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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Antiretroviral drug resistance among HIV-1 infected children failing treatment
Journal of Medical Virology, Volume 68, No. 3, Year 2002
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Description
High levels of HIV-1 replication occur following perinatal infection and antiretroviral drugs may not fully suppress viral load during the early years of childhood. Adherence to treatment may also be difficult among children. These two factors will contribute to development of drug resistance but limited paediatric data are available. This study has, therefore, evaluated the prevalence of drug resistance among children and assessed the contribution of adherence to failing therapy. Samples from 26 children who had experienced virological failure to antiretroviral therapy were tested for drug resistance using the Visible Genetics TRUGENE™ HIV-1 genotyping assay. HIV-1 subtype was determined using a peptide-based EIA and drug adherence determined by physician assessment. Twenty-four children were black African, 23 of whom were infected with a non-B subtype. HIV RNA sequence data was obtained for 21 of the 26 children; at treatment failure resistance mutations were detected in the protease gene of 7 (33%) and the reverse transcriptase gene of 19 (90%). A lower proportion of children had evidence of drug resistance at nadir and no resistance mutations were detected prior to treatment. Genotypic resistance was common in those treated with lamivudine (10/11, 91%), nevirapine (6/8, 75%), and zidovudine (7/11, 64%). The prevalence of mutations was lower among those receiving other nucleoside reverse transcriptase inhibitors and protease inhibitors. In 50% of children, drug adherence was >90%. Antiretroviral drug resistance was common among this group of children failing therapy, the majority of whom were infected with non-B subtypes of HIV-1. As adherence to treatment was low in 50%, this was likely to be an important contributory factor. © 2002 Wiley-Liss, Inc.
Authors & Co-Authors
Mullen, Jane E.
United Kingdom, London
King's College London
O'Shea, Siobhan
United Kingdom, London
Guy's and st Thomas' Nhs Foundation Trust
Chrystie, Ian L.
United Kingdom, London
King's College London
Ball, Colin S.
United Kingdom, London
King's College Hospital
Sharland, Mike R.
United Kingdom, London
St George's Hospital
Easterbrook, Philippa Jane
United Kingdom, London
King's College London
Statistics
Citations: 56
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1002/jmv.10203
ISSN:
01466615
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study