@article{fdi:010068367,
  title = {{P}revalence and effect of pre-treatment drug resistance on the virological response to antiretroviral treatment initiated in {HIV}-infected children : a {E}uro{C}oord-{CHAIN}-{EPPICC} joint project},
  author = {{N}go-{G}iang-{H}uong, {N}icole and {W}ittkop, {L}. and {J}udd, {A}. and {R}eiss, {P}. and {G}oetghebuer, {T}. and {D}uiculescu, {D}. and {N}oguera-{J}ulian, {A}. and {M}arczynska, {M}. and {G}iacquinto, {C}. and {E}ne, {L}. and {R}amos, {J}. {T}. and {C}ellerai, {C}. and {K}limkait, {T}. and {B}richard, {B}. and {V}alerius, {N}. and {S}abin, {C}. and {T}eira, {R}. and {O}bel, {N}. and {S}tephan, {C}. and de {W}it, {S}. and {T}horne, {C}. and {G}ibb, {D}. and {S}chwimmer, {C}. and {C}ampbell, {M}. {A}. and {P}illay, {D}. and {L}allemant, {M}arc},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {F}ew studies have evaluated the impact of pre-treatment drug resistance ({PDR}) on response to combination antiretroviral treatment (c{ART}) in children. {T}he objective of this joint {E}uro{C}oord-{CHAIN}-{EPPICC}/{PENTA} project was to assess the prevalence of {PDR} mutations and their association with virological outcome in the first year of c{ART} in children. {M}ethods: {HIV}-infected children < 18 years initiating c{ART} between 1998 and 2008 were included if having at least one genotypic resistance test prior to c{ART} initiation. {W}e used the {W}orld {H}ealth {O}rganization 2009 resistance mutation list and {S}tanford algorithm to infer resistance to prescribed drugs. {T}ime to virological failure ({VF}) was defined as the first of two consecutive {HIV}-{RNA} > 500 copies/m{L} after 6 months c{ART} and was assessed by {C}ox proportional hazards models. {A}ll models were adjusted for baseline demographic, clinical, immunology and virology characteristics and calendar period of c{ART} start and initial c{ART} regimen. {R}esults: {O}f 476 children, 88 % were vertically infected. {A}t c{ART} initiation, median (interquartile range) age was 6.6 years (2.1-10.1), {CD}4 cell count 297 cells/mm(3) (98-639), and {HIV}-{RNA} 5.2 log(10)copies/m{L} (4.7-5.7). {O}f 37 children (7.8 %, 95 % confidence interval ({CI}), 5.5-10.6) harboring a virus with >= 1 {PDR} mutations, 30 children had a virus resistant to >= 1 of the prescribed drugs. {O}verall, the cumulative {K}aplan-{M}eier estimate for virological failure was 19.8 % (95 % {CI}, 16.4-23.9). {C}umulative risk for {VF} tended to be higher among children harboring a virus with {PDR} and resistant to = 1 drug prescribed than among those receiving fully active c{ART}: 32.1 % (17.2-54.8) versus 19.4 % (15.9-23.6) ({P} = 0.095). {I}n multivariable analysis, age was associated with a higher risk of {VF} with a 12 % reduced risk per additional year ({HR} 0.88; 95 % {CI}, 0.82-0.95; {P} < 0.001). {C}onclusions: {PDR} was not significantly associated with a higher risk of {VF} in children in the first year of c{ART}. {T}he risk of {VF} decreased by 12 % per additional year at treatment initiation which may be due to fading of {PDR} mutations over time. {L}ack of appropriate formulations, in particular for the younger age group, may be an important determinant of virological failure.},
  keywords = {{HIV} ; {C}hildren ; {P}re-treatment drug resistance mutations ; {V}irological failure ; {F}irst-line combination antiretroviral therapy ; {EUROPE} ; {THAILANDE}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {16},
  numero = {},
  pages = {art. 654 [10 p.]},
  ISSN = {1471-2334},
  year = {2016},
  DOI = {10.1186/s12879-016-1968-2},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068367},
}