dc.contributor.author | Atmadja, Sandra Soeria | |
dc.contributor.author | Amuge, Pauline | |
dc.contributor.author | Nanzigu, Sarah | |
dc.contributor.author | Bbuye, Dickson | |
dc.contributor.author | Rubin, Johanna | |
dc.contributor.author | Eriksen, Jaran | |
dc.contributor.author | Kekitiinwa, Adeodata | |
dc.contributor.author | Obua, Celestino | |
dc.contributor.author | Gustafsson, Lars L. | |
dc.contributor.author | Navér, Lars | |
dc.date.accessioned | 2022-08-17T12:41:25Z | |
dc.date.available | 2022-08-17T12:41:25Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Soeria‐Atmadja, S., Amuge, P., Nanzigu, S., Bbuye, D., Rubin, J., Eriksen, J., ... & Navér, L. (2020). Pretreatment HIV drug resistance predicts accumulation of new mutations in ART‐naïve Ugandan children. Acta Paediatrica, 109(12), 2706-2716. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/2387 | |
dc.description.abstract | Aim: To assess the prevalence of pretreatment drug resistance (PDR) and its association with virologic outcomes after 24 weeks of antiretroviral therapy (ART), within an urban cohort of Ugandan children.
Methods: Prospective observational study. Baseline and 24-week assessments of viral load (VL) and genotypic drug resistance to nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) were performed.
Results: Ninety-nine ART-naïve children (3-12 years) initiated efavirenz-based ART 2015- 2016 and 18/90 (20%) had baseline NRTI/NNRTI associated drug resistance mutations (DRMs). By 24 weeks, 72/93 (77%) children had VL < 40 copies/mL and a total of 23 children had DRMs. Children with PDR accumulated new DRMs with a mean number (SD) of 1.4 (2.35) new mutations compared to 0.26 (0.98) in 67 children with wild-type virus (P = .003). High pretreatment VL and PDR (number of baseline DRMs) predicted viremia (P = .003; P = .023) as well as acquired drug resistance (P = .02; P = .04).
Conclusion: Pretreatment drug resistance to NNRTI/NRTI was common among ARTnaïve Ugandan children and predicted viremia and new resistance mutations after only especially when access to resistance testing and VL monitoring is poor. The long-term importance of PDR for non-NNRTI-based regimens needs further evaluation. | en_US |
dc.description.sponsorship | Stockholm County Council (ALF project 20170343) (LN), the Swedish Order of Freemason Foundation for Children (LN),
the Samariten Foundation (SSA), the Jerring Foundation (LN), Karolinska Institutet Funds (LN), the Swedish Research Council
(2011-3440 and VR-Link 2012-3466) (LLG) and Holmia (SSA). | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Acta Paediatrica | en_US |
dc.subject | Child | en_US |
dc.subject | Drug resistance | en_US |
dc.subject | Viral | en_US |
dc.subject | Efavirenz | en_US |
dc.subject | HIV | en_US |
dc.subject | Uganda | en_US |
dc.title | Pretreatment HIV drug resistance predicts accumulation of new mutations in ART-naïve Ugandan children | en_US |
dc.type | Article | en_US |