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

Autor: Ngo-Giang-Huong, Nicole, Ene, Luminita, Ramos, José Tomás, Cellerai, Cristina, Klimkait, Thomas, Brichard, Bénédicte, Valerius, Niels, Sabin, Caroline, Teira, Ramón, Obel, Niels, Stephan, Christoph, Wittkop, Linda, De Wit, Stéphane, Thorne, Claire, Gibb, Diana, Schwimmer, Christine, Campbell, Maria Athena, Pillay, Deenan, Lallemant, Marc, Rosenfeldt, Vibeke, Dabis, François, Judd, Ali, Reiss, Peter, Goetghebuer, Tessa, Duiculescu, Dan, Noguera-Julian, Antoni, Marczynska, Magdalena, Giacquinto, Carlo
Přispěvatelé: UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service d'hématologie et d'oncologie pédiatrique, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Global Health, EuroCoord-CHAIN-EPPICC joint project study group, The EuroCoord-CHAIN-EPPICC joint project study group
Rok vydání: 2016
Předmět:
0301 basic medicine
Male
endocrine system diseases
First-line combination antiretroviral therapy
HIV Infections
Drug resistance
Kaplan-Meier Estimate
Adolescent
Anti-HIV Agents/therapeutic use
CD4 Lymphocyte Count
Child
Child
Preschool
Drug Resistance
Viral/drug effects
Drug Resistance
Viral/genetics
Drug Therapy
Combination
Female
HIV Infections/drug therapy
HIV Infections/mortality
HIV Infections/virology
HIV-1/drug effects
Humans
Infant
Mutation
Reverse Transcriptase Inhibitors/therapeutic use
Viral Load/drug effects
Children
HIV
Pre-treatment drug resistance mutations
Virological failure
0302 clinical medicine
Medical microbiology
Interquartile range
immune system diseases
030212 general & internal medicine
Pathologie maladies infectieuses
virus diseases
Viral Load
3. Good health
Infectious Diseases
Reverse Transcriptase Inhibitors
Viral load
Research Article
Cart
medicine.medical_specialty
Anti-HIV Agents
030106 microbiology
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Internal medicine
mental disorders
Drug Resistance
Viral
medicine
lcsh:RC109-216
ddc:610
Proportional hazards model
business.industry
Confidence interval
eye diseases
Regimen
nervous system
Immunology
HIV-1
sense organs
business
Zdroj: BMC Infectious Diseases, Vol. 16, no. 1, p. 654 [1-10] (2016)
BMC INFECTIOUS DISEASES
r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname
BMC Infectious Diseases
Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid
Consejería de Sanidad de la Comunidad de Madrid
BMC infectious diseases, 16(1). BioMed Central
r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
BMC infectious diseases, vol. 16, no. 1, pp. 654
BMC infectious diseases, 16 (1
BMC Infectious Diseases, Vol 16, Iss 1, Pp 1-10 (2016)
BMC Infectious Diseases, Vol. Nov 8, no.16, p. 654 (2016)
ISSN: 1471-2334
Popis: 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 ≥1 PDR mutations, 30 children had a virus resistant to ≥1 of the prescribed drugs. Overall, the cumulative Kaplan-Meier estimate for virological failure was 19.8 % (95 %CI, 16.4-23.9). Cumulative risk for VF tended to be higher among children harboring a virus with PDR and resistant to ≥1 drug prescribed than among those receiving fully active cART: 32.1 % (17.2-54.8) versus 19.4 % (15.9-23.6) (P = 0.095). In multivariable analysis, age was associated with a higher risk of VF with a 12 % reduced risk per additional year (HR 0.88; 95 %CI, 0.82-0.95; P < 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.
SCOPUS: ar.j
info:eu-repo/semantics/published
Databáze: OpenAIRE
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