Two-year outcome of first-line antiretroviral therapy among HIV-1 vertically-infected children in Hanoi, Vietnam. (October 2015)

• Record Type: Journal Article
• Authors: Pham, HV; Ishizaki, A; Nguyen, LV; Phan, CTT; Phung, TTB; Takemoto, K; Pham, AN; Bi, X; Khu, DTK; Ichimura, H
• Is Part Of: International journal of STD & AIDS. Volume 26:Number 11(2015:Nov.)
• Page Start: 821
• Page End: 830
• Publication Date: 2015-10
• Subjects: Asia -- ART (antiretroviral therapy) -- AIDS -- HIV (human immunodeficiency virus) -- children -- treatment -- virological failure; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462414556328
• Languages: English
• ISSNs: 0956-4624

Abstract

A retrospective analysis of 86 HIV-1 vertically-infected Vietnamese children with a follow-up period >24 months after initiating antiretroviral therapy (ART) was performed from 2008 to 2012, to assess the outcome of first-line ART in resource-limited settings. Of the 86 children, 68 (79.1%) were treated successfully (plasma HIV-1 viral load [VL] <1000 copies/ml), and 63 (73.3%) had full viral suppression (VL <400 copies/ml) after 24 months of ART. No significant difference between successfully treated patients and failure groups was observed in VL, CD4 + T-cell count or clinical stage at baseline; age at ART start; or ART regimen. All 14 children with VL >5000 copies/ml, one of four children with VL 1000–5000 copies/ml and none with VL <1000 copies/ml developed reverse transcriptase inhibitor (RTI)-resistance mutations by 24 months of ART. Y181C and M184V/I were the most dominant non-nucleoside and nucleoside RTI-resistance mutations, respectively (13/15, 86.7%). These findings suggest that VL testing after 24 months of ART can be used to efficiently differentiate ART failures among HIV-1 vertically-infected children in resource-limited settings.