title: Surveillance of HIV drug resistance in children receiving antiretroviral therapy: a pilot study of the World Health Organization's generic protocol in Maputo, Mozambique.
abstract: Between 2007 and 2008, the Mozambique Ministry of Health conducted an assessment of human immunodeficiency virus drug resistance (HIVDR) using World Health Organization (WHO) methods in a cohort of children initiating antiretroviral therapy (ART) at the main pediatric ART referral center in Mozambique. It was shown that prior to ART initiation 5.4% of children had HIVDR that was associated with nevirapine perinatal exposure (P < .001). Twelve months after ART initiation, 77% had viral load suppression (<1000 copies/mL), exceeding the WHO target of ≥ 70%; 10.3% had HIVDR at 12 months. Baseline HIVDR (P = .04), maternal prevention of mother-to-child transmission (P = .02), and estimated days of missed medication (P = .03) predicted HIVDR at 12 months. As efforts to eliminate pediatric AIDS are intensified, implementation of ritonavir-boosted protease inhibitor regimens in children with prevention of mother-to-child transmission exposure may reduce risk of virological failure in our setting.
authors.affiliation: Department of Pediatrics, Hospital Dia Pediátrico, Maputo Central Hospital, Maputo, Mozambique. paulavaz55@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Vaz
authors.forename: O
authors.initials: O
authors.lastname: Augusto
authors.forename: D
authors.initials: D
authors.lastname: Bila
authors.forename: E
authors.initials: E
authors.lastname: Macassa
authors.forename: A
authors.initials: A
authors.lastname: Vubil
authors.forename: I V
authors.initials: IV
authors.lastname: Jani
authors.forename: R
authors.initials: R
authors.lastname: Pillon
authors.forename: P
authors.initials: P
authors.lastname: Sandstrom
authors.forename: D
authors.initials: D
authors.lastname: Sutherland
authors.forename: C
authors.initials: C
authors.lastname: Giaquinto
authors.forename: M R
authors.initials: MR
authors.lastname: Jordan
authors.forename: S
authors.initials: S
authors.lastname: Bertagnolio
mesh_terms: D044966:Anti-Retroviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D005260:Female; D006678:HIV / Q000187:drug effects / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D009073:Mozambique / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D016896:Treatment Outcome; D014944:World Health Organization
chemical_list: D044966:Anti-Retroviral Agents