HIV viral suppression in children and adolescents who transitioned from ritonavir-boosted lopinavir- to dolutegravir-based antiretroviral therapy in Lesotho.

Authors

Jacob Blankenberger, Teresa L F Steffy, Tristan Lee, Thithili Makhesi, Meenakshi Bakaya, Akash Devendra, Pheello Mothepu, Lipontso Motaboli, Nadine Tschumi, Anna Klicpera, Tapiwa Tarumbiswa, Frédérique Chammartin, Lineo K Thahane, Niklaus D Labhardt, Jennifer A Brown

Published in

HIV medicine. Oct 05, 2026. Epub Oct 05, 2026.

Abstract

Children and adolescents living with HIV previously taking ritonavir-boosted lopinavir (LPV/r)-based antiretroviral therapy (ART) have been programmatically transitioned to dolutegravir (DTG)-based regimens in many country programs. We aimed to describe treatment outcomes following this transition in Lesotho, southern Africa.
We analyzed routinely collected data from two open cohorts across 27 health facilities in Lesotho.
We included children and adolescents (<18 years at transition to DTG) who transitioned from first- or second-line ART consisting of LPV/r and 2 nucleoside reverse transcriptase inhibitors (NRTIs) to DTG and 2 NRTIs between July 2019 and July 2023. We report viral load (VL) data before transition, 12 months post-transition, and 24 months post-transition.
Among 852 participants, 410 (48.1%) were female, the median age was 10.1 years (interquartile range [IQR] 7.6-13.0) and the median time on ART at transition was 8.1 years (IQR 5.6-11.1). Of 768 with a pre-transition VL, 617 (80.3%) had viral suppression (VS; <50 copies/mL), 85 (11.1%) had low-level viremia (LLV; 50-999 copies/mL), and 66 (8.6%) had a high VL (HVL; ≥1000 copies/mL). Among 822 with a 12-month post-transition VL, 721 (87.7%) had VS, 76 (9.2%) had LLV and 25 (3.0%) had HVL. Among 787 with 24-month post-transition VL, 686 (87.2%) had VS, 75 (9.5%) had LLV and 26 (3.3%) had HVL.
We observed improved and sustained VS among children and adolescents in routine care in Lesotho after programmatic transition to DTG-based ART, supporting continued scale-up of DTG in paediatric HIV programmes.

PMID:
42833639
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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