ArticlePloS one2012
Pediatric response to second-line antiretroviral therapy in South Africa.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
- Multicentre analysis of second-line antiretroviral treatment in HIV-infected children: adolescents at high risk of failure.Journal of the International AIDS Society · 2017Trial
- Virologic and immunologic outcomes of HIV-infected Ugandan children randomized to lopinavir/ritonavir or nonnucleoside reverse transcriptase inhibitor therapy.Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- Incidence and predictors of virological failure among HIV infected children and adolescents receiving second-line antiretroviral therapy in Uganda, a retrospective study.BMC infectious diseases · 2024Article
- Development of a transition readiness score for adolescents living with perinatally-acquired HIV and transitioning to adult care.AIDS and behavior · 2022Article
- Outcomes After Second-Line Antiretroviral Therapy in Children Living With HIV in Latin America.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Article
- Second line anti-retroviral therapy failure in a pediatric cohort of an Ethiopian tertiary hospital: a retrospective observational study.Scientific reports · 2020Observational
- Cost-Effectiveness of Preemptive Switching to Efavirenz-Based Antiretroviral Therapy for Children With Human Immunodeficiency Virus.Open forum infectious diseases · 2019Article
- Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Observational
- Higher retention and viral suppression with adolescent-focused HIV clinic in South Africa.PloS one · 2017Article
- Treatment Outcomes and Resistance Patterns of Children and Adolescents on Second-Line Antiretroviral Therapy in Asia.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Determinants of durability of first-line antiretroviral therapy regimen and time from first-line failure to second-line antiretroviral therapy initiation.AIDS (London, England) · 2015Article
- Cost-effectiveness of first-line antiretroviral therapy for HIV-infected African children less than 3 years of age.AIDS (London, England) · 2015Article
- Outcomes after viral load rebound on first-line antiretroviraltreatment in children with HIV in the UK and Ireland: an observational cohort study.The lancet. HIV · 2015Observational
- Virologic failure among children taking lopinavir/ritonavir-containing first-line antiretroviral therapy in South Africa.The Pediatric infectious disease journal · 2015Article
- Getting to 90-90-90 in paediatric HIV: What is needed?Journal of the International AIDS Society · 2015Article
- Sequencing paediatric antiretroviral therapy in the context of a public health approach.Journal of the International AIDS Society · 2015Review
- Article
- Viral load versus CD4⁺ monitoring and 5-year outcomes of antiretroviral therapy in HIV-positive children in Southern Africa: a cohort-based modelling study.AIDS (London, England) · 2014Article
- [Treatment failure in children infected with HIV in routine follow-up in a resource-limited setting in Cameroon].The Pan African medical journal · 2013Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundWith improved access to pediatric antiretroviral therapy (ART) in resource-limited settings, more children could experience first-line ART treatment failure.
methodsWe performed a retrospective cohort analysis using electronic medical records from HIV-infected children who initiated ART at McCord Hospital's Sinikithemba Clinic in KwaZulu-Natal, South Africa, from August 2003 to December 2010. We analyzed all records from children who began second-line ART due to first-line treatment failure. We used logistic regression to compare viral outcomes in Protease Inhibitor (PI)-based versus Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)-based second-line ART, controlling for time on first-line ART, sex, and whether HIV genotyping guided the regimen change.
resultsOf the 880 children who initiated ART during this time period, 80 (9.1%) switched to second-line ART due to therapeutic failure of first-line ART after a median of 95 weeks (IQR 65-147 weeks). Eight (10%) of the failures received NNRTI-based second-line ART, all of whom failed a PI-based first-line regimen. Seventy (87.5%) received PI-based second-line ART, all of whom failed a NNRTI-based first-line regimen. Two children (2.5%) received non-standard dual therapy as second-line ART. Six months after switching ART regimens, the viral suppression rate was significantly higher in the PI group (82%) than in the NNRTI group (29%; p=0.003). Forty-one children (51%) were tested for genotypic resistance prior to switching to second-line ART. There was no significant difference in six month viral suppression (p=0.38) between children with and without genotype testing.
conclusionNNRTI-based second-line ART carries a high risk of virologic failure compared to PI-based second-line ART.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.