Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand.

IF 1.3 4区医学 Q4 INFECTIOUS DISEASES

Antiviral Therapy Pub Date : 2022-06-01 DOI:10.1177/13596535221092182

European Pregnancy And Paediatric Infections Cohort Collaboration Eppicc, Alex Lyons, Lindsay Thompson, Elizabeth Chappell, Luminita Ene, Luisa Galli, Tessa Goetghebuer, Gonzague Jourdain, Antoni Noguera-Julian, Christian R Kahlert, Christoph Königs, Pope Kosalaraksa, Pagakrong Lumbiganon, Magdalena Marczyńska, Laura Marques, Marissa Navarro, Lars Naver, Liubov Okhonskaia, Filipa Prata, Thanyawee Puthanakit, Jose T Ramos, Anna Samarina, Claire Thorne, Evgeny Voronin, Anna Turkova, Carlo Giaquinto, Ali Judd, Intira J Collins

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引用次数: 0

Abstract

Background: Etravirine (ETR) is approved as a component of second or third-line antiretroviral treatment (ART) for children living with HIV. We assessed the outcomes of ETR-based ART in children in routine care in Europe and Thailand.

Methods: Data on children aged <18 years at ETR start were pooled from 17 observational cohorts. Characteristics at ETR start, immunological and virological outcomes at 12 months, discontinuations, adverse events (AEs) and serious adverse events (SAEs) were described. Follow-up was censored at ETR discontinuation, death or last visit.

Results: 177 children ever received ETR. At ETR start, median [IQR] age was 15 [12,16] years, CD4 count 480 [287, 713] cells/mm³, 70% had exposure to ≥3 ART classes and 20% had viral load (VL) <50 copies/mL. 95% received ETR in combination with ≥1 potent drug class, mostly protease inhibitor-based regimens. Median time on ETR was 24 [7, 48] months. Amongst those on ETR at 12 months (n=141), 69% had VL<50 copies/mL. Median CD4 increase since ETR start (n=83) was 147 [16, 267] cells/mm³. Overall, 81 (46%) discontinued ETR by last follow-up. Median time to discontinuation was 23 [8, 47] months. Common reasons for discontinuation were treatment simplification (19%), treatment failure (16%) and toxicity (12%). Eight children (5%) had AEs causally associated with ETR, all dermatological/hypersensitivity reactions. Two were SAEs, both Stevens-Johnson Syndrome in children on regimens containing ETR and darunavir and were causally related to either drugs; both resolved following ART discontinuation.

Conclusion: Children receiving ETR were predominantly highly treatment-experienced, over two-thirds were virally suppressed at 12 months.

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欧洲和泰国感染艾滋病毒并有治疗经验的儿童和青少年接受以依曲韦林为基础的抗逆转录病毒治疗的结果。

背景：依曲韦林（ETR）已被批准作为二线或三线抗逆转录病毒治疗（ART）的组成部分，用于艾滋病儿童感染者。我们评估了欧洲和泰国常规治疗中以依曲韦林为基础的儿童抗逆转录病毒疗法的疗效：结果：177 名儿童接受过 ETR 治疗：177名儿童接受了ETR治疗。开始接受 ETR 时，年龄中位数[IQR] 为 15 [12,16] 岁，CD4 细胞计数为 480 [287, 713] cells/mm3，70% 的儿童接受过≥3 种抗病毒疗法，20% 的儿童病毒载量（VL）n=141），69% 的儿童病毒载量（VL）n=83）为 147 [16, 267] cells/mm3。总体而言，81 人（46%）在最后一次随访时停用了 ETR。中位停药时间为 23 [8, 47] 个月。常见的停药原因是治疗简化（19%）、治疗失败（16%）和毒性（12%）。8名儿童（5%）出现了与ETR有因果关系的AE，均为皮肤病/过敏反应。其中两例为SAE，均为儿童在接受含有ETR和达鲁那韦的治疗方案时出现的史蒂文斯-约翰逊综合征，与其中任何一种药物都有因果关系；两例均在停用抗逆转录病毒疗法后缓解：结论：接受ETR治疗的儿童主要具有高度治疗经验，超过三分之二的儿童在12个月时病毒得到抑制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antiviral Therapy 医学-病毒学

CiteScore

2.60

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.