Prevalence and risk factors associated with resistance-associated mutations to etravirine in a cohort of perinatally HIV-infected children
Etravirine is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with reduced cross-resistance to first-generation NNRTIs. Because many perinatally HIV-infected patients have been treated with first-generation NNRTIs, they may have acquired resistance-associated mutations to...
- Autores:
-
Contreras, German A.
Bell, Cynthia S.
Del Bianco, Gabriela P.
Pérez, Norma
Kleinosky, Matthew T.
Murphy, James R.
Heresi, Gloria P.
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2013
- Institución:
- Universidad El Bosque
- Repositorio:
- Repositorio U. El Bosque
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.unbosque.edu.co:20.500.12495/3584
- Acceso en línea:
- http://hdl.handle.net/20.500.12495/3584
https://doi.org/10.1093/jac/dkt198
https://repositorio.unbosque.edu.co
- Palabra clave:
- Antivirales
VIH
Niño
Therapy adherence
Cumulative HIV RNA
Hispanics
- Rights
- openAccess
- License
- Acceso abierto
| Summary: | Etravirine is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with reduced cross-resistance to first-generation NNRTIs. Because many perinatally HIV-infected patients have been treated with first-generation NNRTIs, they may have acquired resistance-associated mutations to etravirine (RAMe). We determined for the interval 1998–2009 the prevalence and factors associated with the presence of RAMe. Twenty-three of 66 (34.8%) children had RAMe; the most common were 181C (19.6%), 190A (7.5%), 98G (6%), 106I (4.5%), 179D (4.5%), 100I (3%), 181I (1.5%), 138A (1.5%) and 179T (1.5%). Eleven children with RAMe (17%) had a mutation score between 2.5 and 3.5 and 1 (1.5%) a score ≥4, indicating an intermediate and reduced response to etravirine. For each 1% increase in CD4% there is a 7% decrease in the odds of RAMe (OR 0.93; 95% CI 0.88–0.97; P < 0.01). History of nevirapine use (OR 8.95; 95% CI 2.31–34.73; P < 0.01) and Hispanic ethnicity (OR 4.76; 95% CI 1.03–21.87; P = 0.04) are significantly associated with risk of RAMe. RAMe are present and common among antiretroviral-experienced perinatally HIV-infected children without previous exposure to etravirine. This could limit the efficacy of etravirine-based regimens. In addition, our results underscore the importance of taking previous history of nevirapine into account for combined antiretroviral therapy regimens that contain etravirine. |
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