{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:52:51Z","timestamp":1790031171851,"version":"4.0.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"NWO-NACCAP"},{"name":"Netherlands Ministry of Foreign Affairs","award":["12454"],"award-info":[{"award-number":["12454"]}]},{"name":"WHO HIVResNet","award":["HQHIV1206655"],"award-info":[{"award-number":["HQHIV1206655"]}]},{"name":"Jura Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate long-term virological failure (VF) and drug resistance among HIV-infected Ugandan children on first-line ART.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a multicentre prospective cohort study, viral load (VL) and drug resistance mutations (DRMs) were investigated at baseline and 6 monthly intervals in children (age\u205f\u2264\u205f12\u2009years). VF (two consecutive VLs\u2009&gt;1000 copies\/mL or death after 6\u2009months of ART) was defined as early VF (0\u201324\u2009months of ART) or late VF (25\u201348\u2009months of ART). An active regimen was defined as partially active if the genotypic susceptibility score (GSS) was\u2009&lt;3.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 2010 and 2011, 316 children were enrolled. Viral suppression was achieved in 75.8%, 71.5%, 72.6% and 69.2% at 12, 24, 36 and 48\u2009months. VF occurred in 111\/286 (38.8%), of which 67.6% was early and 32.4% late VF. Early VF was associated with a partially active regimen at baseline (OR 6.0, 95% CI 1.9\u201318.5), poor adherence (OR 3.1, 95% CI 1.3\u20137.4) and immunodeficiency (OR 3.3, 95% CI 1.1\u201310.2). Late VF was associated with age &gt;3\u2009years (OR 2.5, 95% CI 1.0\u20136.6) and WHO stage 3\/4 (OR 4.2, 95% CI 1.4\u201313.4). Acquired DRMs were detected in 27.0% before 24\u2009months, versus 14.4% after 24\u2009months (P\u205f&lt;\u205f0.001). A total of 92.2% of the children with early VF, versus 56.2% with late VF, had a partially active regimen (P\u205f&lt;\u205f0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>VF rates were high, occurred predominantly in the first 24\u2009months and appeared to increase again in year four. Risk factors and patterns of early VF\/DRMs were different from those of late VF\/DRMs. Virological control may improve by close monitoring and prompt switching to second-line therapy in the first 24\u2009months. Late VF may be prevented by early start of ART.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz266","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T15:10:10Z","timestamp":1559315410000},"page":"3035-3043","source":"Crossref","is-referenced-by-count":13,"title":["Long-term virological outcomes, failure and acquired resistance in a large cohort of Ugandan children"],"prefix":"10.1093","volume":"74","author":[{"given":"M H W","family":"Huibers","sequence":"first","affiliation":[{"name":"Global Child Health Group, Emma Children\u2019s Hospital, Amsterdam UMC, The Netherlands"},{"name":"Amsterdam Institute of Global Health Development (AIGHD), Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Kityo","sequence":"additional","affiliation":[{"name":"Joint Clinical Research Centre (JCRC), Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R 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