{"id":30686,"date":"2016-10-01T09:16:20","date_gmt":"2016-10-01T09:16:20","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=30686"},"modified":"2016-10-03T19:06:45","modified_gmt":"2016-10-03T19:06:45","slug":"raltegravir-based-third-line-art-in-children-and-adolescents","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/30686","title":{"rendered":"Raltegravir-based third-line ART in children and adolescents"},"content":{"rendered":"

\"Global<\/a>Polly Clayden, HIV i-Base<\/strong><\/p>\n

Five case studies from Uganda showed good responses in children and adolescents receiving raltegravir-based third-line ART.<\/strong><\/p>\n

The number of HIV positive children and adolescents failing second-line ART is increasing, leading to resistance to protease inhibitors. There are limited data describing response to raltegravir (RAL)-based third-line ART among children in low- and middle-income settings.<\/p>\n

Victor Musiime described outcomes of five children and adolescents receiving RAL-based ART at Joint Clinical Research Centre (JCRC), Kampala, Uganda. These case studies were presented at the Global HIV Clinical Forum: Integrase Inhibitors meeting before IAS2016.<\/p>\n

The investigators performed a chart and database review of children and adolescents less than 18 years of age attending JCRC with second-line failure; triple class antiretroviral drug resistance (NRTI, NNRTI and PI); and on RAL-based third-line ART.<\/p>\n

Those that fulfilled the selection criteria underwent an assessment of: weight, CD4 count, viral load and World Health Organization (WHO) clinical stage at baseline and after switching to RAL-based ART. The investigators also reviewed the case histories and genotypic resistance test results before switching. Follow up was for a minimum of six and maximum of 54 months.<\/p>\n

Of five cases evaluated, four were male and one was female. They switched to RAL at 9-15 years of age. Their third-line regimens were: darunavir\/ritonavir (DRV\/r) + RAL, n=3; etravirine (ETR) + DRV\/r+ RAL, n=1; tenofovir DF (TDF) + lamivudine (3TC) + DRV\/r + RAL (n=1).<\/p>\n

All had received 2 NRTIs + 1 NNRTI first-line, and lopinavir\/ritonavir (LPV\/r)- based second-line ART. Each case had developed: 5 or more NRTI resistance associated mutations (RAMs); 2 or 3 NNRTI RAMs (n=4) and 1 NNRTI RAM (n=1); and 3 or 4 PI RAMs.<\/p>\n

The investigators reported that all of the five children and adolescents evaluated achieved viral suppression, as well as increased weights and CD4 counts; none developed new WHO stage III\/IV events after switching to RAL-based third-line ART.<\/p>\n

Reference:<\/p>\n

Musiime V et al. Response to raltegravir based third-line antiretroviral therapy among Ugandan children: A case series from an urban HIV clinic. Global HIV Clinical Forum: Integrase Inhibitors. 16 July 2016, Durban, South Africa. Oral abstract O_04.<\/p>\n

http:\/\/regist2.virology-education.com\/2016\/hivforumdurban\/10_Musiime.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Polly Clayden, HIV i-Base Five case studies from Uganda showed good responses in children and adolescents receiving raltegravir-based third-line ART. The number of HIV positive children and adolescents failing second-line ART is increasing, leading to resistance to protease inhibitors. There …<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,3,32],"tags":[233],"class_list":["post-30686","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-antiretrovirals","category-paediatric-care","tag-global-hiv-clinical-forum-durban-2016"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/30686","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=30686"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/30686\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=30686"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=30686"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=30686"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}