A COMMUNITY-DRIVEN APPROACH TO PAEDIATRIC DOLUTEGRAVIR (pDTG) BASED REGIMEN
TRANSITION AMONG CHILDREN OF KEY POPULATIONS LIVING WITH HIV IN NIGERIA
A. Oguntonade 1, G. Emmanuel 2, N. Mwoltu 1, C. Anya 1
1Heartland Alliance Ltd/Gte, Programs, Uyo, Nigeria, 2Heartland Alliance Ltd/Gte, Key Populations Community HIV Action
and Response Project, Abuja, Nigeria
Background Methods
In September 2021, Nigeria adopted and made available pDTG, a The Retention and Audit Determination Tool (RADET) was
clinically superior, more tolerable drug formulation with the utilized from the programme’ s electronic database to
potential to improve adherence to ART and treatment outcomes
determine eligibility for the transitioning at the onset in
in children living with HIV (CLHIV) weighing 3kg to less than 20kg.
This followed the recent WHO recommendation positioning DTG-
October 2021. Eligible Children weighing 3kg to less than
based regimens as the preferred first line for CLHIV from 20kg initiated on ART with non-DTG based regimen between
lopinavir/ritonavir-based regimens. Due to poor adherence to January and December 2021 were identified and profiled for
existing paediatric ARV including less than optimal viral load their refill due date and location. Schedules were then
suppression rates (87%), Heartland Alliance LTD/GTE (HALG) drawn for Community ART teams (cART) to deliver the pDTG
Nigeria rolled out a family centred community driven
to the CLHIV on ART based on the profiles. Also, those living
differentiated service approach to ART initiation and refills for
Children of Key Populations (KPs) to achieve rapid transition to
within proximity were clustered and refilled ahead of their
pDTG in three states: Akwa-Ibom, Cross River and Lagos states refill due dates considering the dynamics of the socio-
under the USAID funded Key Populations Community HIV Actions economic environment of their caregivers.
and Response (KP-CARE 1) project.
TOTAL NUMBER OF CHILDREN 0 – Children < 20kg
14 YEARS ON ART n = 51
N = 134 LPV – pDTG TRANSITION TREND
LPV pDTG
RESPONDENT BY SEX 5
31
41
FEMALE MALE
46 51
51% 49%
20
10
September October November
0
December
pDTG 5 31 41 51
LPV 46 20 10 0
Results
A total of 134 children aged less than 14years were active on ART of out of which there were 69 females (52%), and 65 males (48%). Those with
weight less than 20kg were 51 with 46(90%) being initiated on Lopinavir based regimen and a total of 46 (100%) were transited to pDTG by
December 2021.
Discussion & Conclusion References
1. Consolidated guidelines on the use of antiretroviral
This evidence demonstrates that a KP family-centred and community- drugs for treating and preventing HIV infection:
driven ARV delivery mechanism is an effective approach to rapid recommendations for a public health approach.
transitioning to pDTG Based regimens for CLHIV of key population. Geneva: World Health Organization; 2013
These mechanisms includes syncing of clinic appointment of child and (https://
care givers and a clustered refills - Transitioning and Refilling clients www.who.int/hiv/pub/guidelines/arv2013/downloa
in close proximity even before their clinic appointments d/en, accessed 16 March 2020).
There is need to compare this approach with other methods in further 2. National Rollout of Paediatric DTG , State dissemnatiion
study. meeting , September 2021
Presented at AIDS 2022 – The 24th International AIDS Conference
