title: Effect of HIV genotypic drug resistance testing on the management and clinical course of HIV-infected children and adolescents.
abstract: The clinical utility of genotypic drug resistance testing (DRT) in HIV-infected children on antiretroviral therapy (ART) is not well understood. HIV-infected patients aged <19 years undergoing DRT for virological failure were retrospectively enrolled. Indications for DRT and changes in HIV RNA load were recorded. Between January 2000 and December 2006, 57 patients had DRT. The most common indication for DRT was poor ART adherence (57.7% of patients). ART was changed in 50.9% of patients after DRT. Poor adherence was cited by clinicians for not changing ART significantly more often than any other reason (47.3%, P < 0.001). After DRT, significant improvement in HIV RNA load occurred independent of ART changes, though patients whose ART was modified were more likely to become undetectable (31.5% versus 7.0%, P < 0.001). Poor adherence was a significant factor for ordering DRT and for not changing ART in HIV-infected children.
authors: Department of Pediatrics, The University of New Mexico Health Sciences Center, MSC10 5590, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA.
authors: W
authors: W
authors: Dehority
authors: J G
authors: JG
authors: Deville
authors: J
authors: J
authors: Lujan-Zilbermann
authors: S A
authors: SA
authors: Spector
authors: R M
authors: RM
authors: Viani
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics*; D019468:Disease Management; D018450:Disease Progression; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000235:genetics / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D017421:Sequence Analysis; D016896:Treatment Outcome; D014481:United States; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral
keywords: AIDS; HIV; adherence; adolescents; antiretroviral therapy; drug resistance; genotype; pediatrics