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.

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

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), https://doi.org/10.1097/QAD.0000000000000438

• Journal Article Type: Article
• Publication Date: Oct 23, 2014
• Deposit Date: Feb 15, 2016
• Publicly Available Date: Feb 15, 2016
• Journal: AIDS
• Print ISSN: 0269-9370
• Electronic ISSN: 1473-5571
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 28
• Issue: 16
• DOI: https://doi.org/10.1097/QAD.0000000000000438
• Keywords: antiretroviral therapy, children, HIV, UK/Ireland, virological outcome
• Public URL: https://nottingham-repository.worktribe.com/output/737706
• Publisher URL: http://journals.lww.com/aidsonline/pages/articleviewer.aspx?year=2014&issue=10230&article=00008&type=abstract