393331"},{"key":"e_1_2_8_12_1","volume-title":"The 2018 optimal formulary and limited use list for paediatric ARVs","author":"World Health Organization","year":"2018"},{"key":"e_1_2_8_13_1","volume-title":"Transitioning to an optimal paediatric ARV formulary: implementation considerations","author":"World Health Organization","year":"2018"},{"key":"e_1_2_8_14_1","unstructured":"Merck Sharp & Dohme Corp. (2013).Isentress\u00ae(raltegravir). [package insert].Whitehouse Station NJ."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw488"},{"issue":"7","key":"e_1_2_8_16_1","first-page":"CD004772","article-title":"Effectiveness of antiretroviral therapy in HIV\u2010infected children under 2\u00a0years of age","author":"Penazzato M","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318232b057"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000135"},{"key":"e_1_2_8_19_1","unstructured":"U.S. Food and Drug Administration.Lopinavir\/ritonavir oral pellets FDA letter of tentative approval[Internet].Silver Spring MD:U.S. Department of Health and Human Services Food and Drug Administration; 2015 [cited 2018 Apr 19]. Available from:https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/appletter\/2015\/205425Orig1s000TAltr.pdf"},{"issue":"3","key":"e_1_2_8_20_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"},{"key":"e_1_2_8_21_1","unstructured":"Drugs for Neglected Diseases initiative (DNDi).Paediatric HIV advocacy toolkit: instructions for taking lopinavir\/ritonavir pellets[Internet].Geneva:Drugs for Neglected Diseases initiative (DNDi); 2015 [cited 2018 Apr 19]. Available from:https:\/\/www.dndi.org\/wp-content\/uploads\/2017\/02\/DNDi_Flip-Charts_RL_Instructions.pdf"},{"key":"e_1_2_8_22_1","volume-title":"Lopinavir\/ritonavir oral granules, FDA letter of tentative approval","author":"U.S. Food and Drug Administration"},{"key":"e_1_2_8_23_1","unstructured":"Antiretroviral Procurement Working Group.Memorandum on paediatric lpv\/r formulations[Internet].Geneva:APWG;2019[cited 2019 Feb 9]. Available from:https:\/\/arvprocurementworkinggroup.org\/home"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP3054"},{"key":"e_1_2_8_25_1","unstructured":"Andrieux\u2010MeyerI SalamiO OmolloR WamalwaD Maleche ObimboE KekitiinwaA et\u00a0al.Effectiveness and safety of lpv\/r pellets\u2010based art in children: 48\u2010week analysis. Poster presented at 25th Conference on Retroviruses and Opportunistic Infections; 2018 Mar 4\u20107;Boston MA: 2018. Available from:http:\/\/www.croiconference.org\/sessions\/effectiveness-and-safety-lpvr-pellets-based-art-children-48-week-analysis"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-469"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-201"},{"key":"e_1_2_8_28_1","unstructured":"Fact sheet on lopinavir and ritaonvir (Lpv\/R) oral pellets[Internet].Geneva:United Nation's Children's Fund and World Health Organization;2015[cited 2018 Apr 20]. Available from:http:\/\/www.who.int\/hiv\/pub\/toolkits\/iatt-factsheet-lopinavir-ritonavir\/en"},{"key":"e_1_2_8_29_1","volume-title":"Prospective study of lopinavir based ART for HIV infected children globally (LIVING Study)","author":"US National Library of Medicine"},{"key":"e_1_2_8_30_1","volume-title":"HIV Market Report","author":"Clinton Health Access Initiative","year":"2018"},{"key":"e_1_2_8_31_1","unstructured":"Global Health Supply Chain \u2013 Procurement and Supply Management Program.ARTMIS Product Catalog. 2019 [cited 2019 Feb 11]. Available from:https:\/\/psmsso.ghsc-psm.org"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjia2.25267","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25267","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25267","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T11:55:30Z","timestamp":1694346930000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1002\/jia2.25267"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25267","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]},"assertion":[{"value":"2018-06-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25267"}}