{"doi":"10.17615/ztf8-4p44","title":"Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort","abstract":"Background: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. Methods: Children initiating their first ART regimen between 2 and 14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis. Outcomes of interest were: first-line ART failure (clinical, immunologic, or virologic), change to second-line, and attrition (death or loss to program). Cumulative incidence was computed for first-line failure and second-line initiation, with attrition as a competing event. Results: In 27,031 children, median age at ART initiation was 6.7 years. Median baseline CD4% for children ≤5 years of age was 13.2% and CD4 count for those >5 years was 258 cells per microliter. Almost all (94.4%) initiated a nonnucleoside reverse transcriptase inhibitor; 5.3% a protease inhibitor, and 0.3% a triple nucleoside reverse transcriptase inhibitor-based regimen. At 1 year, 7.7% had failed and 14.4% had experienced attrition; by 5 years, the cumulative incidence was 25.9% and 29.4%, respectively. At 1 year after ART failure, 13.7% had transitioned to second-line and 11.2% had experienced attrition; by 5 years, the cumulative incidence was 31.6% and 25.9%, respectively. Conclusions: High rates of first-line failure and attrition were identified in children within 5 years after ART initiation. Of children meeting failure criteria, only one-third were transitioned to second-line ART within 5 years.","journal":"UNC Libraries","year":2023,"id":402143,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":0.0,"corpus_rank":10062,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.6029,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1179522,"name":"Irene Marete","orcid":"0000-0002-3277-5391","position":1,"is_corresponding":false},{"id":1179811,"name":"Davies, M.-A.","orcid":null,"position":2,"is_corresponding":false},{"id":1179812,"name":"Obama, M.-T.","orcid":null,"position":3,"is_corresponding":false},{"id":1179813,"name":"Sawry, S.","orcid":null,"position":4,"is_corresponding":false},{"id":1179814,"name":"Eboua, F.T.","orcid":null,"position":5,"is_corresponding":false},{"id":1179815,"name":"Yiannoutsos, C.T.","orcid":null,"position":6,"is_corresponding":false},{"id":1179816,"name":"Van Nguyen, L.","orcid":null,"position":7,"is_corresponding":false},{"id":1179817,"name":"Leroy, V.","orcid":null,"position":8,"is_corresponding":false},{"id":1179818,"name":"Newman, J.E.","orcid":null,"position":9,"is_corresponding":false},{"id":1179819,"name":"Wools-Kaloustian, K.","orcid":null,"position":10,"is_corresponding":false},{"id":1179820,"name":"Mofenson, L.M.","orcid":null,"position":11,"is_corresponding":false},{"id":1179821,"name":"Ayaya, S.","orcid":null,"position":12,"is_corresponding":false},{"id":1179822,"name":"Edmonds, A.","orcid":null,"position":13,"is_corresponding":false},{"id":361252,"name":"Shobna Sawry","orcid":"0000-0002-3845-4863","position":14,"is_corresponding":false},{"id":1179823,"name":"Yotebieng, M.","orcid":null,"position":15,"is_corresponding":false},{"id":1179824,"name":"Sohn, A.H.","orcid":null,"position":16,"is_corresponding":false},{"id":1179810,"name":"Musick, B.S.","orcid":null,"position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T01:20:23.920156Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}