Back to Search
Start Over
Prevalence and Outcomes of Recycling NNRTIs Despite Documented NNRTI Resistance in HIV-Infected Children and Youth.
- Source :
-
AIDS Patient Care & STDs . Jan2014, Vol. 28 Issue 1, p10-14. 5p. - Publication Year :
- 2014
-
Abstract
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are commonly used in pediatric patients; however, rapid development of resistance, due to non-adherence and cross-resistance, results in their discontinuation and limits their recycling. We evaluated the clinical experience of recycling NNRTIs despite documented NNRTI resistance (NNRTI-R), and examined virologic and CD4 cell count outcomes among participants enrolled in Longitudinal Epidemiologic Study to Gain Insight into HIV/AIDS in Children and Youth (LEGACY), a national HIV-infected pediatric cohort. We conducted a retrospective analysis of LEGACY participants with major NNRTI-R. Using chi-square analyses and logistic regression, we examined demographic and clinical factors associated with prescription of NNRTIs despite documented NNRTI-R, and associated changes in plasma HIV RNA viral load and CD4 cell counts. Sixteen of 133 (12%) participants with documented NNRTI-R re-started NNRTIs for a median of 370 days (IQR 105-919) with a median 402 days (IQR 70-841) between documentation of NNRTI-R to NNRTI recycling. Participants recycling NNRTIs were less likely to have documented past non-adherence (40.0% vs. 69.2%; p=0.02). Among twelve patients with virologic data at 24 (±8) weeks; seven (58.3%) experienced virologic suppression while on the recycled NNRTI-based regimens. Of the five who failed to suppress, three with subsequent genotyping developed additional NNRTI-R mutations compromising higher generation NNRTIs. While NNRTI's were recycled in only a small fraction of LEGACY participants harboring NNRTI-R mutations, such recycling increased the risk of inducing further resistance mutations that compromised use of higher generation NNRTIs. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CHI-squared test
*DRUG resistance
*DRUGS
*FISHER exact test
*HIV infections
*GENETIC mutation
*PATIENT compliance
*STATISTICS
*LOGISTIC regression analysis
*DATA analysis
*VIRAL load
*RETROSPECTIVE studies
*DATA analysis software
*NON-nucleoside reverse transcriptase inhibitors
*DESCRIPTIVE statistics
*CD4 lymphocyte count
Subjects
Details
- Language :
- English
- ISSN :
- 10872914
- Volume :
- 28
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- AIDS Patient Care & STDs
- Publication Type :
- Academic Journal
- Accession number :
- 93677172
- Full Text :
- https://doi.org/10.1089/apc.2013.0308