Department of Pediatrics, Hospital Dia Pediátrico, Maputo Central Hospital, Maputo, Mozambique.
Clin Infect Dis. 2012 May;54 Suppl 4(Suppl 4):S369-74. doi: 10.1093/cid/cis006.
Between 2007 and 2008, the Mozambique Ministry of Health conducted an assessment of human immunodeficiency virus drug resistance (HIVDR) using World Health Organization (WHO) methods in a cohort of children initiating antiretroviral therapy (ART) at the main pediatric ART referral center in Mozambique. It was shown that prior to ART initiation 5.4% of children had HIVDR that was associated with nevirapine perinatal exposure (P < .001). Twelve months after ART initiation, 77% had viral load suppression (<1000 copies/mL), exceeding the WHO target of ≥ 70%; 10.3% had HIVDR at 12 months. Baseline HIVDR (P = .04), maternal prevention of mother-to-child transmission (P = .02), and estimated days of missed medication (P = .03) predicted HIVDR at 12 months. As efforts to eliminate pediatric AIDS are intensified, implementation of ritonavir-boosted protease inhibitor regimens in children with prevention of mother-to-child transmission exposure may reduce risk of virological failure in our setting.
2007 年至 2008 年期间，莫桑比克卫生部使用世界卫生组织（WHO）的方法，对莫桑比克主要儿科抗逆转录病毒治疗（ART）转介中心开始接受抗逆转录病毒治疗（ART）的儿童队列进行了人类免疫缺陷病毒药物耐药性（HIVDR）评估。结果表明，在开始 ART 治疗之前，有 5.4%的儿童存在 HIVDR，这与围产期使用奈韦拉平有关（P<.001）。ART 治疗开始 12 个月后，77%的儿童病毒载量得到抑制（<1000 拷贝/ml），超过了世卫组织≥70%的目标；12 个月时有 10.3%的儿童出现 HIVDR。基线 HIVDR（P=.04）、母婴传播预防（P=.02）和估计漏服药物天数（P=.03）预测了 12 个月时的 HIVDR。随着消除儿科艾滋病工作的加强，在有母婴传播预防暴露的儿童中实施利托那韦增强型蛋白酶抑制剂方案可能会降低我们环境中病毒学失败的风险。
