title: Multi-drug resistant HIV-1 reverse transcriptase genotype in children treated with dual nucleoside reverse transcriptase inhibitors (NRTIs).
abstract: BACKGROUND
  Multi-drug resistant HIV mutants have been reported after prolonged dual antiretroviral therapy.
  
  
  OBJECTIVE
  To evaluate the prevalence and resistance pattern in HIV-infected children treated with dual NRTIs.
  
  
  METHODS
  Records of HIV-infected children treated with dual NRTIs at Srinagarind Hospital, Khon Kaen University, Thailand, were reviewed for baseline data and their consensually-stored plasma were checked for the occurrence of HIV mutants by genotyping.
  
  
  RESULTS
  Fifty-seven HIV-infected children were treated with dual NRTI regimens (27 males; 30 females). The median age and median CD4+ T-lymphocyte at genotypic testing were 83.5 months and 10.9%, respectively. The median duration of ARV therapy was 22 months. More than half the children (42) were on zidovudine and didanosine. A set of three or more nucleoside analog mutations (NAMs), conferring multi-dideoxynucleoside resistance, was found in 60% of the cases.
  
  
  CONCLUSIONS
  High percentages of NAMs were found in HIV-infected children previously on dual ARV therapy for long periods. Genotypic testing was helpful in designing the second antiretroviral regimen.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. cengchanil@yahoo.com
authors.forename: Chulapan
authors.initials: C
authors.lastname: Engchanil
authors.forename: Pope
authors.initials: P
authors.lastname: Kosalaraksa
authors.forename: Viraphong
authors.initials: V
authors.lastname: Lulitanond
authors.forename: Pagakrong
authors.initials: P
authors.lastname: Lumbiganon
authors.forename: Wasun
authors.initials: W
authors.lastname: Chantratita
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology*; D002648:Child; D024921:Drug Resistance, Multiple, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D054303:HIV Reverse Transcriptase / Q000235:genetics*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D008297:Male; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D013785:Thailand
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D054303:HIV Reverse Transcriptase