000			03185na a2200229 4500
003			PC6509
005			20180113071321.0
008			130622s2012 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_aGonzález Tomé, María Isabel _91354 _ePediatría
245	0	0	_aHigh Drug Resistance Prevalence among Vertically HIV-Infected Patients Transferred from Pediatric Care to Adult Units in Spain. _h[artículo]
260			_bPLoS ONE, _c2012
300			_a7(12):e52155.
500			_aFormato Vancouver: de Mulder M, Yebra G, Navas A, de José MI, Gurbindo MD, González-Tomé MI et al. Madrid Cohort of HIV-Infected Children. High drug resistance prevalence among vertically HIV-infected patients transferred from pediatric care to adult units in Spain. PLoS One. 2012;7(12):e52155.
501			_aPMID: 23284913
504			_aContiene 47 referencias
520			_aBACKGROUND: Antiretroviral treatment (ART) has contributed to increased life expectancy of HIV-1 infected children. In developed countries, an increasing number of children reaching adulthood are transferred to adult units. The objectives were to describe the demographic and clinical features, ART history, antiviral drug resistance and drug susceptibility in HIV-1 perinatally infected adolescents transferred to adult care units in Spain from the Madrid Cohort of HIV-1 infected children. METHODS: Clinical, virological and immunological features of HIV-1 vertically infected patients in the Madrid Cohort of HIV-infected children were analyzed at the time of transfer. Pol sequences from each patient were recovered before transfer. Resistance mutations according to the InternationaI AIDS Society 2011 list were identified and interpreted using the Stanford algorithm. Results were compared to the non-transferred HIV-1 infected pediatric cohort from Madrid. RESULTS: One hundred twelve infected patients were transferred to adult units between 1997 and 2011. They were mainly perinatally infected (93.7%), with a mean nadir CD4+-T-cells count of 10% and presented moderate or severe clinical symptoms (75%). By the time of transfer, the mean age was 18.9 years, the mean CD4+T-cells count was 627.5 cells/ml, 64.2% presented more than 350 CD4+T-cells/ml and 47.3% had ≤ 200 RNA-copies/ml. Most (97.3%) were ART experienced receiving Highly Active ART (HAART) (84.8%). Resistance prevalence among pretreated was 50.9%, 76.9% and 36.5% for Protease Inhibitors (PI), Nucleoside Reverse Transcriptase Inhibitors (NRTI) and Non-NRTI (NNRTI), respectively. Resistance mutations were significantly higher among transferred patients compared to non-transferred for the PI+NRTI combination (19% vs. 8.4%). Triple resistance was similar to non-transferred pediatric patients (17.3% vs. 17.6%). CONCLUSION: Despite a good immunological and virological control before transfer, we found high levels of resistance to PI, NRTI and triple drug resistance in HIV-1 infected adolescents transferred to adult units.
710			_9446 _aServicio de Pediatría-Neonatología
856			_uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3524105/pdf/pone.0052155.pdf _yAcceso libre
942			_n0 _2ddc _cART
999			_c6509 _d6509