Immunovirological response to combined antiretroviral therapy and drug resistance patterns in children: 1- and 2-year outcomes in rural Uganda

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dc.contributor.authorAhoua, Laurence
dc.contributor.authorRouzioux, Christine
dc.contributor.authorAnguzu, Paul
dc.contributor.authorTaburet, Anne-Marie
dc.contributor.authorSuna, Balkan
dc.contributor.authorOlaro, Charles
dc.contributor.authorPujades-Rodríguez, Mar
dc.date.accessioned2023-05-30T18:34:51Z
dc.date.available2023-05-30T18:34:51Z
dc.date.issued2011
dc.description.abstractChildren living with HIV continue to be in urgent need of combined antiretroviral therapy (ART). Strategies to scale up and improve pediatric HIV care in resource-poor regions, especially in sub-Saharan Africa, require further research from these settings. We describe treatment outcomes in children treated in rural Uganda after 1 and 2 years of ART start. Cross-sectional assessment of all children treated with ART for 12 (M12) and 24 (M24) months was performed. CD4 counts, HIV RNA levels, antiretroviral resistance patterns, and non-nucleoside reverse transcriptase inhibitor (NNRTI) plasma concentrations were determined. Patient adherence and antiretroviral-related toxicity were assessed. Cohort probabilities of retention in care were 0.86 at both M12 and M24. At survey, 71 (83%, M12) and 32 (78%, M24) children remained on therapy, and 84% participated in the survey. At ART start, 39 (45%) were female; median age was 5 years. Median initial CD4 percent was 11% [IQR 9-15] in children < 5 years old (n = 12); CD4 count was 151 cells/mm3 [IQR 38-188] in those ≥ 5 years old (n = 26). At M12, median CD4 gains were 11% [IQR 10-14] in patients < 5 years old, and 206 cells/mm3 [IQR 98-348] in ≥ 5 years old. At M24, median CD4 gains were 11% [IQR 5-17] and 132 cells/mm3 [IQR 87-443], respectively. Viral suppression (< 400 copies/mL) was achieved in 59% (M12) and 33% (M24) of children. Antiretroviral resistance was found in 25% (M12) and 62% (M24) of children. Overall, 29% of patients had subtherapeutic NNRTI plasma concentrations. After one year of therapy, satisfactory survival and immunological responses were observed, but nearly 1 in 4 children developed viral resistance and/or subtherapeutic plasma antiretroviral drug levels. Regular weight-adjustment dosing and strategies to reinforce and maintain ART adherence are essential to maximize duration of first-line therapy in children in resource-limited countries.en_US
dc.identifier.citationAhoua, L., Guenther, G., Rouzioux, C., Pinoges, L., Anguzu, P., Taburet, A. M., ... & Pujades-Rodríguez, M. (2011). Immunovirological response to combined antiretroviral therapy and drug resistance patterns in children: 1-and 2-year outcomes in rural Uganda. BMC pediatrics, 11(1), 1-9.https://doi.org/10.1186/1471-2431-11-67en_US
dc.identifier.issn1471-2431
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/8846
dc.language.isoenen_US
dc.publisherBMC pediatricsen_US
dc.subjectChildrenen_US
dc.subjectPharmacokineticsen_US
dc.subjectAntiretroviral therapyen_US
dc.subjectDrug resistanceen_US
dc.titleImmunovirological response to combined antiretroviral therapy and drug resistance patterns in children: 1- and 2-year outcomes in rural Ugandaen_US
dc.typeArticleen_US
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