{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:55:04Z","timestamp":1791222904895,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,4,27]],"date-time":"2016-04-27T00:00:00Z","timestamp":1461715200000},"content-version":"vor","delay-in-days":117,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"name":"Ministry of Health in Togo"},{"name":"Institut de Recherche pour le D\u00e9veloppement and French cooperation in Togo"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Antiretroviral treatment (ART) has been scaled up over the last decade but compared to adults, children living with HIV are less likely to receive ART. Moreover, children and adolescents are more vulnerable than adults to virological failure (VF) and emergence of drug resistance. In this study we determined virological outcome in perinatally HIV\u20101\u2010infected children and adolescents receiving ART in Togo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HIV viral load (VL) testing was consecutively proposed to all children and adolescents who were on ART for at least 12 months when attending HIV healthcare services for their routine follow\u2010up visit (June to September 2014). Plasma HIV\u20101 VL was measured using the m2000 RealTime HIV\u20101 assay (Abbott Molecular, Des Plaines, IL, USA). Genotypic drug resistance was done for all samples with VL&gt;1000 copies\/ml.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>Among 283 perinatally HIV\u20101\u2010infected children and adolescents included, 167 (59%) were adolescents and 116 (41%) were children. The median duration on ART was 48 months (interquartile range: 28 to 68 months). For 228 (80.6%), the current ART combination consisted of two nucleoside reverse transcriptase inhibitors (NRTIs) (zidovudine and lamivudine) and one non\u2010nucleoside reverse transcriptase inhibitor (NNRTI) (nevirapine or efavirenz). Only 28 (9.9%) were on a protease inhibitor (PI)\u2010based regimen. VL was below the detection limit (i.e. 40 copies\/ml) for 102 (36%), between 40 and 1000 copies\/ml for 35 (12.4%) and above 1000 copies\/ml for 146 (51.6%). Genotypic drug\u2010resistance testing was successful for 125\/146 (85.6%); 110\/125 (88.0%) were resistant to both NRTIs and NNRTIs, 1\/125 (0.8%) to NRTIs only, 4\/125 (3.2%) to NNRTIs only and three harboured viruses resistant to reverse transcriptase and PIs. Overall, 86% (108\/125) of children and adolescents experiencing VF and successfully genotyped, corresponding thus to at least 38% of the study population, had either no effective ART or had only a single effective drug in their current ART regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study provided important information on virological outcome on lifelong ART in perinatally HIV\u20101\u2010infected children and adolescents who were still on ART and continued to attend antiretroviral (ARV) clinics for follow\u2010up visits. Actual conditions for scaling up and monitoring lifelong ART in children in resource\u2010limited countries can have dramatic long\u2010term outcomes and illustrate that paediatric ART receives inadequate attention.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.19.1.20683","type":"journal-article","created":{"date-parts":[[2016,4,27]],"date-time":"2016-04-27T08:23:01Z","timestamp":1461745381000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["High rates of virological failure and drug resistance in perinatally HIV\u20101\u2010infected children and adolescents receiving lifelong antiretroviral therapy in routine clinics in Togo"],"prefix":"10.1002","volume":"19","author":[{"given":"Mounerou","family":"Salou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoumou Y","family":"Dagnra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Butel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Vidal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Serrano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elom","family":"Takassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abla A","family":"Konou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spero","family":"Houndenou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Dapam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assetina","family":"Singo\u2010Tokofa\u00ef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palokinam","family":"Pitche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Atakouma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireille","family":"Prince\u2010David","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Delaporte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Peeters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,27]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).Fact sheet: 2014 statistics. 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