@article{fdi:010071412,
  title = {{H}uman {I}mmunodeficiency {V}irus ({HIV}) drug resistance in {A}frican infants and young children newly diagnosed with {HIV} : a multicountry analysis},
  author = {{J}ordan, {M}. {R}. and {P}enazzato, {M}. and {C}ournil, {A}mandine and {V}ubil, {A}. and {J}ani, {I}. and {H}unt, {G}. and {C}armona, {S}. and {M}aphalala, {G}. and {M}thethwa, {N}. and {W}atera, {C}. and {K}aleebu, {P}. and {M}usanhu, {C}. {C}. and {M}tapuri-{Z}inyowera, {S}. and {D}zangare, {J}. and {P}eeters, {M}artine and {Y}ang, {C}. {F}. and {P}arkin, {N}. and {B}ertagnolio, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {P}rograms 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. {H}owever, {HIV} drug resistance ({HIVDR}) data among {HIV}-1-infected young children remain limited. {M}ethods. {S}urveys of pretreatment {HIVDR} among children aged < 18 months who were diagnosed with {HIV} through early infant diagnosis were conducted in 5 sub-{S}aharan {A}frican countries ({M}ozambique, {S}waziland, {S}outh {A}frica, {U}ganda, and {Z}imbabwe) between 2011 and 2014 following {W}orld {H}ealth {O}rganization ({WHO}) guidance. {D}eidentified demographic and clinical data were used to explore risk factors associated with nonnucleoside reverse transcriptase inhibitor ({NNRTI}) resistance. {R}esults. {A}mong the 1450 genotypes analyzed, 1048 had accompanying demographic and clinical data. {T}he 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. {C}onclusions. {P}rotease inhibitor-based regimens in children aged < 3 years are currently recommended by {WHO}, but the implementation of this recommendation is suboptimal. {T}hese results reinforce the urgent need to overcome barriers to scaling up pediatric protease inhibitor-based regimens in sub-{S}aharan {A}frica and underscore the need to accelerate the study and approval of integrase inhibitors for use in young children.},
  keywords = {{HIV} drug resistance ; children ; low- and middle-income countries ; early infant diagnosis ; {AFRIQUE} {SUBSAHARIENNE} ; {MOZAMBIQUE} ; {SWAZILAND} ; {AFRIQUE} {DU} {SUD} ; {OUGANDA} ; {ZIMBABWE}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {65},
  numero = {12},
  pages = {2018--2025},
  ISSN = {1058-4838},
  year = {2017},
  DOI = {10.1093/cid/cix698},
  URL = {https://www.documentation.ird.fr/hor/fdi:010071412},
}