ArticleThe Pediatric infectious disease journal2015
The effect of malnutrition on the pharmacokinetics and virologic outcomes of lopinavir, efavirenz and nevirapine in food insecure HIV-infected children in Tororo, Uganda.
Article in The Pediatric infectious disease journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00978068 (A Randomized Open Label Trial of HIV Protease Inhibitors for the Prevention of Malaria in HIV-Infected Children), which is not on this map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Open Label Trial of HIV Protease Inhibitors for the Prevention of Malaria in HIV-Infected Children
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Burden of virologic failure, and its determinants among HIV positive children in East Africa: a systematic review and meta-analysis.African health sciences · 2024Pooled it
- Effectiveness and Pharmacokinetic Exposures of First-Line Drugs Used to Treat Drug-Susceptible Tuberculosis in Children: A Systematic Review and Meta-Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Pooled it
- Influence of Malnutrition on the Pharmacokinetics of Drugs Used in the Treatment of Poverty-Related Diseases: A Systematic Review.Clinical pharmacokinetics · 2021Pooled it
- Trial
- Pharmacokinetics and Safety of Zidovudine, Lamivudine, and Lopinavir/Ritonavir in HIV-infected Children With Severe Acute Malnutrition in Sub-Saharan Africa: IMPAACT Protocol P1092.The Pediatric infectious disease journal · 2021Trial
- Population pharmacokinetics of abacavir and lamivudine in severely malnourished human immunodeficiency virus-infected children in relation to treatment outcomes.British journal of clinical pharmacology · 2019Trial
- Visceral leishmaniasis relapse hazard is linked to reduced miltefosine exposure in patients from Eastern Africa: a population pharmacokinetic/pharmacodynamic study.The Journal of antimicrobial chemotherapy · 2017Trial
- Brief Report: Food Insufficiency Is Associated With Lack of Sustained Viral Suppression Among HIV-Infected Pregnant and Breastfeeding Ugandan Women.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Prevalence and factors contributing to severe undernutrition in children on antiretroviral therapy (ART) drugs in Ilala District, Tanzania.Scientific reports · 2026Article
- Next-Generation HIV-1 Therapeutics in Co-Endemic Settings.Biomedicines · 2026Review
- Article
- Malnutrition and Its Effect on Drug Pharmacokinetics: A Clinical Perspective.Clinical pharmacokinetics · 2025Review
- Article
- Exploring the Pharmacokinetic Profile of Antiretroviral Efavirenz in Low Protein Malnourished Condition in Wistar Rats.European journal of drug metabolism and pharmacokinetics · 2025Article
- The Impact of Drought on HIV Care in Rural South Africa: An Interrupted Time Series Analysis.EcoHealth · 2023Article
- Determinants of nonsuppression of HIV viral load among children receiving antiretroviral therapy in the Simiyu region: a cross-sectional study.AIDS research and therapy · 2023Article
- Effectiveness of a community-based intervention (Konga model) to address the factors contributing to viral load suppression among children living with HIV in Tanzania: a cluster-randomized clinical trial protocol.Biology methods & protocols · 2022Article
- Strategies to Reduce Mortality Among Children Living With HIV and Children Exposed to HIV but Are Uninfected, Admitted With Severe Acute Malnutrition at Mulago Hospital, Uganda (REDMOTHIV): A Mixed Methods Study.Frontiers in pediatrics · 2022Article
- High levels of viral repression, malnutrition and second-line ART use in adolescents living with HIV: a mixed methods study from Myanmar.BMC infectious diseases · 2020Article
- Association between severe drought and HIV prevention and care behaviors in Lesotho: A population-based survey 2016-2017.PLoS medicine · 2019Article
Corrections and comments
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Authors and funding
15 authors at 9 institutions in 4 countries.
Funding
Abstract
backgroundMalnutrition may impact the pharmacokinetics (PKs) of antiretroviral medications and virologic responses in HIV-infected children. The authors therefore evaluated the PK of nevirapine (NVP), efavirenz (EFV) and lopinavir (LPV) in associations with nutritional status in a cohort of HIV-infected Ugandan children.
methodsSparse dried blood spot samples from Ugandan children were used to estimate plasma concentrations. Historical PK data from children from 3 resource-rich countries (RRC) were utilized to develop the PK models.
resultsConcentrations in 330 dried blood spot from 163 Ugandan children aged 0.7-7 years were analyzed in reference to plasma PK data (1189 samples) from 204 children from RRC aged 0.5-12 years. Among Ugandan children, 48% was malnourished (underweight, thin or stunted). Compared to RRC, Ugandan children exhibited reduced bioavailability of EFV and LPV; 11% (P=0.045) and 18% (P=0.008), respectively. In contrast, NVP bioavailability was 46% higher in Ugandan children (P<0.001) with a trend toward greater bioavailability when malnourished. Children receiving LPV, EFV or NVP had comparable risk of virologic failure. Among children on NVP, low height and weight for age Z scores were associated with reduced risk of virologic failure (P=0.034, P=0.068, respectively).
conclusionsUgandan children demonstrated lower EFV and LPV and higher NVP exposure compared to children in RRC, perhaps reflecting the consequence of malnutrition on bioavailability. In children receiving NVP, the relation between exposure, malnutrition and outcome turned out to be marginally significant. Further investigations are warranted using more intensive PK measurements and adequate adherence assessments, to further assess causes of virologic failure in Ugandan children.
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Registered trials
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