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Home >> Publications >> Second-line protease inhibitor-based highly active antiretroviral therapy after failing non-nucleoside reverse transcriptase inhibitor-based regimens in Asian HIV-infected children.

Publication

Author(s):

Bunupuradah T, Puthanakit T, Fahey P, Kariminia A, Yusoff NK, Khanh TH, Sohn AH, Chokephaibulkit K, Lumbiganon P, Hansudewechakul R, Razali K, Kurniati N, Huy BV, Sudjaritruk T, Kumarasamy N, Fong SM, Saphonn V, Ananworanich J; TApHOD.

Pub Title:

Second-line protease inhibitor-based highly active antiretroviral therapy after failing non-nucleoside reverse transcriptase inhibitor-based regimens in Asian HIV-infected children.

Pub Date:

Oct 1 2013

Pub Region(s):

Asia-Pacific

Page Number:
591-8

Journal:

Title: 
Antiviral Therapy
Link: 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715593/

PubMed: 23296119
Pub PDF: PDF icon nihms-455375.pdf

Abstract
BACKGROUND
: The World Health Organization (WHO) recommends boosted protease inhibitor (bPI)-based HAART after failing non-nucleoside reverse transcriptase inhibitor (NNRTI) treatment. We examined outcomes of this regimen in Asian HIV-infected children.

METHODS: Children from five Asian countries in the TREAT Asia Pediatric HIV Observational Database (TApHOD) with ≥24 weeks of NNRTI-based HAART followed by ≥24 weeks of bPI-based HAART were eligible. Primary outcomes were the proportions with virological suppression (HIV RNA<400 copies/ml) and immune recovery (CD4(+) T-cell percentage [CD4%]≥25% if age <5 years and CD4(+) T-cell count ≥500 cells/mm(3) if age ≥5 years) at 48 and 96 weeks.

RESULTS: Of 3,422 children, 153 were eligible; 52% were female. At switch, median age was 10 years, 26% were in WHO stage 4. Median weight-for-age z-score (WAZ) was -1.9 (n=121), CD4% was 12.5% (n=106), CD4(+) T-cell count was 237 cells/mm(3) (n=112), and HIV RNA was 4.6 log10 copies/ml (n=61). The most common bPI was lopinavir/ritonavir (83%). At 48 weeks, 61% (79/129) had immune recovery, 60% (26/43) had undetectable HIV RNA and 73% (58/79) had fasting triglycerides ≥130 mg/dl. By 96 weeks, 70% (57/82) achieved immune recovery, 65% (17/26) had virological suppression, and hypertriglyceridaemia occurred in 66% (33/50). Predictors for virological suppression at week 48 were longer duration of NNRTI-based HAART (P=0.006), younger age (P=0.007), higher WAZ (P=0.020) and HIV RNA at switch <10,000 copies/ml (P=0.049).

CONCLUSIONS: In this regional cohort of Asian children on bPI-based second-line HAART, 60% of children tested had immune recovery by 1 year, and two-thirds had hyperlipidaemia, highlighting difficulties in optimizing second-line HAART with limited drug options.

PMID: 23296119 [PubMed - in process]

PMCID: PMC3715593

 
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Citation:

Bunupuradah T, Puthanakit T, Fahey P, Kariminia A, Yusoff NK, Khanh TH, Sohn AH, Chokephaibulkit K, Lumbiganon P, Hansudewechakul R, Razali K, Kurniati N, Huy BV, Sudjaritruk T, Kumarasamy N, Fong SM, Saphonn V, Ananworanich J; TApHOD. Second-line protease inhibitor-based HAART after failing non-nucleoside reverse transcriptase inhibitor-based regimens in Asian HIV-infected children. Antivir Ther. 2013;18(4):591-8. doi: 10.3851/IMP2494. Epub 2013 Jan 7. PubMed PMID: 23296119; PubMed Central PMCID: PMC3715593.