| Title: |
Tolerability of lopinavir versus dolutegravir in children and adolescents with HIV |
| Authors: |
Blankenberger, Jacob; Devendra, Akash; Bakaya, Meenakshi; Lee, Tristan; Steffy, Teresa L. F.; Makhesi, Thithili; Gilbride, Charlie J.; Belus, Jennifer M.; Thahane, Lineo; Tschumi, Nadine; Marake, Nthuseng B.; Tarumbiswa, Tapiwa; Huber, Reto; Chammartin, Frédérique; Labhardt, Niklaus D.; Brown, Jennifer A. |
| Source: |
AIDS ; volume 40, issue 5, page 600-610 ; ISSN 0269-9370 1473-5571 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2026 |
| Description: |
Background: Children and adolescents with HIV previously taking ritonavir-boosted lopinavir (LPV/r)-based antiretroviral therapy (ART) were recently programmatically transitioned to dolutegravir (DTG)-based ART in Lesotho, southern Africa. We investigated associated changes in treatment satisfaction and potential side effects. Methods: This single-center prospective cohort study enrolled participants younger than 18 years transitioned from LPV/r-based to DTG-based ART during the national programmatic DTG rollout in 2022–2023. Virally suppressed participants who were at least 6 years old and able to handle a sleep diary and actigraphy were eligible for additional sleep monitoring. Enrollment occurred 2 weeks before (with actigraphy) or at (without actigraphy) transition with follow-up until 4 weeks posttransition. Co-primary endpoints were change in treatment satisfaction assessed with the HIV Treatment Satisfaction Questionnaire change version (HIVTSQc; Teen and Parent versions) at 4 weeks, and difference in mean sleep period length over a 2-week period before and after transition (only actigraphy participants). Secondary endpoints assessed treatment satisfaction status, gastrointestinal symptoms, depressive symptoms, and additional sleep measures. Results: Among 245 participants with transition and 4-week data, 115 (47%) were girls and median age was 11.1 (interquartile range 8.9–13.6) years. HIVTSQc outcomes favored DTG, with 88/92 (96%) HIVTSQc-Teen and 149/151 (99%) HIVTSQc-Parent responses indicating being ‘much more satisfied now’ posttransition. Among 69 (28%) actigraphy participants, mean sleep period length was 9.0 h [standard deviation (SD) 1.0] before and 9.2 h (SD 1.0) 2–4 weeks posttransition [mean difference 0.2, 95% confidence interval (CI) 0.0–0.4]. Secondary outcomes did not change meaningfully. Conclusion: Observed treatment satisfaction and tolerability support the rollout of DTG in pediatric HIV care. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1097/qad.0000000000004432 |
| DOI: |
10.1097/QAD.0000000000004432 |
| Availability: |
https://doi.org/10.1097/qad.0000000000004432; https://journals.lww.com/10.1097/QAD.0000000000004432 |
| Rights: |
http://creativecommons.org/licenses/by/4.0 |
| Accession Number: |
edsbas.3BFAB8EF |
| Database: |
BASE |