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dc.contributor.authorBratholm, Clara Sofie
dc.contributor.authorJohannessen, Asgeir
dc.contributor.authorNaman, Ezra
dc.contributor.authorGundersen, Svein Gunnar
dc.contributor.authorKivuyo, Sokoine
dc.contributor.authorHolberg-Petersen, Mona
dc.contributor.authorOrmaasen, Vidar
dc.contributor.authorBruun, Johan N
dc.date.accessioned2012-09-10T09:28:49Z
dc.date.available2012-09-10T09:28:49Z
dc.date.issued2010
dc.description.abstractTo assess long-term virological efficacy and the emergence of drug resistance in children who receive antiretroviral treatment (ART) in rural Tanzania. Haydom Lutheran Hospital has provided ART to HIV-infected individuals since 2003. From February through May 2009, a cross-sectional virological efficacy survey was conducted among children (<15 years) who had completed ≥6 months of first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based ART. Genotypic resistance was determined in those with a viral load of >200 copies/mL. Virological response was measured in 19 of 23 eligible children; 8 of 19 were girls and median age at ART initiation was 5 years (range 2–14 years). Median duration of ART at the time of the survey was 40 months (range 11–61 months). Only 8 children were virologically suppressed (≤40 copies/mL), whereas 11 children had clinically relevant resistance mutations in the reverse transcriptase gene. The most frequent mutations were M184V (n = 11), conferring resistance to lamivudine and emtricitabine, and Y181C (n = 4), G190A/S (n = 4) and K103N (n = 4), conferring resistance to NNRTIs. Of concern, three children had thymidine analogue mutations, associated with cross-resistance to all nucleoside reverse transcriptase inhibitors. Despite widespread resistance, however, only one child experienced a new WHO stage 4 event and none had a CD4 cell count of <200 cells/mm3. Among children on long-term ART in rural Tanzania, >50% harboured drug resistance. Results for children were markedly poorer than for adults attending the same programme, underscoring the need for improved treatment strategies for children in resource-limited settings.en
dc.identifier.citationJournal of Antimicrobial Chemotherapy 65(2010) nr. 9 s. 1996-2000en
dc.identifier.cristinIDFRIDAID 348295
dc.identifier.doidoi: 10.1093/jac/dkq234
dc.identifier.issn0305-7453
dc.identifier.urihttps://hdl.handle.net/10037/4419
dc.identifier.urnURN:NBN:no-uit_munin_4135
dc.language.isoengen
dc.publisherOxford Journalsen
dc.rights.accessRightsopenAccess
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801en
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en
dc.titleDrug resistance is widespread among children who receive long-term antiretroviral treatment at a rural Tanzanian hospitalen
dc.typeJournal articleen
dc.typeTidsskriftartikkelen
dc.typePeer revieweden


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