ArticleThe Pediatric infectious disease journal2012
Antiretroviral treatment strategies in highly treatment experienced perinatally HIV-infected youth.
Article in The Pediatric infectious disease journal, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Trial
- Using CD4 percentage and age to optimize pediatric antiretroviral therapy initiation.Pediatrics · 2014Trial
- Age-specific all-cause mortality rates among adolescents and youth living with and without HIV: Evidence from a cohort study in South Africa.Journal of the International AIDS Society · 2025Article
- Psychiatric trajectories across adolescence in perinatally HIV-exposed youth: the role of HIV infection and associations with viral load.AIDS (London, England) · 2020Article
- Impact of Human Immunodeficiency Virus Drug Resistance on Treatment of Human Immunodeficiency Virus Infection in Children in Low- and Middle-Income Countries.The Journal of infectious diseases · 2017Article
- Trends in Diagnoses Among Hospitalizations of HIV-infected Children and Adolescents in the United States: 2003-2012.The Pediatric infectious disease journal · 2017Article
- Antiretroviral Drug Resistance Among Children and Youth in the United States With Perinatal HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Article
- CD4+ and viral load outcomes of antiretroviral therapy switch strategies after virologic failure of combination antiretroviral therapy in perinatally HIV-infected youth in the United States.AIDS (London, England) · 2015Observational
- Addressing the socio-development needs of adolescents living with HIV/AIDS in Nigeria: a call for action.African journal of reproductive health · 2014Article
- The changing epidemiology of the global paediatric HIV epidemic: keeping track of perinatally HIV-infected adolescents.Journal of the International AIDS Society · 2013Review
- Antiretroviral treatment, management challenges and outcomes in perinatally HIV-infected adolescents.Journal of the International AIDS Society · 2013Review
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThere is limited information on antiretroviral (ARV) regimens and outcomes in perinatally HIV (PHIV)-infected youth. Substantial drug resistance after long-term ARV use and nonadherence hinder efforts to design suppressive regimens for PHIV-infected youth. This study compares clinical outcomes by expected activity of the prescribed ARV regimens.
methodsA retrospective cohort study of 13- to 24-year-old PHIV-infected youth on stable ARV regimens for ≥6 months was conducted at a pediatric HIV clinic. ARV regimens were retrospectively categorized as optimal or suboptimal based on accumulated genotypic resistance before study regimen initiation.
resultsFifty-two patients with similar baseline characteristics met inclusion criteria (21 optimal and 31 suboptimal regimens). Patients receiving optimal regimens had significantly higher increases in CD4 than those given suboptimal regimens by week 48 of treatment (+62 versus +8 cells/mm, respectively; P = 0.04) and by the end of study period (+93 versus -1 cells/mm, respectively; P = 0.03). There were no significant differences between the groups in decline of viral load, frequency of opportunistic infections or hospitalizations or accumulation of resistance mutations. Overall, 60% of the optimal and 45% of the suboptimal groups had nonadherence during the study regimen (P = 0.3).
conclusionsPHIV-infected youth receiving optimal regimens had greater CD4 improvements but no difference in virologic outcomes compared with those receiving suboptimal regimens. In a patient population with significant nonadherence, providers must weigh the immunologic benefits of initiating an optimal regimen versus the potential risks of further resistance accumulation limiting future treatment options.
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