{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T14:10:55Z","timestamp":1783692655095,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,5,26]],"date-time":"2020-05-26T00:00:00Z","timestamp":1590451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the prevalence of pretreatment drug resistance (PDR) and its association with virologic outcomes after 24\u00a0weeks of antiretroviral therapy (ART), within an urban cohort of Ugandan children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective observational study. Baseline and 24\u2010week assessments of viral load (VL) and genotypic drug resistance to nucleoside reverse transcriptase inhibitors (NRTI) and non\u2010nucleoside reverse transcriptase inhibitors (NNRTI) were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010nine ART\u2010na\u00efve children (3\u201012\u00a0years) initiated efavirenz\u2010based ART 2015\u20102016 and 18\/90 (20%) had baseline NRTI\/NNRTI associated drug resistance mutations (DRMs). By 24\u00a0weeks, 72\/93 (77%) children had VL\u00a0&lt;\u00a040\u00a0copies\/mL and a total of 23 children had DRMs. Children with PDR accumulated new DRMs with a mean number (SD) of 1.4 (2.35) new mutations compared to 0.26 (0.98) in 67 children with wild\u2010type virus (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.003). High pretreatment VL and PDR (number of baseline DRMs) predicted viremia (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.003; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.023) as well as acquired drug resistance (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pretreatment drug resistance to NNRTI\/NRTI was common among ART\u2010na\u00efve Ugandan children and predicted viremia and new resistance mutations after only 24\u00a0weeks of efavirenz\u2010based therapy. PDR may compromise long\u2010term ART outcomes\u2014especially when access to resistance testing and VL monitoring is poor. The long\u2010term importance of PDR for non\u2010NNRTI\u2010based regimens needs further evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.15320","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T18:46:15Z","timestamp":1587235575000},"page":"2706-2716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pretreatment HIV drug resistance predicts accumulation of new mutations in ART\u2010na\u00efve Ugandan children"],"prefix":"10.1111","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0552-6872","authenticated-orcid":false,"given":"Sandra","family":"Soeria\u2010Atmadja","sequence":"first","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology Division of Paediatrics Karolinska Institutet Stockholm Sweden"},{"name":"Department of Paediatrics Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Amuge","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children\u2019s Foundation\u2010Uganda Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nanzigu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology &amp; Therapeutics Makerere University Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dickson","family":"Bbuye","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children\u2019s Foundation\u2010Uganda Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Rubin","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology Division of Paediatrics Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaran","family":"Eriksen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Science Division of Clinical Pharmacology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Public Health Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeodata","family":"Kekitiinwa","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children\u2019s Foundation\u2010Uganda Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celestino","family":"Obua","sequence":"additional","affiliation":[{"name":"College of Health Sciences Mbarara University of Science and Technology Mbarara Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars L.","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Department of Laboratory Science Division of Clinical Pharmacology Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6027-0211","authenticated-orcid":false,"given":"Lars","family":"Nav\u00e9r","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology Division of Paediatrics Karolinska Institutet Stockholm Sweden"},{"name":"Department of Paediatrics Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,26]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"UNAIDS.Global HIV & AIDS statistics \u2014 2018 fact sheet.http:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_en.pdf. 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