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Human Immunodeficiency Virus (HIV) Drug Resistance in African Infants and Young Children Newly Diagnosed With HIV: A Multicountry Analysis.
Jordan, Michael R; Penazzato, Martina; Cournil, Amandine; Vubil, Adolfo; Jani, Ilesh; Hunt, Gillian; Carmona, Sergio; Maphalala, Gugu; Mthethwa, Nobuhle; Watera, Christine; Kaleebu, Pontiano; Musanhu, Christine Chakanyuka; Mtapuri-Zinyowera, Sekesai; Dzangare, Janet; Peeters, Martine; Yang, Chunfu; Parkin, Neil; Bertagnolio, Silvia.
Afiliación
  • Jordan MR; Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts.
  • Penazzato M; Department of HIV/AIDS, World Health Organization, Geneva, Switzerland.
  • Cournil A; IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, France.
  • Vubil A; Instituto Nacional de Saúde, Maputo, Mozambique.
  • Jani I; Instituto Nacional de Saúde, Maputo, Mozambique.
  • Hunt G; National Institute for Communicable Diseases.
  • Carmona S; Witwatersrand University, Johannesburg, South Africa.
  • Maphalala G; Ministry of Health Swaziland, Mbabane.
  • Mthethwa N; Ministry of Health Swaziland, Mbabane.
  • Watera C; Uganda Virus Research Institute, Entebbe.
  • Kaleebu P; Uganda Virus Research Institute, Entebbe.
  • Musanhu CC; World Health Organization, Country Office.
  • Mtapuri-Zinyowera S; National Microbiology Reference Laboratory.
  • Dzangare J; Ministry of Health and Child Care, Harare, Zimbabwe.
  • Peeters M; IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, France.
  • Yang C; Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Parkin N; Data First Consulting, Belmont, California.
  • Bertagnolio S; Department of HIV/AIDS, World Health Organization, Geneva, Switzerland.
Clin Infect Dis ; 65(12): 2018-2025, 2017 Nov 29.
Article en En | MEDLINE | ID: mdl-29020335
BACKGROUND: Programs for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) have been scaled up in many low- and middle-income countries. However, HIV drug resistance (HIVDR) data among HIV-1-infected young children remain limited. METHODS: Surveys of pretreatment HIVDR among children aged <18 months who were diagnosed with HIV through early infant diagnosis were conducted in 5 sub-Saharan African countries (Mozambique, Swaziland, South Africa, Uganda, and Zimbabwe) between 2011 and 2014 following World Health Organization (WHO) guidance. Deidentified demographic and clinical data were used to explore risk factors associated with nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance. RESULTS: Among the 1450 genotypes analyzed, 1048 had accompanying demographic and clinical data. The median age of children was 4 months; 50.4% were female. HIV from 54.1% showed resistance to 1 or more antiretroviral (ARV) drugs, with 53.0% and 8.8% having resistance to 1 or more NNRTI or nucleoside reverse transcriptase inhibitors, respectively. NNRTI resistance was particularly high in children exposed to ARV drugs through PMTCT; adjusted odds ratios were 1.8 (95% confidence interval [CI], 1.3-2.6) for maternal exposure only and 2.4 (CI, 1.6-3.6) for neonatal exposure only. CONCLUSIONS: Protease inhibitor-based regimens in children aged <3 years are currently recommended by WHO, but the implementation of this recommendation is suboptimal. These results reinforce the urgent need to overcome barriers to scaling up pediatric protease inhibitor-based regimens in sub-Saharan Africa and underscore the need to accelerate the study and approval of integrase inhibitors for use in young children.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / VIH-1 / Transmisión Vertical de Enfermedad Infecciosa / Farmacorresistencia Viral Tipo de estudio: Diagnostic_studies / Etiology_studies / Guideline / Risk_factors_studies Límite: Female / Humans / Infant / Male / Newborn País/Región como asunto: Africa Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / VIH-1 / Transmisión Vertical de Enfermedad Infecciosa / Farmacorresistencia Viral Tipo de estudio: Diagnostic_studies / Etiology_studies / Guideline / Risk_factors_studies Límite: Female / Humans / Infant / Male / Newborn País/Región como asunto: Africa Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos