@article{fdi:010066915,
  title = {{H}igh rates of virological failure and drug resistance in perinatally {HIV}-1-infected children and adolescents receiving lifelong antiretroviral therapy in routine clinics in {T}ogo},
  author = {{S}alou, {M}. and {D}agnra, {A}. {Y}. and {B}utel, {C}hristelle and {V}idal, {N}icole and {S}errano, {L}. and {T}akassi, {E}. and {K}onou, {A}. {A}. and {H}oundenou, {S}. and {D}apam, {N}. and {S}ingo-{T}okofai, {A}. and {P}itche, {P}. and {A}takouma, {Y}. and {P}rince-{D}avid, {M}. and {D}elaporte, {E}ric and {P}eeters, {M}artine},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction: {A}ntiretroviral treatment ({ART}) has been scaled up over the last decade but compared to adults, children living with {HIV} are less likely to receive {ART}. {M}oreover, children and adolescents are more vulnerable than adults to virological failure ({VF}) and emergence of drug resistance. {I}n this study we determined virological outcome in perinatally {HIV}-1-infected children and adolescents receiving {ART} in {T}ogo. {M}ethods: {HIV} viral load ({VL}) testing was consecutively proposed to all children and adolescents who were on {ART} for at least 12 months when attending {HIV} healthcare services for their routine follow-up visit ({J}une to {S}eptember 2014). {P}lasma {HIV}-1 {VL} was measured using the m2000 {R}eal{T}ime {HIV}-1 assay ({A}bbott {M}olecular, {D}es {P}laines, {IL}, {USA}). {G}enotypic drug resistance was done for all samples with {VL} > 1000 copies/ml. {R}esults and discussion: {A}mong 283 perinatally {HIV}-1-infected children and adolescents included, 167 (59%) were adolescents and 116 (41%) were children. {T}he median duration on {ART} was 48 months (interquartile range: 28 to 68 months). {F}or 228 (80.6%), the current {ART} combination consisted of two nucleoside reverse transcriptase inhibitors ({NRTI}s) (zidovudine and lamivudine) and one non-nucleoside reverse transcriptase inhibitor ({NNRTI}) (nevirapine or efavirenz). {O}nly 28 (9.9%) were on a protease inhibitor ({PI})-based regimen. {VL} was below the detection limit (i.e. 40 copies/ml) for 102 (36%), between 40 and 1000 copies/ml for 35 (12.4%) and above 1000 copies/ml for 146 (51.6%). {G}enotypic drug-resistance testing was successful for 125/146 (85.6%); 110/125 (88.0%) were resistant to both {NRTI}s and {NNRTI}s, 1/125 (0.8%) to {NRTI}s only, 4/125 (3.2%) to {NNRTI}s only and three harboured viruses resistant to reverse transcriptase and {PI}s. {O}verall, 86% (108/125) of children and adolescents experiencing {VF} and successfully genotyped, corresponding thus to at least 38% of the study population, had either no effective {ART} or had only a single effective drug in their current {ART} regimen. {C}onclusions: {O}ur study provided important information on virological outcome on lifelong {ART} in perinatally {HIV}-1-infected children and adolescents who were still on {ART} and continued to attend antiretroviral ({ARV}) clinics for follow-up visits. {A}ctual conditions for scaling up and monitoring lifelong {ART} in children in resource-limited countries can have dramatic long-term outcomes and illustrate that paediatric {ART} receives inadequate attention.},
  keywords = {{HIV} ; virological failure ; drug resistance ; children ; antiretroviral ; treatment ; {T}ogo ; {A}frica ; {TOGO}},
  booktitle = {},
  journal = {{J}ournal of the {I}nternational {A}ids {S}ociety},
  volume = {19},
  numero = {},
  pages = {20683 [7 ]},
  ISSN = {1758-2652},
  year = {2016},
  DOI = {10.7448/ias.19.1.20683},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066915},
}