Two-year outcome of first-line antiretroviral therapy among HIV-1 vertically-infected children in Hanoi, Vietnam

Pham, Hūng Viêt; Ishizaki, Azumi; Nguyen, Lam Van; Phan, Chung Thi Thu; Phung, Thuy Thi Bich; Takemoto, Kazushi; Pham, An Nhat; Bi, Xiuqiong; Khu, Dung Thi Khanh; Ishiguro, Hiroshi

doi:10.1177/0956462414556328

Cited by 13 publications

(14 citation statements)

References 36 publications

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“…The total study population was 86, with 68 children having VL <1000 copies/ml and 64 having full viral suppression with VL <400 copies/ml after 24 months of ART. There was no significant difference between successfully treated patients and failure groups in terms of clinical parameters and demographics at the baseline [22]. Among the children with treatment failure, one developed reverse-transcriptase inhibitor resistance mutations by 24 months of treatment.…”

Section: Prevalence and Different Types Of Drug Resistance Mutationsmentioning

confidence: 77%

“…None of the successfully treated patient developed DRMs. The most dominant NNTRIs and NRTIs resistance mutations were Y181C and M184V/I, respectively [22].…”

Section: Prevalence and Different Types Of Drug Resistance Mutationsmentioning

confidence: 99%

“…This is also consistent with the evidence that knowledge of patient's virus resistance profile prior to treatment will go a long way to avoid unnecessary stopping of a particular regimen and switching to others regimens. The cohorts showed resistance across the main ARV classes although in varying degrees [15,18,22,[24][25][26][27][28][29][30][31].…”

Section: Prevalence and Different Types Of Drug Resistance Mutationsmentioning

confidence: 99%

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Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children

Adetokunboh

Atibioke

Balogun

et al. 2015

Curr Infect Dis Rep

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Paediatric HIV-infected patients have higher risk of developing resistance to antiretroviral drugs, and from public health perspective, drug resistance remains a limiting factor for effective management of HIV infection in children. We reviewed the current evidences available on the antiretroviral treatment and resistance patterns in HIV-infected children. Prevalence of HIV drug resistance varied among the three main classes of antiretroviral drugs, namely nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors in both treatment naïve and treatment-experienced children in different countries. Most of the patients with extensive triple-class drug-resistant mutations were found to be considerably exposed to the three main classes of antiretroviral agents. Identification of genetic factors linked with susceptibility to perinatal transmission of HIV may be key in understanding the development of resistance due to waning antiviral effectiveness. Children who were less likely to achieve viral re-suppression were more likely to have resistance mutations. Newer drugs such as etravirine can be used as alternatives in case of resistance to efavirenz while newly developed diagnostic method such as next-generation sequencing is a platform for improving quality of detections especially minor variant drug resistance mutations.

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Section: Prevalence and Different Types Of Drug Resistance Mutationsmentioning

confidence: 77%

“…None of the successfully treated patient developed DRMs. The most dominant NNTRIs and NRTIs resistance mutations were Y181C and M184V/I, respectively [22].…”

Section: Prevalence and Different Types Of Drug Resistance Mutationsmentioning

confidence: 99%

Section: Prevalence and Different Types Of Drug Resistance Mutationsmentioning

confidence: 99%

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Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children

Adetokunboh

Atibioke

Balogun

et al. 2015

Curr Infect Dis Rep

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“…Since 2008, we have followed up with HIV-infected children in Hanoi, Vietnam to find an efficient and cost-effective method and immunological markers for monitoring ART in resource-limited settings [18]. Based on the results of that field study, we conducted this cross-sectional study to clarify the impact of HIV infection and ART on the immune profile and microbial translocation status of children aged over 2 years who have an immune status considered to be relatively mature and stable [9,19,20].…”

Section: Introductionmentioning

confidence: 99%

Impact of HIV Infection and Anti-Retroviral Therapy on the Immune Profile of and Microbial Translocation in HIV-Infected Children in Vietnam

Ishizaki

Nguyen

et al. 2016

IJMS

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CD4+ T-lymphocyte destruction, microbial translocation, and systemic immune activation are the main mechanisms of the pathogenesis of human immunodeficiency virus type 1 (HIV) infection. To investigate the impact of HIV infection and antiretroviral therapy (ART) on the immune profile of and microbial translocation in HIV-infected children, 60 HIV vertically infected children (31 without ART: HIV(+) and 29 with ART: ART(+)) and 20 HIV-uninfected children (HIV(−)) aged 2–12 years were recruited in Vietnam, and their blood samples were immunologically and bacteriologically analyzed. Among the HIV(+) children, the total CD4+-cell and their subset (type 1 helper T-cell (Th1)/Th2/Th17) counts were inversely correlated with age (all p < 0.05), whereas regulatory T-cell (Treg) counts and CD4/CD8 ratios had become lower, and the CD38+HLA (human leukocyte antigen)-DR+CD8+- (activated CD8+) cell percentage and plasma soluble CD14 (sCD14, a monocyte activation marker) levels had become higher than those of HIV(−) children by the age of 2 years; the CD4/CD8 ratio was inversely correlated with the plasma HIV RNA load and CD8+-cell activation status. Among the ART(+) children, the total CD4+-cell and Th2/Th17/Treg-subset counts and the CD4/CD8 ratio gradually increased, with estimated ART periods of normalization being 4.8–8.3 years, whereas Th1 counts and the CD8+-cell activation status normalized within 1 year of ART initiation. sCD14 levels remained high even after ART initiation. The detection frequency of bacterial 16S/23S ribosomal DNA/RNA in blood did not differ between HIV-infected and -uninfected children. Thus, in children, HIV infection caused a rapid decrease in Treg counts and the early activation of CD8+ cells and monocytes, and ART induced rapid Th1 recovery and early CD8+-cell activation normalization but had little effect on monocyte activation. The CD4/CD8 ratio could therefore be an additional marker for ART monitoring.

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“…As well as the increased immune system disturbance compared with adults, the rate of treatment failure in HIV‐infected children is also much higher than that in adults. Pham et al . reported that the treatment failure rate in HIV‐infected children on anti‐retroviral therapy (ART) in Vietnam was 25% after a 36 month follow up.…”

mentioning

confidence: 99%

Growth in children infected with HIV receiving anti‐retroviral therapy in Vietnam

Dang

Pham

Dinh

et al. 2019

Pediatrics International

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Background: There are currently two markers used to monitor treatment response to anti-retroviral therapy (ART) in HIV-infected children: CD4 T-cell count and HIV viral load; but analysis of these could be challenging in resource-poor countries. The aim of this study was therefore to determine whether change in growth parameters such as weight-for-age Z score (WAZ), height-for-age Z score (HAZ) and body mass index-for-age Z score (BMIZ) is associated with treatment response in HIV-infected children.Methods: This was a nested case-control study, in which the data were collected at enrolment and then periodically every 6 months for a total 36 month follow up of 107 HIV-infected children enrolled and treated at National Hospital of Pediatrics, Vietnam. Results: At treatment initiation, WAZ, HAZ and BMIZ were not significantly higher in the treatment success (TS) group compared with the treatment failure (TF) group. After ART initiation, WAZ and HAZ increased, and this was significant in the TS group (from À1.5 to À0.54, P < 0.01 and from À2.06 to À0.84, P < 0.01, respectively). Low HAZ was significantly associated with TF (HR, 0.71; 95% CI: 0.54-0.92). Conclusion: Height-for-age Z score was the most sensitive growth parameter in prediction of the treatment response. In order to use growth parameters, particularly HAZ as a prognosis marker for TF in clinical practice, further research should be conducted to evaluate the role of growth parameters and their effects on treatment response.

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Two-year outcome of first-line antiretroviral therapy among HIV-1 vertically-infected children in Hanoi, Vietnam

Cited by 13 publications

References 36 publications

Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children

Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children

Impact of HIV Infection and Anti-Retroviral Therapy on the Immune Profile of and Microbial Translocation in HIV-Infected Children in Vietnam

Growth in children infected with HIV receiving anti‐retroviral therapy in Vietnam

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