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Second- and Third-line Antiretroviral Therapy for Children and Adolescents: A Scoping Review.

Abstract The World Health Organization identified a need for evidence to inform revision of second- and third-line antiretroviral therapy (ART) options in children failing ART. We performed an in-depth scoping review of all available literature on second-line and subsequent ART regimens in children younger than 18 years.
PMID
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Second and Third Line Antiretroviral Therapy for Children and Adolescents: A Scoping Review.

Authors

Mayor MeshTerms

Antiretroviral Therapy, Highly Active

Keywords
Journal Title the pediatric infectious disease journal
Publication Year Start




PMID- 28403052
OWN - NLM
STAT- MEDLINE
DA  - 20170413
DCOM- 20170420
LR  - 20170420
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 36
IP  - 5
DP  - 2017 May
TI  - Second- and Third-line Antiretroviral Therapy for Children and Adolescents: A
      Scoping Review.
PG  - 492-499
LID - 10.1097/INF.0000000000001481 [doi]
AB  - BACKGROUND: The World Health Organization identified a need for evidence to
      inform revision of second- and third-line antiretroviral therapy (ART) options in
      children failing ART. We performed an in-depth scoping review of all available
      literature on second-line and subsequent ART regimens in children younger than 18
      years. METHODS: We comprehensively searched, without language or date
      limitations, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE,
      the World Health Organization's International Clinical Trials Registry Platform
      and ClinicalTrials.gov. RESULTS: The search retrieved 1982 records. Eighteen
      studies provided efficacy data: 1 randomized controlled trial, 7 phase II trials,
      5 prospective and 5 retrospective cohorts. Five studies evaluated regimens in
      children failing first-line ART, 4 in children with multidrug resistance and 9 in
      children with variable treatment experience. Only 10/18 studies reported week 48 
      or month 12 outcomes. The overall proportion of children with virologic
      suppression defined by study at week 48 was 61.8%. Although the randomized
      controlled trial had low risk of bias, outcomes were similar between groups
      because of highly active optimized background regimens. All phase II and
      prospective studies were judged to have moderate to high risk of bias. No study
      compared currently recommended lopinavir-based second-line regimens for
      nonnucleoside reverse transcriptase inhibitor failures to other non-nonnucleoside
      reverse transcriptase inhibitor regimens head-to-head. CONCLUSIONS: We found no
      evidence comparing current World Health Organization-recommended second- and
      third-line ART regimens with regimens including drugs of interest: raltegravir,
      darunavir, etravirine and atazanavir. Randomized controlled trials or prospective
      cohort studies with comparator arms, and bridging studies, ideally conducted in
      resource-limited settings, are required to guide future recommendations.
FAU - Lazarus, Erica
AU  - Lazarus E
AD  - From the *Perinatal HIV Research Unit, Faculty of Health Sciences, University of 
      the Witwatersrand, Johannesburg, South Africa; daggerFAMCRU, Children's'
      Infectious Diseases Clinical Research Unit, Department of Paediatrics and Child
      Health, Stellenbosch University, Cape Town, South Africa; double daggerWorld
      Health Organization, HIV Department, Treatment and Care Unit, Geneva,
      Switzerland; and section signCentre for Evidence-based Health Care, Department of
      Interdisciplinary Health, Faculty of Medicine and Health Sciences, Stellenbosch
      University, Stellenbosch, South Africa.
FAU - Nicol, Simone
AU  - Nicol S
FAU - Frigati, Lisa
AU  - Frigati L
FAU - Penazzato, Martina
AU  - Penazzato M
FAU - Cotton, Mark F
AU  - Cotton MF
FAU - Centeno-Tablante, Elizabeth
AU  - Centeno-Tablante E
FAU - Violari, Avy
AU  - Violari A
FAU - Nicol, Liesl
AU  - Nicol L
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Pyridazines)
RN  - 0C50HW4FO1 (etravirine)
RN  - 43Y000U234 (Raltegravir Potassium)
RN  - 4MT4VIE29P (Atazanavir Sulfate)
RN  - YO603Y8113 (Darunavir)
SB  - IM
MH  - Adolescent
MH  - Anti-HIV Agents/*therapeutic use
MH  - *Antiretroviral Therapy, Highly Active
MH  - Atazanavir Sulfate/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Clinical Trials, Phase II as Topic
MH  - Cohort Studies
MH  - Darunavir/therapeutic use
MH  - Drug Administration Schedule
MH  - Female
MH  - HIV Infections/*drug therapy/virology
MH  - Humans
MH  - Male
MH  - Practice Guidelines as Topic
MH  - Pyridazines/therapeutic use
MH  - Raltegravir Potassium/therapeutic use
MH  - Viral Load/drug effects
EDAT- 2017/04/14 06:00
MHDA- 2017/04/21 06:00
CRDT- 2017/04/14 06:00
AID - 10.1097/INF.0000000000001481 [doi]
AID - 00006454-201705000-00012 [pii]
PST - ppublish
SO  - Pediatr Infect Dis J. 2017 May;36(5):492-499. doi: 10.1097/INF.0000000000001481.

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