scholarly journals Looking back at paediatric HIV treatment in South Africa. My, how we have grown!

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Leon J. Levin ◽  
Juliet L. Horak ◽  
James Nuttall

Antiretroviral treatment has undergone major changes in the last 20 years, from monotherapy, to dual therapy and finally to triple therapy. Lately, more focus has been placed on better, more well-tolerated combinations and formulations. As in most other disciplines in medicine, the development of paediatric HIV dosages and formulations always tends to lag behind adult research. Twenty years ago, it could take several years before data were available to enable the use of life-saving antiretrovirals in children. Paediatricians, being ever resourceful, were not prepared to let their paediatric patients suffer despite the lack of data or formulations and so made a plan. This article describes some of the trials and tribulations that we went through trying to make sure that our paediatric HIV patients not only survived but thrived. Clinicians treating paediatric patients today have it so much easier because of what our colleagues and their patients went through in those early days.

Author(s):  
Graham S. Cooke ◽  
Kirsty E. Little ◽  
Ruth M. Bland ◽  
Hilary Thulare ◽  
Marie-Louise Newell

PLoS ONE ◽  
2009 ◽  
Vol 4 (9) ◽  
Author(s):  
Graham S. Cooke ◽  
Kirsty E. Little ◽  
Ruth M. Bland ◽  
Hilary Thulare ◽  
Marie-Louise Newell

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohandran Archary ◽  
Riana Van Zyl ◽  
Nosisa Sipambo ◽  
Gillian Sorour

While the progress towards reaching the UNAIDS 95-95-95 targets in South African adults seems promising, the progress in the paediatric population is lagging far behind; only 79% percent of children living with HIV know their status. Of these, only 47% are on treatment, and a mere 34% of those are virally suppressed. Thus, virological suppression has been attained in only 13% of children living with HIV in South Africa. Multiple factors contribute to the high treatment failure rate, one of them being a lack of paediatric-friendly antiretroviral treatment (ART) formulations. For example, the Lopinavir/ritonavir syrup, which is the current mainstay of ART for young children, has an extremely unpleasant taste, contributing to the poor tolerability and lack of adherence by children using the formulation. Furthermore, the lack of appropriate formulations limits the optimisation of regimens, especially for young children and those who cannot swallow tablets. Switching from syrups to dispersible tablets will improve ease of administration and adherence and result in cost-saving. Despite the approval of simplified paediatric-friendly formulations internationally, including other sub-Saharan African countries, unnecessary delays are experienced in South Africa. Clinician groups and community organisations must speak up and demand that approvals be expedited to ensure the delivery of life-changing and life-saving formulations to our patients as a matter of urgency.


2021 ◽  
Vol 27 (1) ◽  
pp. 28-35
Author(s):  
Mariantonietta Pisaturo ◽  
Lorenzo Onorato ◽  
Antonio Russo ◽  
Salvatore Martini ◽  
Paolo Chiodini ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document