Lyons, Alex;
Thompson, Lindsay;
Chappell, Elizabeth;
Ene, Luminita;
Galli, Luisa;
Goetghebuer, Tessa;
Jourdain, Gonzague;
... Collins, Intira J; + view all
(2022)
Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand.
Antiviral Therapy
, 27
(3)
10.1177/13596535221092182.
(In press).
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Chappell_Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand_AAM.pdf - Accepted Version Download (5MB) | Preview |
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/mm3, 70% had exposure to 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/mm3. 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. CONCLUSIONS:Children receiving ETR were predominantly highly treatment-experienced, over two-thirds were virally suppressed at 12-months.
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