Pretreatment HIV drug resistance results in virological failure and accumulation of additional resistance mutations in Ugandan children.

ABSTRACT: Background:Pretreatment HIV drug resistance (PDR) can impair virological response to ART, jeopardizing effective treatment for children. Methods:Children aged ?12?years initiated first-line ART in Uganda during 2010-11. Baseline and 6 monthly viral load (VL) and genotypic resistance testing if VL?>1000?copies/mL was done. The 2015 IAS-USA mutation list and Stanford algorithm were used to score drug resistance mutations (DRMs) and susceptibility. Virological failure (VF) was defined as two consecutive VLs >1000?copies/mL or death after 6?months of ART. Factors associated with failure and acquired drug resistance (ADR) were assessed in a logistic regression analysis. Results:Among 317 children enrolled, median age was 4.9?years and 91.5% received NNRTI-based regimens. PDR was detected in 47/278 (16.9%) children, of whom 22 (7.9%) had resistance against their first-line regimen and were therefore on a partially active regimen. After 24?months of follow-up, 92/287 (32.1%) had experienced VF. Children with PDR had a higher risk of VF (OR 15.25, P?

SUBMITTER: Kityo C 

PROVIDER: S-EPMC5890670 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature