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Antiretroviral Resistance Patterns in Children with HIV Infection

J Nuttall1, V Pillay2

  • 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
PubMed

Insights

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.
Abstract

Keywords:
AntiretroviralChildrenHIVResistance

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