Kulkanya Chokephaibulkit1, Azar Kariminia, Peninnah Oberdorfer, Revathy Nallusamy, Torsak Bunupuradah, Rawiwan Hansudewechakul, Khu Thi Khanh Dung, Vonthanak Saphonn, Nagalingeswaran Kumarasamy, Pagakrong Lumbiganon, Do Chau Viet, Nia Kurniati, Nik Khairuddin Nik Yusoff, Kamarul Razali, Siew Moy Fong, Truong Huu Khanh, Dewi Kumara Wati, Annette H Sohn. 1. From the *Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; †Biostatistics and Databases Program, The Kirby Institute, Faculty of Medicine, The University of New South Wales, Sydney, Australia; ‡Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; §Penang Hospital, Penang, Malaysia; ¶HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok; ‖Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand; **National Hospital of Pediatrics, Hanoi, Vietnam; ††National Centre for HIV/AIDS Dermatology and STDs, Phnom Penh, Cambodia; ‡‡YR Gaitonde Centre for AIDS Research and Education, Chennai, India; §§Khon Kaen University, Khon Kaen, Thailand; ¶¶Children's Hospital 2, Ho Chi Minh City, Vietnam; ‖‖Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; ***Hospital Raja Perempuan Zainab II, Kelantan; †††Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur; ‡‡‡Hospital Likas, Kota Kinabalu, Malaysia; §§§Children's Hospital 1, Ho Chi Minh City, Vietnam; ¶¶¶Sanglah Hospital, Udayana University, Bali, Indonesia; and ‖‖‖TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
Abstract
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.
BACKGROUND: More perinatally HIV-infectedchildren 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.
Authors: C Dollfus; J Le Chenadec; A Faye; S Blanche; N Briand; C Rouzioux; J Warszawski Journal: Clin Infect Dis Date: 2010-07-15 Impact factor: 9.079
Authors: Bill G Kapogiannis; Minn M Soe; Steven R Nesheim; Elaine J Abrams; Rosalind J Carter; John Farley; Paul Palumbo; Linda J Koenig; Marc Bulterys Journal: Clin Infect Dis Date: 2011-11 Impact factor: 9.079
Authors: Jean B Nachega; Michael Hislop; Hoang Nguyen; David W Dowdy; Richard E Chaisson; Leon Regensberg; Mark Cotton; Gary Maartens Journal: J Acquir Immune Defic Syndr Date: 2009-05-01 Impact factor: 3.731
Authors: Celestin Bakanda; Josephine Birungi; Robert Mwesigwa; Jean B Nachega; Keith Chan; Alexis Palmer; Nathan Ford; Edward J Mills Journal: PLoS One Date: 2011-04-29 Impact factor: 3.240
Authors: Gayatri Mirani; Paige L Williams; Miriam Chernoff; Mark J Abzug; Myron J Levin; George R Seage; James M Oleske; Murli U Purswani; Rohan Hazra; Shirley Traite; Bonnie Zimmer; Russell B Van Dyke Journal: Clin Infect Dis Date: 2015-08-12 Impact factor: 9.079
Authors: Priscilla R Tsondai; Kate Braithwaite; Geoffrey Fatti; Carolyn Bolton Moore; Cleophas Chimbetete; Helena Rabie; Sam Phiri; Shobna Sawry; Brian Eley; Michael A Hobbins; Andrew Boulle; Katayoun Taghavi; Annette H Sohn; Mary-Ann Davies Journal: AIDS Date: 2020-12-01 Impact factor: 4.632
Authors: Rashida A Ferrand; Datonye Briggs; Jane Ferguson; Martina Penazzato; Alice Armstrong; Peter MacPherson; David A Ross; Katharina Kranzer Journal: Trop Med Int Health Date: 2016-01-10 Impact factor: 2.622