{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:40:43Z","timestamp":1777927243667,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T00:00:00Z","timestamp":1537315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>Alternative modes of antiretroviral administration are sought for people with impaired intestinal passage and\/or absorption. We present a case of late HIV diagnosis (CD4+ count 160 cells\/\u00b5L) with gastric outlet obstruction due to stomach adenocarcinoma. Co-morbidities included oesophageal candidiasis, Helicobacter pylori-positive duodenal ulcers and cytomegalovirus duodenitis. The gastric outlet obstruction required total parenteral nutrition and parenteral medication during four weeks of diagnostic work-up leading to pyloric resection. Crushed dolutegravir, abacavir and lamivudine were administered during this time in the evening via nasogastric tube, which was kept clamped overnight. The tube was unclamped in the morning and stomach content was drained during the daytime. This mode of administration resulted in rapid and sustained viral load suppression (from 300,000 to 115 copies per mL in 28 days, 81 copies\/mL after 42 days of treatment and less than 40 copies\/mL thereafter). Therapeutic drug monitoring confirmed sufficient antiretroviral plasma levels during this mode of administration. The absorption of crushed dolutegravir, abacavir and lamivudine in the stomach may be considered in people with questionable gastrointestinal passage or impaired gastric emptying to achieve viral load suppression.<\/jats:p>","DOI":"10.1177\/0956462418797847","type":"journal-article","created":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T02:36:37Z","timestamp":1537410997000},"page":"94-98","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Crushed dolutegravir\/abacavir\/lamivudine given via nasogastric tube in gastric outlet obstruction caused by cancer resulted in rapid viral load suppression"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4572-745X","authenticated-orcid":false,"given":"Ale\u0161","family":"Chrdle","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, \u010cesk\u00e9 Bud\u011bjovice Hospital, \u010cesk\u00e9 Bud\u011bjovice, Czech Republic"},{"name":"Tropical and Infectious Diseases Unit, Royal Liverpool University Hospital, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zde\u0148ka","family":"Jerhotov\u00e1","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, \u010cesk\u00e9 Bud\u011bjovice Hospital, \u010cesk\u00e9 Bud\u011bjovice, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Vac\u00edk","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, \u010cesk\u00e9 Bud\u011bjovice Hospital, \u010cesk\u00e9 Bud\u011bjovice, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Linka","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for HIV\/AIDS, National Institute of Public Health, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00e1clav","family":"Chmel\u00edk","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, \u010cesk\u00e9 Bud\u011bjovice Hospital, \u010cesk\u00e9 Bud\u011bjovice, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,9,19]]},"reference":[{"key":"bibr1-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1835"},{"key":"bibr2-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e31821b42d1"},{"key":"bibr3-0956462418797847","doi-asserted-by":"publisher","DOI":"10.2165\/11318110-000000000-00000"},{"key":"bibr4-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e31820fa528"},{"key":"bibr5-0956462418797847","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200847060-00001"},{"key":"bibr6-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01000-08"},{"key":"bibr7-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70290-0"},{"key":"bibr8-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1177\/2325957417692678"},{"key":"bibr9-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.1.176-182.2004"},{"key":"bibr10-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01209-10"},{"key":"bibr11-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199911120-00006"},{"key":"bibr12-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr139"},{"key":"bibr13-0956462418797847","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/S0022-3565(25)11886-7","volume":"120","author":"Hogben CA","year":"1957","journal-title":"J Pharmacol Exp Ther"},{"key":"bibr14-0956462418797847","unstructured":"Triumeq Product Monograph. 2017, www.viivexchange.com\/xx-ca\/media\/147715\/triumeq-monograph-english.pdf (accessed on 5 February 2018)."},{"key":"bibr15-0956462418797847","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000193"},{"key":"bibr16-0956462418797847","author":"Roskam-Kwint M","journal-title":"J Antimicrob Chemother"},{"key":"bibr17-0956462418797847","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp160102"}],"container-title":["International Journal of STD &amp; 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