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Viral failure in hiv childrens

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https://www.readbyqxmd.com/read/28475554/sustained-viral-suppression-in-hiv-infected-children-on-once-daily-lopinavir-ritonavir-in-clinical-practice
#1
Ivar P E Gondrie, Diane E T Bastiaans, Pieter L A Fraaij, Gertjan J A Driessen, Linda C Van Der Knaap, Eline G Visser, Petronette Van Jaarsveld, Ronald de Groot, Nico G Hartwig, David M Burger, Annemarie M C Van Rossum
BACKGROUND: The use of lopinavir/ritonavir once-daily (LPV/r QD) has not been approved for children. Good short-term clinical, virological and immunological outcomes have been observed in children on LPV/r QD. METHODS: We evaluated the long-term effectiveness of a LPV/r QD containing regimen in HIV-1 infected children in clinical practice. Selected children (aged 0-18 years) with an undetectable HIV-1 RNA viral load (<50 copies/mL) for at least 6 months on a twice-daily (BID) LPV/r-containing regimen switched to LPV/r QD...
May 4, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28468852/a-simple-phosphate-buffered-saline-extraction-method-improves-specificity-of-hiv-viral-load-monitoring-using-dried-blood-spots
#2
A Tariro Makadzange, F Kathryn Boyd, Benjamin Chimukangara, Collen Masimirembwa, David Katzenstein, Chiratidzo E Ndhlovu
Introduction: Although Roche COBAS Ampliprep/COBAS Taqman (CAP/CTM) systems are widely used in sub-Saharan Africa for early infant diagnosis of HIV from Dried blood spots (DBS), viral load monitoring with this system is not practical due to non-specific extraction of both cell free and cell associated viral nucleic acids. A simplified DBS extraction technique for cell free virus elution (FVE) using phosphate buffered saline (PBS) may provide an alternative analyte for lower cost quantitative HIV virus load (VL) testing to monitor antiretroviral therapy (ART)...
May 3, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28468608/factors-associated-with-virological-non-suppression-among-hiv-positive-patients-on-antiretroviral-therapy-in-uganda-august-2014-july-2015
#3
Lilian Bulage, Isaac Ssewanyana, Victoria Nankabirwa, Fred Nsubuga, Christine Kihembo, Gerald Pande, Alex R Ario, Joseph Kb Matovu, Rhoda K Wanyenze, Charles Kiyaga
BACKGROUND: Despite the growing number of people on antiretroviral therapy (ART), there is limited information about virological non-suppression and its determinants among HIV-positive (HIV+) individuals enrolled in HIV care in many resource-limited settings. We estimated the proportion of virologically non-suppressed patients, and identified the factors associated with virological non-suppression. METHODS: We conducted a descriptive cross-sectional study using routinely collected program data from viral load (VL) samples collected across the country for testing at the Central Public Health Laboratories (CPHL) in Uganda...
May 3, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28453240/virological-response-and-resistances-over-12-months-among-hiv-infected-children-less-than-two-years-receiving-first-line-lopinavir-ritonavir-based-antiretroviral-therapy-in-cote-d-ivoire-and-burkina-faso-the-monod-anrs-12206-cohort
#4
Clarisse Amani-Bosse, Désiré Lucien Dahourou, Karen Malateste, Madeleine Amorissani-Folquet, Malik Coulibaly, Sophie Dattez, Arlette Emieme, Mamadou Barry, Christine Rouzioux, Sylvie N'gbeche, Caroline Yonaba, Marguerite Timité-Konan, Véronique Mea, Sylvie Ouédraogo, Stéphane Blanche, Nicolas Meda, Carole Seguin-Devaux, Valériane Leroy
INTRODUCTION: Lopinavir/ritonavir-based antiretroviral therapy (ART) is recommended for all HIV-infected children less than three years. However, little is known about its field implementation and effectiveness in West Africa. We assessed the 12-month response to lopinavir/ritonavir-based antiretroviral therapy in a cohort of West African children treated before the age of two years. METHODS: HIV-1-infected, ART-naive except for a prevention of mother-to-child transmission (PMTCT), tuberculosis-free, and less than two years of age children with parent's consent were enrolled in a 12-month prospective therapeutic cohort with lopinavir/ritonavir ART and cotrimoxazole prophylaxis in Ouagadougou and Abidjan...
April 25, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28434406/efavirenz-based-simplification-after-successful-early-lopinavir-boosted-ritonavir-based-therapy-in-hiv-infected-children-in-burkina-faso-and-c%C3%A3-te-d-ivoire-the-monod-anrs-12206-non-inferiority-randomised-trial
#5
Désiré Lucien Dahourou, Madeleine Amorissani-Folquet, Karen Malateste, Clarisse Amani-Bosse, Malik Coulibaly, Carole Seguin-Devaux, Thomas Toni, Rasmata Ouédraogo, Stéphane Blanche, Caroline Yonaba, François Eboua, Philippe Lepage, Divine Avit, Sylvie Ouédraogo, Philippe Van de Perre, Sylvie N'Gbeche, Angèle Kalmogho, Roger Salamon, Nicolas Meda, Marguerite Timité-Konan, Valériane Leroy
BACKGROUND: The 2016 World Health Organization guidelines recommend all children <3 years start antiretroviral therapy (ART) on protease inhibitor-based regimens. But lopinavir/ritonavir (LPV/r) syrup has many challenges in low-income countries, including limited availability, requires refrigeration, interactions with anti-tuberculous drugs, twice-daily dosing, poor palatability in young children, and higher cost than non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Successfully initiating LPV/r-based ART in HIV-infected children aged <2 years raises operational challenges that could be simplified by switching to a protease inhibitor-sparing therapy based on efavirenz (EFV), although, to date, EFV is not recommended in children <3 years...
April 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28272247/high-levels-of-virological-failure-with-major-genotypic-resistance-mutations-in-hiv-1-infected-children-after-5-years-of-care-according-to-who-recommended-1st-line-and-2nd-line-antiretroviral-regimens-in-the-central-african-republic-a-cross-sectional-study
#6
Christian Diamant Mossoro-Kpinde, Jean-Chrysostome Gody, Ralph-Sydney Mboumba Bouassa, Olivia Mbitikon, Mohammad-Ali Jenabian, Leman Robin, Mathieu Matta, Kamal Zeitouni, Jean De Dieu Longo, Cecilia Costiniuk, Gérard Grésenguet, Ndèye Coumba Touré Kane, Laurent Bélec
A large cohort of 220 HIV-1-infected children (median [range] age: 12 [4-17] years) was cared and followed up in the Central African Republic, including 198 in 1st-line and 22 in 2nd-line antiretroviral regimens. Patients were monitored clinically and biologically for HIV-1 RNA load and drug resistance mutations (DRMs) genotyping. A total of 87 (40%) study children were virological responders and 133 (60%) nonresponders. In children with detectable viral load, the majority (129; 97%) represented a virological failure...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28246135/cohort-profile-improving-treatment-of-hiv-infected-ethiopian-children-through-better-detection-of-treatment-failure-in-southern-ethiopia
#7
Birkneh Tilahun Tadesse, Byron Alexander Foster, Degu Jerene, Andrea Ruff
PURPOSE: The Ethiopian Paediatric HIV Cohort (EPHIC) was established to identify clinical and laboratory predictors of virological treatment failure to ultimately develop a clinical-immunological prediction rule with area under the curve of >0.80 for detecting first-line antiretroviral therapy failure (ARTF). It will also assess the performance of the current WHO guidelines for detection of first-line ARTF in children. PARTICIPANTS: Using a prospective cohort design, HIV-infected children and adolescents below the age of 18 years are followed every 6 months with a set of clinical and laboratory parameters at 6 hospitals in southern Ethiopia...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28242151/-viral-failure-in-infants-perinatally-infected-with-hiv-a-double-punishment
#8
N Trocmé, M-F Courcoux, M-D Tabone, F Hervé, E Bui, P Faucher, L Selleret, M-G Lebrette, G Leverger, C Dollfus
BACKGROUND: Considering the remarkable efficacy of the strategies for preventing mother-to-child transmission of HIV infection (PMTCT), failures are rare in high-resource countries and deserve further investigation. Moreover, infants have been found to be at increased risk of viral failure. We analyzed the factors related to the children's environment, including maternal psychological factors that may be associated with viral failure in children diagnosed before the age of 1 year. PATIENTS AND METHODS: Retrospective study of all HIV-infected infants, born in France between July 2003 and July 2013, diagnosed before the age of 1 year, cared for in a single reference center, comparing the group of children in viral success to the group of children presenting at least one episode of viral failure, using data available in their medical, psychological and social files...
February 24, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28198788/high-rates-of-baseline-drug-resistance-and-virologic-failure-among-art-na%C3%A3-ve-hiv-infected-children-in-mali
#9
Claudia S Crowell, Almoustapha I Maiga, Mariam Sylla, Babafemi Taiwo, Niaboula Kone, Assaf P Oron, Robert L Murphy, Anne-Geneviève Marcelin, Ban Traore, Djeneba B Fofana, Gilles Peytavin, Ellen G Chadwick
BACKGROUND: Limited data exist on drug resistance and antiretroviral treatment (ART) outcomes in HIV-1 infected children in West Africa. We determined the prevalence of baseline resistance and correlates of virologic failure (VF) in a cohort of ART naïve HIV-1 infected children <10 years of age initiating ART in Mali. METHODS: Reverse transcriptase and protease genes were sequenced at baseline (before ART) and at 6 months. Resistance was defined according to the Stanford HIV Genotypic Resistance database...
February 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28043170/impact-of-disease-drug-and-patient-adherence-on-the-effectiveness-of-antiviral-therapy-in-pediatric-hiv
#10
Chiara Piana, Meindert Danhof, Oscar Della Pasqua
Maintaining effective antiretroviral treatment for life is a major problem in both resource-limited and resource-rich countries. Despite the progress observed in paediatric antiretroviral therapy, approximately 12% of children still experience treatment failure due to drug resistance, inadequate dosing and poor adherence. We explore the current status of antiretroviral therapy in children with focus on the interaction between disease, drug pharmacokinetics and patient behavior, all of which are strongly interconnected and determine treatment outcome...
May 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28002185/field-evaluation-of-dried-blood-spots-for-hiv-1-viral-load-monitoring-in-adults-and-children-receiving-antiretroviral-treatment-in-kenya-implications-for-scale-up-in-resource-limited-settings
#11
Mary E Schmitz, Simon Agolory, Muthoni Junghae, Laura N Broyles, Muthusi Kimeu, Joseph Ombayo, Mamo Umuro, Irene Mukui, Kennedy Alwenya, Moses Baraza, Kenneth Ndiege, Samuel Mwalili, Emilia Rivadeneira, Lucy Ng'ang'a, Chunfu Yang, Clement Zeh
BACKGROUND: WHO recommends viral load (VL) as the preferred method for diagnosing antiretroviral therapy (ART) failure; however, operational challenges have hampered the implementation of VL monitoring in most resource-limited settings. This study evaluated the accuracy of dried blood spot (DBS) VL testing under field conditions as a practical alternative to plasma in determining virologic failure (VF). METHODS: From May to December 2013, paired plasma and DBS specimens were collected from 416 adults and 377 children on ART ≥6 months at 12 clinics in Kenya...
December 17, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27943261/efavirenz-or-nevirapine-in-three-drug-combination-therapy-with-two-nucleoside-or-nucleotide-reverse-transcriptase-inhibitors-for-initial-treatment-of-hiv-infection-in-antiretroviral-na%C3%A3-ve-individuals
#12
REVIEW
Lawrence Mbuagbaw, Sara Mursleen, James H Irlam, Alicen B Spaulding, George W Rutherford, Nandi Siegfried
BACKGROUND: The advent of highly active antiretroviral therapy (ART) has reduced the morbidity and mortality due to HIV infection. The World Health Organization (WHO) ART guidelines focus on three classes of antiretroviral drugs, namely nucleoside or nucleotide reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors. Two of the most common medications given as first-line treatment are the NNRTIs, efavirenz (EFV) and nevirapine (NVP)...
December 10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27836020/high-levels-of-pre-treatment-hiv-drug-resistance-and-treatment-failure-in-nigerian-children
#13
Ragna S Boerma, T Sonia Boender, Kim C E Sigaloff, Tobias F Rinke de Wit, Michael Boele van Hensbroek, Nicaise Ndembi, Titilope Adeyemo, Edamisan O Temiye, Akin Osibogun, Pascale Ondoa, Job C Calis, Alani Sulaimon Akanmu
INTRODUCTION: Pre-treatment HIV drug resistance (PDR) is an increasing problem in sub-Saharan Africa. Children are an especially vulnerable population to develop PDR given that paediatric second-line treatment options are limited. Although monitoring of PDR is important, data on the paediatric prevalence in sub-Saharan Africa and its consequences for treatment outcomes are scarce. We designed a prospective paediatric cohort study to document the prevalence of PDR and its effect on subsequent treatment failure in Nigeria, the country with the second highest number of HIV-infected children in the world...
2016: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/27758114/short-communication-impact-of-viral-load-use-on-treatment-switch-in-perinatally-hiv-infected-children-in-asia
#14
Thahira Jamal Mohamed, Sirinya Teeraananchai, Stephen Kerr, Wanatpreeya Phongsamart, Nik Khairulddin Nik Yusoff, Rawiwan Hansudewechakul, Penh Sun Ly, Lam Van Nguyen, Tavitiya Sudjaritruk, Pagakrong Lumbiganon, Viet Chau Do, Nia Kurniati, Nagalingeswaran Kumarasamy, Dewi Kumara Wati, Moy Siew Fong, Revathy Nallusamy, Azar Kariminia, Annette H Sohn
We sought to assess the impact of routine HIV viral load (VL) monitoring on the incidence of switching from a first- to a second-line antiretroviral therapy (ART) regimen, and to describe factors associated with switch. Data from a regional cohort of 16 clinical programs in six Asian countries were analyzed. Second-line switch was defined as a change from a non-nucleoside reverse transcriptase inhibitor (NNRTI) to a protease inhibitor (PI) or vice versa, and ≥1 of the following: (1) reported treatment failure by local criteria, (2) switch of ≥1 additional drug, or (3) a preceding HIV VL ≥1,000 copies/ml...
March 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/27681154/keeping-kids-in-care-virological-failure-in-a-paediatric-antiretroviral-clinic-and-suggestions-for-improving-treatment-outcomes
#15
Susan Purchase, Jayne Cunningham, Monika Esser, Donald Skinner
The burden of paediatric HIV in South Africa is extremely high. Antiretrovirals (ARVs) are now widely accessible in the country and the clinical emphasis has shifted from initiation of treatment to retention in care. This study describes the cumulative virological failure rate amongst children on ARVs in a peri-urban clinic, and suggests ways in which clinics and partners could improve treatment outcomes. The study was conducted by the non-profit organisation HOPE Cape Town Association. A retrospective file audit determined the cumulative virological failure rate, that is, the sum of all children with a viral load >1000 copies/ml, children on monotherapy, children who had stopped treatment, children lost to follow-up (LTFU) and children who had died...
September 2016: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/27677163/development-of-hiv-drug-resistance-and-therapeutic-failure-in-children-and-adolescents-in-rural-tanzania-an-emerging-public-health-concern
#16
Lukas Muri, Anna Gamell, Alex J Ntamatungiro, Tracy R Glass, Lameck B Luwanda, Manuel Battegay, Hansjakob Furrer, Christoph Hatz, Marcel Tanner, Ingrid Felger, Thomas Klimkait, Emilio Letang
OBJECTIVE: To investigate the prevalence and determinants of virologic failure and acquired drug resistance-associated mutations (DRMs) in HIV-infected children and adolescents in rural Tanzania. DESIGN: Prospective cohort study with cross-sectional analysis. METHODS: All children 18 years or less attending the paediatric HIV Clinic of Ifakara and on antiretroviral therapy (ART) for at least 12 months were enrolled. Participants with virologic failure were tested for HIV-DRM...
January 2, 2017: AIDS
https://www.readbyqxmd.com/read/27634175/second-line-hiv-treatment-in-ugandan-children-favorable-outcomes-and-no-protease-inhibitor-resistance
#17
Ragna S Boerma, Cissy Kityo, T Sonia Boender, Elizabeth Kaudha, Joshua Kayiwa, Victor Musiime, Andrew Mukuye, Mary Kiconco, Immaculate Nankya, Lilian Nakatudde, Peter N Mugyenyi, Michael Boele van Hensbroek, Tobias F Rinke de Wit, Kim C E Sigaloff, Job C J Calis
Background: Data on pediatric second-line antiretroviral treatment (ART) outcomes are scarce, but essential to evaluate second-line and design third-line regimens. Methods: Children ≤12 years switching to second-line ART containing a protease inhibitor (PI) in Uganda were followed for 24 months. Viral load (VL) was determined at switch to second-line and every 6 months thereafter; genotypic resistance testing was done if VL ≥ 1000 cps/ml. Results: 60 children were included in the analysis; all had ≥1 drug resistance mutations at switch...
April 1, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/27625109/higher-rates-of-triple-class-virological-failure-in-perinatally-hiv-infected-teenagers-compared-with-heterosexually-infected-young-adults-in-europe
#18
A Judd, R Lodwick, A Noguera-Julian, D M Gibb, K Butler, D Costagliola, C Sabin, A van Sighem, B Ledergerber, C Torti, A Mocroft, D Podzamczer, M Dorrucci, S De Wit, N Obel, F Dabis, A Cozzi-Lepri, F García, N H Brockmeyer, J Warszawski, M I Gonzalez-Tome, C Mussini, G Touloumi, R Zangerle, J Ghosn, A Castagna, G Fätkenheuer, C Stephan, L Meyer, M A Campbell, G Chene, A Phillips
OBJECTIVES: The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection. METHODS: We analysed individual patient data from cohorts in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). A total of 5972 participants starting antiretroviral therapy (ART) from 1998, aged < 20 years at the start of ART for those with perinatal infection and 15-29 years for those with heterosexual infection, with ART containing at least two nucleoside reverse transcriptase inhibitors (NRTIs) and a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (bPI), were followed from ART initiation until the most recent viral load (VL) measurement...
March 2017: HIV Medicine
https://www.readbyqxmd.com/read/27583591/effect-of-lopinavir-and-nevirapine-concentrations-on-viral-outcomes-in-protease-inhibitor-experienced-hiv-infected-children
#19
Retsilisitsoe R Moholisa, Michael Schomaker, Louise Kuhn, Sandra Castel, Lubbe Wiesner, Ashraf Coovadia, Renate Strehlau, Faeezah Patel, Francoise Pinillos, Elaine J Abrams, Gary Maartens, Helen McIlleron
BACKGROUND: Adequate exposure to antiretroviral drugs is necessary to achieve and sustain viral suppression. However, the target antiretroviral concentrations associated with long-term viral suppression have not been adequately defined in children. We assessed the relationship between plasma lopinavir or nevirapine concentrations and the risk of subsequent viremia in children initially suppressed on antiretroviral therapy. METHODS: After an induction phase of antiretroviral treatment, 195 children with viral suppression (viral load ≤400 copies/mL) were randomized to continue a lopinavir/ritonavir-based regimen or to switch to a nevirapine-based regimen (together with lamivudine and stavudine)...
December 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27547761/virological-and-immunological-status-of-the-people-living-with-hiv-aids-undergoing-art-treatment-in-nepal
#20
MULTICENTER STUDY
Chet Raj Ojha, Geeta Shakya, Shyam Prakash Dumre
Antiretroviral therapy (ART) has increased the life span of the people living with HIV (PLHIV), but their virological and immunological outcomes are not well documented in Nepal. The study was conducted at a tertiary care center including 826 HIV-1 seropositive individuals undergoing ART for at least six months. Plasma viral load (HIV-1 RNA) was detected by Real Time PCR and CD4(+) T-lymphocyte (CD4(+)) counts were estimated by flow cytometry. The mean CD4(+) count of patients was 501 (95% CI = 325-579) cells/cumm, but about 35% of patients had CD4(+) T cell counts below 350 cells/cumm...
2016: BioMed Research International
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