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Prevalence and effect of pre-treatment drug resistance on the virological response to antiretroviral treatment initiated in HIV-infected children - a EuroCoord-CHAIN-EPPICC joint project
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID
4393092
Author(s)
Ngo-Giang-Huong, N.; Wittkop, L.; Judd, A.; Reiss, P.; Goetghebuer, T.; Duiculescu, D.; Noguera-Julian, A.; Marczynska, M.; Giacquinto, C.; Ene, L.; Ramos, J. T.; Cellerai, C.; Klimkait, T.; Brichard, B.; Valerius, N.; Sabin, C.; Teira, R.; Obel, N.; Stephan, C.; de Wit, S.; Thorne, C.; Gibb, D.; Schwimmer, C.; Campbell, M. A.; Pillay, D.; Lallemant, M.; EuroCoord, Chain-Eppicc joint project study group
Prevalence and effect of pre-treatment drug resistance on the virological response to antiretroviral treatment initiated in HIV-infected children - a EuroCoord-CHAIN-EPPICC joint project
Adolescent; Anti-HIV Agents, therapeutic use; CD4 Lymphocyte Count; Child; Child, Preschool; Drug Resistance, Viral, genetics; Drug Therapy, Combination; Female; HIV Infections, virology; HIV-1, drug effects; Humans; Infant; Kaplan-Meier Estimate; Male; Mutation; Reverse Transcriptase Inhibitors, therapeutic use; Viral Load, drug effects
Abstract
BACKGROUND: Few studies have evaluated the impact of pre-treatment drug resistance (PDR) on response to combination antiretroviral treatment (cART) in children. The objective of this joint EuroCoord-CHAIN-EPPICC/PENTA project was to assess the prevalence of PDR mutations and their association with virological outcome in the first year of cART in children. METHODS: HIV-infected children 500 copies/mL after 6 months cART and was assessed by Cox proportional hazards models. All models were adjusted for baseline demographic, clinical, immunology and virology characteristics and calendar period of cART start and initial cART regimen. RESULTS: Of 476 children, 88 % were vertically infected. At cART initiation, median (interquartile range) age was 6.6 years (2.1-10.1), CD4 cell count 297 cells/mm3 (98-639), and HIV-RNA 5.2 log10copies/mL (4.7-5.7). Of 37 children (7.8 %, 95 % confidence interval (CI), 5.5-10.6) harboring a virus with 0.001). CONCLUSIONS: PDR was not significantly associated with a higher risk of VF in children in the first year of cART. The risk of VF decreased by 12 % per additional year at treatment initiation which may be due to fading of PDR mutations over time. Lack of appropriate formulations, in particular for the younger age group, may be an important determinant of virological failure.
