ArticleThe Pediatric infectious disease journal2015
Virologic failure among children taking lopinavir/ritonavir-containing first-line antiretroviral therapy in South Africa.
Article in The Pediatric infectious disease journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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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, 2 syntheses or guidelines pooled it.
- Factors associated with unsuppressed HIV viral load among children under 15 years in sub-Saharan africa: a systematic review.AIDS research and therapy · 2025Pooled it
- Treatment failure among Sub-Sahara African children living with HIV: a systematic review and meta-analysis.Italian journal of pediatrics · 2024Pooled it
- Multicentre analysis of second-line antiretroviral treatment in HIV-infected children: adolescents at high risk of failure.Journal of the International AIDS Society · 2017Trial
- Article
- Resistance is common in paediatric patients failing ART in South Africa.The Journal of antimicrobial chemotherapy · 2023Article
- Article
- Third-Line Antiretroviral Therapy: What Do We Do When the Appropriate Formulations Are Not Available?Children (Basel, Switzerland) · 2022Article
- 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
- Antiretroviral Resistance Patterns in Children with HIV Infection.Current infectious disease reports · 2019Review
- Outcomes of protease inhibitor-based antiretroviral therapy amongst children and associated-factors in Yaoundé, Cameroon.PloS one · 2019Article
- 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
- Virological response and resistances over 12 months among HIV-infected children less than two years receiving first-line lopinavir/ritonavir-based antiretroviral therapy in Cote d'Ivoire and Burkina Faso: the MONOD ANRS 12206 cohort.Journal of the International AIDS Society · 2017Article
- Impact of lopinavir-ritonavir exposure in HIV-1 infected children and adolescents in Madrid, Spain during 2000-2014.PloS one · 2017Article
- Tuberculosis and pneumonia in HIV-infected children: an overview.Pneumonia (Nathan Qld.) · 2016Review
- Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children.Current infectious disease reports · 2015Article
- Tuberculosis: opportunities and challenges for the 90-90-90 targets in HIV-infected children.Journal of the International AIDS Society · 2015Review
- Getting to 90-90-90 in paediatric HIV: What is needed?Journal of the International AIDS Society · 2015Article
- Targeting 90-90-90--don't leave children and adolescents behind.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
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo report the outcomes, clinical management decisions and results of resistance testing among a group of children who developed virologic failure on first-line lopinavir/ritonavir (LPV/r)-based therapy from a large cohort of antiretroviral therapy-treated children in Soweto.
designHistorical cohort study.
methodsChildren with virologic failure were identified from a group of 1692 children <3 years who had initiated first-line LPV/r-containing therapy since 2000 up to the end November 2011. Genotyping was conducted in some children, and outcomes, management decisions and resistance results were described.
resultsA total of 152 children with virologic failure on first-line LPV/r-containing antiretroviral therapy were included. Resistance testing was performed in 75/152 (49%), and apart from a younger age (11.1 vs. 15.1 months, P = 0.04), the children with versus those without resistance testing were similar for baseline characteristics (weight, CD4, viral load and time to failure). Genotyping revealed that 8/75 (10.7%) had significant LPV/r-associated resistance mutations, including 2 with intermediate darunavir resistance. Among 63/75 (84%) children remaining on LPV/r-based therapy, 32/63 (51%) achieved virologic suppression, and 2 of these children with significant LPV mutations. In accordance with the local guidelines at the time, 12/152 (8%) children were switched to non-nucleoside reverse-transcriptase inhibitors-based therapy. Of these, 4/12 (33%) resuppressed, and the rest did not achieve virologic suppression including the 2 with lopinavir mutations.
conclusionsVirologic failure of LPV/r-containing first-line regimens is associated with accumulation of LPV/r mutations in children. The implications are unclear, and surveillance at selected sites is warranted for long-term virologic outcomes and development of resistance.
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