Multicentre analysis of second-line antiretroviral treatment in HIV-infected children: adolescents at high risk of failure.

摘要: Introduction: The number of HIV-infected children and adolescents requiring second-line antiretroviral treatment (ART) is increasing in low- middle-income countries (LMIC). However, the effectiveness paediatric ART potential risk factors for virologic failure are poorly characterized. We performed an aggregate analysis outcomes assessed need third-line ART. Methods: a multicentre by systematically reviewing literature to identify cohorts receiving LMIC, contacting corresponding study groups including patient-level data on clinical outcomes. Kaplan–Meier survival estimates Cox proportional hazard models were used describe cumulative rates predictors failure. Virologic was defined as two consecutive viral load measurements >1000 copies/ml after at least six months treatment. Results: included 12 representing 928 protease inhibitor (PI)-based 14 Asia sub-Saharan Africa. After 24 months, 16.4% (95% confidence interval (CI): 13.9–19.4) experienced Adolescents (10–18 years) had 14.5 CI 11.9–17.6) per 100 person-years compared 4.5 3.4–5.8) younger (3–9 years). Risk adolescence (adjusted ratio [aHR] 3.93, p  48 months, respectively, <24 months). Conclusions: In PI-based associated with relatively low rates. showed exceptionally poor optimizing their HIV care requires urgent attention. addition, 16% failed will require integrase inhibitors construct salvage regimens. These drugs currently not available LMIC.