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Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort.
Wools-Kaloustian, Kara; Marete, Irene; Ayaya, Samuel; Sohn, Annette H; Van Nguyen, Lam; Li, Shanshan; Leroy, Valériane; Musick, Beverly S; Newman, Jamie E; Edmonds, Andrew; Davies, Mary-Ann; Eboua, François T; Obama, Marie-Thérèse; Yotebieng, Marcel; Sawry, Shobna; Mofenson, Lynne M; Yiannoutsos, Constantin T.
Afiliación
  • Wools-Kaloustian K; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.
  • Marete I; Deptartment of Child Health and Pediatrics, School of Medicine, Moi University, Eldoret, Kenya.
  • Ayaya S; Deptartment of Child Health and Pediatrics, School of Medicine, Moi University, Eldoret, Kenya.
  • Sohn AH; TREAT Asia/amfAR-The Foundation for AIDS Research, Bangkok, Thailand.
  • Van Nguyen L; Department of Infectious Diseases, National Hospital of Pediatrics, Hanoi, Vietnam.
  • Li S; Department of Epidemiology, Fairbanks School of Public Health, Indianapolis, IN.
  • Musick BS; Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN.
  • Newman JE; Inserm U1027, Toulouse 3 University, Toulouse, FranceRTI International, Public Health Informatics Program, Research Triangle Park, NC.
  • Edmonds A; Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC.
  • Eboua FT; Department of Pediatrics, Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire.
  • Obama MT; Département de pédiatrie, Centre Hospitalier et Universitaire, Yaoundé, Cameroon.
  • Yotebieng M; Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH.
  • Sawry S; Wits Reproductive Health and HIV Institute, University of the Witwatersrand, School of Clinical Medicine, Johannesburg, South Africa.
  • Mofenson LM; Elizabeth Glaser Pediatric AIDS Foundation, Washington DC.
  • Yiannoutsos CT; Department of Epidemiology, Fairbanks School of Public Health, Indianapolis, IN.
J Acquir Immune Defic Syndr ; 78(2): 221-230, 2018 06 01.
Article en En | MEDLINE | ID: mdl-29509590
BACKGROUND: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. METHODS: Children initiating their first ART regimen between 2 and 14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis. Outcomes of interest were: first-line ART failure (clinical, immunologic, or virologic), change to second-line, and attrition (death or loss to program ). Cumulative incidence was computed for first-line failure and second-line initiation, with attrition as a competing event. RESULTS: In 27,031 children, median age at ART initiation was 6.7 years. Median baseline CD4% for children ≤5 years of age was 13.2% and CD4 count for those >5 years was 258 cells per microliter. Almost all (94.4%) initiated a nonnucleoside reverse transcriptase inhibitor; 5.3% a protease inhibitor, and 0.3% a triple nucleoside reverse transcriptase inhibitor-based regimen. At 1 year, 7.7% had failed and 14.4% had experienced attrition; by 5 years, the cumulative incidence was 25.9% and 29.4%, respectively. At 1 year after ART failure, 13.7% had transitioned to second-line and 11.2% had experienced attrition; by 5 years, the cumulative incidence was 31.6% and 25.9%, respectively. CONCLUSIONS: High rates of first-line failure and attrition were identified in children within 5 years after ART initiation. Of children meeting failure criteria, only one-third were transitioned to second-line ART within 5 years.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Tipo de estudio: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male País/Región como asunto: Africa / Asia Idioma: En Revista: J Acquir Immune Defic Syndr Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Tipo de estudio: Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male País/Región como asunto: Africa / Asia Idioma: En Revista: J Acquir Immune Defic Syndr Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos