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  • ISSN: 2374-0094
    Early Online
    Volume 5, Issue 1
    Research Article
    Hung Viet Pham*, Lam Van Nguyen, Yen Thi Le, Hanh Hong Thi Mai, Chung Thu Thi Phan, and Liem Thanh Nguyen
    Introduction: Antiretroviral therapy (ART) was scaled up in HIV-infected Vietnamese children and adults as well. Few studies documented the association between drug-naïve resistant HIV-1 with treatment outcome, especially in children. This study aimed to determine the rate of drug-resistance mutations before initiating ART, and the treatment outcome after six months of ART.
    Methods: During 2010 - 2011, 140 HIV-1 infected children were admitted at National Children Hospital Viet Nam. Of them, 116 were initiated first-line ART, their clinical profile, CD4+ T-cell counts, and HIV load after six months of ART were retrospectively collected. Their plasma before initiating ART was stored for analysis by 2012. Of 116 samples, 52 had the HIV-1 pol gene successfully sequenced to detect drug- resistance mutations.
    Results: 18 children (29.0 ± 28.8 months) died, within an average of 1.6 ± 1.4 months of ART. Baseline WHO clinical stage 3-4 (p<0.001), and lower CD4+ T-cell counts (p=0.03) was associated with fatality. Stored plasma samples of 52 were sufficiently analyzed, six carried drug-resistance HIV-1. One of six was exposed to ART through prevention of mother-to-child transmission. Of RT-inhibition resistance, three had single mutant; one had K65R/Q151M / K101E/Y181C with six-month virological failure. Among PR-inhibition resistance, two had either M46L or M46L/L90M.
    Conclusion: Transmitted drug - resistance mutations were found in 9.6% of 52 children. Six-month treatment outcome was induced by baseline clinical and immunological stage. Pre-treatment drug-resistance mutations might not associate with six-month mortality but induce risk of virological failure.
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