Publications des scientifiques de l'IRD

Suaysod R., Ngo-Giang-Huong Nicole, Salvadori Nicolas, Cressey T. R., Kanjanavanit S., Techakunakorn P., Krikajornkitti S., Srirojana S., Laomanit L., Chalermpantmetagul S., Lallemant Marc, Le Coeur S., McIntosh K., Traisathit P., Jourdain Gonzague. (2015). Treatment failure in HIV-infected children on second-line protease inhibitor-based antiretroviral therapy. Clinical Infectious Diseases, 61 (1), p. 95-101. ISSN 1058-4838.

Titre du document
Treatment failure in HIV-infected children on second-line protease inhibitor-based antiretroviral therapy
Année de publication
2015
Type de document
Article référencé dans le Web of Science WOS:000359323500016
Auteurs
Suaysod R., Ngo-Giang-Huong Nicole, Salvadori Nicolas, Cressey T. R., Kanjanavanit S., Techakunakorn P., Krikajornkitti S., Srirojana S., Laomanit L., Chalermpantmetagul S., Lallemant Marc, Le Coeur S., McIntosh K., Traisathit P., Jourdain Gonzague
Source
Clinical Infectious Diseases, 2015, 61 (1), p. 95-101 ISSN 1058-4838
Background. Human immunodeficiency virus (HIV)-infected children failing second-line antiretroviral therapy (ART) have no access to third-line antiretroviral drugs in many resource-limited settings. It is important to identify risk factors for second-line regimen failure. Methods. HIV-infected children initiating protease inhibitor (PI)-containing second-line ART within the Program for HIV Prevention and Treatment observational cohort study in Thailand between 2002 and 2010 were included. Treatment failure was defined as confirmed HIV type 1 RNA load >400 copies/mL after at least 6 months on second-line regimen or death. Adherence was assessed by drug plasma levels and patient self-report. Cox proportional hazards regression analyses were used to identify risk factors for failure. Results. A total of 111 children started a PI-based second-line regimen, including 59 girls (53%). Median first-line ART duration was 1.9 years (interquartile range [IQR], 1.4-3.3 years), and median age at second-line initiation was 10.7 years (IQR, 6.3-13.4 years). Fifty-four children (49%) experienced virologic failure, and 2 (2%) died. The risk of treatment failure 24 months after second-line initiation was 41%. In multivariate analyses, failure was independently associated with exposure to first-line ART for >2 years (adjusted hazard ratio [aHR], 1.8; P = .03), age > 13 years (aHR, 2.9; P < .001), body mass index-for-age z score < -2 standard deviations at second-line initiation (aHR, 2.8; P = .03), and undetectable drug levels within 6 months following second-line initiation (aHR, 4.5; P < .001). Conclusions. Children with longer exposure to first-line ART, entry to adolescence, underweight, and/or undetectable drug levels were at higher risk of failing second-line ART and thus should be closely monitored.
Plan de classement
Santé : généralités [050] ; Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
THAILANDE
Localisation
Fonds IRD [F B010064892]
Identifiant IRD
fdi:010064892
Contact