Virologic Failure in Different Antiretroviral Regimens Among Pediatric Patients with HIV Referring to a Voluntary Counseling and Testing (VCT) Center in Tehran, Iran (2004 - 2017)

Objectives: This study aimed to evaluate the virologic failure rate of treatment for various types of antiretroviral treatment (ART) regimens in pediatric patients with HIV. Methods: The present study was conducted among 75 HIV-positive pediatric patients characterized by the presence of a viral load of 200 or more copies per mL after six months of effective, continuous ART regimen. Therefore, treatment failure was defined based on virologic failure. We designed a questionnaire that included patients’ demographic characteristics, viral load markers, TCD4+ count, antiretroviral regimen received, and the probable treatment failure, along with the results of the drug resistance tests. Results: In total, 22 (29.2%) children experienced treatment failure. The most common primary antiretroviral regimen was Zidovudine (AZT)/Lamivudine (3TC)/Nevirapine (NVP) (59.2%), followed by AZT/3TC/Efavirenz (EFV) (29.6%). The highest rate of virologic failure was related to the AZT/3TC/NVP regimen (68.2%). In children who used NVP, the virologic failure was significantly higher than in children on other regimens (P = 0.02). Conclusions: The present study showed that patients receiving ART regimens based on reverse transcriptase non-nucleoside inhibitors, especially NVP, experienced more treatment failure than patients receiving other regimens.