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Viral failure in hiv childrens

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https://www.readbyqxmd.com/read/29734220/recovery-of-effective-hiv-specific-cd4-t-cell-activity-following-antiretroviral-therapy-in-paediatric-infection-requires-sustained-suppression-of-viraemia
#1
Emily Adland, Luisa Mori, Leana Laker, Anna Csala, Maximilian Muenchhoff, Alice Swordy, Masa Mori, Philippa Matthews, Gareth Tudor-Williams, Pieter Jooste, Philip Goulder
: The success of increasing access to antiretroviral therapy (ART) in paediatric HIV infection prompts the question of the potential for eradication of HIV infection in this age group. 'Shock-and-kill' HIV cure approaches, currently in development, may depend upon an effective antiviral T-cell response to eradicate virus-infected cells. We here investigate the ability of HIV-infected children receiving ART from early childhood (median 24 months' age) to generate effective HIV-specific CD4+ and CD8+ T-cell immune responses that would facilitate future immune-based cure therapies...
May 3, 2018: AIDS
https://www.readbyqxmd.com/read/29684092/weekends-off-efavirenz-based-antiretroviral-therapy-in-hiv-infected-children-adolescents-and-young-adults-breather-extended-follow-up-results-of-a-randomised-open-label-non-inferiority-trial
#2
Anna Turkova, Cecilia L Moore, Karina Butler, Alexandra Compagnucci, Yacine Saïdi, Victor Musiime, Annet Nanduudu, Elizabeth Kaudha, Tim R Cressey, Suwalai Chalermpantmetagul, Karen Scott, Lynda Harper, Samuel Montero, Yoann Riault, Torsak Bunupuradah, Alla Volokha, Patricia M Flynn, Rosa Bologna, Jose T Ramos Amador, Steven B Welch, Eleni Nastouli, Nigel Klein, Carlo Giaquinto, Deborah Ford, Abdel Babiker, Diana M Gibb
BACKGROUND: Weekends off antiretroviral therapy (ART) may help engage HIV-1-infected young people facing lifelong treatment. BREATHER showed short cycle therapy (SCT; 5 days on, 2 days off ART) was non-inferior to continuous therapy (CT) over 48 weeks. Planned follow-up was extended to 144 weeks, maintaining original randomisation. METHODS: BREATHER was an open-label, non-inferiority trial. Participants aged 8-24yrs with virological suppression on efavirenz-based first-line ART were randomised 1:1, stratified by age and African/non-African sites, to remain on CT or change to SCT...
2018: PloS One
https://www.readbyqxmd.com/read/29652972/-genetic-analysis-of-the-mutations-in-hiv-1-infected-population-in-ecuador
#3
Manuel González-González, Consuelo Correa-Sierra, Katherine Hermida-Álava, Ana Machado-Díaz, L Fernando Gómez-Andrade, Martha Castillo-Segovia, C Lissette Pérez-Santos, Vivian Kourí-Cardellá
Background The international recommendations of antiretroviral treatment include resistance tests to guide the treatment regimen in each patient, which is not available on a regular basis in Ecuador. Aim To describe mutations that confer resistance to antiretrovirals in a population of Ecuadorian patients. Methods Plasma samples from 101 HIV-1 patients with failure to antiretroviral therapy, divided into 15 children and 86 adults, were studied with the GS Junior (Roche) and the sequences were analyzed with the DeepChek program...
2018: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29649264/age-at-antiretroviral-therapy-initiation-and-cell-associated-hiv-1-dna-levels-in-hiv-1-infected-children
#4
Louise Kuhn, Maria Paximadis, Bianca Da Costa Dias, Shayne Loubser, Renate Strehlau, Faeezah Patel, Stephanie Shiau, Ashraf Coovadia, Elaine J Abrams, Caroline T Tiemessen
BACKGROUND: The latent viral reservoir is the major obstacle to achieving HIV remission and necessitates life-long antiretroviral therapy (ART) for HIV-infected individuals. Studies in adults and children have found that initiating ART soon after infection is associated with a reduction in the size of the HIV-1 reservoir. Here we quantified cell-associated HIV-1 DNA in early-treated but currently older HIV-infected children suppressed on ART. METHODS: The study participants comprised of a cohort of 146 early-treated children with HIV-1 RNA <50 copies/ml enrolled as part of a clinical trial in Johannesburg, South Africa...
2018: PloS One
https://www.readbyqxmd.com/read/29626042/incidence-and-risk-factors-of-first-line-antiretroviral-treatment-failure-among-human-immunodeficiency-virus-infected-children-in-amhara-regional-state-ethiopia-a-retrospective-follow-up-study
#5
Malede Mequanent Sisay, Tadesse Awoke Ayele, Yalemzewod Assefa Gelaw, Adino Tesfahun Tsegaye, Kassahun Alemu Gelaye, Melkitu Fentie Melak
OBJECTIVE: This study aimed to assess the incidence and risk factors of treatment failure among HIV/AIDS-infected children who were on antiretroviral therapy (ART) in Amhara National Regional State, Ethiopia. METHODS: A retrospective follow-up study was conducted from January 2010 to March 2016. A total of 824 children under the age of 15 who had started ART were included in the study. Data were collected from children's medical charts and ART registration logbook using a standard checklist...
April 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29547438/multitype-violence-exposures-and-adolescent-antiretroviral-nonadherence-in-south-africa
#6
Lucie Cluver, Franziska Meinck, Elona Toska, F Mark Orkin, Rebecca Hodes, Lorraine Sherr
OBJECTIVES: HIV-positive adolescents have low-ART adherence, with consequent increased risks of mortality, morbidity, and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine associations of ART adherence with adolescent violence victimization by caregivers, teachers, peers, community members, and healthcare providers. DESIGN AND METHODS: HIV-positive adolescents were interviewed (n = 1060), and clinic biomarker data collected...
May 15, 2018: AIDS
https://www.readbyqxmd.com/read/29301267/the-effect-of-detectable-hiv-viral-load-among-hiv-infected-children-during-antiretroviral-treatment-a-cross-sectional-study
#7
Visal Moolasart, Suthat Chottanapund, Jarurnsook Ausavapipit, Sirirat Likanonsakul, Sumonmal Uttayamakul, Don Changsom, Hatairat Lerdsamran, Pilaipan Puthavathana
The RNA viral load of human immunodeficiency virus (HIV) is initially used to determine the status of the HIV infection. The goal of therapy following treatment failure is to achieve and maintain virologic suppression. A detectable viral load may relate to the progression of HIV infection. A cross-sectional survey was conducted from January 2013 to December 2014 at the Bamrasnaradura Infectious Diseases Institute, Thailand. The aim was to determine the prevalence of detectable HIV viral load (dVL) and analyze the factors associated with post-dVL conditions that occur independently of a switch to a new antiretroviral agent...
January 1, 2018: Children
https://www.readbyqxmd.com/read/29181714/discontinuation-of-efavirenz-in-paediatric-patients-why-do-children-switch
#8
Elke Wynberg, Eleri Williams, Gareth Tudor-Williams, Hermione Lyall, Caroline Foster
BACKGROUND: Efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI) is used globally as first-line antiretroviral therapy (ART) in combination with a dual nucleoside backbone in adults and children from 3 years of age. Up to 40% of adults taking efavirenz report central nervous system (CNS) adverse effects, and the rates of discontinuation of efavirenz-based treatment are higher than other first-line regimens. Data on efavirenz discontinuation are more limited for children and adolescents...
March 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29171190/routine-viral-load-monitoring-in-hiv-infected-infants-and-children-in-low-and-middle-income-countries-challenges-and-opportunities
#9
Stephen M Arpadi, Stephanie Shiau, Eduarda Pimentel De Gusmao, Avy Violari
INTRODUCTION: The objective of this commentary is to review considerations for implementing routine viral load (VL) monitoring programmes for HIV-infected infants and children living in low- and middle-income countries (LMIC). Since 2013, the World Health Organization (WHO) guidelines recommend VL testing as the preferred monitoring approach for all individuals treated with ART in order to assess treatment response, detect treatment failure and determine the need to switch to a second-line regimen in a timely manner...
November 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29171180/the-case-for-viral-load-testing-in-adolescents-in-resource-limited-settings
#10
REVIEW
Rebecca Marcus, Rashida A Ferrand, Katharina Kranzer, Linda-Gail Bekker
INTRODUCTION: The success of HIV treatment programmes globally has resulted in children with perinatally acquired HIV reaching adolescence in large numbers. The number of adolescents living with HIV is growing further due to persisting high HIV incidence rates among adolescents in low- and middle-income settings, particularly in sub-Saharan Africa. Although expanding access to HIV viral load monitoring is necessary to achieve the 90-90-90 targets across the HIV care continuum, implementation is incomplete...
November 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29136032/virological-response-and-resistance-among-hiv-infected-children-receiving-long-term-antiretroviral-therapy-without-virological-monitoring-in-uganda-and-zimbabwe-observational-analyses-within-the-randomised-arrow-trial
#11
RANDOMIZED CONTROLLED TRIAL
Alexander J Szubert, Andrew J Prendergast, Moira J Spyer, Victor Musiime, Philippa Musoke, Mutsa Bwakura-Dangarembizi, Patricia Nahirya-Ntege, Margaret J Thomason, Emmanuel Ndashimye, Immaculate Nkanya, Oscar Senfuma, Boniface Mudenge, Nigel Klein, Diana M Gibb, A Sarah Walker
BACKGROUND: Although WHO recommends viral load (VL) monitoring for those on antiretroviral therapy (ART), availability in low-income countries remains limited. We investigated long-term VL and resistance in HIV-infected children managed without real-time VL monitoring. METHODS AND FINDINGS: In the ARROW factorial trial, 1,206 children initiating ART in Uganda and Zimbabwe between 15 March 2007 and 18 November 2008, aged a median 6 years old, with median CD4% of 12%, were randomised to monitoring with or without 12-weekly CD4 counts and to receive 2 nucleoside reverse transcriptase inhibitors (2NRTI, mainly abacavir+lamivudine) with a non-nucleoside reverse transcriptase inhibitor (NNRTI) or 3 NRTIs as long-term ART...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29135578/when-prevention-of-mother-to-child-hiv-transmission-fails-preventing-pretreatment-drug-resistance-in-african-children
#12
Seth C Inzaule, Raph L Hamers, Job Calis, Ragna Boerma, Kim Sigaloff, Clement Zeh, Peter Mugyenyi, Sulaimon Akanmu, Tobias F Rinke de Wit
No abstract text is available yet for this article.
January 14, 2018: AIDS
https://www.readbyqxmd.com/read/29104904/the-effect-of-community-based-support-for-caregivers-on-the-risk-of-virological-failure-in-children-and-adolescents-with-hiv-in-harare-zimbabwe-zenith-an-open-label-randomised-controlled-trial
#13
Rashida A Ferrand, Victoria Simms, Ethel Dauya, Tsitsi Bandason, Grace Mchugh, Hilda Mujuru, Prosper Chonzi, Joanna Busza, Katharina Kranzer, Shungu Munyati, Helen A Weiss, Richard J Hayes
Background: Children and adolescents have poorer HIV treatment outcomes than adults. We aimed to assess the effect of community-based support for caregivers of HIV-infected children and adolescents, who are key mediators to children engaging with care, on treatment outcomes. Methods: In this open-label, randomised contolled trial, we recruited children aged 6-15 years with newly-diagnosed HIV attending primary health-care clinics in Harare, Zimbabwe. Children were randomly assigned to receive decentralised primary health-care clinic-based HIV care (control group), according to national guidelines for 18 months, or decentralised care plus structured support visits by trained community health workers (intervention group) according to national guidelines for 18 months...
November 2017: Lancet Child & Adolescent Health
https://www.readbyqxmd.com/read/29061072/perinatally-hiv-infected-youths-after-transition-from-pediatric-to-adult-care-a-single-center-experience-from-northern-italy
#14
Ilaria Izzo, Eugenia Quiros-Roldan, Barbara Saccani, Erika Chiari, Salvatore Casari, Emanuele Focà, Maria Chiara Pezzoli, Maria Antonia Forleo, Andrea Bonito, Raffaele Badolato, Laura Dotta, Francesco Castelli
With the development of combination antiretroviral therapy (cART), the first generation of perinatally HIV-infected children has reached young adulthood. A retrospective study was conducted on perinatally HIV-infected young adults after transition to adult care in Brescia (Northern Italy). Twenty-four patients were transferred to Infectious Disease outpatient Clinic from Pediatric Clinic between 2004 and 2016. Median age at transition was 18 years. 37.5% were male, and 75% were Italian. Median CD4(+) T-cell count was 534 cell/μL, and 9/24 presented detectable HIV-RNA at the time of transition...
November 17, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28953325/multicentre-analysis-of-second-line-antiretroviral-treatment-in-hiv-infected-children-adolescents-at-high-risk-of-failure
#15
RANDOMIZED CONTROLLED TRIAL
Ragna S Boerma, Torsak Bunupuradah, Dorothy Dow, Joseph Fokam, Azar Kariminia, Dara Lehman, Cissy Kityo, Victor Musiime, Paul Palumbo, Annelot Schoffelen, Sam Sophan, Brian Zanoni, Tobias F Rinke de Wit, Job C J Calis, Kim C E Sigaloff
INTRODUCTION: The number of HIV-infected children and adolescents requiring second-line antiretroviral treatment (ART) is increasing in low- and middle-income countries (LMIC). However, the effectiveness of paediatric second-line ART and potential risk factors for virologic failure are poorly characterized. We performed an aggregate analysis of second-line ART outcomes for children and assessed the need for paediatric third-line ART. METHODS: We performed a multicentre analysis by systematically reviewing the literature to identify cohorts of children and adolescents receiving second-line ART in LMIC, contacting the corresponding study groups and including patient-level data on virologic and clinical outcomes...
September 15, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28899102/community-based-antiretroviral-treatment-in-rural-zimbabwe
#16
Benjamin Chimukangara, Justen Manasa, Rebecca Mitchell, Georgina Nyabadza, David Katzenstein, Collen Masimirembwa
Treatment of HIV has reduced HIV/AIDS-related mortality. Sustaining >90% virologic suppression in sub-Saharan Africa requires decentralized care and prevention services to rural communities. In Zimbabwe, the number of people receiving antiretroviral treatment (ART) has increased rapidly. However, access to treatment monitoring tools such as viral load and drug resistance testing is limited. We assessed virologic treatment outcomes among ART recipients in Nyamutora, a rural community receiving bimonthly ART and prevention services...
December 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28868299/tubuloreticular-inclusions-in-the-absence-of-systemic-lupus-erythematosus-and-hiv-infection-a-report-of-three-pediatric-cases
#17
Ayah Elmaghrabi, Elizabeth Brown, Ei Khin, Jared Hassler, Allen R Hendricks
Tubuloreticular inclusions (TRIs) are subcellular structures located within the cisternae of endoplasmic reticulum. Formation of TRIs has been linked to the exposure of excess interferon (IFN), either from endogenous or exogenous sources. In renal disease, TRIs have been most commonly associated with systemic lupus erythematosus (SLE), and human immunodeficiency virus-associated nephropathy (HIVAN). Case reports of patients with renal biopsies showing TRIs without underlying SLE or HIV are infrequent in adults, and to our knowledge none have been reported in children...
May 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28704560/performance-characteristics-of-finger-stick-dried-blood-spots-dbs-on-the-determination-of-human-immunodeficiency-virus-hiv-treatment-failure-in-a-pediatric-population-in-mozambique
#18
COMPARATIVE STUDY
Joy Chang, Amina de Sousa, Jennifer Sabatier, Mariamo Assane, Guoqing Zhang, Dulce Bila, Paula Vaz, Charity Alfredo, Loide Cossa, Nilesh Bhatt, Emilia H Koumans, Chunfu Yang, Emilia Rivadeneira, Ilesh Jani, James C Houston
Quantitative plasma viral load (VL) at 1000 copies /mL was recommended as the threshold to confirm antiretroviral therapy (ART) failure by the World Health Organization (WHO). Because of ongoing challenges of using plasma for VL testing in resource-limited settings (RLS), especially for children, this study collected 717 DBS and paired plasma samples from children receiving ART ≥1 year in Mozambique and compared the performance of DBS using Abbott's VL test with a paired plasma sample using Roche's VL test...
2017: PloS One
https://www.readbyqxmd.com/read/28694558/impact-of-vaccination-on-distribution-of-t-cell-subsets-in-antiretroviral-treated-hiv-infected-children
#19
Premrutai Thitilertdecha, Ladawan Khowawisetsut, Palanee Ammaranond, Poonsin Poungpairoj, Varangkana Tantithavorn, Nattawat Onlamoon
Antiretroviral therapy (ART) is generally prescribed to patients with human immunodeficiency virus (HIV) infection with vaccination introduced to prevent disease complications. However, little is known about the influence of immunization on T cell subsets' distribution during the course of infection. This study aims to identify the impact of viral replication and immunization on naïve, effector, effector memory, and central memory T cell subpopulations in ART-treated HIV-infected children. Fifty patients were recruited and injected intramuscularly with influenza A (H1N1) 2009 vaccine on the day of enrollment (day 0) and day 28...
2017: Disease Markers
https://www.readbyqxmd.com/read/28686654/a-retrospective-case-cohort-study-comparing-treatment-outcomes-in-abacavir-versus-stavudine-containing-first-line-antiretroviral-treatment-regimens-in-children-3yrs-old-at-a-paediatric-programme-based-in-soweto-south-africa
#20
Haseena Cassim, Kennedy Otwombe, Erica Lazarus, Afaaf Liberty, Glenda E Gray, Oppel B W Greeff, Avy Violari
INTRODUCTION: The current World Health Organization guideline for first line antiretroviral therapy (ART) in HIV-infected children recommends the use of abacavir and lamivudine as nucleoside backbones and no longer includes stavudine. We compared treatment outcomes with abacavir (ABC) versus stavudine (d4T) in a cohort of HIV-1 infected children 6 and 12 months after antiretroviral therapy was initiated. METHODS: This was a retrospective case-cohort study, using programmatic data from children enrolled in the Paediatric Wellness Programme at the Perinatal HIV Research Unit in Soweto, South Africa between 2005 and 2013...
2017: PloS One
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