HIV-1 Drug Resistance in Children and Implications for Pediatric Treatment Strategies: A Systematic Review and Meta-analysis

作者：Joseph Fokam, Aude Christelle Ka’e, Yagaï Bouba, Maria Mercedes Santoro, Judith Kose Otieno, Natella Rakhmanina, Collins Ambe Chenwi, Alex Durand Nka, Ezéchiel Ngoufack Jagni Semengue, Davy-Hyacinthe Anguechia Gouissi, Willy Leroi Pabo Togna, Nelly Kamgaing, Tetang Suzie, Désiré Takou, Georges Této, Tatiana Anim-Keng Tekoh, Jeremiah Efakika Gabisa, Audrey Nayang Mundo, Lum Forgwei, Naomi-Karell Etame, Aurelie Minelle Kengni Ngueko, Michel Carlos Tommo Tchouaket, Boris Tchounga, Patrice Tchendjou, Joelle Nounouce Bouba Pamen, Rogers Ajeh Awoh, Gregory Halle‐Ekane, Giulia Cappelli, Alexis Ndjolo, Francesca Ceccherini‐Silberstein, Vittorio Colizzi, Jean Kaseya, Nicaise Ndembi, Carlo Federico Perno · 发表于：Open Forum Infectious Diseases · 年份：2025 · DOI：10.1093/ofid/ofaf378 · 被引用次数：4 · 研究领域：HIV/AIDS drug development and treatment、HIV/AIDS Research and Interventions、Biological Research and Disease Studies

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.