Observational studyAIDS research and human retroviruses2016
HIV Drug Resistance Among Children Initiating First-Line Antiretroviral Treatment in Uganda.
Observational study in AIDS research and human retroviruses, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- HIV-1 Drug Resistance Mutations in Children: A Systematic Review of Global Genotypic Evidence (2014-2026).Pathogens (Basel, Switzerland) · 2026Pooled it
- Pediatric human immunodeficiency virus infection in the modern era: A systematic review of recent advances and their implications.Pediatric investigation · 2025Review
- 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
- Prevalence and Risk Factors of HIV Drug Resistance in Zimbabwe: Evidence from Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) 2020 Survey.Tropical medicine and infectious disease · 2024Article
- Primary resistance against integrase strand transfer inhibitors in integrase strand transfer inhibitor-naive patients failing first- and second-line ART in Tanzania.The Journal of antimicrobial chemotherapy · 2022Article
- Magnitude and predictors of HIV-Drug resistance in Africa: A protocol for systematic review and meta-analysis.PloS one · 2022Article
- HIV Drug Resistance in Children and Adolescents: Always a Challenge?Current epidemiology reports · 2021Review
- Observational
- Health care professionals' perspectives on barriers to treatment seeking for formal health services among orphan children and adolescents with HIV/AIDS and mental distress in a rural district in central, Uganda.Child and adolescent psychiatry and mental health · 2020Article
- The urgent need for more potent antiretroviral therapy in low-income countries to achieve UNAIDS 90-90-90 and complete eradication of AIDS by 2030.Infectious diseases of poverty · 2019Article
- Article
- High predictive efficacy of integrase strand transfer inhibitors in perinatally HIV-1-infected African children in therapeutic failure of first- and second-line antiretroviral drug regimens recommended by the WHO.The Journal of antimicrobial chemotherapy · 2019Article
- Challenges faced by caregivers of virally non-suppressed children on the intensive adherence counselling program in Uganda: a qualitative study.BMC health services research · 2019Article
- Antiretroviral Resistance Patterns in Children with HIV Infection.Current infectious disease reports · 2019Review
- Propelling the Pediatric HIV Therapeutic Agenda With Science, Innovation, and Collaboration.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Challenges to and opportunities for the adoption and routine use of early warning indicators to monitor pediatric HIV drug resistance in Kenya.BMC pediatrics · 2018Article
- Article
- What is new in perinatal HIV prevention?Current opinion in pediatrics · 2018Review
- Article
- Prevalence of Pre-antiretroviral-Treatment Drug Resistance by Gender, Age, and Other Factors in HIV-Infected Individuals Initiating Therapy in Kenya, 2013-2014.The Journal of infectious diseases · 2017Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are limited data on primary human immunodeficiency virus drug resistance (HIVDR) in pediatric populations. This study aimed to assess the prevalence of primary HIVDR and associated risk factors among children initiating first-line antiretroviral therapy (ART) in Uganda.
methodsAt three Ugandan clinics, children (age <12 years) requiring ART were recruited between January 2010 and August 2011. Before starting ART, blood was collected for viral load and pol gene sequencing. Drug resistance mutations were determined using the 2010 International AIDS Society-USA mutation list. Risk factors for HIVDR were assessed with multivariate regression analysis.
resultsThree hundred nineteen HIV-infected children with a median age of 4.9 years were enrolled. Sequencing was successful in 279 children (87.5%). HIVDR was present in 10% of all children and 15.2% of children <3 years. Nucleoside reverse transcriptase inhibitors (NRTIs), non-NRTI (NNRTI), and dual-class resistance was present in 5.7%, 7.5%, and 3.2%, respectively. HIVDR occurred in 35.7% of prevention of mother-to-child transmission (PMTCT)-exposed children, 15.6% in children with unknown PMTCT history, and 7.7% among antiretroviral-naive children. History of PMTCT exposure [adjusted odds ratio (AOR): 2.6, 95% CI: 1.3-5.1] or unknown PMTCT status (AOR: 3.8, 95% CI: 1.1-13.5), low CD4 (AOR: 2.2, 95% CI: 1.3-3.6), current breastfeeding (AOR: 7.4, 95% CI: 2.6-21), and current maternal ART use (AOR: 6.4, 95% CI: 3.4-11.9) emerged as risk factors for primary HIVDR in multivariate analysis.
conclusionPretreatment HIVDR is high, especially in children with PMTCT exposure. Protease inhibitor (PI)-based regimens are advocated by the World Health Organization, but availability in children is limited. Children with (unknown) PMTCT exposure, low CD4 count, current breastfeeding, or maternal ART need to be prioritized to receive PI-based regimens.
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