PMID- 29140932
STAT- In-Data-Review
LR  - 20180611
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 37
IP  - 7
DP  - 2018 Jul
TI  - Characteristics of Treatment-experienced HIV-infected African Children and
      Adolescents Initiating Darunavir and/or Etravirine-based Antiretroviral
PG  - 669-672
LID - 10.1097/INF.0000000000001843 [doi]
AB  - BACKGROUND: Data are limited on the selection and sequencing of second-line and
      third-line pediatric antiretroviral treatment (ART) in resource-limited settings.
      This study aimed to evaluate characteristics of African pediatric patients
      initiated on darunavir (DRV) and/or etravirine (ETR) through a specific drug
      donation program. METHODS: This was a cross-sectional study of baseline
      immunologic, virologic and demographic characteristics of children and
      adolescents initiating DRV-based and/or ETR-based ART. Descriptive statistics
      were used. RESULTS: Study enrolled 48 patients (45.8% women; median age = 15
      years [interquartile range 17.7-10.3]) at 9 clinical sites in Zambia, Swaziland, 
      Kenya and Lesotho. The majority (87.5%; n = 42) had received >/=2 prior ART
      regimens; most (81.2%) had received lopinavir/ritonavir-based ART before switch. 
      All patients had detectable HIV RNA (median = 56,653 copies/mL). Forty seven
      patients (98.9%) had HIV genotype results: 41 (87.2%) had >/=1 nucleos(t)ide
      reverse transcriptase inhibitor (NRTI)-resistance mutation (RM), predominantly
      M184V (76.6%; n = 36); 31 (65.9%) had >/=1 non-NRTI-RM, including 27 (57.4%) with
      >/=1 ETR-RM; 30 (63.8%) had >/=3 protease inhibitor RM, including 20 (42.6%) with
      >/=1 DRV-RM. For new ART regimens, DRV and raltegravir were most frequently
      prescribed (83.3%; n = 40 on DRV and raltegravir, each). Eighteen patients
      (37.5%) were initiated on the NRTI-sparing ART. CONCLUSIONS: In our study, a
      significant proportion of treatment-experienced African children and adolescents 
      had one or more DRV-RM and ETR-RM. For the new regimen, more than a third of
      pediatric patients failing second-line ART were prescribed NRTI-sparing regimens.
      Better understanding of the current approaches to pediatric ART sequencing in
      resource-limited settings is needed.
FAU - Corrigan, Bethany
AU  - Corrigan B
AD  - From the Technical Assistance and Sustainability, EGPAF, Washington, DC.
FAU - Mukui, Irene
AU  - Mukui I
AD  - National AIDS & STI Control Program, Ministry of Health, Nairobi, Kenya.
FAU - Mulenga, Lloyd
AU  - Mulenga L
AD  - Adult Infectious Diseases Centre, University Teaching Hospital, Lusaka, Zambia.
AD  - School of Medicine, University of Zambia, Lusaka, Zambia.
FAU - Mthethwa, Nobuhle
AU  - Mthethwa N
AD  - Ministry of Health, Mbabane, Swaziland.
FAU - Letsie, Mosilinyane
AU  - Letsie M
AD  - Disease Control, Ministry of Health, Maseru, Lesotho.
FAU - Bruno, Stephanie
AU  - Bruno S
AD  - From the Technical Assistance and Sustainability, EGPAF, Washington, DC.
FAU - Rakhmanina, Natella
AU  - Rakhmanina N
AD  - From the Technical Assistance and Sustainability, EGPAF, Washington, DC.
AD  - Division of Infectious Diseases, Children's National Health System, Washington,
AD  - Department of Pediatrics The George Washington University School of Medicine and 
      Health Sciences, Washington, DC.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
EDAT- 2017/11/16 06:00
MHDA- 2017/11/16 06:00
CRDT- 2017/11/16 06:00
PHST- 2017/11/16 06:00 [pubmed]
PHST- 2017/11/16 06:00 [medline]
PHST- 2017/11/16 06:00 [entrez]
AID - 10.1097/INF.0000000000001843 [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2018 Jul;37(7):669-672. doi: 10.1097/INF.0000000000001843.