Non-Nucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Therapy in Perinatally HIV-Infected, Treatment-Naïve Adolescents in Asia

The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine
David C BoettigerAzar Kariminia

Abstract

About a third of untreated, perinatally HIV-infected children reach adolescence. We evaluated the durability and effectiveness of non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART) in this population. Data from perinatally HIV-infected, antiretroviral-naïve patients initiated on NNRTI-based ART aged 10-19 years who had ≥6 months of follow-up were analyzed. Competing risk regression was used to assess predictors of NNRTI substitution and clinical failure (World Health Organization Stage 3/4 event or death). Viral suppression was defined as a viral load <400 copies/mL. Data from 534 adolescents met our inclusion criteria (56.2% female; median age at treatment initiation 11.8 years). After 5 years of treatment, median height-for-age z score increased from -2.3 to -1.6, and median CD4+ cell count increased from 131 to 580 cells/mm(3). The proportion of patients with viral suppression after 6 months was 87.6% and remained >80% up to 5 years of follow-up. NNRTI substitution and clinical failure occurred at rates of 4.9 and 1.4 events per 100 patient-years, respectively. Not using cotrimoxazole prophylaxis at ART initiation was associated with NNRTI substitution (hazard ratio [HR], 1.5 vs. using;...Continue Reading

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Citations

Jul 30, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David C BoettigerUNKNOWN Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) Pediatric HIV Observational Database
Feb 13, 2018·Current Opinion in HIV and AIDS·Paige L Williams, Julie Jesson
Aug 20, 2019·BMC Pediatrics·Patrinee TraisathitGonzague Jourdain

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