{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:49:40Z","timestamp":1777452580916,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,5,1]],"date-time":"2013-05-01T00:00:00Z","timestamp":1367366400000},"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":["Antiviral Therapy"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Poor adherence to antiretroviral therapy contributes to pharmacokinetic variability and is the major determinant of virological failure. However, measuring treatment adherence is difficult, especially in children. We investigated the relationship between plasma lopinavir concentrations, pretreatment characteristics and viral load &gt;400 copies\/ml.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 237 HIV-infected children aged 4\u201342 months on lopinavir\/ritonavir oral solution were studied prospectively and followed for up to 52 weeks. Viral load and lopinavir concentration were measured at clinic visits 12, 24, 36 and 52 weeks after starting treatment. Cox multiple failure events models were used to estimate the crude and adjusted effect of lopinavir concentrations on the hazard of viral load &gt;400 copies\/ml.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median (IQR) pretreatment CD4\n                      <jats:sup>+<\/jats:sup>\n                      T-lymphocyte percentage was 18.80% (12.70-25.35) and 53% of children had a pretreatment viral load &gt;750,000 copies\/ml. The median (IQR) weight-for-age and height-for-age z-scores were -2.17 (-3.35\u20142.84) and -3.34 (-4.57\u20143.41), respectively. Median (IQR) lopinavir concentrations were 8.00 mg\/l (4.11-12.42) at median (IQR) 3.50 h (2.67-4.25) after the dose. The hazard of viral load &gt;400 copies\/ml was increased with lopinavir concentrations &lt;1 mg\/l versus \u22651 mg\/l (adjusted hazard ratio 2.3 [95% CI 1.63, 3.26]) and lower height-for-age z-scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low lopinavir concentrations (&lt;1 mg\/l) are associated with viraemia in children. This measure could be used as a proxy for adherence and to determine which children are more likely to fail.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3851\/imp2749","type":"journal-article","created":{"date-parts":[[2014,2,12]],"date-time":"2014-02-12T07:32:26Z","timestamp":1392190346000},"page":"399-406","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Plasma Lopinavir Concentrations Predict Virological Failure in a Cohort of South African Children Initiating a Protease-Inhibitor-Based Regimen"],"prefix":"10.1177","volume":"19","author":[{"given":"Retsilisitsoe R","family":"Moholisa","sequence":"first","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schomaker","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Gertrude H Sergievsky Center, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Meredith","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lubbe","family":"Wiesner","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Coovadia","sequence":"additional","affiliation":[{"name":"Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate","family":"Strehlau","sequence":"additional","affiliation":[{"name":"Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leigh","family":"Martens","sequence":"additional","affiliation":[{"name":"Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine J","family":"Abrams","sequence":"additional","affiliation":[{"name":"ICAP, Mailman School of Public Health, and College of Physicians &amp; Surgeons, Columbia University, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Maartens","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa"},{"name":"Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"McIlleron","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa"},{"name":"Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,5]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"CD004772","article-title":"Effectiveness of antiretroviral therapy in HIV-infected children under 2 years of age","volume":"7","author":"Penazzato M.","year":"2012","unstructured":"Penazzato M., Prendergast A., Tierney J., Cotton M., Gibb D. 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