Drug Resistance Among Drug-naive and First-line Antiretroviral Treatment-failing Children in Cameroon

Fokam, Joseph; Salpini, Romina; Santoro, Maria Mercedes; Cento, Valeria; Perno, Carlo Federico; Colizzi, Vittorio; Ndumbe, Peter M.; Ntungen, Charles Fokunang; Tetang, Suzie Moyo; Nanfack, Aubin; Komego, Désiré Augustin Takou; Cappelli, Giulia

doi:10.1097/inf.0b013e31822db54c

Cited by 44 publications

(62 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They also found that the DNA extracted from buffy coat samples (thought to contain archived viral reservoir) demonstrated a high degree of resistant virus; however, the presence of resistance in the DNA was distributed fairly evenly between infants who did and did not experience virologic failure, which suggests that DNA analysis of infant samples after single-dose NVP was not predictive of ART success [46]. As suggested by recent studies [99], due to the cost of genotypic resistance testing, there is a need to develop in-house, cost-effective and more affordable protocols that heightened sensitivity to detect strains circulating in African populations.…”

Section: Immunological and Clinical Criteria Of The Whomentioning

confidence: 85%

“…A high prevalence of drug-resistance mutation occurs in untreated, HIV infected infants, reaching 32% in Senegal [97] and 85.4% in South Africa [98], although prevalence was much lower at 4.9% in Cameroon [99]. Longer exposure to failing regimens increased the rate of TAM, which can compromise subsequent second-line treatments [97].…”

Section: Immunological and Clinical Criteria Of The Whomentioning

confidence: 99%

See 1 more Smart Citation

Tackling virological failure in HIV-infected children living in Africa

Jenabian

Costiniuk

Bouassa

et al. 2015

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

Drug resistance in HIV-infected children is one of the main contributors to antiretroviral treatment (ART) failure, especially in developing countries. Sub-Saharan Africa has the largest burden of pediatric HIV infection in the world. Herein, we systematically review the current status of ART failure in HIV-infected African children. A literature search for publications within 10 years was performed through PubMed to identify relevant articles. Included studies examined the impact of timing of ART initiation, criteria for diagnosing therapeutic failure, predictors of therapeutic failure, management strategies and future directions to minimize failure rates in these pediatric populations. Although there is scale-up of ART programs in Africa, novel therapeutic and management strategies are needed to overcome current challenges.

show abstract

Section: Immunological and Clinical Criteria Of The Whomentioning

confidence: 85%

Section: Immunological and Clinical Criteria Of The Whomentioning

confidence: 99%

Tackling virological failure in HIV-infected children living in Africa

Jenabian

Costiniuk

Bouassa

et al. 2015

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

show abstract

“…Current treatment guidelines in the United States and Europe recommend genotypic resistance testing in all antiretroviral naive patients, including vertically infected children, to detect the presence of PDR mutations and to adapt their first-line treatment accordingly [15, 16]. Several studies have evaluated the prevalence of PDR mutations among HIV-infected children [6, 17–25]; however, few have determined their effect on virological response to first-line cART [6, 14, 23]. …”

Section: Introductionmentioning

confidence: 99%

Prevalence and effect of pre-treatment drug resistance on the virological response to antiretroviral treatment initiated in HIV-infected children – a EuroCoord-CHAIN-EPPICC joint project

et al. 2016

View full text Add to dashboard Cite

BackgroundFew studies have evaluated the impact of pre-treatment drug resistance (PDR) on response to combination antiretroviral treatment (cART) in children. The objective of this joint EuroCoord-CHAIN-EPPICC/PENTA project was to assess the prevalence of PDR mutations and their association with virological outcome in the first year of cART in children.MethodsHIV-infected children <18 years initiating cART between 1998 and 2008 were included if having at least one genotypic resistance test prior to cART initiation. We used the World Health Organization 2009 resistance mutation list and Stanford algorithm to infer resistance to prescribed drugs. Time to virological failure (VF) was defined as the first of two consecutive HIV-RNA > 500 copies/mL after 6 months cART and was assessed by Cox proportional hazards models. All models were adjusted for baseline demographic, clinical, immunology and virology characteristics and calendar period of cART start and initial cART regimen.ResultsOf 476 children, 88 % were vertically infected. At cART initiation, median (interquartile range) age was 6.6 years (2.1–10.1), CD4 cell count 297 cells/mm3 (98–639), and HIV-RNA 5.2 log10copies/mL (4.7–5.7). Of 37 children (7.8 %, 95 % confidence interval (CI), 5.5–10.6) harboring a virus with ≥1 PDR mutations, 30 children had a virus resistant to ≥1 of the prescribed drugs. Overall, the cumulative Kaplan-Meier estimate for virological failure was 19.8 % (95 %CI, 16.4–23.9). Cumulative risk for VF tended to be higher among children harboring a virus with PDR and resistant to ≥1 drug prescribed than among those receiving fully active cART: 32.1 % (17.2–54.8) versus 19.4 % (15.9–23.6) (P = 0.095). In multivariable analysis, age was associated with a higher risk of VF with a 12 % reduced risk per additional year (HR 0.88; 95 %CI, 0.82–0.95; P < 0.001).ConclusionsPDR was not significantly associated with a higher risk of VF in children in the first year of cART. The risk of VF decreased by 12 % per additional year at treatment initiation which may be due to fading of PDR mutations over time. Lack of appropriate formulations, in particular for the younger age group, may be an important determinant of virological failure.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1968-2) contains supplementary material, which is available to authorized users.

show abstract

“…For DEMG10CM008 (Genbank: JX140676), a near full-length sequence is available, which appears to be closely related throughout its length to other sequences classified as belonging to subtype G using REGA (de Oliveira et al, 2014) (data not shown). For participant 12541, a partial pol consensus sequence is available which also appears to be subtype G-like (data not shown, GenBank: JQ796143 (Fokam et al, 2011b)). Together, this suggests that the subtype G-assigned sequences in lineage G7 are not CRF06_cpx sequences that have been misclassified as subtype G. Nonetheless, CRF06_cpx env appears to be derived from a sequence related to the G env sequences of lineage G7.…”

Section: Phylogenetic Analysesmentioning

confidence: 95%

Phylogenetics of HIV-1 subtype G env: Greater complexity and older origins than previously reported

Tongo

Essomba

Nindo

et al. 2015

Infection, Genetics and Evolution

Self Cite

View full text Add to dashboard Cite

Drug Resistance Among Drug-naive and First-line Antiretroviral Treatment-failing Children in Cameroon

Abstract: 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.

Cited by 44 publications

References 66 publications

Tackling virological failure in HIV-infected children living in Africa

Tackling virological failure in HIV-infected children living in Africa

Prevalence and effect of pre-treatment drug resistance on the virological response to antiretroviral treatment initiated in HIV-infected children – a EuroCoord-CHAIN-EPPICC joint project

Phylogenetics of HIV-1 subtype G env: Greater complexity and older origins than previously reported

Contact Info

Product

Resources

About