CCR5 antagonists: a therapeutic option in HIV-1 perinatally infected children experiencing virologic failure?

AIDS
Pierre FrangeMarie-Laure Chaix

Abstract

The risk of virologic failure and selection of resistant strains remains a challenge in HIV-1 perinatally infected children. HIV-1 coreceptor usage was determined in HAART-failing children followed in Necker Hospital (Paris, France) in order to estimate the proportion of these patients who may benefit from CCR5-antagonists therapy. HIV-1 coreceptor usage was determined with the SVM(Geno2pheno10%) algorithm in 51 children with virologic failure after a median treatment exposure of 7.8 years. CXCR4-tropic strains were found in 31.4% of the patients. CXCR4 usage was associated with high HIV-1 DNA (P=0.01), old age (P=0.02), long ART cumulative exposure (P=0.006), and previous exposure to high number of different drugs (P=0.03) and ART combinations (P=0.03) in univariate analysis. Selection of resistant viruses and current exposure to a darunavir-based HAART tended to be more frequent in the CXCR4 group compared with the children infected with CCR5-tropic strains (P=0.06). In multivariate analysis, CXCR4 usage was exclusively correlated with HIV-1 DNA (P=0.03), which accurately reflects the cumulative exposure to viral replication over the whole duration of HIV infection. Two-thirds of HAART-failing children could benefit from CCR5...Continue Reading

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Nov 20, 2012·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·V Avettand-FenoelM Leruez-Ville
Nov 28, 2013·The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases·Flávia Jacqueline AlmeidaLuis Fernando de Macedo Brígido
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