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dc.contributor.authorNicole Ngo-Giang-Huongen_US
dc.contributor.authorLinda Wittkopen_US
dc.contributor.authorAli Judden_US
dc.contributor.authorPeter Reissen_US
dc.contributor.authorTessa Goetghebueren_US
dc.contributor.authorDan Duiculescuen_US
dc.contributor.authorAntoni Noguera-Julianen_US
dc.contributor.authorMagdalena Marczynskaen_US
dc.contributor.authorCarlo Giacquintoen_US
dc.contributor.authorLuminita Eneen_US
dc.contributor.authorJose T. Ramosen_US
dc.contributor.authorCristina Celleraien_US
dc.contributor.authorThomas Klimkaiten_US
dc.contributor.authorBenedicte Bricharden_US
dc.contributor.authorNiels Valeriusen_US
dc.contributor.authorCaroline Sabinen_US
dc.contributor.authorRamon Teiraen_US
dc.contributor.authorNiels Obelen_US
dc.contributor.authorChristoph Stephanen_US
dc.contributor.authorStéphane de Witen_US
dc.contributor.authorClaire Thorneen_US
dc.contributor.authorDiana Gibben_US
dc.contributor.authorChristine Schwimmeren_US
dc.contributor.authorMaria Athena Campbellen_US
dc.contributor.authorDeenan Pillayen_US
dc.contributor.authorMarc Lallemanten_US
dc.contributor.authorVibeke Rosenfeldten_US
dc.contributor.authorFrançois Dabisen_US
dc.date.accessioned2018-09-05T03:07:45Z-
dc.date.available2018-09-05T03:07:45Z-
dc.date.issued2016-11-08en_US
dc.identifier.issn14712334en_US
dc.identifier.other2-s2.0-85000983894en_US
dc.identifier.other10.1186/s12879-016-1968-2en_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85000983894&origin=inwarden_US
dc.identifier.urihttp://cmuir.cmu.ac.th/jspui/handle/6653943832/56014-
dc.description.abstract© 2016 The Author(s). Background: Few studies have evaluated the impact of pre-treatment drug resistance (PDR) on response to combination antiretroviral treatment (cART) in children. The objective of this joint EuroCoord-CHAIN-EPPICC/PENTA project was to assess the prevalence of PDR mutations and their association with virological outcome in the first year of cART in children. Methods: HIV-infected children <18 years initiating cART between 1998 and 2008 were included if having at least one genotypic resistance test prior to cART initiation. We used the World Health Organization 2009 resistance mutation list and Stanford algorithm to infer resistance to prescribed drugs. Time to virological failure (VF) was defined as the first of two consecutive HIV-RNA > 500 copies/mL after 6 months cART and was assessed by Cox proportional hazards models. All models were adjusted for baseline demographic, clinical, immunology and virology characteristics and calendar period of cART start and initial cART regimen. Results: Of 476 children, 88 % were vertically infected. At cART initiation, median (interquartile range) age was 6.6 years (2.1-10.1), CD4 cell count 297 cells/mm3(98-639), and HIV-RNA 5.2 log10copies/mL (4.7-5.7). Of 37 children (7.8 %, 95 % confidence interval (CI), 5.5-10.6) harboring a virus with ≥1 PDR mutations, 30 children had a virus resistant to ≥1 of the prescribed drugs. Overall, the cumulative Kaplan-Meier estimate for virological failure was 19.8 % (95 %CI, 16.4-23.9). Cumulative risk for VF tended to be higher among children harboring a virus with PDR and resistant to ≥1 drug prescribed than among those receiving fully active cART: 32.1 % (17.2-54.8) versus 19.4 % (15.9-23.6) (P = 0.095). In multivariable analysis, age was associated with a higher risk of VF with a 12 % reduced risk per additional year (HR 0.88; 95 %CI, 0.82-0.95; P < 0.001). Conclusions: PDR was not significantly associated with a higher risk of VF in children in the first year of cART. The risk of VF decreased by 12 % per additional year at treatment initiation which may be due to fading of PDR mutations over time. Lack of appropriate formulations, in particular for the younger age group, may be an important determinant of virological failure.en_US
dc.subjectMedicineen_US
dc.titlePrevalence and effect of pre-treatment drug resistance on the virological response to antiretroviral treatment initiated in HIV-infected children - a EuroCoord-CHAIN-EPPICC joint projecten_US
dc.typeJournalen_US
article.title.sourcetitleBMC Infectious Diseasesen_US
article.volume16en_US
article.stream.affiliationsChiang Mai Universityen_US
article.stream.affiliationsHarvard School of Public Healthen_US
article.stream.affiliationsUniversite de Bordeauxen_US
article.stream.affiliationsUCLen_US
article.stream.affiliationsAcademic Medical Centre, University of Amsterdamen_US
article.stream.affiliationsCentre Hospitalier Universitaire Saint Pierre, Brusselsen_US
article.stream.affiliationsVictor Babes National Instituteen_US
article.stream.affiliationsUniversitat de Barcelonaen_US
article.stream.affiliationsMedical University of Warsawen_US
article.stream.affiliationsUniversita degli Studi di Padovaen_US
article.stream.affiliationsHospital Universitario de Getafeen_US
article.stream.affiliationsCentre Hospitalier Universitaire Vaudoisen_US
article.stream.affiliationsUniversitat Baselen_US
article.stream.affiliationsHôpital Saint-Lucen_US
article.stream.affiliationsKobenhavns Universiteten_US
article.stream.affiliationsHospital Sierrallanaen_US
article.stream.affiliationsRigshospitaleten_US
article.stream.affiliationsKlinikum und Fachbereich Medizin Johann Wolfgang Goethe-Universitat Frankfurt am Mainen_US
article.stream.affiliationsUCL Institute of Child Healthen_US
article.stream.affiliationsMedical Research Councilen_US
article.stream.affiliationsInsermen_US
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