2025/06/26 by Joseph Fokam, Aude Christelle Ka’e, Yagaï Bouba +31 · 1 voice
Biochemistry, Genetics and Molecular Biology · Medicine · #Biological Research and Disease Studies #HIV/AIDS Research and Interventions #HIV/AIDS drug development and treatment
paper · pdf · doi:10.1093/ofid/ofaf378
openalex publication_date 2025/06/26 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Abstract Introduction Failure in the prevention of mother-to-child HIV transmission (PMTCT) and pediatric treatment challenges led to pretreatment drug resistance (PDR) and acquired drug resistance (ADR) in children with HIV (CWHIV). Method Interventional and observational data published between 2010 and 2024 on PDR and ADR in CWHIV were included and analyzed by random effects models. Results Overall, 72 studies encompassing 9973 children were included. The prevalence (95% CI) of PDR was 32.48% (26.08–39.21), and high among those who failed PMTCT prophylaxis (43.23% [32.94–53.82]) versus those without PMTCT-intervention (P < .01) and driven by nonnucleoside reverse transcriptase inhibitors (NNRTI) mutations (28.38% [18.74–39.08]; P = .013). The prevalence of ADR was 61.43% (49.82–72.45), driven by NNRTI-mutations (65.17% [53.95–75.63]; P < .001). INSTI-ADR was low (5.53% [2.49–9.53]) but emerging. Conclusion There are high burdens of PDR and ADR among CWHIV, suggesting the need to phase out pediatric NNRTIs used for either PMTCT or treatment. Emerging INSTI resistance among CWHIV highlights the relevance of drug-resistance surveillance strategies. Prospero registration No CRD42023470034.