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Antiretroviral Resistance Patterns in Children with HIV Infection.
1Paediatric Infectious Diseases Unit, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa. james.nuttall@uct.ac.za.
Current Infectious Disease Reports
|March 2, 2019
Summary
High HIV drug resistance in children, especially to NNRTIs, leads to poor outcomes. New dolutegravir regimens offer hope for improved treatment in low-income countries.
Area of Science:
- Pediatric infectious diseases
- HIV/AIDS research
- Pharmacology
Background:
- HIV drug resistance is a growing concern in children.
- Understanding resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To update on HIV drug resistance patterns in children.
- Focus on pretreatment and acquired drug resistance (PDR/ADR).
- Emphasis on low- and middle-income countries (LMICs).
Main Methods:
- Review of recent data on HIV drug resistance in pediatric populations.
- Analysis of treatment outcomes with various antiretroviral regimens.
Main Results:
- High PDR to NNRTIs reported, linked to poor outcomes on NNRTI-based ART.
- Limited data on PI-based regimens show tolerability and resistance issues.
- Lack of virological monitoring and resistance testing delays treatment adjustments.
- Dolutegravir-based regimens show promise but require child-friendly formulations and completed studies.
Conclusions:
- Effective ART regimens with higher resistance barriers are needed for global targets.
- PI-based regimens face formulation, tolerability, and cost challenges in LMICs.
- Dolutegravir-based regimens are expected to improve pediatric HIV treatment outcomes.
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