Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand
Year: 2022
Type: article
Study design: Observational Study
Abstract: Background Etravirine (ETR) is approved as a component of second or third-line antiretroviral treatment (ART) for children living with HIV. We assessed the outcomes of ETR-based ART in children in routine care in Europe and Thailand. Methods Data on children aged <18 years at ETR start were pooled from 17 observational cohorts. Characteristics at ETR start, immunological and virological outcomes at 12 months, discontinuations, adverse events (AEs) and serious adverse events (SAEs) were described. Follow-up was censored at ETR discontinuation, death or last visit. Results 177 children ever received ETR. At ETR start, median [IQR] age was 15 [12,16] years, CD4 count 480 [287, 713] cells/mm 3 , 70% had exposure to ≥3 ART classes and 20% had viral load (VL) <50 copies/mL. 95% received ETR in combination with ≥1 potent drug class, mostly protease inhibitor-based regimens. Median time on ETR was 24 [7, 48] months. Amongst those on ETR at 12 months ( n=141), 69% had VL<50 copies/mL. Median CD4 increase since ETR start ( n=83) was 147 [16, 267] cells/mm 3 . Overall, 81 (46%) discontinued ETR by last follow-up. Median time to discontinuation was 23 [8, 47] months. Common reasons for discontinuation were treatment simplification (19%), treatment failure (16%) and toxicity (12%). Eight children (5%) had AEs causally associated with ETR, all dermatological/hypersensitivity reactions. Two were SAEs, both Stevens–Johnson Syndrome in children on regimens containing ETR and darunavir and were causally related to either drugs; both resolved following ART discontinuation. Conclusion Children receiving ETR were predominantly highly treatment-experienced, over two-thirds were virally suppressed at 12 months.
Source: Antiviral Therapy
Authors: European Pregnancy and Paediatric Infections Cohort Collabor, Alex Lyons, Lindsay Thompson, Elizabeth Chappell, Luminita Ene, Luisa Galli, Tessa Goetghebuer, Gonzague Jourdain, Antoni Noguera-Julian, Christian R Kahlert, Christoph Königs, Pope Kosalaraksa, Pagakrong Lumbiganon, Magdalena Marczyńska, Laura Marques, Marissa Navarro, Lars Naver, Liubov Okhonskaia, Filipa Prata, Thanyawee Puthanakit, Jose T Ramos, Anna Samarina, Claire Thorne, Evgeny Voronin, Anna Turkova, Carlo Giaquinto, Ali Judd, Intira J Collins
Institutions: MRC Clinical Trials Unit at UCL, University College London, Meyer Children's Hospital, University of Florence, Centre Hospitalier Universitaire de Saint-Pierre, Institut de Recherche pour le Développement, Chiang Mai University, Hospital Sant Joan de Déu Barcelona, Sant Joan de Déu Research Foundation, Kantonsspital St. Gallen, Ostschweizer Kinderspital, University Hospital Frankfurt, Khon Kaen University, Medical University of Warsaw, Universidad Complutense de Madrid, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Karolinska University Hospital, Karolinska Institutet, Ministry of Health of the Russian Federation, Hospital de Santa Maria, Thai Red Cross Society, Chulalongkorn University, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Centre for Prevention and Control of AIDS and Infectious Diseases, Great Ormond Street Hospital, PENTA Foundation
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,800
Awards: G3078245608, G553738029
OpenAlex ID: W4293506691