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Open AccessArticle

Prevalence and Correlates of Pre-Treatment HIV Drug Resistance among HIV-Infected Children in Ethiopia

1
Department of Pediatrics, College of Medicine and Health Sciences, Hawassa University, Hawassa 1560, Ethiopia
2
Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
3
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
4
Department of Pharmacology, College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia
5
Adama General Hospital and Medical College, Adama 84, Ethiopia
6
Department of Microbiology, SNNPR Reference Laboratory, Hawassa 149, Ethiopia
7
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada
8
Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT Africa), College of Health Sciences, Addis Ababa University, Addis Ababa 9086, Ethiopia
9
Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
*
Authors to whom correspondence should be addressed.
Viruses 2019, 11(9), 877; https://doi.org/10.3390/v11090877
Received: 1 August 2019 / Revised: 10 September 2019 / Accepted: 17 September 2019 / Published: 19 September 2019
(This article belongs to the Special Issue Antiviral Agents)
Pediatric human immunodeficiency virus (HIV) care in resource-limited settings remains a major challenge to achieving global HIV treatment and virologic suppression targets, in part because the administration of combination antiretroviral therapies (cART) is inherently complex in this population and because viral load and drug resistance genotyping are not routinely available in these settings. Children may also be at elevated risk of transmission of drug-resistant HIV as a result of suboptimal antiretroviral administration for prevention of mother-to-child transmission. We investigated the prevalence and the correlates of pretreatment HIV drug resistance (PDR) among HIV-infected, cART-naive children in Ethiopia. We observed an overall PDR rate of 14%, where all cases featured resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs): ~9% of participants harbored resistance solely to NNRTIs while ~5% harbored resistance to both NNRTIs and nucleoside reverse transcriptase inhibitors (NRTIs). No resistance to protease inhibitors was observed. No sociodemographic or clinical parameters were significantly associated with PDR, though limited statistical power is noted. The relatively high (14%) rate of NNRTI resistance in cART-naive children supports the use of non-NNRTI-based regimens in first-line pediatric treatment in Ethiopia and underscores the urgent need for access to additional antiretroviral classes in resource-limited settings. View Full-Text
Keywords: HIV; pediatrics; Ethiopia; pre-treatment drug resistance; combination antiretroviral therapy (cART); dried plasma spots; dried blood spots HIV; pediatrics; Ethiopia; pre-treatment drug resistance; combination antiretroviral therapy (cART); dried plasma spots; dried blood spots
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Tadesse, B.T.; Tsai, O.; Chala, A.; Chaka, T.E.; Eromo, T.; Lapointe, H.R.; Baraki, B.; Shahid, A.; Tadesse, S.; Makonnen, E.; Brumme, Z.L.; Aklillu, E.; Brumme, C.J. Prevalence and Correlates of Pre-Treatment HIV Drug Resistance among HIV-Infected Children in Ethiopia. Viruses 2019, 11, 877.

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