E-resources
-
Collins, Intira Jeannie; Ene, Luminita; Foster, Caroline; Kahlert, Christian; Smit, Colette; Goodall, Ruth; Marques, Laura; Judd, Ali; Gibb, Diana M; Noguera-Julian, Antoni; Guillen, Sara; Conejo, Pablo Rojo; Warszawski, Josiane; Koenigs, Chris; Spoulou, Vana; Prata, Filipa; Goetghebuer, Tessa; de Martino, Maurizio; Gabiano, Clara; Naver, Lars; Giaquinto, Carlo; Thorne, Claire; Marczynska, Magdalena; Okhonskaia, Liubov; Jourdain, Gonzague; Lertpienthum, Narong; Puangsombat, Achara; Bailey, Heather; Malyuta, Ruslan; Volokha, Alla; Radoi, Roxana
Clinical infectious diseases, 02/2018, Volume: 66, Issue: 4Journal Article
Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors NRTIs plus nonnucleoside reverse transcriptase inhibitor NNRTI or boosted protease inhibitor PI) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch.
Author
![loading ... loading ...](themes/default/img/ajax-loading.gif)
Shelf entry
Permalink
- URL:
Impact factor
Access to the JCR database is permitted only to users from Slovenia. Your current IP address is not on the list of IP addresses with access permission, and authentication with the relevant AAI accout is required.
Year | Impact factor | Edition | Category | Classification | ||||
---|---|---|---|---|---|---|---|---|
JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
Select the library membership card:
If the library membership card is not in the list,
add a new one.
DRS, in which the journal is indexed
Database name | Field | Year |
---|
Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
---|
Source: Personal bibliographies
and: SICRIS
The material is available in full text. If you wish to order the material anyway, click the Continue button.