Virologic response to efavirenz-based first-line antiretroviral therapy in children with previous exposure to antiretrovirals to prevent mother-to-child transmission
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 regressi...
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| Published in | PloS one Vol. 15; no. 5; p. e0233693 |
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| Main Authors | , , , , , , , , , , , , , |
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29.05.2020
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| Abstract | 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). |
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| AbstractList | 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). Efavirenz-based first-line regimens have been widely used for children [greater than or equal to]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). |
| Audience | Academic |
| Author | Kuhn, Louise Rabie, Helena Giddy, Janet Sipambo, Nosisa Fairlie, Lee Nyakato, Patience Eley, Brian Technau, Karl-Gunter Tanser, Frank Sawry, Shobna Fatti, Geoffrey Boulle, Andrew Davies, Mary-Ann Wood, Robin |
| AuthorAffiliation | 15 Department of Paediatrics and Child Health, University of Cape Town, Cape Town, Western Cape, South Africa 1 Center for Infectious Diseases Epidemiology and Research, School of Public Health an Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa 4 Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, Cape Town, Western Cape, South Africa 9 School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa 13 Gugulethu ART Program, Cape Town, Western Cape, South Africa 11 Khayelitsha ART Program, Cape Town, Western Cape, South Africa 19 Gertrude H Sergievsky Center, College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America 17 McCord Hospital, Durban, South Africa 5 University of Stellenbosch, Stellenbosch, Cape To |
| AuthorAffiliation_xml | – name: 18 Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, Johannesburg, South Africa – name: Consejo Superior de Investigaciones Cientificas, SPAIN – name: 8 Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, England, United Kingdom – name: 3 Kheth’Impilo AIDS Free Living, Cape Town, Western Cape, South Africa – name: 13 Gugulethu ART Program, Cape Town, Western Cape, South Africa – name: 9 School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa – name: 7 Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa – name: 14 Red Cross War Memorial Children’s Hospital, Cape Town, Western Cape, South Africa – name: 1 Center for Infectious Diseases Epidemiology and Research, School of Public Health an Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa – name: 11 Khayelitsha ART Program, Cape Town, Western Cape, South Africa – name: 12 Western Cape Department of Health, Cape Town, Western Cape, South Africa – name: 2 Empilweni Services and Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa – name: 4 Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, Cape Town, Western Cape, South Africa – name: 10 Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa – name: 16 Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa – name: 17 McCord Hospital, Durban, South Africa – name: 5 University of Stellenbosch, Stellenbosch, Cape Town, Western Cape, South Africa – name: 15 Department of Paediatrics and Child Health, University of Cape Town, Cape Town, Western Cape, South Africa – name: 19 Gertrude H Sergievsky Center, College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America – name: 6 Tygerberg Academic Hospital, Cape Town, Western Cape, South Africa |
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| Cites_doi | 10.1097/INF.0b013e3181a458f9 10.1080/14656566.2017.1309023 10.1056/NEJMc1807653 10.1093/jac/dkx188 10.1097/QAD.0000000000000261 10.7448/IAS.18.7.20265 10.1093/ije/dyr080 10.1097/QAI.0000000000000606 10.1001/jama.2015.13631 10.1097/FTD.0000000000000637 10.1016/S1473-3099(16)00117-1 10.1056/NEJMoa1000931 10.7448/IAS.19.1.21140 10.1097/INF.0000000000000848 10.1371/journal.pone.0111948 10.1097/QAI.0b013e3182060610 10.1056/NEJMoa1113249 10.1007/s40265-015-0446-2 |
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| Copyright | COPYRIGHT 2020 Public Library of Science 2020 Nyakato et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2020 Nyakato et al 2020 Nyakato et al |
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| SubjectTerms | 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 |
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| Title | Virologic response to efavirenz-based first-line antiretroviral therapy in children with previous exposure to antiretrovirals to prevent mother-to-child transmission |
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