| Title | Drug resistance in the Chinese National Pediatric Highly Active Antiretroviral Therapy Cohort: implications for paediatric treatment in the developing world. | | Author(s) | Zhang F, Haberer J, Wei H, Wang N, Chu A, Zhao Y, Zhao H | | Institution | National Center for AIDS/STD Control and Prevention/Chinese Center for Disease Control and Prevention, China. | | Source | Int J STD AIDS 2009 Jun; 20(6):406-9. | | MeSH | Adolescent
Anti-HIV Agents
Child
China
Cohort Studies
Developing Countries
Drug Resistance, Viral
Drug Therapy, Combination
Female
HIV Infections
HIV Reverse Transcriptase
HIV-1
Humans
Male
Mutation
National Health Programs
Prevalence
Reverse Transcriptase Inhibitors
Viral Load
| | Abstract | China's National Pediatric ART Program began in 2005, in which 32 ART-experienced and 51 antiretroviral therapy (ART)-naïve children received paediatric formulations of (zidovudine or stavudine) plus lamivudine plus (nevirapine or efavirenz). Reverse transcriptase sequencing and analysis was performed on plasma samples with >1000 HIV copies/mL after one year of treatment. Thirty-four samples were sequenced. Nearly all patients had nucleoside reverse transcriptase inhibitor and non-nucleoside reverse transcriptase inhibitor mutations. High/intermediate resistance was found to lamivudine/emtricitabine in 31 patients; to didanosine, abacavir, stavudine and zidovudine in 18 patients; and to tenofovir in 11 patients. All had high-level resistance to nevirapine; all but one had high/intermediate-level resistance to efavirenz. Viral load was the only cohort characteristic significantly associated with developing resistance. Resistance to zidovudine, stavudine and tenofovir was more common in ART-experienced versus ART-naïve patients (P = 0.02-0.05). Drug resistance is high in this cohort. Second-line therapy will require additional ART strategies and options, which are currently unavailable in most developing settings. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
| | PubMed ID | 19451326 |
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