Worse Drug Resistance Seen in HIV Positive Children

HIV in children more likely to become drug resistant than other people

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Once the HIV virus becomes resistant to a drug, that resistance is permanent. Drug resistance in HIV-infected children makes finding an effective treatment more difficult.

A research team studied a group of children and youth with the HIV virus to determine the frequency and type of drug-resistant HIV virus.

In a recent scientific presentation, the team presented findings that showed that drug resistance in the HIV virus was worse in children than in the general population.

More of the HIV infected children had drug resistance and their viruses were resistant to more drugs than those of the general population.

"Take your medications as prescribed by your doctor."

The research study was conducted by a team led by Russell B Van Dyke, MD, FAAP of Tulane University School of Medicine in New Orleans, LA.

The study enrolled children ages 7 to 16 who were infected with the HIV virus around the time of birth.

Most of the participants were 15 years old, 57 percent were female, 70 percent were black and 25 were Hispanic.

Study participants were tested for the amount of HIV virus they had—called viral load. Their viruses were genetically tested to see if they were resistant to drugs and which drugs they were resistant to.

Of the 451 subjects recruited into the study, 446 had their viral load measured and 230 of those had the drug resistance of their HIV virus determined.

The researchers found that 74 percent of the children had developed resistance to at least one type of HIV drug treatment. Thirty percent of the children in the study were resistant to at least two classes drugs used to treat HIV.

Previous measurements in adults found that almost 36 percent of adults with HIV have resistance to one form of HIV drugs and 12 percent have resistance to at least two classes of drugs used to treat HIV.

The frequency of drug-resistant HIV virus in the children and youth in this study was higher than that found the general population of people infected with HIV.

Of those HIV viruses that were drug resistant, 40 percent were resistant to zidovudine, nevirapine, and efavirenz, 39 percent were resistant to stavudine, 37 percent were resistant to lamivudine and 32 percent were resistant to didanosine and nelfinavir.

The lowest resistance was seen for lopinavir, etravirine, tipranavir and darunavir.

Dr. Van Dyke said, “You develop resistance when you take some of your medications but not all.”

“The problem with drug resistance is that once you develop it, it never goes away,” he said.

The authors remarked that most children and youth who have a drug-resistant HIV viral infection still remain sensitive to newer drugs that can be used to provide treatment.

An abstract of the research study was presented at the 2014 Conference on Retroviruses and Opportunistic Infections in Boston, MA.

Funding for the study was provided by the National Institutes of Health.

Review Date: 
May 24, 2014
Last Updated:
May 27, 2014