Multi-Drug Resistant HIV-1 Reverse Transcriptase Genotype in Children Treated with Dual Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Chulapan Engchanil MD*, Pope Kosalaraksa MD**, Viraphong Lulitanond PhD*, Pagakrong Lumbiganon MD**, Wasun Chantratita PhD***
Affiliation : * Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen ** Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen *** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Background : Multi-drug resistant HIV mutants have been reported after prolonged dual antiretroviral therapy.
Objective : To evaluate the prevalence and resistance pattern in HIV-infected children treated with dual
NRTIs.
Materials and Methods : Records of HIV-infected children treated with dual NRTIs at Srinagarind Hospital,
Khon Kaen University, Thailand, were reviewed for baseline data and their consensually-stored plasma were
checked for the occurrence of HIV mutants by genotyping.
Results : Fifty-seven HIV-infected children were treated with dual NRTI regimens (27 males; 30 females). The
median age and median CD4+ T-lymphocyte at genotypic testing were 83.5 months and 10.9%, respectively.
The median duration of ARV therapy was 22 months. More than half the children (42) were on zidovudine and
didanosine. A set of three or more nucleoside analog mutations (NAMs), conferring multi-dideoxynucleoside
resistance, was found in 60% of the cases.
Conclusion : High percentages of NAMs were found in HIV-infected children previously on dual ARV therapy
for long periods. Genotypic testing was helpful in designing the second antiretroviral regimen.
Keywords : HIV, Children, Drug resistance
