Publication:
Disease- and Treatment-related Morbidity in Adolescents with Perinatal HIV Infection in Asia

Issued Date

2019-03-01

Resource Type

Article

ISSN

15320987
08913668

DOI

10.1097/INF.0000000000002208

Other identifier(s)

2-s2.0-85061251641

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Pediatric Infectious Disease Journal. Vol.38, No.3 (2019), 287-292

Suggested Citation

Adam W. Bartlett, Thahira Jamal Mohamed, Tavitiya Sudjaritruk, Nia Kurniati, Revathy Nallusamy, Rawiwan Hansudewechakul, Penh Sun Ly, Khanh Huu Truong, Pagakrong Lumbiganon, Thanyawee Puthanakit, Kulkanya Chokephaibulkit, Lam Van Nguyen, Viet Chau Do, Nagalingeswaran Kumarasamy, Nik Khairulddin Nik Yusoff, Moy Siew Fong, Dewi Kumara Wati, Annette H. Sohn, Azar Kariminia Disease- and Treatment-related Morbidity in Adolescents with Perinatal HIV Infection in Asia. Pediatric Infectious Disease Journal. Vol.38, No.3 (2019), 287-292. doi:10.1097/INF.0000000000002208 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51844

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Title

Disease- and Treatment-related Morbidity in Adolescents with Perinatal HIV Infection in Asia

Author(s)

Adam W. Bartlett
 Thahira Jamal Mohamed
 Tavitiya Sudjaritruk
 Nia Kurniati
 Revathy Nallusamy
 Rawiwan Hansudewechakul
 Penh Sun Ly
 Khanh Huu Truong
 Pagakrong Lumbiganon
 Thanyawee Puthanakit
 Kulkanya Chokephaibulkit
 Lam Van Nguyen
 Viet Chau Do
 Nagalingeswaran Kumarasamy
 Nik Khairulddin Nik Yusoff
 Moy Siew Fong
 Dewi Kumara Wati
 Annette H. Sohn
 Azar Kariminia

Other Contributor(s)

VHS Medical Centre India
 National Hospital of Pediatrics Hanoi
 Universitas Udayana
 Universitas Indonesia
 Chulalongkorn University
 Kirby Institute
 Faculty of Medicine, Khon Kaen University
 Kuala Lumpur Hospital
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 Chiang Mai University
 Children's Hospital 2
 Children's Hospital 1
 Hospital Raja Perempuan Zainab II
 Foundation for AIDS Research
 Chiangrai Prachanukroh Hospital
 Hospital Likas
 National Center for HIV/AIDS
 Penang Hospital

Abstract

© 2018 Wolters Kluwer Health, Inc. All rights reserved. Background: Perinatally HIV-infected adolescents (PHIVA) are exposed to a chronic systemic infection and long-term antiretroviral therapy (ART), leaving them susceptible to morbidities associated with inflammation, immunodeficiency and drug toxicity. Methods: Data collected 2001 to 2016 from PHIVA 10-19 years of age within a regional Asian cohort were analyzed using competing risk time-to-event and Poisson regression analyses to describe the nature and incidence of morbidity events and hospitalizations and identify factors associated with disease-related, treatment-related and overall morbidity. Morbidity was defined according to World Health Organization clinical staging criteria and U.S. National Institutes of Health Division of AIDS criteria. Results: A total 3,448 PHIVA contributed 17,778 person-years. Median age at HIV diagnosis was 5.5 years, and ART initiation was 6.9 years. There were 2,562 morbidity events and 307 hospitalizations. Cumulative incidence for any morbidity was 51.7%, and hospitalization was 10.0%. Early adolescence was dominated by disease-related infectious morbidity, with a trend toward noninfectious and treatment-related morbidity in later adolescence. Higher overall morbidity rates were associated with a CD4 count <350 cells/μL, HIV viral load ≥10,000 copies/mL and experiencing prior morbidity at age <10 years. Lower overall morbidity rates were found for those 15-19 years of age compared with 10-14 years and those who initiated ART at age 5-9 years compared with <5 or ≥10 years. Conclusions: Half of our PHIVA cohort experienced a morbidity event, with a trend from disease-related infectious events to treatment-related and noninfectious events as PHIVA age. ART initiation to prevent immune system damage, optimize virologic control and minimize childhood morbidity are key to limiting adolescent morbidity.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/51844

Collections

Scopus 2019