Risk of extended viral resistance in human immunodeficiency virus-1-infected Mozambican children after first-line treatment failure
Pediatr. infect. dis. j
; 28(12): [1-15]?, Dec 28. 2009.
Artículo
en Inglés
| RSDM
| ID: biblio-1525332
Biblioteca responsable:
MZ1.1
ABSTRACT
Background:
Resistant virus may be selected by sub-optimal control of HIV-1 replication during antiretroviral treatment. The incidence and profile of resistance in children receiving World Health Organization-recommended treatment remains to be evaluated on a large scale. Goals Assessment of the frequency and profile of resistant virus in HIV-1-infected children, treated for at least 6 months with stavudine/zidovudine + lamivudine + nevirapine and presenting virological failure in a large access program in Maputo, Mozambique.Results:
Cross-sectional evaluation of plasma HIV-1 viral load (VL) in 495 evaluable children among 512 treated for at least 6 months showed that 360 (72.7%) had a VL of <50 copies/mL of HIV-1 RNA. Genotypic resistance tests were performed in the 84 available samples from the 135 treated children with VL > or = 50 copies/mL 92% of the viruses were resistant to lamivudine and/or nevirapine, and 15% were resistant to stavudine. Twenty children (24%) harbored virus with a extended spectrum of cross-resistance defined as resistance to the 3 drugs of the combination received by the child and/or at least 1 resistance to a drug to which the child had never been exposed (abacavir 5%, tenofovir 6%, didanosine 3.5% and the new generation non nucleoside inhibitor, etravirine 6%). The only factor identified by multivariate analysis as being associated with this extended resistance profile was the duration of treatment (aOR 6.67 [95% CI 1.24-35.93], P = 0.015 for treatment >24 months) with a per month increase of 1.09 (1.02-1.16) P = 0.007.
Texto completo:
Disponible
Colección:
Bases de datos nacionales
/
MZ
Contexto en salud:
ODS3 - Meta 3.7 Acceso universal a servicios de salud relacionados con salud sexual y reproductiva
/
ODS3 - Meta 3.8 Alcanzar cobertura universal de salud
/
ODS3 - Salud y Bienestar
Problema de salud:
Infecciones de Transmisión Sexual: Prevención y Atención
/
Acuerdos de Entrega
/
Meta 3.8: Alcanzar cobertura universal de salud
/
Meta 3.3: Poner fin a las enfermedades desatendidas y detener enfermedades transmisibles
Base de datos:
RSDM
Asunto principal:
Resistencia a Medicamentos
/
Infecciones por VIH
/
VIH-1
/
Inhibidores de la Transcriptasa Inversa
/
Fármacos Anti-VIH
Tipo de estudio:
Estudio de etiología
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adolescente
/
Niño
/
Niño, preescolar
/
Humanos
/
Masculino
País/Región como asunto:
Africa
Idioma:
Inglés
Revista:
Pediatr. infect. dis. j
Año:
2009
Tipo del documento:
Artículo
Institución/País de afiliación:
Hospital central de maputo/MZ
/
Hôpital Necker-Enfants Malades/FR
/
Institut National d Etudes Démographiques/FR
/
Instituto nacional de saude/MZ
/
Karolinska Institute/SE
/
Université Paris Descartes/FR
/
Université Paris Descartes/MZ