UNASSIGNED: We described the transition rate to, and new initiation of, pDTG, viral load suppression (VLS) post-pDTG, and factors associated with VLS among children living with HIV.
UNASSIGNED: We conducted a retrospective cohort study involving children aged < 9 years and abstracted data from clinical sources. We used logistic regression to assess VLS and pDTG initiation predictors.
UNASSIGNED: Of 1353 children, 1146 initiated pDTG; 196 (14.5%) had no recorded weight. Post-pDTG switch, 98.9% (950/961) of children maintained the same nucleoside reverse transcriptase inhibitor backbone. After initiating Abacavir/Lamivudine+pDTG, 834 (72.8%) children remained on the regimen, 156 (13.6%) switched off (majority to Dolutegravir 50mg), 22 (1.9%) had ≥ 2 anchor drug switches; 134 (11.7%) had no documented follow-up regimen. Factors associated with pDTG initiation or switch were younger age (adjusted odds ratio [AOR] = 0.71 [0.63-0.80]) and a recorded weight (AOR = 55.58 [33.88-91.18]). VLS among the 294 children with a viral load (VL) test after ≥ 5 months post-pDTG was 75.5% (n = 222/294). Pre-pDTG VLS rate among treatment-experienced children was 56.5% (n = 130/230). Factors associated with VLS were older age (AOR = 1.18 [1.03-1.34]) and previous VLS (AOR = 2.27 [1.27-4.06]).
UNASSIGNED: Most eligible children initiated pDTG per guidelines, improving post-pDTG VLS. Challenges included unexplained switches off pDTG after initiation, low VL coverage and inadequate documentation in clinic records.
■我们描述了过渡率,和新的开始,pDTG,pDTG后的病毒载量抑制(VLS),以及感染艾滋病毒儿童中与VLS相关的因素。
■我们进行了一项涉及9岁以下儿童的回顾性队列研究,并从临床来源提取数据。我们使用逻辑回归来评估VLS和pDTG启动预测因子。
■在1353个孩子中,1146起始的pDTG;196(14.5%)没有记录体重。pDTG后开关,98.9%(950/961)的儿童维持相同的核苷逆转录酶抑制剂骨架。开始阿巴卡韦/拉米夫定+pDTG后,834名(72.8%)儿童仍在接受该方案,156(13.6%)关闭(大多数为Dolutegravir50mg),22(1.9%)有≥2种锚定药物转换;134(11.7%)没有记录的随访方案。与pDTG启动或转换相关的因素是年龄较小(调整比值比[AOR]=0.71[0.63-0.80])和体重记录(AOR=55.58[33.88-91.18])。在pDTG后≥5个月进行病毒载量(VL)测试的294名儿童中,VLS为75.5%(n=222/294)。有治疗经验的儿童pDTG前VLS率为56.5%(n=130/230)。与VLS相关的因素是年龄较大(AOR=1.18[1.03-1.34])和既往VLS(AOR=2.27[1.27-4.06])。
■大多数符合条件的儿童根据指南启动了pDTG,改进pDTG后VLS。挑战包括启动后无法解释的关闭pDTG,VL覆盖率低,临床记录中文件不足。