ARV resistance greater among youth with perinatal HIV
Recent research data in Clinical Infectious Diseases showed that resistance to ART was significantly greater among a cohort of perinatally infected children and adolescents with HIV.
“We present the prevalence of [antiretroviral (ARV)]-resistant virus among a cohort of U.S. children and youth with [perinatal HIV infection (PHIV)], compare the prevalence to that of national data, describe the patterns of drug resistance, and identify factors associated with ARV resistance,” Russell B. Van Dyke, MD, of the department of pediatrics within the School of Medicine at Tulane University, and colleagues wrote. “Among a cohort of children and youth with PHIV infection and virologic failure, 75% [95% CI, 69-80] had intermediate- or high-level resistance to at least one ARV, approximately twice the prevalence of all individuals tested at the reference laboratory during the same time period.”
The researchers studied a cohort of 451 children and adolescents aged 7 to 16 years from 15 sites in the United States and Puerto Rico. Clinical and laboratory data were gathered from medical charts and through self-reporting. ARV treatment adherence was determined by caregiver- or participant-reported ARV doses taken within the last 7 days. Participants had their most recent plasma sample tested for genotypic resistance to determine viral resistance.
Study results showed that 72% of participants had high levels of ARV resistance, and 3% had intermediate resistance. Among the remaining participants, 19% had fully susceptible virus, and 6% had low-level resistance. The researchers said these resistance levels were significantly higher when compared with the 36% to 44% overall resistance levels for the reference laboratory.
“As these youth transition to adult care, it is important that providers be aware of their high rate of viral resistance,” Van Dyke and colleagues wrote. “Fortunately, resistance to newer ARVs is uncommon and effective treatment regimens are available for most youth with resistant virus.” – by David Costill
Disclosure: Van Dyke reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.