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Long-term virological outcome in children on antiretroviral therapy in the UK and Ireland

Duong, Trinh; Judd, Ali; Collins, Intira Jeannie; Doerholt, Katja; Lyall, Hermione; Foster, Caroline; Butler, Karina; Tookey, Pat; Shingadia, Delane; Menson, Esse; Dunn, David T.; Gibb, Di M.; Smyth, Alan R.

Authors

Trinh Duong

Ali Judd

Intira Jeannie Collins

Katja Doerholt

Hermione Lyall

Caroline Foster

Karina Butler

Pat Tookey

Delane Shingadia

Esse Menson

David T. Dunn

Di M. Gibb

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ALAN SMYTH alan.smyth@nottingham.ac.uk
Professor of Child Health



Abstract

Objective: To assess factors at the start of antiretroviral therapy (ART) associated with long-term virological response in children.
Design: Multicentre national cohort.
Methods: Factors associated with viral load below 400 copies/ml by 12 months and virologic failure among children starting 3/4-drug ART in the UK/Irish Collaborative HIV Paediatric Study were assessed using Poisson models.
Results: Nine hundred and ninety-seven children started ART at a median age of 7.7 years (inter-quartile range 2.9–11.7), 251 (25%) below 3 years: 411 (41%) with efavirenz and two nucleoside reverse transcriptase inhibitors (EFVþ2NRTIs), 264 (26%) with nevirapine and two NRTIs (NVPþ2NRTIs), 119 (12%; 106 NVP, 13 EFV) with non-nucleoside reverse transcriptase inhibitor and three NRTIs (NNRTIþ3NRTIs), and 203 (20%) with boosted protease inhibitor-based regimens. Median follow-up after ART initiation was 5.7 (3.0–8.8) years. Viral load was less than 400 copies/ml by 12 months in 92% [95% confidence interval (CI) 91–94%] of the children. Time to suppression was similar across regimens (P¼0.10), but faster over calendar time, with older age and lower baseline viral load. Three hundred and thirtynine (34%) children experienced virological failure. Although progression to failure varied by regimen (P

Journal Article Type Article
Publication Date Oct 23, 2014
Journal AIDS
Print ISSN 0269-9370
Electronic ISSN 1473-5571
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 28
Issue 16
APA6 Citation Duong, T., Judd, A., Collins, I. J., Doerholt, K., Lyall, H., Foster, C., …Smyth, A. R. (2014). Long-term virological outcome in children on antiretroviral therapy in the UK and Ireland. AIDS, 28(16), doi:10.1097/QAD.0000000000000438
DOI https://doi.org/10.1097/QAD.0000000000000438
Keywords antiretroviral therapy, children, HIV, UK/Ireland, virological outcome
Publisher URL http://journals.lww.com/aidsonline/pages/articleviewer.aspx?year=2014&issue=10230&article=00008&type=abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0





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