PROTEASE INHIBITOR RESISTANCE IN SOUTH AFRICAN CHILDREN WITH VIROLOGIC FAILURE
Copyright policy )PROTEASE INHIBITOR RESISTANCE IN SOUTH AFRICAN CHILDREN WITH VIROLOGIC FAILURE
In South Africa, first-line antiretroviral therapy for children younger than 3 years of age combines a protease inhibitor (PI) with 2 nucleoside reverse transcription inhibitors. In our study, some pediatric patients received ritonavir (RTV) as single PI (RTV-sPI) and others ritonavir-boosted lopinavir (LPV/r), which has a higher resistance barrier. We explored antiretroviral resistance mutations in pediatric patients failing PI-based antiretroviral therapy and the predictors of major PI resistance mutations (MPIRM) in these patients.We studied pediatric HIV patients at Tygerberg Academic Hospital experiencing virologic failure on a PI regimen. Mixed-effects linear- and mixed-effect logistic regression modeling, were used to explore predictors of MPIRM.MPIRM were found in 12 of 17 patients exposed to RTV-sPI compared with 1 of 13 patients treated with LPV/r. Exposure to RTV-sPI was significantly associated with MPIRM, with both exposure time and estimated failing time on RTV-sPI being significant positive predictors of MPIRM. Neither CD4 count, viral load, age at first visit nor receiving rifampin predicted MPIRM.RTV-sPI in infants and children poses a significant risk of MPIRM which is dependent on the exposure time and time failing while receiving the regimen.
- University of Cape Town South Africa
- South African Medical Research Council South Africa
- Stellenbosch University South Africa
- Tygerberg Children’s Hospital South Africa
- University of the Western Cape South Africa
610, HIV Infections, thymidine derivative, rifampicin, drug treatment failure, preschool child, 618, South Africa, Human immunodeficiency virus infection, Humans, Protease Inhibitors, human, Treatment Failure, child, clinical article, Ritonavir, Human immunodeficiency virus, article, CD4 lymphocyte count, risk assessment, HIV, Viral Load, infant, lopinavir, ritonavir, priority journal, risk factor, Anti-Retroviral Agents, Regression Analysis, lamivudine
610, HIV Infections, thymidine derivative, rifampicin, drug treatment failure, preschool child, 618, South Africa, Human immunodeficiency virus infection, Humans, Protease Inhibitors, human, Treatment Failure, child, clinical article, Ritonavir, Human immunodeficiency virus, article, CD4 lymphocyte count, risk assessment, HIV, Viral Load, infant, lopinavir, ritonavir, priority journal, risk factor, Anti-Retroviral Agents, Regression Analysis, lamivudine
selected citations These citations are derived from selected sources.This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).39 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Average influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
Citations provided by BIP!Popularity provided by BIP!