title: Two-year outcome of first-line antiretroviral therapy among HIV-1 vertically-infected children in Hanoi, Vietnam.
abstract: A retrospective analysis of 86 HIV-1 vertically-infected Vietnamese children with a follow-up period >24 months after initiating antiretroviral therapy (ART) was performed from 2008 to 2012, to assess the outcome of first-line ART in resource-limited settings. Of the 86 children, 68 (79.1%) were treated successfully (plasma HIV-1 viral load [VL] <1000 copies/ml), and 63 (73.3%) had full viral suppression (VL <400 copies/ml) after 24 months of ART. No significant difference between successfully treated patients and failure groups was observed in VL, CD4(+) T-cell count or clinical stage at baseline; age at ART start; or ART regimen. All 14 children with VL >5000 copies/ml, one of four children with VL 1000-5000 copies/ml and none with VL <1000 copies/ml developed reverse transcriptase inhibitor (RTI)-resistance mutations by 24 months of ART. Y181C and M184V/I were the most dominant non-nucleoside and nucleoside RTI-resistance mutations, respectively (13/15, 86.7%). These findings suggest that VL testing after 24 months of ART can be used to efficiently differentiate ART failures among HIV-1 vertically-infected children in resource-limited settings.
authors.affiliation: Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: H V
authors.initials: HV
authors.lastname: Pham
authors.affiliation: Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ishizaki
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: L V
authors.initials: LV
authors.lastname: Nguyen
authors.affiliation: Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: C T T
authors.initials: CT
authors.lastname: Phan
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: T T B
authors.initials: TT
authors.lastname: Phung
authors.affiliation: Department of Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takemoto
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: A N
authors.initials: AN
authors.lastname: Pham
authors.affiliation: Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: X
authors.initials: X
authors.lastname: Bi
authors.affiliation: National Hospital of Pediatrics, Hanoi, Vietnam.
authors.forename: D T K
authors.initials: DT
authors.lastname: Khu
authors.affiliation: Department of Viral Infection and International Health, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan Kanazawa University Innovative Preventive Medicine Joint Education and Research Center, Kanazawa University, Kanazawa, Japan ichimura@med.kanazawa-u.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Ichimura
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D024882:Drug Resistance, Viral; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome; D014744:Vietnam; D019562:Viral Load / Q000187:drug effects*
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors
keywords: AIDS; ART (antiretroviral therapy); Asia; HIV (human immunodeficiency virus); children; treatment; virological failure