{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T11:58:34Z","timestamp":1793361514884,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["5U62PS223540"],"award-info":[{"award-number":["5U62PS223540"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["5U2GPS001537"],"award-info":[{"award-number":["5U2GPS001537"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Children living with human immunodeficiency virus (HIV) (CLHIV) receiving antiretroviral therapy (ART) in resource-limited settings are susceptible to high rates of acquired HIV drug resistance (HIVDR), but few studies include children initiating age-appropriate World Health Organization (WHO)-recommended first-line regimens. We report data from a cohort of ART-naive South African children who initiated first-line ART.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>ART-eligible CLHIV aged 0\u201312 years were enrolled from 2012 to 2014 at 5 public South African facilities and were followed for up to 24 months. Enrolled CLHIV received standard-of-care WHO-recommended first-line ART. At the final study visit, a dried blood spot sample was obtained for viral load and genotypic resistance testing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 72 successfully genotyped CLHIV, 49 (68.1%) received ABC\/3TC\/LPV\/r, and 23 (31.9%) received ABC\/3TC\/EFV. All but 2 children on ABC\/3TC\/LPV\/r were &amp;lt;3 years, and all CLHIV on ABC\/3TC\/EFV were \u22653 years. Overall, 80.6% (58\/72) had at least one drug resistance mutation (DRM). DRMs to nonnucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTIs) were found among 65% and 51% of all CLHIV, respectively, with no statistical difference by ART regimen. More CLHIV on ABC\/3TC\/EFV, 47.8% (11\/23), were found to have 0 or only 1 effective antiretroviral drug remaining in their current regimen compared to 8.2% (4\/49) on ABC\/3TC\/LPV\/r.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>High levels of NNRTI and NRTI DRMs among CLHIV receiving ABC\/3TC\/LPV\/r suggests a lasting impact of failed mother-to-child transmission interventions on DRMs. However, drug susceptibility analysis reveals that CLHIV with detectable viremia on ABC\/3TC\/LPV\/r are more likely to have maintained at least 2 effective agents on their current HIV regimen than those on ABC\/3TC\/EFV.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1068","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T19:13:19Z","timestamp":1595617999000},"page":"e2217-e2225","source":"Crossref","is-referenced-by-count":14,"title":["Drug Resistance Mutations Among South African Children Living With HIV on WHO-recommended ART Regimens"],"prefix":"10.1093","volume":"73","author":[{"given":"Stephanie","family":"Hackett","sequence":"first","affiliation":[{"name":"US Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-8972","authenticated-orcid":false,"given":"Chloe A","family":"Teasdale","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health & Health Policy, New York, USA"},{"name":"ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, New York, USA"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Zeh","sequence":"additional","affiliation":[{"name":"US Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artur","family":"Ramos","sequence":"additional","affiliation":[{"name":"US Centers for Disease Control and Prevention, Maputo, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia D","family":"Rivadeneira","sequence":"additional","affiliation":[{"name":"US Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"DeVos","sequence":"additional","affiliation":[{"name":"US Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Sleeman","sequence":"additional","affiliation":[{"name":"US Centers for Disease 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