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Acceptability of lopinavir/r pellets (minitabs), tablets and syrups in HIV-infected children

Adeodata Kekitiinwa1, Victor Musiime2,3, Margaret J Thomason4

  • 1Department of Pediatrics and Adolescent Health, Baylor College of Medicine Children's Foundation Uganda, Paediatric Infectious Diseases Clinic, Mulago Hospital Kampala, Kampala, Uganda.

Antiviral Therapy
|April 30, 2016
PubMed

Insights

Lopinavir/ritonavir pellets showed improved acceptability in young children initially but waned over time. Pellets offer storage advantages over syrup but taste is a concern for older children.

Area of Science:

  • Pediatric infectious diseases
  • Pharmaceutical formulation
  • HIV/AIDS treatment

Background:

  • Lopinavir/ritonavir pellets, a new formulation, have received tentative approval.
  • Understanding the acceptability of this formulation in pediatric populations is crucial for treatment adherence.

Purpose of the Study:

  • To evaluate the acceptability of lopinavir/ritonavir pellets compared to syrup and tablets in HIV-infected infants and children.
  • To assess formulation preference and taste perception over a 48-week period.

Main Methods:

  • A randomized, two-period crossover trial (CHAPAS-2) involving 77 HIV-infected children aged 3 months to 13 years.
  • Participants were divided into three groups based on age: infants (3-<12 months), young children (1-<4 years), and older children (4-<13 years).
  • Acceptability and preference data for syrup, pellets, and tablets were collected at multiple time points up to 48 weeks.

Main Results:

  • For infants and young children (<4 years), pellet preference peaked at week 12 (72% and 64%, respectively) but decreased by week 48 (44% and 36%).
  • Older children (4-<13 years) showed a progressive decrease in pellet preference compared to tablets over time (from 41% to 13%).
  • Pellets had similar taste acceptability to syrup in younger children but were perceived as worse tasting than tablets in older children. Storage and transportation were easier for pellets than syrup.

Conclusions:

  • Lopinavir/ritonavir pellets are more acceptable for children under 4 years at 12 weeks but not at 48 weeks.
  • Pellets offer logistical benefits over syrup, particularly in terms of storage and transport.
  • Taste improvements and healthcare worker support are recommended to enhance and sustain pellet acceptability in pediatric HIV treatment.
Abstract

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