Predictors of Treatment Failure in Children With HIV Starting First-line Antiretroviral Therapy in the ODYSSEY Trial.

In 30 seconds

The ODYSSEY trial investigated predictors of treatment failure in 381 children starting first-line antiretroviral therapy (ART), primarily in Africa. The study found that treatment failure was significantly lower in those receiving dolutegravir (DTG) compared to standard-of-care (SOC) with a hazard ratio of 0.47. Key predictors of failure included younger age, lower BMI-for-age, and lower CD4% at ART initiation.

Key findings

• Treatment failure was lower on DTG than SOC, with a hazard ratio of 0.47.
• Each unit gain in BMI-for-age Z-score decreased failure risk by 18% (HR = 0.82).
• Children at African sites had a higher failure risk (HR = 2.09).
• Younger age and lower CD4% at ART initiation were associated with increased failure risk.

Why it matters

Understanding predictors of treatment failure in children with HIV is crucial for optimizing ART strategies. Identifying at-risk populations can help clinicians provide targeted interventions and support to improve treatment outcomes.