Trial reportJournal of the International AIDS Society2017
Multicentre analysis of second-line antiretroviral treatment in HIV-infected children: adolescents at high risk of failure.
Trial report in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Second-line HIV treatment failure in sub-Saharan Africa: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Second-Line Antiretroviral Therapy for Children Living with HIV in Africa.The New England journal of medicine · 2025Trial
- Tenofovir, Lamivudine, and Dolutegravir Among Rural Adolescents in Zimbabwe: A Cautionary Tale.AIDS research and human retroviruses · 2022Trial
- Optimizing the location of point-of-care infant HIV testing devices in Zimbabwe to maximize impact and value: A modeling analysis.PloS one · 2026Article
- 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
- Article
- Impact of COVID-19 on Adolescent HIV Prevention and Treatment Services in the AHISA Network.AIDS and behavior · 2023Article
- Viral load suppression in HIV-infected adolescents in cameroon: towards achieving the UNAIDS 95% viral suppression target.BMC pediatrics · 2023Article
- Development of a transition readiness score for adolescents living with perinatally-acquired HIV and transitioning to adult care.AIDS and behavior · 2022Article
- Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand.Antiviral therapy · 2022Article
- 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
- Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis.AIDS research and therapy · 2021Article
- Addressing Pediatric HIV Pretreatment Drug Resistance and Virologic Failure in Sub-Saharan Africa: A Cost-Effectiveness Analysis of Diagnostic-Based Strategies in Children ≥3 Years Old.Diagnostics (Basel, Switzerland) · 2021Article
- HIV Drug Resistance in Children and Adolescents: Always a Challenge?Current epidemiology reports · 2021Review
- Article
- Unsatisfactory long-term virological suppression in human immunodeficiency virus-infected children in the Amazonas State, Brazil.Revista da Sociedade Brasileira de Medicina Tropical · 2020Article
- Article
- Drug resistance and optimizing dolutegravir regimens for adolescents and young adults failing antiretroviral therapy.AIDS (London, England) · 2019Article
- Impact of the frequency of plasma viral load monitoring on treatment outcomes among children with perinatally acquired HIV.Journal of the International AIDS Society · 2019Article
- Magnitude and correlates of virological failure among adult HIV patients receiving PI based second line ART regimens in north western Tanzania; a case control study.BMC infectious diseases · 2019Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
introductionThe number of HIV-infected children and adolescents requiring second-line antiretroviral treatment (ART) is increasing in low- and middle-income countries (LMIC). However, the effectiveness of paediatric second-line ART and potential risk factors for virologic failure are poorly characterized. We performed an aggregate analysis of second-line ART outcomes for children and assessed the need for paediatric third-line ART.
methodsWe performed a multicentre analysis by systematically reviewing the literature to identify cohorts of children and adolescents receiving second-line ART in LMIC, contacting the corresponding study groups and including patient-level data on virologic and clinical outcomes. Kaplan-Meier survival estimates and Cox proportional hazard models were used to describe cumulative rates and predictors of virologic failure. Virologic failure was defined as two consecutive viral load measurements >1000 copies/ml after at least six months of second-line treatment.
resultsWe included 12 cohorts representing 928 children on second-line protease inhibitor (PI)-based ART in 14 countries in Asia and sub-Saharan Africa. After 24 months, 16.4% (95% confidence interval (CI): 13.9-19.4) of children experienced virologic failure. Adolescents (10-18 years) had failure rates of 14.5 (95% CI 11.9-17.6) per 100 person-years compared to 4.5 (95% CI 3.4-5.8) for younger children (3-9 years). Risk factors for virologic failure were adolescence (adjusted hazard ratio [aHR] 3.93,
conclusionsIn LMIC, paediatric PI-based second-line ART was associated with relatively low virologic failure rates. However, adolescents showed exceptionally poor virologic outcomes in LMIC, and optimizing their HIV care requires urgent attention. In addition, 16% of children and adolescents failed PI-based treatment and will require integrase inhibitors to construct salvage regimens. These drugs are currently not available in LMIC.
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