Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort
dc.contributor.author | Wools-Kaloustian, Kara | |
dc.contributor.author | Marete, Irene | |
dc.contributor.author | Ayaya, Samuel | |
dc.contributor.author | Sohn, Annette H. | |
dc.contributor.author | Nguyen, Lam Van | |
dc.contributor.author | Li, Shanshan | |
dc.contributor.author | Leroy, Valériane | |
dc.contributor.author | Musick, Beverly S. | |
dc.contributor.author | Newman, Jamie E. | |
dc.contributor.author | Edmonds, Andrew | |
dc.contributor.author | Davies, Mary-Ann | |
dc.contributor.author | Tanoh Eboua, François | |
dc.contributor.author | Obama, Marie-Thérèse | |
dc.contributor.author | Yotebieng, Marcel | |
dc.contributor.author | Sawry, Shobna | |
dc.contributor.author | Mofenson, Lynne M. | |
dc.contributor.author | Yiannoutsos, Constantin T. | |
dc.contributor.department | Medicine, School of Medicine | en_US |
dc.date.accessioned | 2019-08-27T13:50:03Z | |
dc.date.available | 2019-08-27T13:50:03Z | |
dc.date.issued | 2018-06-01 | |
dc.description.abstract | BACKGROUND: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. METHODS: Children initiating their first ART regimen between 2 and 14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis. Outcomes of interest were: first-line ART failure (clinical, immunologic, or virologic), change to second-line, and attrition (death or loss to program ). Cumulative incidence was computed for first-line failure and second-line initiation, with attrition as a competing event. RESULTS: In 27,031 children, median age at ART initiation was 6.7 years. Median baseline CD4% for children ≤5 years of age was 13.2% and CD4 count for those >5 years was 258 cells per microliter. Almost all (94.4%) initiated a nonnucleoside reverse transcriptase inhibitor; 5.3% a protease inhibitor, and 0.3% a triple nucleoside reverse transcriptase inhibitor-based regimen. At 1 year, 7.7% had failed and 14.4% had experienced attrition; by 5 years, the cumulative incidence was 25.9% and 29.4%, respectively. At 1 year after ART failure, 13.7% had transitioned to second-line and 11.2% had experienced attrition; by 5 years, the cumulative incidence was 31.6% and 25.9%, respectively. CONCLUSIONS: High rates of first-line failure and attrition were identified in children within 5 years after ART initiation. Of children meeting failure criteria, only one-third were transitioned to second-line ART within 5 years. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Wools-Kaloustian, K., Marete, I., Ayaya, S., Sohn, A. H., Van Nguyen, L., Li, S., … Yiannoutsos, C. T. (2018). Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort. Journal of acquired immune deficiency syndromes (1999), 78(2), 221–230. doi:10.1097/QAI.0000000000001667 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/20600 | |
dc.language.iso | en_US | en_US |
dc.publisher | Wolters Kluwer | en_US |
dc.relation.isversionof | 10.1097/QAI.0000000000001667 | en_US |
dc.relation.journal | Journal of Acquired Immune Deficiency Syndromes | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | HIV | en_US |
dc.subject | Children | en_US |
dc.subject | ART | en_US |
dc.subject | Failure | en_US |
dc.subject | First-line | en_US |
dc.subject | Second-line | en_US |
dc.title | Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort | en_US |
dc.type | Article | en_US |