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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Drug resistance among drug-naive and first-line antiretroviral treatment-failing children in Cameroon
Pediatric Infectious Disease Journal, Volume 30, No. 12, Year 2011
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Description
Background: Scale-up to antiretroviral therapy (ART) requires surveillance for HIV drug resistance. With the goal of attaining 100% pediatric ART coverage in Cameroon, strategies to limit the spread of HIV resistance among children are very important. Methods: From June 2009 through February 2011, 92 HIV-1-infected children (41 ART-naive, 51 failing first-line ART) living in Yaoundé, Cameroon, were enrolled; HIV-1 Prot-RT genotypic resistance testing (GRT) was performed using an inhouse assay. Among 40 children failing first-line ART, treatment response was evaluated at weeks 24 and 48 after treatment was changed, based on GRT results. Results: The mean age was 72 months both for children who were drug-naive and those failing ART (range: 3-144 and 12-144, respectively), with a mean viremia of 5.59 log and 4.71 log RNA copies/mL, a median CD4 of 17% (588 cells/μL) and 23% (719 cells/μL), respectively. Median time-to-treatment failure was 610 days. A prevalence of 4.9% and 90% drug resistance was observed, respectively, among children who were drug-naive and those failing first-line ART, with circulating recombinant form CRF02-AG as the most prevalent clade (58.6% and 62%, respectively). After a change to GRT-based treatment, more than 90% of children had viremia <3 log RNA copies/mL at week 24 and confirmed at week 48, with 70% achieving undetectable viremia, although without correlation to immune response; 97.5% had switched to lopinavir/ritonavir-containing regimens. Conclusion: HIV-1 drug resistance was low among ART-naive children and very high among those failing first-line ART. Treatment change based on GRT was successful for most children, with lopinavir/ritonavir regimens being very promising for second-line use. © 2011 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Fokam, Joseph
Cameroon, Yaounde
Chantal Biya International Reference Centre
Cameroon, Yaounde
Université de Yaoundé I
Salpini, Romina
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Santoro, Maria Mercedes
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Cento, Valeria
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Perno, Carlo Federico
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Colizzi, Vittorio C.
Cameroon, Yaounde
Chantal Biya International Reference Centre
Italy, Rome
Ircss Lazarro Spallanzani
Ndumbe, Peter Martins
Cameroon, Yaounde
Chantal Biya International Reference Centre
Cameroon, Yaounde
Université de Yaoundé I
Cameroon, Buea
University of Buea
Fokunang Ntungen, Charles
Cameroon, Yaounde
Université de Yaoundé I
Ndiang Tetang, Suzie Moyo
Cameroon, Yaounde
National Social Insurance Fond Hospital
Nanfack, Aubin Joseph
Cameroon, Yaounde
Chantal Biya International Reference Centre
Takou Komego, Désiré Augustin
Cameroon, Yaounde
Chantal Biya International Reference Centre
Cappelli, Giulia
Cameroon, Yaounde
Chantal Biya International Reference Centre
Italy, Rome
Consiglio Nazionale Delle Ricerche
Statistics
Citations: 51
Authors: 12
Affiliations: 7
Identifiers
Doi:
10.1097/INF.0b013e31822db54c
ISSN:
08913668
e-ISSN:
15320987
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
Cameroon