Pellets may not sound like the most appealing thing for a baby to eat—but lopinavir/ritonavir (LPV/r) pellets may actually save their life.
LPV/r pellets are a new, more palatable, and easier-to-administer formulation of a medication for babies and children with HIV. Because of how well they work for pediatric patients, the World Health Organization now recommends LPV/r pellets as the first-line treatment for children 3 months or older, who weigh 5 kilograms or more, and who are able to swallow the pellets with liquid or soft foods. With 180,000 new pediatric HIV infections globally in 2017, there are many young children eligible for this medication.1
LPV/r pellets have been well-received by health care workers and parents, in part because of their delivery: the pellets can be hidden in a cup of breast milk or foods like yogurt and porridge, making them easier for children to swallow.
“When children have an easier time taking a medication, they’re more likely to take it on time and not miss doses,” says Helen Cornman, Technical Director for the Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project who also works on pediatric treatment. “Children who can adhere to their treatment schedule have lower viral loads and stay healthier longer.”
As more countries integrate this medication into treatment regimens, they need assistance in incorporating LPV/r pellets into their regular supply chain of HIV medications. Health facilities also need materials to train their staff in prescribing and administering pellets.
LPV/r Pellet Toolkit
To meet this need, AIDSFree created the LPV/r Pellet Toolkit, a comprehensive set of online resources for health care workers, children’s caregivers, ministry of health staff, and other stakeholders. The LPV/r Pellet Toolkit provides countries with practical advice on how to introduce pellets into their health system.
The toolkit is divided into two main sections. The Rollout Planning and Management section contains information on programmatic decisions and planning for initial product distribution, as well as interactive tools to help manage the supply chain. In the Health Care Worker section, clinical staff can access an overview of LPV/r pellets; a tool to determine dosing; and health provider training materials, such as case examples and frequently asked questions. It also includes simple tools to use with children’s caregivers to explain why LPV/r pellets are important and materials on how to give them to the baby, including a demonstration video, poster, and written instructions.
The materials are all adapted for use on laptops and mobile phones and are available to download so that those with limited internet connectivity can use them online or off.
“With the LPV/r Pellet Toolkit, a country can go from ordering their first supply of the medication to teaching moms how to give pellets to their children,” says Cornman. “This will be a great resource as more countries adopt LPV/r pellets.”
1 UNICEF. “HIV/AIDS: Global and regional trends – July 2018”. Accessed July 2018 at https://data.unicef.org/topic/hivaids/global-regional-trends/ Among children aged 0-4 years