{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:41:19Z","timestamp":1753882879827,"version":"3.41.2"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medical Case Reports"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p> The Namibia national antiretroviral therapy guidelines recommend that patients living with HIV who interrupt antiretrovirals and in the process disengage from care be restarted on their usual antiretroviral therapy regimen upon return. We introduce a 39-year-old male patient on first-line antiretroviral therapy, namely, tenofovir disoproxil fumarate, lamivudine and efavirenz, from 2015 to 2019 (4\u2009years), who returned to care after the fourth episode of interrupting his treatment, though his adherence to antiretroviral therapy was deemed poor. Thus, he presented with severe immunosuppression and an AIDS-defining condition. Hence, he was switched to second-line antiretroviral therapy, treated with fluconazole for oesophageal candidiasis and reinitiated on cotrimoxazole prophylaxis. The client is currently clinically stable with a suppressed viral load. Medical and drug history taking with an emphasis on the previous history of treatment failure in patients returning to care are paramount in guiding the choice of future prescriptions of antiretrovirals. The multiple antiretroviral therapy interruptions from the patient and the delay in decision-making on the side of the clinician to switch treatments contributed to the emergence of an AIDS-defining condition. <\/jats:p>","DOI":"10.1177\/2050313x221144209","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T13:02:37Z","timestamp":1671454957000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A case report of clinical implications of a delayed antiretroviral therapy switch in a patient with multiple treatment interruptions"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7894-4536","authenticated-orcid":false,"given":"Mireille A Mpalang","family":"Kakubu","sequence":"first","affiliation":[{"name":"Ministry of Health & Social Services, Windhoek, Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kandali","family":"Frans","sequence":"additional","affiliation":[{"name":"Ministry of Health & Social Services, Windhoek, Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson","family":"Gibutai","sequence":"additional","affiliation":[{"name":"Ministry of Health & Social Services, Windhoek, Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick DMC","family":"Katoto","sequence":"additional","affiliation":[{"name":"Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"issue":"2","key":"bibr1-2050313X221144209","volume":"97","author":"Cheng Y","year":"2018","journal-title":"Medicine"},{"key":"bibr2-2050313X221144209","doi-asserted-by":"publisher","DOI":"10.4172\/2155-6113.1000652"},{"key":"bibr3-2050313X221144209","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-019-0573-1"},{"key":"bibr4-2050313X221144209","unstructured":"Ministry of Health and Social Services of Namibia. National guidelines for antiretroviral therapy 2016. 5th ed., http:\/\/differentiatedservicedelivery.org\/Portals\/0\/adam\/Content\/VVys6XEqAkiCUujlnxr3qA\/File\/na_national_guidelines_art.pdf"},{"key":"bibr5-2050313X221144209","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky278"},{"issue":"3","key":"bibr6-2050313X221144209","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0092014","volume":"9","author":"O\u2019Malley G","year":"2014","journal-title":"PLoS ONE"},{"issue":"9","key":"bibr7-2050313X221144209","first-page":"687","volume":"94","author":"Goldschmidt RH","year":"2016","journal-title":"Am Fam Physician"},{"key":"bibr8-2050313X221144209","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v18i1.776"},{"key":"bibr9-2050313X221144209","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix570"},{"key":"bibr10-2050313X221144209","unstructured":"Stanford University. HIV drug resistance database, 2020, https:\/\/hivdb.stanford.edu\/"}],"container-title":["SAGE Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X221144209","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X221144209","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X221144209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T02:15:04Z","timestamp":1740881704000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X221144209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":10,"alternative-id":["10.1177\/2050313X221144209"],"URL":"https:\/\/doi.org\/10.1177\/2050313x221144209","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"type":"print","value":"2050-313X"},{"type":"electronic","value":"2050-313X"}],"subject":[],"published":{"date-parts":[[2022,1]]},"article-number":"2050313X221144209"}}