@article{fdi:010064892,
  title = {{T}reatment failure in {HIV}-infected children on second-line protease inhibitor-based antiretroviral therapy},
  author = {{S}uaysod, {R}. and {N}go-{G}iang-{H}uong, {N}icole and {S}alvadori, {N}icolas and {C}ressey, {T}. {R}. and {K}anjanavanit, {S}. and {T}echakunakorn, {P}. and {K}rikajornkitti, {S}. and {S}rirojana, {S}. and {L}aomanit, {L}. and {C}halermpantmetagul, {S}. and {L}allemant, {M}arc and {L}e {C}oeur, {S}. and {M}c{I}ntosh, {K}. and {T}raisathit, {P}. and {J}ourdain, {G}onzague},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {H}uman immunodeficiency virus ({HIV})-infected children failing second-line antiretroviral therapy ({ART}) have no access to third-line antiretroviral drugs in many resource-limited settings. {I}t is important to identify risk factors for second-line regimen failure. {M}ethods. {HIV}-infected children initiating protease inhibitor ({PI})-containing second-line {ART} within the {P}rogram for {HIV} {P}revention and {T}reatment observational cohort study in {T}hailand between 2002 and 2010 were included. {T}reatment failure was defined as confirmed {HIV} type 1 {RNA} load >400 copies/m{L} after at least 6 months on second-line regimen or death. {A}dherence was assessed by drug plasma levels and patient self-report. {C}ox proportional hazards regression analyses were used to identify risk factors for failure. {R}esults. {A} total of 111 children started a {PI}-based second-line regimen, including 59 girls (53%). {M}edian 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). {F}ifty-four children (49%) experienced virologic failure, and 2 (2%) died. {T}he risk of treatment failure 24 months after second-line initiation was 41%. {I}n multivariate analyses, failure was independently associated with exposure to first-line {ART} for >2 years (adjusted hazard ratio [a{HR}], 1.8; {P} = .03), age > 13 years (a{HR}, 2.9; {P} < .001), body mass index-for-age z score < -2 standard deviations at second-line initiation (a{HR}, 2.8; {P} = .03), and undetectable drug levels within 6 months following second-line initiation (a{HR}, 4.5; {P} < .001). {C}onclusions. {C}hildren 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.},
  keywords = {antiretroviral therapy failure ; {HIV}-infected children ; protease inhibitor ; second-line {ART} ; genotypic resistance ; {THAILANDE}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {61},
  numero = {1},
  pages = {95--101},
  ISSN = {1058-4838},
  year = {2015},
  DOI = {10.1093/cid/civ271},
  URL = {https://www.documentation.ird.fr/hor/fdi:010064892},
}