TY - JOUR
T1 - Characterizing HIV manifestations and treatment outcomes of perinatally infected adolescents in Asia
AU - TREAT Asia Pediatric HIV Observational Database
AU - Chokephaibulkit, Kulkanya
AU - Kariminia, Azar
AU - Oberdorfer, Peninnah
AU - Nallusamy, Revathy
AU - Bunupuradah, Torsak
AU - Hansudewechakul, Rawiwan
AU - Dung, Khu T.hi Khanh
AU - Saphonn, Vonthanak
AU - Kumarasamy, Nagalingeswaran
AU - Lumbiganon, Pagakrong
AU - Viet, Do C.hau
AU - Kurniati, Nia
AU - Yusoff, Nik K.hairuddin Nik
AU - Razali, Kamarul
AU - Fong, Siew M.oy
AU - Khanh, Truong H.uu
AU - Wati, Dewi K.umara
AU - Sohn, Annette H.
PY - 2014/3/1
Y1 - 2014/3/1
N2 - BACKGROUND: More perinatally HIV-infected children in Asia are reaching adolescence.METHODS: We analyzed data from July 1991 to March 2011 reported by 18 clinics in 6 countries of children age >12 years.RESULTS: Of 1254 adolescents, 33 (2.6%) died, and 52 (4.1%) were lost to follow-up within 2.4-year (3566 person-years) median follow-up period. Of 1061 adolescents under active follow-up, 485 (46%) were male, median (interquartile range) age was 14.7 (13.3-16.4) years, 73% had lost a parent(s), 93% attended school and 62% were aware of their HIV status. At the most recent evaluation, 93% were receiving highly active antiretroviral therapy, 71% (N = 737/1035) had CD4 ≥ 500 cells/mm(3) and 87% (N = 718/830) had viral load (VL) <400 copies/mL. Current CD4 ≥ 200 cells/mm(3), no previous World Health Organization stage 3 or 4 and being on a first-line regimen were independently associated with recent VL <400 copies/mL. Current age <15 years, VL <400 copies/mL, CD4 15-24% (vs. <10%) at antiretroviral therapy initiation, no previous World Health Organization stage 3 or 4 and antiretroviral therapy duration of ≥ 1 year were associated with recent CD4 ≥ 500 cells/mm(3). Primary causes of death after age 12 were opportunistic infections (N = 15/33) and other AIDS- or treatment-related conditions (N = 9/33). Those at age 12 with CD4 <200 versus ≥ 500 cells/mm and those with VL ≥ 10,000 versus <10,000 copies/mL were 17.4 and 4.76 times more likely to die in adolescence, respectively.CONCLUSION: Adolescents in this cohort have been successfully maintained in HIV care. Initiating treatment at earlier stages of disease was associated with immune recovery and virologic suppression during adolescence.
AB - BACKGROUND: More perinatally HIV-infected children in Asia are reaching adolescence.METHODS: We analyzed data from July 1991 to March 2011 reported by 18 clinics in 6 countries of children age >12 years.RESULTS: Of 1254 adolescents, 33 (2.6%) died, and 52 (4.1%) were lost to follow-up within 2.4-year (3566 person-years) median follow-up period. Of 1061 adolescents under active follow-up, 485 (46%) were male, median (interquartile range) age was 14.7 (13.3-16.4) years, 73% had lost a parent(s), 93% attended school and 62% were aware of their HIV status. At the most recent evaluation, 93% were receiving highly active antiretroviral therapy, 71% (N = 737/1035) had CD4 ≥ 500 cells/mm(3) and 87% (N = 718/830) had viral load (VL) <400 copies/mL. Current CD4 ≥ 200 cells/mm(3), no previous World Health Organization stage 3 or 4 and being on a first-line regimen were independently associated with recent VL <400 copies/mL. Current age <15 years, VL <400 copies/mL, CD4 15-24% (vs. <10%) at antiretroviral therapy initiation, no previous World Health Organization stage 3 or 4 and antiretroviral therapy duration of ≥ 1 year were associated with recent CD4 ≥ 500 cells/mm(3). Primary causes of death after age 12 were opportunistic infections (N = 15/33) and other AIDS- or treatment-related conditions (N = 9/33). Those at age 12 with CD4 <200 versus ≥ 500 cells/mm and those with VL ≥ 10,000 versus <10,000 copies/mL were 17.4 and 4.76 times more likely to die in adolescence, respectively.CONCLUSION: Adolescents in this cohort have been successfully maintained in HIV care. Initiating treatment at earlier stages of disease was associated with immune recovery and virologic suppression during adolescence.
UR - http://www.scopus.com/inward/record.url?scp=85028266230&partnerID=8YFLogxK
U2 - 10.1097/INF.0b013e3182a18223
DO - 10.1097/INF.0b013e3182a18223
M3 - Article
C2 - 23942457
AN - SCOPUS:85028266230
SN - 0891-3668
VL - 33
SP - 291
EP - 294
JO - The Pediatric infectious disease journal
JF - The Pediatric infectious disease journal
IS - 3
ER -