SidaSubSaharaV1, Pmc, Corpus, bibRecord, 001D62

SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS

Identifieur interne : 001D62 ( Pmc/Corpus ); précédent : 001D61; suivant : 001D63

SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS

Auteurs : Philippa Musoke ; Alexander J. Szubert ; Victor Musiime ; Kusum Nathoo ; Patricia Nahirya-Ntege ; Kuda Mutasa ; David Eram Williams ; Andrew J. Prendergast ; Moira Spyer ; A Sarah Walker ; Diana M. Gibb

Source :

AIDS (London, England) [ 0269-9370 ] ; 2015.

RBID : PMC:4833198

Abstract

Objectives

To assess the impact of exposure to single-dose nevirapine (sdNVP) on virological response in young Ugandan/Zimbabwean children (<3 years) initiating antiretroviral therapy (ART), and investigate other predictors of response.

Design

Observational analysis within the ARROW randomised trial.

Methods

sdNVP exposure was ascertained by caregiver’s self-report when the child initiated NNRTI based ART. Viral load (VL) was assayed retrospectively over median 4.1 years follow-up. Multivariable logistic regression models were used to identify independent predictors of VL <80 copies/ml 48 and 144 weeks after ART initiation (backwards elimination, exit p=0.1).

Results

Median (IQR) age at ART initiation was 17 (10-23) months in 78 sdNVP exposed children versus 21 (14-27) months in 289 non-exposed children (36% vs 20% <12 months). At week 48, 49/73 (67%) sdNVP exposed and 154/272 (57%) non-exposed children had VL<80 copies/ml (adjusted (a)OR=2.34 [1.26-4.34] p=0.007); 79% and 77% had VL<400copies/ml. Suppression was significantly lower in males (p=0.009), those with higher pre-ART VL (p=0.001), taking syrups (p=0.05) and with lower self-reported adherence (p=0.04). At week 144, 55/73 (75%) exposed and 188/272 (69%) non-exposed had <80 copies/ml (aOR=1.75 [0.93-3.29] p=0.08). There was no difference between children with and without previous sdNVP exposure in intermediate/high-level resistance to NRTIs (p>0.3) or NNRTIs (p>0.1) (n=88) at week 144.

Conclusion

Given the limited global availability of lopinavir/ritonavir, its significant formulation challenges in young children, and the significant paediatric treatment gap, tablet fixed-dose-combination nevirapine-based ART remains a good alternative to syrup lopinavir-based ART for children, particularly those over one year and even if exposed to sdNVP.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833198

DOI: 10.1097/QAD.0000000000000749
PubMed: 26193705
PubMed Central: 4833198

Links to Exploration step

PMC:4833198

Le document en format XML

<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS</title>
<author><name sortKey="Musoke, Philippa" sort="Musoke, Philippa" uniqKey="Musoke P" first="Philippa" last="Musoke">Philippa Musoke</name>
</author>
<author><name sortKey="Szubert, Alexander J" sort="Szubert, Alexander J" uniqKey="Szubert A" first="Alexander J" last="Szubert">Alexander J. Szubert</name>
</author>
<author><name sortKey="Musiime, Victor" sort="Musiime, Victor" uniqKey="Musiime V" first="Victor" last="Musiime">Victor Musiime</name>
</author>
<author><name sortKey="Nathoo, Kusum" sort="Nathoo, Kusum" uniqKey="Nathoo K" first="Kusum" last="Nathoo">Kusum Nathoo</name>
</author>
<author><name sortKey="Nahirya Ntege, Patricia" sort="Nahirya Ntege, Patricia" uniqKey="Nahirya Ntege P" first="Patricia" last="Nahirya-Ntege">Patricia Nahirya-Ntege</name>
</author>
<author><name sortKey="Mutasa, Kuda" sort="Mutasa, Kuda" uniqKey="Mutasa K" first="Kuda" last="Mutasa">Kuda Mutasa</name>
</author>
<author><name sortKey="Williams, David Eram" sort="Williams, David Eram" uniqKey="Williams D" first="David Eram" last="Williams">David Eram Williams</name>
</author>
<author><name sortKey="Prendergast, Andrew J" sort="Prendergast, Andrew J" uniqKey="Prendergast A" first="Andrew J." last="Prendergast">Andrew J. Prendergast</name>
</author>
<author><name sortKey="Spyer, Moira" sort="Spyer, Moira" uniqKey="Spyer M" first="Moira" last="Spyer">Moira Spyer</name>
</author>
<author><name sortKey="Walker, A Sarah" sort="Walker, A Sarah" uniqKey="Walker A" first="A Sarah" last="Walker">A Sarah Walker</name>
</author>
<author><name sortKey="Gibb, Diana M" sort="Gibb, Diana M" uniqKey="Gibb D" first="Diana M" last="Gibb">Diana M. Gibb</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">26193705</idno>
<idno type="pmc">4833198</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833198</idno>
<idno type="RBID">PMC:4833198</idno>
<idno type="doi">10.1097/QAD.0000000000000749</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">001D62</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001D62</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS</title>
<author><name sortKey="Musoke, Philippa" sort="Musoke, Philippa" uniqKey="Musoke P" first="Philippa" last="Musoke">Philippa Musoke</name>
</author>
<author><name sortKey="Szubert, Alexander J" sort="Szubert, Alexander J" uniqKey="Szubert A" first="Alexander J" last="Szubert">Alexander J. Szubert</name>
</author>
<author><name sortKey="Musiime, Victor" sort="Musiime, Victor" uniqKey="Musiime V" first="Victor" last="Musiime">Victor Musiime</name>
</author>
<author><name sortKey="Nathoo, Kusum" sort="Nathoo, Kusum" uniqKey="Nathoo K" first="Kusum" last="Nathoo">Kusum Nathoo</name>
</author>
<author><name sortKey="Nahirya Ntege, Patricia" sort="Nahirya Ntege, Patricia" uniqKey="Nahirya Ntege P" first="Patricia" last="Nahirya-Ntege">Patricia Nahirya-Ntege</name>
</author>
<author><name sortKey="Mutasa, Kuda" sort="Mutasa, Kuda" uniqKey="Mutasa K" first="Kuda" last="Mutasa">Kuda Mutasa</name>
</author>
<author><name sortKey="Williams, David Eram" sort="Williams, David Eram" uniqKey="Williams D" first="David Eram" last="Williams">David Eram Williams</name>
</author>
<author><name sortKey="Prendergast, Andrew J" sort="Prendergast, Andrew J" uniqKey="Prendergast A" first="Andrew J." last="Prendergast">Andrew J. Prendergast</name>
</author>
<author><name sortKey="Spyer, Moira" sort="Spyer, Moira" uniqKey="Spyer M" first="Moira" last="Spyer">Moira Spyer</name>
</author>
<author><name sortKey="Walker, A Sarah" sort="Walker, A Sarah" uniqKey="Walker A" first="A Sarah" last="Walker">A Sarah Walker</name>
</author>
<author><name sortKey="Gibb, Diana M" sort="Gibb, Diana M" uniqKey="Gibb D" first="Diana M" last="Gibb">Diana M. Gibb</name>
</author>
</analytic>
<series><title level="j">AIDS (London, England)</title>
<idno type="ISSN">0269-9370</idno>
<idno type="eISSN">1473-5571</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P4">To assess the impact of exposure to single-dose nevirapine (sdNVP) on virological response in young Ugandan/Zimbabwean children (<3 years) initiating antiretroviral therapy (ART), and investigate other predictors of response.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P5">Observational analysis within the ARROW randomised trial.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P6">sdNVP exposure was ascertained by caregiver’s self-report when the child initiated NNRTI based ART. Viral load (VL) was assayed retrospectively over median 4.1 years follow-up. Multivariable logistic regression models were used to identify independent predictors of VL <80 copies/ml 48 and 144 weeks after ART initiation (backwards elimination, exit p=0.1).</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P7">Median (IQR) age at ART initiation was 17 (10-23) months in 78 sdNVP exposed children versus 21 (14-27) months in 289 non-exposed children (36% vs 20% <12 months). At week 48, 49/73 (67%) sdNVP exposed and 154/272 (57%) non-exposed children had VL<80 copies/ml (adjusted (a)OR=2.34 [1.26-4.34] p=0.007); 79% and 77% had VL<400copies/ml. Suppression was significantly lower in males (p=0.009), those with higher pre-ART VL (p=0.001), taking syrups (p=0.05) and with lower self-reported adherence (p=0.04). At week 144, 55/73 (75%) exposed and 188/272 (69%) non-exposed had <80 copies/ml (aOR=1.75 [0.93-3.29] p=0.08). There was no difference between children with and without previous sdNVP exposure in intermediate/high-level resistance to NRTIs (p>0.3) or NNRTIs (p>0.1) (n=88) at week 144.</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P8">Given the limited global availability of lopinavir/ritonavir, its significant formulation challenges in young children, and the significant paediatric treatment gap, tablet fixed-dose-combination nevirapine-based ART remains a good alternative to syrup lopinavir-based ART for children, particularly those over one year and even if exposed to sdNVP.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">8710219</journal-id>
<journal-id journal-id-type="pubmed-jr-id">1493</journal-id>
<journal-id journal-id-type="nlm-ta">AIDS</journal-id>
<journal-id journal-id-type="iso-abbrev">AIDS</journal-id>
<journal-title-group><journal-title>AIDS (London, England)</journal-title>
</journal-title-group>
<issn pub-type="ppub">0269-9370</issn>
<issn pub-type="epub">1473-5571</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26193705</article-id>
<article-id pub-id-type="pmc">4833198</article-id>
<article-id pub-id-type="doi">10.1097/QAD.0000000000000749</article-id>
<article-id pub-id-type="manuscript">EMS67330</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>MUSOKE</surname>
<given-names>Philippa</given-names>
</name>
<aff id="A1">Baylor-Uganda, Paediatric Infectious Diseases Clinic, Mulago Hospital, Kampala, Uganda; Makerere University College of Health Sciences, Kampala, Uganda</aff>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>SZUBERT</surname>
<given-names>Alexander J</given-names>
</name>
<aff id="A2">MRC Clinical Trials Unit at University College London, London, UK</aff>
</contrib>
<contrib contrib-type="author"><name><surname>MUSIIME</surname>
<given-names>Victor</given-names>
</name>
<aff id="A3">Joint Clinical Research Centre, Kampala, Uganda; Makerere University College of Health Sciences, Kampala, Uganda</aff>
</contrib>
<contrib contrib-type="author"><name><surname>NATHOO</surname>
<given-names>Kusum</given-names>
</name>
<aff id="A4">University of Zimbabwe College of Health Sciences, Harare, Zimbabwe</aff>
</contrib>
<contrib contrib-type="author"><name><surname>NAHIRYA-NTEGE</surname>
<given-names>Patricia</given-names>
</name>
<aff id="A5">Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda</aff>
</contrib>
<contrib contrib-type="author"><name><surname>MUTASA</surname>
<given-names>Kuda</given-names>
</name>
<aff id="A6">Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe</aff>
</contrib>
<contrib contrib-type="author"><name><surname>WILLIAMS</surname>
<given-names>David Eram</given-names>
</name>
<aff id="A7">Joint Clinical Research Centre, Kampala, Uganda</aff>
</contrib>
<contrib contrib-type="author"><name><surname>PRENDERGAST</surname>
<given-names>Andrew J.</given-names>
</name>
<aff id="A8">Queen Mary University of London, London, UK</aff>
</contrib>
<contrib contrib-type="author"><name><surname>SPYER</surname>
<given-names>Moira</given-names>
</name>
<aff id="A9">MRC Clinical Trials Unit at University College London, London, UK</aff>
</contrib>
<contrib contrib-type="author"><name><surname>WALKER</surname>
<given-names>A Sarah</given-names>
</name>
<aff id="A10">MRC Clinical Trials Unit at University College London, London, UK</aff>
<xref ref-type="author-notes" rid="FN3">##</xref>
</contrib>
<contrib contrib-type="author"><name><surname>GIBB</surname>
<given-names>Diana M</given-names>
</name>
<aff id="A11">MRC Clinical Trials Unit at University College London, London, UK</aff>
<xref ref-type="author-notes" rid="FN3">##</xref>
</contrib>
<contrib contrib-type="author"><collab>ARROW Trial Team</collab>
</contrib>
</contrib-group>
<author-notes><corresp id="CR1">Corresponding author: Alexander J Szubert, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, 125 Kingsway, London, WC2B 6NH, UK. Tel +44 (0) 20 7670 4746. Fax +44 (0) 20 7670 4814. <email>a.szubert@ucl.ac.uk</email>
</corresp>
<fn id="FN3"><label>##</label>
<p id="P42">equal contribution.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>3</day>
<month>3</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><day>24</day>
<month>8</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>15</day>
<month>4</month>
<year>2016</year>
</pub-date>
<volume>29</volume>
<issue>13</issue>
<fpage>1623</fpage>
<lpage>1632</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/QAD.0000000000000749</pmc-comment>
      <abstract><sec id="S1"><title>Objectives</title>
<p id="P4">To assess the impact of exposure to single-dose nevirapine (sdNVP) on virological response in young Ugandan/Zimbabwean children (<3 years) initiating antiretroviral therapy (ART), and investigate other predictors of response.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P5">Observational analysis within the ARROW randomised trial.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P6">sdNVP exposure was ascertained by caregiver’s self-report when the child initiated NNRTI based ART. Viral load (VL) was assayed retrospectively over median 4.1 years follow-up. Multivariable logistic regression models were used to identify independent predictors of VL <80 copies/ml 48 and 144 weeks after ART initiation (backwards elimination, exit p=0.1).</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P7">Median (IQR) age at ART initiation was 17 (10-23) months in 78 sdNVP exposed children versus 21 (14-27) months in 289 non-exposed children (36% vs 20% <12 months). At week 48, 49/73 (67%) sdNVP exposed and 154/272 (57%) non-exposed children had VL<80 copies/ml (adjusted (a)OR=2.34 [1.26-4.34] p=0.007); 79% and 77% had VL<400copies/ml. Suppression was significantly lower in males (p=0.009), those with higher pre-ART VL (p=0.001), taking syrups (p=0.05) and with lower self-reported adherence (p=0.04). At week 144, 55/73 (75%) exposed and 188/272 (69%) non-exposed had <80 copies/ml (aOR=1.75 [0.93-3.29] p=0.08). There was no difference between children with and without previous sdNVP exposure in intermediate/high-level resistance to NRTIs (p>0.3) or NNRTIs (p>0.1) (n=88) at week 144.</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P8">Given the limited global availability of lopinavir/ritonavir, its significant formulation challenges in young children, and the significant paediatric treatment gap, tablet fixed-dose-combination nevirapine-based ART remains a good alternative to syrup lopinavir-based ART for children, particularly those over one year and even if exposed to sdNVP.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>Africa</kwd>
<kwd>children</kwd>
<kwd>antiretroviral therapy</kwd>
<kwd>viral load</kwd>
<kwd>sdNVP</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Pmc/Corpus

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001D62 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 001D62 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    SidaSubSaharaV1
   |flux=    Pmc
   |étape=   Corpus
   |type=    RBID
   |clé=     PMC:4833198
   |texte=   SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i   -Sk "pubmed:26193705" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd   \
       | NlmPubMed2Wicri -a SidaSubSaharaV1

This area was generated with Dilib version V0.6.32.
Data generation: Mon Nov 13 19:31:10 2017. Site generation: Wed Mar 6 19:14:32 2024

	Le SIDA en Afrique subsaharienne (serveur d'exploration)
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Le SIDA en Afrique subsaharienne (serveur d'exploration)

SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS

SINGLE DOSE NEVIRAPINE EXPOSURE DOES NOT AFFECT RESPONSE TO ANTI-RETROVIRAL THERAPY IN HIV-INFECTED AFRICAN CHILDREN AGED <3 YEARS

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki