{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T07:49:27Z","timestamp":1790495367604,"version":"4.1.0"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"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":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:p>\n                    Established antiretroviral therapy (ART) programs in sub-Saharan Africa have well-defined first-and second-line therapies but no standard third-line ART regimen. The impact of third-line ART on patients with multiclass-resistant HIV in resource-limited settings has not been well characterized. We conducted a retrospective review of patients on third-line ART at the University Teaching Hospital in Lusaka, Zambia. We assessed virologic and immunologic outcomes following 6 months of third-line therapy and found among those with a documented viral load, viral suppression (\u22641000 copies\/ml) at 24 weeks was 95% (63\/66) with a mean increase in CD4 count of 116 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    and viral suppression of 63% (63\/100) by imputation of missing data. This study suggests that third-line therapy is clinically and virologically effective among patients with multiclass-resistance in a resource-limited setting in sub-Saharan Africa.\n                  <\/jats:p>","DOI":"10.1177\/23259582211022463","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T15:36:34Z","timestamp":1622734594000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Retrospective Review of Virologic and Immunologic Response in Treatment-Experienced Patients on Third-Line HIV Therapy in Lusaka, Zambia"],"prefix":"10.1177","volume":"20","author":[{"given":"Paul Msanzya","family":"Zulu","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"},{"name":"Zambia National Public Health Institute, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6059-3616","authenticated-orcid":false,"given":"Mona-Gekanju","family":"Toeque","sequence":"additional","affiliation":[{"name":"Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA"},{"name":"University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lottie","family":"Hachaambwa","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"},{"name":"Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA"},{"name":"University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lameck","family":"Chirwa","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sombo","family":"Fwoloshi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"},{"name":"Ministry of Health, Ndeke House, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpanji","family":"Siwingwa","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melody","family":"Mbewe","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle I","family":"Rosser","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases & Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen A","family":"Stafford","sequence":"additional","affiliation":[{"name":"Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA"},{"name":"University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Lindsay","sequence":"additional","affiliation":[{"name":"Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA"},{"name":"University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Mulenga","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"},{"name":"Ministry of Health, Ndeke House, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5059-7894","authenticated-orcid":false,"given":"Cassidy W","family":"Claassen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia"},{"name":"Adult Infectious Diseases Center, University Teaching Hospital, Lusaka, Zambia"},{"name":"Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA"},{"name":"University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"key":"bibr1-23259582211022463","unstructured":"World Health Organization (WHO). HIV\/AIDS | WHO | Regional Office for Africa. WHO. Published 2018. Accessed December 31, 2020. https:\/\/www.afro.who.int\/health-topics\/hivaids"},{"key":"bibr2-23259582211022463","unstructured":"UNAIDS. Zambia | UNAIDS. UNAIDS. Published 2018. Accessed September 2, 2020. https:\/\/www.unaids.org\/en\/regionscountries\/countries\/zambia"},{"key":"bibr3-23259582211022463","unstructured":"Ministry of Health. Republic of zambia national aids council zambia country report Monitoring the Declaration of Commitment on HIV and AIDS and the Universal Access Biennial Report submitted to the United Nations general assembly special session on HIV and AIDS; Published April 30, 2015. Accessed April 4, 2020."},{"key":"bibr4-23259582211022463","unstructured":"World Health Organization. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. World Health Organization; 2016. Accessed March 9, 2020. http:\/\/apps.who.int\/iris\/bitstream\/10665\/208825\/1\/9789241549684_eng.pdf"},{"key":"bibr5-23259582211022463","volume-title":"HIV Drug Resistance Report 2017 Trends Quality Action","author":"World Health Organization","year":"2017"},{"key":"bibr6-23259582211022463","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220159"},{"key":"bibr7-23259582211022463","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.980"},{"key":"bibr8-23259582211022463","volume-title":"Zambia Consolidated Guidelines for Treatment and Prevention of HIV Infection","author":"Ministry of Health"},{"key":"bibr9-23259582211022463","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-015-0081-8"},{"key":"bibr10-23259582211022463","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001883"},{"key":"bibr11-23259582211022463","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30146-8"},{"key":"bibr12-23259582211022463","doi-asserted-by":"crossref","unstructured":"Steigbigel RT, Cooper DA, Kumar PN, et al. 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