دورية أكاديمية
أعرض في EDS

High level of treatment failure and drug resistance to first-line antiretroviral therapies among HIV-infected children receiving decentralized care in Senegal.

التفاصيل البيبلوغرافية
العنوان: High level of treatment failure and drug resistance to first-line antiretroviral therapies among HIV-infected children receiving decentralized care in Senegal.
المؤلفون: Cissé AM; Service de pédiatrie Établissement Public de Santé (EPS) de Mbour, UFR Sciences de la Santé, Thiès University, Thiès, Senegal., Laborde-Balen G; Expertise France, Paris, France.; ANRS-Senegal site, Dakar, Senegal.; Centre régional de recherche et de formation à la prise en charge clinique de Fann (CRCF), Dakar, Senegal., Kébé-Fall K; Bacteriology-Virology Laboratory, A. Le Dantec CHU, Cheikh Anta Diop University, Dakar, Senegal., Dramé A; Bacteriology-Virology Laboratory, A. Le Dantec CHU, Cheikh Anta Diop University, Dakar, Senegal., Diop H; Bacteriology-Virology Laboratory, A. Le Dantec CHU, Cheikh Anta Diop University, Dakar, Senegal., Diop K; Expertise France, Paris, France.; Centre régional de recherche et de formation à la prise en charge clinique de Fann (CRCF), Dakar, Senegal.; Division de lutte contre le sidxa et les IST (DLSI), Ministry of Health and Social Action (MSAS), Dakar, Senegal., FatouNiasse-Traoré; Conseil national de lutte contre le sida (CNLS), Dakar, Senegal., Coulibaly M; Division de lutte contre le sidxa et les IST (DLSI), Ministry of Health and Social Action (MSAS), Dakar, Senegal., Have NN; Réseau national des associations de personnes vivant avec le VIH au (RNP+), Dakar, Senegal., Vidal N; Institut de Recherche pour le Développement (IRD), Montpellier, France., Thiam S; Conseil national de lutte contre le sida (CNLS), Dakar, Senegal., Wade AS; Division de lutte contre le sidxa et les IST (DLSI), Ministry of Health and Social Action (MSAS), Dakar, Senegal., Peeters M; Institut de Recherche pour le Développement (IRD), Montpellier, France., Taverne B; Centre régional de recherche et de formation à la prise en charge clinique de Fann (CRCF), Dakar, Senegal.; Institut de Recherche pour le Développement (IRD), Montpellier, France., Msellati P; Institut de Recherche pour le Développement (IRD), Montpellier, France. philippe.msellati@ird.fr.; TransVIHMI, IRD, PACCI, 18 BP 1954, Abidjan 18, Abidjan, Côte d'Ivoire. philippe.msellati@ird.fr., Touré-Kane C; Bacteriology-Virology Laboratory, A. Le Dantec CHU, Cheikh Anta Diop University, Dakar, Senegal.
المصدر: BMC pediatrics [BMC Pediatr] 2019 Feb 05; Vol. 19 (1), pp. 47. Date of Electronic Publication: 2019 Feb 05.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100967804 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2431 (Electronic) Linking ISSN: 14712431 NLM ISO Abbreviation: BMC Pediatr Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Drug Resistance, Viral* , Treatment Failure*, Anti-Retroviral Agents/*therapeutic use , HIV Infections/*drug therapy, Adolescent ; Child ; Child, Preschool ; Cross-Sectional Studies ; Delivery of Health Care/organization & administration ; Female ; HIV Infections/epidemiology ; Humans ; Infant ; Male ; Senegal/epidemiology ; Young Adult
مستخلص: Background: In Senegal in 2015, an estimated 4800 children were living with HIV, with 1200 receiving ARV treatment, of whom half had follow-up care in decentralized sites outside Dakar. However, until now no studies have determined the efficacy of pediatric treatment in decentralized settings, even though the emergence of viral resistance, particularly among children in Africa, is a well-known phenomenon. This study aimed to assess the virological status of HIV-infected children in all decentralized facilities to help improve access to quality care.
Methods: A cross-sectional epidemiological and virological study was conducted in all of Senegal's regions, except Dakar, between March and June 2015 and sought to include all HIV-infected children and adolescents (0-19 years), treated or not with ARVs. Socio-demographic and clinical data and a blood sample on blotting paper were collected for children from treatment sites. Samples were routed on public transportation, assisted by a network of community health workers. A viral load (VL) assay was performed for each child, followed by genotyping when it exceeded 1000 copies/mL (3 log 10 ).
Results: Of the 851 identified children, 666 (78%) were enrolled in the study. Half of the children were girls, and the average age was 8 years (6 months-19 years). Most of the children (96.7%) were infected with HIV-1, and 90% were treated with ART, primarily with AZT + 3TC + NVP/EFV therapeutic regimen. The median duration of time on ART was 21 months (1-129). VL was measured for 2% of children before this study. Almost two-thirds (64%) of the children are experiencing virological failure. Among them, there was resistance to at least one drug for 86.5% of cases. Also, 25% children presented resistance to one drug and 40% to two out of three. For nearly one-third of the children presenting resistance, none of the three drugs of the treatment was active. Factors associated with virological failure were male sex, follow-up by a generalist rather than a specialist, and treatment interruptions.
Conclusions: We observed a high level of virological failure and a high percentage of viral resistance among children receiving health care in decentralized facilities in Senegal.
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فهرسة مساهمة: Keywords: Antiretroviral; Decentralization; Pediatric HIV; Senegal; Viral resistance
المشرفين على المادة: 0 (Anti-Retroviral Agents)
تواريخ الأحداث: Date Created: 20190207 Date Completed: 20200220 Latest Revision: 20200309
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC6362577
DOI: 10.1186/s12887-019-1420-z
PMID: 30722780
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2431
DOI:10.1186/s12887-019-1420-z