Dr. Nadine Tschumi

LoDoCA is a prospective cohort study among children and adolescents with HIV in Lesotho, southern Africa who changed from an antiretroviral therapy regimen containing lopinavir to a regimen containing dolutegravir. The study compares treatment satisfaction and previously reported adverse effects of either drug, including neuropsychiatric (sleep, depression) and gastrointestinal outcomes. Sleep is a key focus, as sleep disturbance has previously been reported as an adverse effect of dolutegravir among adults. Thus, sleep is measured by actigraphy (movement-sensing devices worn by participants around their wrist from around bedtime to morning) in addition to questionnaires.

The Genotype-Informed Versus Empiric Management Of VirEmia (GIVE MOVE) randomised clinical trial assesses the clinical impact and cost-effectiveness of genotypic resistance testing of HIV to inform clinical management in HIV-positive children and adolescents whose treatment is failing to control the virus. Though routine in high-income countries, this key diagnostic tool is not available in many settings where it is most needed.

GIVE MOVE will assess the influence of genotypic resistance testing on clinical decision making and its impact on the health of children and adolescents with unsuppressed HIV-1 and if clinically relevant, assessing the cost and cost-effectiveness of HIV-1 genotypic resistance testing. The cost and cost-effectiveness analysis, in combination with lessons learned with respect to feasibility, are intended to guide implementation of HIV-1 resistance testing in countries or settings were access is currently limited.