Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS One. 2024 Mar 27;19(3):e0299942. doi: 10.1371/journal.pone.0299942. eCollection 2024.
Monthly intravenous infusion of broadly neutralizing monoclonal antibodies may be an attractive alternative to daily oral antiretroviral treatment for children living with HIV. However, acceptability among caregivers remains unknown.
We evaluated monthly infusion of dual bNAbs (VRCO1LS and 10-1074) as a treatment alternative to ART among children participating in the Tatelo Study in Botswana. Eligible children aged 2-5 years received 8-32 weeks of bNAbs overlapping with ART, and up to 24 weeks of bNAbs alone as monthly intravenous infusion. Using closed-ended questionnaires, we evaluated caregiver acceptability of each treatment strategy prior to the first bNAb administration visit (pre-intervention) and after the completion of the final bNAb administration visit (post-intervention).
Twenty-five children completed the intervention phase of the study, and acceptability data were available from 24 caregivers at both time points. Responses were provided by the child's mother at both visits (60%), an extended family member at both visits (28%), or a combination of mother and an extended family member (12%). Caregiver acceptance of monthly bNAb infusions was extremely high both pre-and post-intervention, with 21/24 (87.5%) preferring bNAbs to ART pre-intervention, and 21/25 (84%) preferring bNAbs post-intervention. While no caregiver preferred ART pre-intervention, 2/25 preferred it post-intervention. Pre-intervention, 3 (13%) caregivers had no preference between monthly bNAbs or daily ART, and 2 (8%) had no preference post-intervention. Pre-intervention, the most common reasons for preferring bNAbs over ART were the perception that bNAbs were better at suppressing the virus than ART (n = 10) and the fact that infusions were dosed once monthly compared to daily ART (n = 9). Post-intervention, no dominant reason for preferring bNAbs over ART emerged from caregivers.
Monthly intravenous bNAb infusions were highly acceptable to caregivers of children with HIV in Botswana and preferred over standard ART by the majority of caregivers.
NCT03707977.
每月静脉输注广泛中和单克隆抗体可能是一种有吸引力的替代方案，用于替代 HIV 感染者的每日口服抗逆转录病毒治疗。然而，护理人员的接受程度尚不清楚。
我们评估了每月输注双中和抗体（VRCO1LS 和 10-1074）作为博茨瓦纳 Tatelo 研究中儿童接受抗逆转录病毒治疗的替代方案。符合条件的 2-5 岁儿童接受 8-32 周的双中和抗体重叠治疗，以及长达 24 周的双中和抗体单独作为每月静脉输注。使用封闭式问卷，我们在第一次接受双中和抗体治疗前（干预前）和最后一次接受双中和抗体治疗后（干预后）评估了护理人员对每种治疗策略的可接受性。
25 名儿童完成了研究的干预阶段，24 名护理人员在两个时间点均提供了可接受性数据。两次访问均由孩子的母亲（60%）、两次访问均由一个扩展家庭成员（28%）或母亲和扩展家庭成员的组合（12%）提供回复。在干预前后，护理人员对每月接受双中和抗体输注的接受度极高，24 名护理人员中有 21 名（87.5%）在干预前更喜欢双中和抗体而不是抗逆转录病毒治疗，21 名（84%）在干预后更喜欢双中和抗体。虽然没有护理人员在干预前更喜欢抗逆转录病毒治疗，但在干预后有 2 名（8%）更喜欢它。在干预前，3 名（13%）护理人员在每月接受双中和抗体或每日接受抗逆转录病毒治疗之间没有偏好，2 名（8%）在干预后没有偏好。在干预前，更喜欢双中和抗体而不是抗逆转录病毒治疗的最常见原因是认为双中和抗体比抗逆转录病毒治疗更能抑制病毒（n=10），以及输注剂量为每月一次，而不是每日抗逆转录病毒治疗（n=9）。在干预后，护理人员没有从更喜欢双中和抗体而不是抗逆转录病毒治疗的原因中脱颖而出。
每月静脉内输注中和抗体在博茨瓦纳感染 HIV 的儿童的护理人员中非常受欢迎，并且大多数护理人员都更喜欢这种治疗方法，而不是标准的抗逆转录病毒治疗。
NCT03707977。
