Early Outcomes of Darunavir- and/or Raltegravir-Based Antiretroviral Therapy in Children with Multidrug-Resistant HIV at a Pediatric Center in Botswana
| Autor: | Brianna L. Kirk MD, Andres Gomila MD, Mogomotsi Matshaba MD, Marape Marape MBBCh, BAO, MPH, PhD, Dipesalema R. Joel MBBCh, BAO, BMedSc, MRCP, Gabriel Anabwani MD, Michael A. Tolle MD, MPH |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Journal of the International Association of Providers of AIDS Care, Vol 12 (2013) |
| Druh dokumentu: | article |
| ISSN: | 2325-9574 2325-9582 15451097 |
| DOI: | 10.1177/1545109712463073 |
| Popis: | Background: Data on the use of ritonavir-boosted darunavir (DRV/r) and/or raltegravir (RAL) in resource-limited settings are rare and there is currently no published data regarding their use among African children. Botswana has recently made DRV/r and RAL available for patients failing second-line antiretroviral therapy (ART). Methods: Retrospective chart review of 4 multidrug-resistant pediatric patients on DRV/r- and/or RAL-based regimens. Viral load, CD4 count, adherence by pill count, and World Health Organization (WHO) clinical stage prior to and after switch to DRV/r- and/or RAL-based regimen were assessed. Antiretroviral therapy history, duration of virologic failure, and time to viral suppression were also noted. Genotypic resistance assays reviewed for mutations present prior to switch. Results: All patients achieved viral suppression, showed improved/stable CD4 counts, and obtained or maintained WHO clinical treatment stage I, even after long-standing virologic/immunologic failure. Conclusions: Well tolerated by and effective in our patients, DRV/r and RAL provide potentially lifesaving ART options for children and adolescents in resource-limited settings failing ART due to ritonavir-boosted lopinavir (LPV/r) resistance. |
| Databáze: | Directory of Open Access Journals |
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