{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:15:22Z","timestamp":1788984922839,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T00:00:00Z","timestamp":1628380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Although widely recommended, data about dolutegravir efficacy in HIV\u20101\u2010infected children\/adolescents are scarce, limited to short\u2010term follow\u2010up and mainly extrapolated from studies in adults with good adherence to treatment. This study aimed to provide long\u2010term data about the risk of virological failure (VF) and acquired genotypic resistance in children and adolescents receiving dolutegravir.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective monocentric study included 134 paediatric patients who received a dolutegravir\u2010based regimen for \u2265\u00a012\u00a0months in 2014\u20132020. Virological failure was defined as not achieving a plasma viral load (pVL) &lt;\u00a050 copies\/mL within 3 months of dolutegravir initiation or as experiencing virological rebound \u2265\u00a050 copies\/mL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most of the subjects were antiretroviral therapy\u2010experienced (90.3%), na\u00efve from integrase inhibitors (90.3%) and displayed virological suppression at baseline (63.4%). Their median (interquartile range, IQR) age was 12.0 (8.0\u201315.8)\u00a0years. Genotypic susceptibility score of the new regimen was \u2265\u00a02 in 96% of cases. Median (IQR) follow\u2010up was 34\u00a0(22\u201350) months. Virological failure occurred in 43 people (32.1%), more frequently where the baseline pVL was \u2265\u00a050 copies\/mL (67.4% <jats:italic>vs<\/jats:italic>. 22.0%, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.01). M184V\/I mutations in the <jats:italic>reverse transcriptase<\/jats:italic> gene were newly detected in three people with VF. Resistance to dolutegravir (mutations G118R and E138A in the <jats:italic>integrase<\/jats:italic> gene) emerged in one adolescent (0.7% of subjects, 2.3% of those with VF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Whereas VF is relatively common on dolutegravir in the paediatric population, regimens associating dolutegravir with more than one fully active drug were associated with a low rate of emergent drug resistance. This result strengthens the recommendation of dolutegravir as part of preferred combinations in children\/adolescents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13154","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T03:44:45Z","timestamp":1628480685000},"page":"958-964","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Dolutegravir in the long term in children and adolescents: frequent virological failure but rare acquired genotypic resistance"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-8369","authenticated-orcid":false,"given":"Pierre","family":"Frange","sequence":"first","affiliation":[{"name":"Laboratoire de Microbiologie clinique H\u00f4pital Necker \u2013 Enfants Malades Groupe hospitalier Assistance Publique \u2013 H\u00f4pitaux de Paris Centre Universit\u00e9 de Paris (APHP.CUP) Paris France"},{"name":"EHU 7328 PACT Institut Imagine Universit\u00e9 de Paris Paris France"},{"name":"Unit\u00e9 d\u2019Immunologie, H\u00e9matologie et Rhumatologie P\u00e9diatriques AP\u2010HP H\u00f4pital Universitaire Necker \u2013 Enfants Malades Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Blanche","sequence":"additional","affiliation":[{"name":"Unit\u00e9 d\u2019Immunologie, H\u00e9matologie et Rhumatologie P\u00e9diatriques AP\u2010HP H\u00f4pital Universitaire Necker \u2013 Enfants Malades Paris France"},{"name":"Universit\u00e9 de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Veber","sequence":"additional","affiliation":[{"name":"Unit\u00e9 d\u2019Immunologie, H\u00e9matologie et Rhumatologie P\u00e9diatriques AP\u2010HP H\u00f4pital Universitaire Necker \u2013 Enfants Malades Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique","family":"Avettand\u2010Fenoel","sequence":"additional","affiliation":[{"name":"Laboratoire de Microbiologie clinique H\u00f4pital Necker \u2013 Enfants Malades Groupe hospitalier Assistance Publique \u2013 H\u00f4pitaux de Paris Centre Universit\u00e9 de Paris (APHP.CUP) Paris France"},{"name":"Universit\u00e9 de Paris Paris France"},{"name":"U1016 CNRS UMR8104 Institut Cochin INSERM Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60208-0"},{"key":"e_1_2_10_3_1","unstructured":"SengR BignaJJ FayeA et al.Poorer control of viral load in patients infected perinatally versus during adulthood. Abstract 0807. 26th Conference on Retroviruses and Opportunistic Infections Seattle Washington USA 2019."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70141-4"},{"key":"e_1_2_10_5_1","unstructured":"World Health Organization.HIV treatment. Update of recommendations on first\u2010 and second\u2010line antiretroviral regimens. July 2019. 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Abstract 36. 10th International Workshop on HIV Pediatrics Amsterdam The Netherlands 2018."},{"key":"e_1_2_10_11_1","unstructured":"CollinsI CrichtonS GibbD JuddA on behalf of theCHIPS Steering Committee.Safety and effectiveness of dolutegravir (DTG) in children and adolescents with HIV in the UK\/Ireland. 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