Excessive Burdens of Drug Resistance Present in Children With HIV

Treatment for kids with HIV may be difficult, partially on account of the opportunity of drug resistance when making an attempt to focus on the virus. A failure to forestall the transmission of HIV from mom to youngster was discovered to result in pretreatment drug resistance (PDR) and purchased drug resistance (ADR) in kids included in a evaluate printed in Open Forum Infectious Diseases.¹

The fee of transmission of HIV from a mom to her youngster with out intervention ranges from 15% to 45% when considering the time of being pregnant, labor, and breastfeeding.² With intervention, these numbers may be diminished to lower than 2% within the US.³ However, kids nonetheless contract HIV regardless of these interventions, and entry to therapy stays restricted. This evaluate aimed to evaluate the prevalence of PDR and ADR in kids dwelling with HIV previously decade.

PubMed/MEDLINE, ScienceDirect, Google Scholar, grey literature databases, and African journals on-line had been looked for related research. Studies had been included within the evaluate in the event that they included contributors aged 0 to fifteen years; had been concerned in interventions to forestall transmission from mom to youngster, with these with no publicity from their mum or dad performing because the comparability group; had been printed between 2010 and early 2014 and had been printed in English or French; and had been randomized, nonrandomized, cohort, or cross-sectional research. Pooled prevalence of PDR and ADR in kids with HIV and being handled for HIV-1 acted as the first consequence. Case studies, letters, feedback, critiques, and meta-analyses had been excluded from the evaluate.

Study design, sampling methodology, sampling interval, age, gender, pattern sort, pattern measurement, fee of drug resistance, and publicity to parent-to-child HIV transmission had been all extracted from the research included within the evaluate. Use of antiretroviral remedy (ART) was additionally assessed.

There had been 325 research together with 9973 kids that had been included within the evaluate; 52.5% of the contributors had been male. Cross-sectional research made up nearly all of the research (38.46%), adopted by cohort research (17.9%).

A complete of 5884 contributors had information concerning PDR accessible. There had been 3836 contributors who had information on publicity to HIV from their mum or dad, of whom 66.36% had been uncovered to prophylaxis to forestall transmission. Overall prevalence of PDR was 31.94%, with 43.23% of these uncovered to prophylaxis having PDR in contrast with 19.40% who had no publicity. Sub-Saharan African kids had a prevalence of PDR of 39.13% in contrast with 22.56% in different areas.

A complete of 4140 kids had information on ADR. Prevalence of ADR was greater at 61.43% in those that had virological failure. Children in sub-Saharan Africa had a prevalence of ADR totaling 67.58% in contrast with 18.75% in different international locations.

Nonnucleoside reverse transcriptase inhibitors (NNRTI) had been the motive force of PDR in kids with HIV (OR, 2.46; 95% CI, 2.12-7.86). The prevalence of PDR in these utilizing NNRTIs was 28.38% in contrast with 12.06% in these utilizing nucleoside reverse transcriptase inhibitors and 5.51% in these utilizing protease inhibitors. NNRTI resistance was additionally the dominant motive for ADR by drug class (OR, 3.84%; 95% CI, 3.36-4.38) with a pooled prevalence of 65.17%.

The authors concluded that there was a excessive prevalence of PDR and ADR in kids dwelling with HIV, pointing to NNRTIs as a selected supply of drug resistance for these populations.

“Overall, the threat of [drug resistance] in children calls for newer [ART] prophylactic and therapeutic strategies [and] personalized clinical management, while advocating for the development of newer pediatric [ARTs] to fast-track the elimination of AIDS in this vulnerable population,” the authors wrote.

References

1. Fokam J, Da’e AC, Yagai B, et al. HIV-1 drug resistance in kids and implications for pediatric therapy methods: a scientific evaluate and meta-analysis. Open Forum Infect Dis. 2025;12(7):ofaf378. doi:10.1093/ofid/ofaf378

2. Mother-to-child transmission of HIV. World Health Organization. Accessed July 23, 2025. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv

3. Perinatal (mother-to-child) HIV transmission. Minnesota Department of Health. Updated October 20, 2022. Accessed July 23, 2025.