ArticleJournal of the International AIDS Society2020
Outcomes of second-line antiretroviral therapy among children living with HIV: a global cohort analysis.
Article in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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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.
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Who cites it
6 citing papers in PubMed.
- Long-term risk of mortality and loss to follow-up in children and adolescents on antiretroviral therapy in Asia.HIV medicine · 2025Observational
- Development and emerging trends of drug resistance mutations in HIV: a bibliometric analysis based on CiteSpace.Frontiers in microbiology · 2024Article
- Outcomes After Second-Line Antiretroviral Therapy in Children Living With HIV in Latin America.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Are we there yet? 40 years of successes and challenges for children and adolescents living with HIV.Journal of the International AIDS Society · 2021Article
- Article
- Outcomes of second-line antiretroviral therapy among children living with HIV: a global cohort analysis.Journal of the International AIDS Society · 2020Article
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Authors and funding
1 author.
Funding
Abstract
introductionLimited data describe outcomes on second-line antiretroviral therapy (ART) among children globally. Our objective was to contribute data on outcomes among children living with HIV after initiation of second-line ART in the context of routine care within a large global cohort collaboration.
methodsPatient-level data from 1993 through 2015 from 11 paediatric HIV cohorts were pooled. Characteristics at switch and through two years of follow-up were summarized for children who switched to second-line ART after starting a standard first-line regimen in North America, Latin America, Europe, Asia, Southern Africa (South Africa & Botswana) and the rest of sub-Saharan Africa (SSA). Cumulative incidences of mortality and loss to follow-up (LTFU) were estimated using a competing risks framework.
resultsOf the 85,389 children on first-line ART, 3,555 (4%) switched to second-line after a median of 2.8 years on ART (IQR: 1.6, 4.7); 69% were from Southern Africa or SSA and 86% of second-line regimens were protease inhibitor-based. At switch, median age was 8.4 years and 50% had a prior AIDS diagnosis. Median follow-up after switch to second-line ranged from 1.8 years in SSA to 5.3 years in North America. Median CD4 counts at switch to second-line ranged from 235 cells/mm
conclusionsChildren switched to second-line ART experience CD4 count increases as well as low to moderate rates of LTFU and mortality within two years after switch. Severe immune deficiency at time of switch in some settings suggests need for improved recognition and management of treatment failure in children.
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