{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:58:00Z","timestamp":1791244680596,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["IZ07Z0_160876\/1"],"award-info":[{"award-number":["IZ07Z0_160876\/1"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["PCEFP3_181355"],"award-info":[{"award-number":["PCEFP3_181355"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["10003309"],"award-info":[{"award-number":["10003309"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["P500PM_221966"],"award-info":[{"award-number":["P500PM_221966"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["P5R5\u20103_239083"],"award-info":[{"award-number":["P5R5\u20103_239083"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Children and adolescents living with HIV previously taking ritonavir\u2010boosted lopinavir (LPV\/r)\u2010based antiretroviral therapy (ART) have been programmatically transitioned to dolutegravir (DTG)\u2010based regimens in many country programs. We aimed to describe treatment outcomes following this transition in Lesotho, southern Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We analyzed routinely collected data from two open cohorts across 27 health facilities in Lesotho.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included children and adolescents (&lt;18\u2009years at transition to DTG) who transitioned from first\u2010 or second\u2010line ART consisting of LPV\/r and 2 nucleoside reverse transcriptase inhibitors (NRTIs) to DTG and 2 NRTIs between July 2019 and July 2023. We report viral load (VL) data before transition, 12\u2009months post\u2010transition, and 24\u2009months post\u2010transition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 852 participants, 410 (48.1%) were female, the median age was 10.1\u2009years (interquartile range [IQR] 7.6\u201313.0) and the median time on ART at transition was 8.1\u2009years (IQR 5.6\u201311.1). Of 768 with a pre\u2010transition VL, 617 (80.3%) had viral suppression (VS; &lt;50 copies\/mL), 85 (11.1%) had low\u2010level viremia (LLV; 50\u2013999 copies\/mL), and 66 (8.6%) had a high VL (HVL; \u22651000 copies\/mL). Among 822 with a 12\u2010month post\u2010transition VL, 721 (87.7%) had VS, 76 (9.2%) had LLV and 25 (3.0%) had HVL. Among 787 with 24\u2010month post\u2010transition VL, 686 (87.2%) had VS, 75 (9.5%) had LLV and 26 (3.3%) had HVL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed improved and sustained VS among children and adolescents in routine care in Lesotho after programmatic transition to DTG\u2010based ART, supporting continued scale\u2010up of DTG in paediatric HIV programmes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70316","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:37:01Z","timestamp":1791243421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>HIV<\/scp>\n                    viral suppression in children and adolescents who transitioned from ritonavir\u2010boosted lopinavir\u2010 to dolutegravir\u2010based antiretroviral therapy in\n                    <scp>Lesotho<\/scp>"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7178-0986","authenticated-orcid":false,"given":"Jacob","family":"Blankenberger","sequence":"first","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research University Hospital Basel  Basel Switzerland"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2779-3911","authenticated-orcid":false,"given":"Teresa L. F.","family":"Steffy","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation Lesotho  Maseru Lesotho"},{"name":"Department of Pediatrics Baylor College of Medicine  Houston Texas USA"},{"name":"Texas Children's Hospital Global Health Corps  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7391-8379","authenticated-orcid":false,"given":"Tristan","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research University Hospital Basel  Basel Switzerland"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thithili","family":"Makhesi","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation Lesotho  Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenakshi","family":"Bakaya","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation Lesotho  Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Devendra","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation Lesotho  Maseru Lesotho"},{"name":"Department of Pediatrics Baylor College of Medicine  Houston Texas USA"},{"name":"Texas Children's Hospital Global Health Corps  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pheello","family":"Mothepu","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation Lesotho  Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lipontso","family":"Motaboli","sequence":"additional","affiliation":[{"name":"SolidarMed, Partnerships for Health  Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-9542","authenticated-orcid":false,"given":"Nadine","family":"Tschumi","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research University Hospital Basel  Basel Switzerland"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0036-0084","authenticated-orcid":false,"given":"Anna","family":"Klicpera","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research University Hospital Basel  Basel Switzerland"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapiwa","family":"Tarumbiswa","sequence":"additional","affiliation":[{"name":"Ministry of Health  Maseru Lesotho"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8959-2724","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9rique","family":"Chammartin","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research University Hospital Basel  Basel Switzerland"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4467-4029","authenticated-orcid":false,"given":"Lineo K.","family":"Thahane","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation Lesotho  Maseru Lesotho"},{"name":"Department of Pediatrics Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3599-1791","authenticated-orcid":false,"given":"Niklaus D.","family":"Labhardt","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research University Hospital Basel  Basel Switzerland"},{"name":"University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1874-6153","authenticated-orcid":false,"given":"Jennifer A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research University Hospital Basel  Basel Switzerland"},{"name":"University of Basel  Basel Switzerland"},{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"},{"name":"Centre for the AIDS Programme of Research in South Africa (CAPRISA) University of KwaZulu\u2013Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"HIV Statistics \u2010 Global and Regional Trends. Accessed October 15 2025.https:\/\/data.unicef.org\/topic\/hivaids\/global-regional-trends\/."},{"key":"e_1_2_9_3_1","unstructured":"Policy brief: update of recommendations on first\u2010 and second\u2010line antiretroviral regimens. Accessed October 17 2025.https:\/\/iris.who.int\/items\/553ef669-75fd-4f15-8873-964b2964ed33."},{"key":"e_1_2_9_4_1","unstructured":"Consolidated guidelines on HIV prevention testing treatment service delivery and monitoring: recommendations for a public health approach. Accessed October 17 2025.https:\/\/www.who.int\/publications\/i\/item\/9789240031593."},{"key":"e_1_2_9_5_1","volume-title":"National Guidelines on the Use of Antiretroviral Therapy for HIV Prevention and Treatment","year":"2022"},{"key":"e_1_2_9_6_1","volume-title":"National Guidelines on the Use of Antiretroviral Therapy for HIV Prevention and Treatment (5th Edition)","year":"2016"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"2531","DOI":"10.1056\/NEJMoa2108793","article-title":"Dolutegravir as first\u2010 or second\u2010line treatment for HIV\u20101 infection in children","volume":"385","author":"Turkova A","year":"2021","journal-title":"N Engl J Med"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1056\/NEJMoa2404597","article-title":"Second\u2010line antiretroviral therapy for children living with HIV in Africa","volume":"392","author":"Musiime V","year":"2025","journal-title":"N Engl J Med"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1097\/QAD.0000000000003835","article-title":"HIV viral suppression in children and adolescents 2\u2009years after transition to dolutegravir: a multicentre cohort study","volume":"38","author":"Devendra A","year":"2024","journal-title":"AIDS (London, England)"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-085404","article-title":"Cohort profile: the viral load cohort north\u2010East Lesotho (VICONEL) from 2016 to 2023 \u2010 cohort description, test volumes, predictors of viraemia and the road ahead","volume":"15","author":"Brown JA","year":"2025","journal-title":"BMJ Open"},{"key":"e_1_2_9_11_1","volume-title":"Addendum to the National Guidelines on the Use of Antiretroviral Therapy for HIV Prevention and Streatment","author":"Ministry of Health, Government of Lesotho","year":"2019"},{"key":"e_1_2_9_12_1","volume-title":"UNAIDS data 2024","year":"2024"},{"key":"e_1_2_9_13_1","volume-title":"HIV Market Report 2024: the State of HIV Treatment, Testing, and Prevention in Low\u2010 and Middle\u2010Income Countries","author":"Clinton Health Access Initiative","year":"2024"},{"key":"e_1_2_9_14_1","volume-title":"HIV Market Report 2020: the State of HIV Treatment, Testing and Prevention in Low\u2010 and Middle\u2010Income Countries","author":"Clinton Health Access Initiative","year":"2020"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.1056\/NEJMoa2210005","article-title":"Second\u2010line switch to dolutegravir for treatment of HIV infection","volume":"388","author":"Ombajo LA","year":"2023","journal-title":"N Engl J Med"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S1473-3099(19)30036-2","article-title":"Dolutegravir versus ritonavir\u2010boosted lopinavir both with dual nucleoside reverse transcriptase inhibitor therapy in adults with HIV\u20101 infection in whom first\u2010line therapy has failed (DAWNING): an open\u2010label, non\u2010inferiority, phase 3b trial","volume":"19","author":"Aboud M","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1093\/cid\/ciad390","article-title":"Two\u2010year outcomes of treatment\u2010experienced adults after programmatic transitioning to dolutegravir: longitudinal data from the VICONEL human immunodeficiency virus cohort in Lesotho","volume":"77","author":"Tschumi N","year":"2023","journal-title":"Clin Infect Dis"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"e836","DOI":"10.1016\/S2352-3018(25)00162-6","article-title":"Virological and drug\u2010resistance outcomes for people living with HIV initiating or switching to tenofovir, lamivudine, and dolutegravir in six PEPFAR\u2010supported countries: a prospective cohort study","volume":"12","author":"Marc JB","year":"2025","journal-title":"Lancet HIV"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1097\/INF.0000000000003878","article-title":"Realizing the promise of dolutegravir in effectively treating children and adolescents living with HIV in real\u2010world settings in 6 countries in eastern and southern Africa","volume":"42","author":"Bacha JM","year":"2023","journal-title":"Pediatr Infect Dis J"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1093\/cid\/ciae185","article-title":"Emergence of acquired dolutegravir resistance in treatment\u2010experienced people with HIV in Lesotho","volume":"79","author":"Tschumi N","year":"2024","journal-title":"Clin Infect Dis"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"e698","DOI":"10.1016\/S2214-109X(24)00553-9","article-title":"Predicted dolutegravir resistance in people living with HIV in South Africa during 2020\u201335: a modelling study","volume":"13","author":"Loosli T","year":"2025","journal-title":"Lancet Glob Health"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70316","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70316","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:37:05Z","timestamp":1791243425000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":20,"alternative-id":["10.1111\/hiv.70316"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70316","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"2026-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hiv.70316"}}