دورية أكاديمية
أعرض في EDS

Sequencing paediatric antiretroviral therapy in the context of a public health approach.

التفاصيل البيبلوغرافية
العنوان: Sequencing paediatric antiretroviral therapy in the context of a public health approach.
المؤلفون: Boerma RS; Amsterdam Institute for Global Health and Development and Department of Global Health, Academic Medical Center of the University of Amsterdam, The Netherlands.; Global Child Health Group, Emma Children's Hospital/Academic Medical Center of the University of Amsterdam, The Netherlands; r.boerma@aighd.org., Boender TS; Amsterdam Institute for Global Health and Development and Department of Global Health, Academic Medical Center of the University of Amsterdam, The Netherlands., van Hensbroek MB; Global Child Health Group, Emma Children's Hospital/Academic Medical Center of the University of Amsterdam, The Netherlands., Rinke de Wit TF; Amsterdam Institute for Global Health and Development and Department of Global Health, Academic Medical Center of the University of Amsterdam, The Netherlands., Sigaloff KC; Amsterdam Institute for Global Health and Development and Department of Global Health, Academic Medical Center of the University of Amsterdam, The Netherlands.; Division of Infectious Diseases, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
المصدر: Journal of the International AIDS Society [J Int AIDS Soc] 2015 Dec 02; Vol. 18 (Suppl 6), pp. 20265. Date of Electronic Publication: 2015 Dec 02 (Print Publication: 2015).
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: eCollection Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE
أسماء مطبوعة: Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc
Original Publication: [London] : BioMed Central
مواضيع طبية MeSH: Public Health*, Anti-HIV Agents/*therapeutic use , HIV Infections/*drug therapy, Child ; Humans ; Reverse Transcriptase Inhibitors/therapeutic use
مستخلص: Introduction: As access to prevention of mother-to-child transmission (PMTCT) efforts has increased, the total number of children being born with HIV has significantly decreased. However, those children who do become infected after PMTCT failure are at particular risk of HIV drug resistance, selected by exposure to maternal or paediatric antiretroviral drugs used before, during or after birth. As a consequence, the response to antiretroviral therapy (ART) in these children may be compromised, particularly when non-nucleoside reverse transcriptase inhibitors (NNRTIs) are used as part of the first-line regimen. We review evidence guiding choices of first- and second-line ART.
Discussion: Children generally respond relatively well to ART. Clinical trials show the superiority of protease inhibitor (PI)- over NNRTI-based treatment in young children, but observational reports of NNRTI-containing regimens are usually favourable as well. This is reassuring as national guidelines often still recommend the use of NNRTI-based treatment for PMTCT-unexposed young children, due to the higher costs of PIs. After failure of NNRTI-based, first-line treatment, the rate of acquired drug resistance is high, but HIV may well be suppressed by PIs in second-line ART. By contrast, there are currently no adequate alternatives in resource-limited settings (RLS) for children failing either first- or second-line, PI-containing regimens.
Conclusions: Affordable salvage treatment options for children in RLS are urgently needed.
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فهرسة مساهمة: Keywords: HIV drug resistance; antiretroviral therapy; low- and middle-income countries; non-nucleoside reverse transcriptase inhibitor; paediatric HIV; protease inhibitor
المشرفين على المادة: 0 (Anti-HIV Agents)
0 (Reverse Transcriptase Inhibitors)
تواريخ الأحداث: Date Created: 20151208 Date Completed: 20160802 Latest Revision: 20181202
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC4670836
DOI: 10.7448/IAS.18.7.20265
PMID: 26639116
قاعدة البيانات: MEDLINE
الوصف
تدمد:1758-2652
DOI:10.7448/IAS.18.7.20265