ArticleAIDS research and therapy2014
Drug resistance in children at virological failure in a rural KwaZulu-Natal, South Africa, cohort.
Article in AIDS research and therapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- HIV-1 Drug Resistance Mutations in Children: A Systematic Review of Global Genotypic Evidence (2014-2026).Pathogens (Basel, Switzerland) · 2026Pooled it
- Design and Evaluation of Next-Generation HIV Genotyping for Detection of Resistance Mutations to 28 Antiretroviral Drugs Across 5 Major Classes Including Lenacapavir.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- The cumulative prevalence of HIV-1 drug resistance in perinatal HIV.AIDS (London, England) · 2025Observational
- Global, regional, and national prevalence of HIV-1 drug resistance in treatment-naive and treatment-experienced children and adolescents: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Treatment Management Challenges in Naïve and Experienced HIV-1-Infected Individuals Carrying the M184V Mutation.Viruses · 2024Review
- Full-spectrum HIV drug resistance mutation detection by high-resolution complete pol gene sequencing.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2023Article
- Resistance is common in paediatric patients failing ART in South Africa.The Journal of antimicrobial chemotherapy · 2023Article
- Drug Resistance Mutations Among South African Children Living With HIV on WHO-recommended ART Regimens.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Second-generation mother-to-child HIV transmission in South Africa is characterized by poor outcomes.AIDS (London, England) · 2021Observational
- Antiretroviral Resistance Patterns in Children with HIV Infection.Current infectious disease reports · 2019Review
- High prevalence of virological failure and HIV drug mutations in a first-line cohort of Malawian children.The Journal of antimicrobial chemotherapy · 2018Article
- Long-term virological outcome in children receiving first-line antiretroviral therapy.AIDS research and therapy · 2018Article
- Article
- HIV-1 Drug Resistance by Ultra-Deep Sequencing Following Short Course Zidovudine, Single-Dose Nevirapine, and Single-Dose Tenofovir with Emtricitabine for Prevention of Mother-to-Child Transmission.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- High rates of virological failure and drug resistance in perinatally HIV-1-infected children and adolescents receiving lifelong antiretroviral therapy in routine clinics in Togo.Journal of the International AIDS Society · 2016Article
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- Genome-Wide Association Study of HIV Whole Genome Sequences Validated using Drug Resistance.PloS oneArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBetter understanding of drug resistance patterns in HIV-infected children on antiretroviral therapy (ART) is required to inform public health policies in high prevalence settings. The aim of this study was to characterise the acquired drug resistance in HIV-infected children failing first-line ART in a decentralised rural HIV programme.
methodsPlasma samples were collected from 101 paediatric patients (≤15 yrs of age) identified as failing ART. RNA was extracted from the plasma, reverse transcribed and a 1.3 kb region of the pol gene was amplified and sequenced using Sanger sequencing protocols. Sequences were edited in Geneious and drug resistance mutations were identified using the RegaDB and the Stanford resistance algorithms. The prevalence and frequency of mutations were analysed together with selected clinical and demographic data in STATA v11.
resultsA total of 101 children were enrolled and 89 (88%) were successfully genotyped; 73 on a non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based regimen and 16 on a protease inhibitor (PI)-based regimen at the time of genotyping. The majority of patients on an NNRTI regimen (80%) had both nucleoside reverse-transcriptase inhibitor (NRTI) and NNRTI resistance mutations. M184V and K103N were the most common mutations amongst children on NNRTI-based and M184V among children on PI-based regimens. 30.1% had one or more thymidine analogue mutation (TAM) and 6% had ≥3 TAMs. Only one child on a PI-based regimen harboured a major PI resistance mutation.
conclusionsWhilst the patterns of resistance were largely predictable, the few complex resistance patterns seen with NNRTI-based regimens and the absence of major PI mutations in children failing PI-based regimens suggest the need for wider access to genotypic resistance testing in this setting.
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Registered trials
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