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dc.contributor.authorDavid C. Boettigeren_US
dc.contributor.authorTavitiya Sudjaritruken_US
dc.contributor.authorRevathy Nallusamyen_US
dc.contributor.authorPagakrong Lumbiganonen_US
dc.contributor.authorSupattra Rungmaitreeen_US
dc.contributor.authorRawiwan Hansudewechakulen_US
dc.contributor.authorNagalingeswaran Kumarasamyen_US
dc.contributor.authorTorsak Bunupuradahen_US
dc.contributor.authorVonthanak Saphonnen_US
dc.contributor.authorKhanh Huu Truongen_US
dc.contributor.authorNik K.N. Yusoffen_US
dc.contributor.authorViet Chau Doen_US
dc.contributor.authorLam V. Nguyenen_US
dc.contributor.authorKamarul A.M. Razalien_US
dc.contributor.authorSiew Moy Fongen_US
dc.contributor.authorNia Kurniatien_US
dc.contributor.authorAzar Kariminiaen_US
dc.description.abstract© 2016 Society for Adolescent Health and Medicine. All rights reserved. Purpose 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. Methods 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. Results 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/mm3. 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; 95% confidence interval [CI] = 1.0-2.2; p =.05). Baseline CD4+ count ≤200 cells/mm3(HR, 3.3 vs. >200; 95% CI = 1.2-8.9; p =.02) and not using cotrimoxazole prophylaxis at ART initiation (HR, 2.1 vs. using; 95% CI = 1.0-4.6; p =.05) were both associated with clinical failure. Conclusions Despite late ART initiation, adolescents achieved good rates of catch-up growth, CD4+ count recovery, and virological suppression. Earlier ART initiation and routine cotrimoxazole prophylaxis in this population may help to reduce current rates of NNRTI substitution and clinical failure.en_US
dc.titleNon-Nucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Therapy in Perinatally HIV-Infected, Treatment-Naïve Adolescents in Asiaen_US
article.title.sourcetitleJournal of Adolescent Healthen_US
article.volume58en_US of New South Wales (UNSW) Australiaen_US Mai Universityen_US Hospitalen_US Kaen Universityen_US Universityen_US Prachanukroh Hospitalen_US Medical Centre Indiaen_US HIV Netherlands Australia Thailand Research Collaborationen_US of Health Sciencesen_US's Hospital 1en_US Raja Perempuan Zainab IIen_US's Hospital 2en_US Hospital of Pediatrics Hanoien_US Lumpur Hospitalen_US Likasen_US of Indonesia, RSUPN Dr. Cipto Mangunkusumoen_US
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