ArticleAIDS (London, England)2015
Determinants of durability of first-line antiretroviral therapy regimen and time from first-line failure to second-line antiretroviral therapy initiation.
Article in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 23 citations in OpenAlex.
- Long-term risk of mortality and loss to follow-up in children and adolescents on antiretroviral therapy in Asia.HIV medicine · 2025Observational
- Exploring the sexual and reproductive health knowledge, practices and needs of adolescents living with perinatally acquired HIV in Côte d'Ivoire: a qualitative study.Reproductive health · 2024Article
- Determinants of nonsuppression of HIV viral load among children receiving antiretroviral therapy in the Simiyu region: a cross-sectional study.AIDS research and therapy · 2023Article
- Article
- Identification, Management, and Outcomes of Combination Antiretroviral Treatment Failure in Adolescents With Perinatal Human Immunodeficiency Virus Infection in Asia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Outcomes After Second-Line Antiretroviral Therapy in Children Living With HIV in Latin America.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Time to First-Line Antiretroviral Treatment Failure and Its Predictors among HIV-Positive Children in Shashemene Town Health Facilities, Oromia Region, Ethiopia, 2019.TheScientificWorldJournal · 2021Article
- Outcomes of second-line antiretroviral therapy among children living with HIV: a global cohort analysis.Journal of the International AIDS Society · 2020Article
- High levels of viral repression, malnutrition and second-line ART use in adolescents living with HIV: a mixed methods study from Myanmar.BMC infectious diseases · 2020Article
- Incidence of switching to second-line antiretroviral therapy and associated factors in children with HIV: an international cohort collaboration.The lancet. HIV · 2019Article
- Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2019Article
- Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- 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
- Article
- Survival and predictors of mortality among human immunodeficiency virus patients on anti-retroviral treatment at Jinka Hospital, South Omo, Ethiopia: a six years retrospective cohort study.Epidemiology and health · 2016Article
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 5 countries.
Funding
Abstract
backgroundWe described reasons for switching to second-line antiretroviral treatment (ART) and time to switch in HIV-infected children failing first-line ART in West Africa.
methodsWe included all children aged 15 years or less, starting ART (at least three drugs) in the paediatric IeDEA clinical centres in five West-African countries. We estimated the incidence of switch (at least one a drug class change) within 24 months of ART and associated factors were identified in a multinomial logistic regression. Among children with clinical-immunological failure, we estimated the 24-month probability of switching to a second-line and associated factors, using competing risks. Children who switched to second-line ART following the withdrawal of nelfinavir in 2007 were excluded.
resultsOverall, 2820 children initiated ART at a median age of 5 years; 144 (5%) were on nelfinavir. At 24-month post-ART initiation, 188 (7%) had switched to second-line. The most frequent reasons were drug stock outs (20%), toxicity (18%), treatment failure (16%) and poor adherence (8%). Over the 24-month follow-up period, 322 (12%) children failed first-line ART after a median time of 7 months. Of these children, 21 (7%) switched to second-line after a median time of 21 weeks in failure. This was associated with older age [subdistribution hazard ratio (sHR) 1.21, 95% confidence interval (95% CI) 1.10-1.33] and longer time on ART (sHR 1.16, 95% CI 1.07-1.25).
conclusionSwitches for clinical failure were rare and switches after an immunological failure were insufficient. These gaps reveal that it is crucial to advocate for both sustainable access to first-line and alternative regimens to provide adequate roll-out of paediatric ART programmes.
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