BACKGROUND:: Scale-up to antiretroviral therapy (ART) requires surveillance for HIV drug resistance. With the goal of attaining 100% pediatric ART coverage in Cameroon, strategies to limit the spread of HIV resistance among children are very important. METHODS:: From June 2009 through February 2011, 92 HIV-1-infected children (41 ART-naive, 51 failing first-line ART) living in Yaoundé, Cameroon, were enrolled; HIV-1 Prot-RT genotypic resistance testing (GRT) was performed using an inhouse assay. Among 40 children failing first-line ART, treatment response was evaluated at weeks 24 and 48 after treatment was changed, based on GRT results. RESULTS:: The mean age was 72 months both for children who were drug-naive and those failing ART (range: 3-144 and 12-144, respectively), with a mean viremia of 5.59 log and 4.71 log RNA copies/mL, a median CD4 of 17% (588 cells/μL) and 23% (719 cells/μL), respectively. Median time-to-treatment failure was 610 days. A prevalence of 4.9% and 90% drug resistance was observed, respectively, among children who were drug-naive and those failing first-line ART, with circulating recombinant form CRF02_AG as the most prevalent clade (58.6% and 62%, respectively). After a change to GRT-based treatment, more than 90% of children had viremia <3 log RNA copies/mL at week 24 and confirmed at week 48, with 70% achieving undetectable viremia, although without correlation to immune response; 97.5% had switched to lopinavir/ritonavir-containing regimens. CONCLUSION:: HIV-1 drug resistance was low among ART-naive children and very high among those failing first-line ART. Treatment change based on GRT was successful for most children, with lopinavir/ritonavir regimens being very promising for second-line use.
Fokam, J., Salpini, R., Santoro, M.M., Cento, V., Perno, C., Colizzi, V., et al. (2011). Drug Resistance Among Drug-naive and First-line Antiretroviral Treatment-failing Children in Cameroon. THE PEDIATRIC INFECTIOUS DISEASE JOURNAL.
|Tipologia:||Articolo su rivista|
|Citazione:||Fokam, J., Salpini, R., Santoro, M.M., Cento, V., Perno, C., Colizzi, V., et al. (2011). Drug Resistance Among Drug-naive and First-line Antiretroviral Treatment-failing Children in Cameroon. THE PEDIATRIC INFECTIOUS DISEASE JOURNAL.|
|IF:||Con Impact Factor ISI|
|Settore Scientifico Disciplinare:||Settore MED/07 - Microbiologia e Microbiologia Clinica|
Settore MED/04 - Patologia Generale
|Revisione (peer review):||Sì, ma tipo non specificato|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/INF.0b013e31822db54c|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||3-ago-2011|
|Titolo:||Drug Resistance Among Drug-naive and First-line Antiretroviral Treatment-failing Children in Cameroon|
|Autori:||Fokam, J; Salpini, R; Santoro, MM; Cento, V; Perno, C; Colizzi, V; Ndumbe, PM; Fokunang Ntungen, C; Ndiang Tetang, SM; Nanfack, AJ; Takou Komego, DA; Cappelli, G|
|Appare nelle tipologie:||01 - Articolo su rivista|