{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:10:55Z","timestamp":1777853455806,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T00:00:00Z","timestamp":1357862400000},"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":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Data on the use of ritonavir-boosted darunavir (DRV\/r) and\/or raltegravir (RAL) in resource-limited settings are rare and there is currently no published data regarding their use among African children. Botswana has recently made DRV\/r and RAL available for patients failing second-line antiretroviral therapy (ART).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective chart review of 4 multidrug-resistant pediatric patients on DRV\/r- and\/or RAL-based regimens. Viral load, CD4 count, adherence by pill count, and World Health Organization (WHO) clinical stage prior to and after switch to DRV\/r- and\/or RAL-based regimen were assessed. Antiretroviral therapy history, duration of virologic failure, and time to viral suppression were also noted. Genotypic resistance assays reviewed for mutations present prior to switch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All patients achieved viral suppression, showed improved\/stable CD4 counts, and obtained or maintained WHO clinical treatment stage I, even after long-standing virologic\/immunologic failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Well tolerated by and effective in our patients, DRV\/r and RAL provide potentially lifesaving ART options for children and adolescents in resource-limited settings failing ART due to ritonavir-boosted lopinavir (LPV\/r) resistance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1545109712463073","type":"journal-article","created":{"date-parts":[[2013,1,12]],"date-time":"2013-01-12T02:10:04Z","timestamp":1357956604000},"page":"90-94","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Early Outcomes of Darunavir- and\/or Raltegravir-Based Antiretroviral Therapy in Children with Multidrug-Resistant HIV at a Pediatric Center in Botswana"],"prefix":"10.1177","volume":"12","author":[{"given":"Brianna L.","family":"Kirk","sequence":"first","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"},{"name":"Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children\u2019s Hospital, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Gomila","sequence":"additional","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"},{"name":"Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children\u2019s Hospital, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mogomotsi","family":"Matshaba","sequence":"additional","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"},{"name":"Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children\u2019s Hospital, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marape","family":"Marape","sequence":"additional","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dipesalema R.","family":"Joel","sequence":"additional","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Anabwani","sequence":"additional","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"},{"name":"Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children\u2019s Hospital, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Tolle","sequence":"additional","affiliation":[{"name":"Botswana-Baylor Children\u2019s Clinical Centre of Excellence, Gaborone, Botswana"},{"name":"Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children\u2019s Hospital, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,1,11]]},"reference":[{"key":"bibr1-1545109712463073","doi-asserted-by":"publisher","DOI":"10.1086\/423178"},{"key":"bibr2-1545109712463073","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3182060610"},{"key":"bibr3-1545109712463073","doi-asserted-by":"publisher","DOI":"10.3851\/IMP1423"},{"key":"bibr4-1545109712463073","unstructured":"World Health Organization (WHO). Antiretroviral therapy for HIV infection in infants and children: towards universal access. Recommendations for a public health approach, 2010 revision."},{"key":"bibr5-1545109712463073","doi-asserted-by":"publisher","DOI":"10.2165\/11593330-000000000-00000"},{"key":"bibr6-1545109712463073","unstructured":"United Nations Program on HIV\/AIDS: UNAIDS. UNAIDS report on the Global HIV Epidemic 2010. http:\/\/www.unaids.org\/globalreport\/Global_report.htm. Accessed March 9, 2012."},{"key":"bibr7-1545109712463073","unstructured":"World Health Organization (WHO). Global HIV\/AIDS response: epidemic update and health sector progress towards Universal Access. Progress Report 2011. http:\/\/whqlibdoc.who.int\/publications\/2011\/9789241502986_eng.pdf. Accessed June 22, 2012."},{"key":"bibr8-1545109712463073","unstructured":"Ministry of Health, Botswana. Department of HIV\/AIDS Prevention and Care. Botswana National HIV\/AIDS Treatment Guidelines, 2012 Version."},{"issue":"2","key":"bibr9-1545109712463073","first-page":"22","volume":"24","author":"Food and Drug Administration (FDA) notifications","year":"2009","journal-title":"AIDS Alert"},{"key":"bibr10-1545109712463073","unstructured":"U.S. Food & Drug Administration. FDA expands use of HIV drug Isentress to children and adolescents. FDA News Release 2011. http:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm284473.htm. Accessed March 28, 2012."},{"key":"bibr11-1545109712463073","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328330abaa"},{"key":"bibr12-1545109712463073","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S4595"},{"key":"bibr13-1545109712463073","unstructured":"Nachman S, Acosta E, Samson P,  Pharmocokinetic (PK), safety and efficacy data on cohort IIA; youth aged 6-11 from IMPAACT P1066: a phase I\/II study to evaluate raltegravir (RAL) in HIV-1 infected youth. In: 17th Conference on Retroviruses and Opportunistic Infections (CROI 2009); San Francisco, CA; 2010."},{"key":"bibr14-1545109712463073","doi-asserted-by":"publisher","DOI":"10.1177\/1545109711422273"},{"key":"bibr15-1545109712463073","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2652-14-55"},{"key":"bibr16-1545109712463073","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181af829d"},{"key":"bibr17-1545109712463073","unstructured":"Gomila A, Kirk B, Tolle M, Patel P, Anabwani G. Protease genotypes in children and adolescents failing protease inhibitor (PI) -based antiretroviral therapy (ART) at the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana. Presented at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. 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