دورية أكاديمية
Alarming increase in pretreatment HIV drug resistance in children living in sub-Saharan Africa: a systematic review and meta-analysis.
| العنوان: | Alarming increase in pretreatment HIV drug resistance in children living in sub-Saharan Africa: a systematic review and meta-analysis. |
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| المؤلفون: | Boerma RS; Amsterdam Institute for Global Health and Development & Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands r.boerma@aighd.org.; Global Child Health Group, Emma Children's Hospital, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands., Sigaloff KC; Amsterdam Institute for Global Health and Development & Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.; Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands., Akanmu AS; Department of Haematology, University Teaching Hospital, University of Lagos, Lagos, Nigeria., Inzaule S; Amsterdam Institute for Global Health and Development & Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands., Boele van Hensbroek M; Global Child Health Group, Emma Children's Hospital, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands., Rinke de Wit TF; Amsterdam Institute for Global Health and Development & Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands., Calis JC; Global Child Health Group, Emma Children's Hospital, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.; Department of Pediatric Intensive Care, Emma Children's Hospital, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands. |
| المصدر: | The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2017 Feb; Vol. 72 (2), pp. 365-371. Date of Electronic Publication: 2016 Dec 20. |
| نوع المنشور: | Journal Article; Meta-Analysis; Review; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 7513617 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1460-2091 (Electronic) Linking ISSN: 03057453 NLM ISO Abbreviation: J Antimicrob Chemother Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1997- : London : Oxford University Press Original Publication: London, New York, Academic Press. |
| مواضيع طبية MeSH: | Drug Resistance, Viral*, HIV/*drug effects , HIV Infections/*epidemiology , HIV Infections/*virology, Africa South of the Sahara/epidemiology ; Child ; Child, Preschool ; HIV/genetics ; HIV/isolation & purification ; Humans ; Infant ; Infant, Newborn ; Prevalence |
| مستخلص: | Background: Children have an augmented risk of pretreatment HIV drug resistance (PDR) due to exposure to antiretroviral drugs for the prevention of mother-to-child transmission (PMTCT). Paediatric data are essential to evaluate the effectiveness of the restricted number of paediatric regimens currently available, but these data are scarce. Methods: We conducted a systematic review of the literature on PDR in children (median age ≤12 years) in sub-Saharan Africa. We separately extracted the proportion of children with PDR for children with and without prior PMTCT exposure, used random-effects meta-analysis to pool proportions and used meta-regression to assess subgroup differences. Results: We included 19 studies representing 2617 children from 13 countries. The pooled PDR prevalence was 42.7% (95% CI 26.2%-59.1%) among PMTCT-exposed children and 12.7% (95% CI 6.7%-18.7%) among PMTCT-unexposed children (P = 0.004). The PDR prevalence in PMTCT-unexposed children increased from 0% in 2004 to 26.8% in 2013 (P = 0.009). NNRTI mutations were detected in 32.4% (95% CI 18.7%-46.1%) of PMTCT-exposed children and in 9.7% (95% CI 4.6%-14.8%) of PMTCT-unexposed children; PI mutations were uncommon (<2.5%). PDR was more common in children aged <3 years compared with children aged ≥3 years [40.9% (95% CI 27.6%-54.3%) versus 17.6% (95% CI 8.9%-26.3%), respectively (P = 0.025)]. Conclusions: The PDR prevalence in African children is high and rapidly increasing. Even in PMTCT-unexposed children, the most recent reports indicate that PDR is present in up to a third of children starting first-line therapy. Our data underscore the importance of initiating PI-based first-line ART in young children (<3 years of age) and suggest that older children may also benefit from this approach. (© The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.) |
| تواريخ الأحداث: | Date Created: 20161222 Date Completed: 20170817 Latest Revision: 20220409 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1093/jac/dkw463 |
| PMID: | 27999070 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1460-2091 |
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| DOI: | 10.1093/jac/dkw463 |