PMID- 37896860
OWN - NLM
STAT- MEDLINE
DCOM- 20231030
LR  - 20240210
IS  - 1999-4915 (Electronic)
IS  - 1999-4915 (Linking)
VI  - 15
IP  - 10
DP  - 2023 Oct 12
TI  - HIV Drug Resistance Patterns and Characteristics Associated with Clinically 
      Significant Drug Resistance among Children with Virologic Failure on 
      Antiretroviral Treatment in Kenya: Findings from the Opt4Kids Randomized 
      Controlled Trial.
LID - 10.3390/v15102083 [doi]
LID - 2083
AB  - Increasing HIV drug resistance (DR) among children with HIV (CHIV) on 
      antiretroviral treatment (ART) is concerning. CHIV ages 1-14 years enrolled from 
      March 2019 to December 2020 from five facilities in Kisumu County, Kenya, were 
      included. Children were randomized 1:1 to control (standard-of-care) or 
      intervention (point-of-care viral load (POC VL) testing every three months with 
      targeted genotypic drug resistance testing (DRT) for virologic failure (VF) 
      (>/=1000 copies/mL)). A multidisciplinary committee reviewed CHIV with DRT results 
      and offered treatment recommendations. We describe DR mutations and present 
      logistic regression models to identify factors associated with clinically 
      significant DR. We enrolled 704 children in the study; the median age was 9 years 
      (interquartile range (IQR) 7, 12), 344 (49%) were female, and the median time on 
      ART was 5 years (IQR 3, 8). During the study period, 106 (15%) children had DRT 
      results (84 intervention and 22 control). DRT detected mutations associated with 
      DR in all participants tested, with 93 (88%) having major mutations, including 51 
      (54%) with dual-class resistance. A history of VF in the prior 2 years (adjusted 
      odds ratio (aOR) 11.1; 95% confidence interval (CI) 6.3, 20.0) and less than 2 
      years on ART at enrollment (aOR 2.2; 95% CI 1.1, 4.4) were associated with 
      increased odds of major DR. DR is highly prevalent among CHIV on ART with VF in 
      Kenya. Factors associated with drug resistance may be used to determine which 
      children should be prioritized for DRT.
FAU - Abuogi, Lisa
AU  - Abuogi L
AUID- ORCID: 0000-0003-1492-5090
AD  - Department of Pediatrics, University of Colorado, Denver, CO 80045, USA.
FAU - Oyaro, Patrick
AU  - Oyaro P
AUID- ORCID: 0000-0002-1205-0721
AD  - Health Innovations Kenya (HIK), Kisumu 40100, Kenya.
AD  - United States Agency for International Development, Washington, DC 20004, USA.
FAU - Wakjira, Garoma
AU  - Wakjira G
AD  - Department of Medicine, University of Washington, Seattle, WA 98195, USA.
FAU - Thomas, Katherine K
AU  - Thomas KK
AD  - Department of Global Health, University of Washington, Seattle, WA 98105, USA.
FAU - Scallon, Andrea J
AU  - Scallon AJ
AD  - Department of Global Health, University of Washington, Seattle, WA 98105, USA.
FAU - Mukui, Irene
AU  - Mukui I
AD  - Drugs for Neglected Diseases Initiative (DNDI), Nairobi 21936, Kenya.
FAU - Chohan, Bhavna H
AU  - Chohan BH
AUID- ORCID: 0000-0002-2125-6799
AD  - Department of Global Health, University of Washington, Seattle, WA 98105, USA.
AD  - Kenya Medical Research Institute, Nairobi 00200, Kenya.
FAU - Brown, Evelyn
AU  - Brown E
AD  - UWKenya, Nairobi 00200, Kenya.
FAU - Karauki, Enericah
AU  - Karauki E
AD  - UWKenya, Nairobi 00200, Kenya.
FAU - Yongo, Nashon
AU  - Yongo N
AD  - UWKenya, Nairobi 00200, Kenya.
FAU - Ahmed, Bilaal
AU  - Ahmed B
AD  - Department of Pediatrics, University of Colorado, Denver, CO 80045, USA.
FAU - Hassan, Shukri A
AU  - Hassan SA
AUID- ORCID: 0000-0001-6732-9263
AD  - Department of Medicine, University of Washington, Seattle, WA 98195, USA.
FAU - Wagude, James
AU  - Wagude J
AUID- ORCID: 0000-0003-4793-9296
AD  - Department of Health, Ministry of Health, Siaya 40600, Kenya.
FAU - Kinywa, Eunice
AU  - Kinywa E
AD  - Department of Health, Ministry of Health, Kisumu 40100, Kenya.
FAU - Otieno, Linda
AU  - Otieno L
AD  - Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu 
      40100, Kenya.
FAU - Kingwara, Leonard
AU  - Kingwara L
AUID- ORCID: 0000-0001-5382-8053
AD  - National HIV Reference Laboratory, Kenya Ministry of Health, Nairobi 00202, 
      Kenya.
FAU - Oyaro, Boaz
AU  - Oyaro B
AD  - Kenya Medical Research Institute-CDC, Kisumu 40100, Kenya.
FAU - Frenkel, Lisa M
AU  - Frenkel LM
AD  - Department of Medicine, University of Washington, Seattle, WA 98195, USA.
AD  - Department of Global Health, University of Washington, Seattle, WA 98105, USA.
AD  - Departments of Pediatrics, University of Washington, Seattle, WA 98195, USA.
AD  - Department of Laboratory Medicine and Pathology, University of Washington, 
      Seattle, WA 98195, USA.
FAU - John-Stewart, Grace
AU  - John-Stewart G
AD  - Department of Medicine, University of Washington, Seattle, WA 98195, USA.
AD  - Department of Global Health, University of Washington, Seattle, WA 98105, USA.
AD  - Departments of Pediatrics, University of Washington, Seattle, WA 98195, USA.
FAU - Patel, Rena C
AU  - Patel RC
AUID- ORCID: 0000-0001-9893-5856
AD  - Department of Medicine, University of Washington, Seattle, WA 98195, USA.
AD  - Department of Global Health, University of Washington, Seattle, WA 98105, USA.
LA  - eng
GR  - R34 MH115769/MH/NIMH NIH HHS/United States
GR  - UL1 TR002319/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20231012
PL  - Switzerland
TA  - Viruses
JT  - Viruses
JID - 101509722
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Humans
MH  - Child
MH  - Female
MH  - Male
MH  - *HIV Infections/drug therapy
MH  - Kenya
MH  - Treatment Failure
MH  - *HIV-1/genetics
MH  - Drug Resistance, Viral/genetics
MH  - Anti-Retroviral Agents/therapeutic use
MH  - Viral Load
MH  - *Anti-HIV Agents/therapeutic use/pharmacology
PMC - PMC10612029
OTO - NOTNLM
OT  - children
OT  - drug resistance
OT  - human immunodeficiency virus (HIV)
OT  - virologic failure
COIS- The authors declare no conflict of interest.
EDAT- 2023/10/28 11:48
MHDA- 2023/10/30 06:46
PMCR- 2023/10/12
CRDT- 2023/10/28 01:29
PHST- 2023/08/28 00:00 [received]
PHST- 2023/09/29 00:00 [revised]
PHST- 2023/10/09 00:00 [accepted]
PHST- 2023/10/30 06:46 [medline]
PHST- 2023/10/28 11:48 [pubmed]
PHST- 2023/10/28 01:29 [entrez]
PHST- 2023/10/12 00:00 [pmc-release]
AID - v15102083 [pii]
AID - viruses-15-02083 [pii]
AID - 10.3390/v15102083 [doi]
PST - epublish
SO  - Viruses. 2023 Oct 12;15(10):2083. doi: 10.3390/v15102083.