Virologic response to efavirenz-based first-line antiretroviral therapy in children with previous exposure to antiretrovirals to prevent mother-to-child transmission

• Published in: PloS one Vol. 15; no. 5; p. e0233693
• Main Authors: Nyakato, Patience, Davies, Mary-Ann, Technau, Karl-Gunter, Fatti, Geoffrey, Rabie, Helena, Tanser, Frank, Boulle, Andrew, Wood, Robin, Eley, Brian, Sawry, Shobna, Giddy, Janet, Sipambo, Nosisa, Kuhn, Louise, Fairlie, Lee
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 29.05.2020; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adults; Age; AIDS; AIDS research; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiviral agents; Biology and Life Sciences; Children; Children & youth; Childrens health; Collaboration; Drug dosages; Drug resistance; Drug therapy; Efavirenz; Epidemiology; Exposure; Health aspects; Health sciences; HIV; Hospitals; Human immunodeficiency virus; Infectious diseases; Maternal-fetal exchange; Medicine; Medicine and Health Sciences; Nevirapine; Non-nucleoside reverse transcriptase inhibitors; Patient outcomes; Pediatric HIV infections; Pediatrics; People and Places; Prevention; Public health; Public sector; Reproductive health; RNA-directed DNA polymerase; Tuberculosis; Spain; New York; South Africa; United States > US; Southern Africa; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0233693

Efavirenz-based first-line regimens have been widely used for children ≥3 years of age starting antiretroviral therapy, despite possible resistance with prior exposure to non-nucleoside reverse transcriptase inhibitors for prevention of mother-to-child transmission (PMTCT). We used logistic regression to examine the association between PMTCT exposure and viral failure (VF) defined as two consecutive viral loads (VL)>1000 copies/ml between 6-18 months on ART. Children with previous nevirapine exposure for PMTCT were not at higher risk of VF compared to unexposed children (adjusted Odds Ratio (aOR): 0.79; 95% CI:0.56, 1.11).