Antiretroviral drug resistance profiles and response to second-line therapy among HIV Type 1-infected Ugandan children

V. Musiime, E. Kaudha, J. Kayiwa, G. Mirembe, M. Odera, H. Kizito, I. Nankya, F. Ssali, C. Kityo, R. Colebunders, P. Mugyenyi

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    Abstract

    We sought to determine the pattern of resistance-associated mutations (RAMs) among HIV-1-infected children failing first-line antiretroviral therapy (ART) and ascertain their response to second-line regimens in 48 weeks of follow-up. The design involved a cohort study within an HIV care program. We studied records of 142 children on ART with virological failure to first-line ART and switched to second-line ART with prior genotypic resistance testing. The pattern of RAMs was determined in frequency runs and the factors associated with accumulation of>/=3 thymidine analogue mutations (TAMs) and K103N were determined using multivariate logistic models. Changes in weight, height, CD4, and viral load at weeks 24 and 48 after switch to second-line therapy were determined using descriptive statistics. The children were mean age 10.9+/-4.6 years and 55.6% were male. The commonest nucleoside reverse transcriptase inhibitor (NRTI) RAM was M184V in 129/142 (90.8%) children. TAMs,>/=3 TAMs, 69 insertion complex, K65R/N, and Q151M were observed in 43.0%, 10.6%, 18.3%, 2.8%, and 2.1% of the children, respectively. The commonest nonnucleoside reverse transcriptase inhibitor (NNRTI) RAM was K103N in 72/142 (50.7%) children. The starting ART regimen was associated with accumulation of both>/=3 TAMs (p=0.046) and K103N (p
    Original languageEnglish
    JournalAIDS Research and Human Retroviruses
    Volume29
    Issue number3
    Pages (from-to)449-455
    Number of pages7
    ISSN0889-2229
    DOIs
    Publication statusPublished - 2013

    Keywords

    • Viral diseases
    • HIV-1
    • AIDS
    • HAART
    • Antiretrovirals
    • Children
    • Drug resistance
    • Second-line drugs
    • Mutations
    • Nucleoside
    • Reverse transcriptase inhibitors
    • Compliance
    • Lopinavir
    • Ritonavir
    • Viral load
    • CD4 lymphocyte count
    • Weight
    • Height
    • Uganda
    • Africa-East

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