| Autor: |
Jane R. Millar, Nomonde Bengu, Rowena Fillis, Ken Sprenger, Vuyokazi Ntlantsana, Vinicius A. Vieira, Nisreen Khambati, Moherndran Archary, Maximilian Muenchhoff, Andreas Groll, Nicholas Grayson, John Adamson, Katya Govender, Krista Dong, Photini Kiepiela, Bruce D. Walker, David Bonsall, Thomas Connor, Matthew J. Bull, Nelisiwe Nxele, Julia Roider, Nasreen Ismail, Emily Adland, Maria C. Puertas, Javier Martinez-Picado, Philippa C. Matthews, Thumbi Ndung'u, Philip Goulder |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
EClinicalMedicine, Vol 22, Iss , Pp - (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2589-5370 |
| DOI: |
10.1016/j.eclinm.2020.100344 |
| Popis: |
Background: Early combination antiretroviral therapy (cART) reduces the size of the viral reservoir in paediatric and adult HIV infection. Very early-treated children may have higher cure/remission potential. Methods: In an observational study of 151 in utero (IU)-infected infants in KwaZulu-Natal, South Africa, whose treatment adhered strictly to national guidelines, 76 infants diagnosed via point-of-care (PoC) testing initiated cART at a median of 26 h (IQR 18–38) and 75 infants diagnosed via standard-of-care (SoC) laboratory-based testing initiated cART at 10 days (IQR 8–13). We analysed mortality, time to suppression of viraemia, and maintenance of aviraemia over the first 2 years of life. Findings: Baseline plasma viral loads were low (median 8000 copies per mL), with 12% of infants having undetectable viraemia pre-cART initiation. However, barely one-third (37%) of children achieved suppression of viraemia by 6 months that was maintained to >12 months. 24% had died or were lost to follow up by 6 months. Infant mortality was 9.3%. The high-frequency virological failure in IU-infected infants was associated not with transmitted or acquired drug-resistant mutations but with cART non-adherence (plasma cART undetectable/subtherapeutic, p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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