Publication:
Characteristics, mortality and outcomes at transition for adolescents with perinatal HIV infection in Asia

Issued Date

2018-01-01

Resource Type

Article

ISSN

14735571
02699370

DOI

10.1097/QAD.0000000000001883

Other identifier(s)

2-s2.0-85056582448

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

AIDS. Vol.32, No.12 (2018), 1689-1697

Suggested Citation

Adam W. Bartlett, Khan Huu Truong, Wipaporn Natalie Songtaweesin, Kulkanya Chokephaibulkit, Rawiwan Hansudewechakul, Penh Sun Ly, Pagakrong Lumbiganon, Tavitiya Sudjaritruk, Lam Van Nguyen, Viet Chau Do, Nagalingeswaran Kumarasamy, Nik Khairulddin Nik Yusoff, Nia Kurniati, Moy Siew Fong, Dewi Kumara Wati, Revathy Nallusamy, Annette H. Sohn, Matthew G. Law, Thahira Jamal Mohamed Characteristics, mortality and outcomes at transition for adolescents with perinatal HIV infection in Asia. AIDS. Vol.32, No.12 (2018), 1689-1697. doi:10.1097/QAD.0000000000001883 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46081

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Title

Characteristics, mortality and outcomes at transition for adolescents with perinatal HIV infection in Asia

Author(s)

Adam W. Bartlett
 Khan Huu Truong
 Wipaporn Natalie Songtaweesin
 Kulkanya Chokephaibulkit
 Rawiwan Hansudewechakul
 Penh Sun Ly
 Pagakrong Lumbiganon
 Tavitiya Sudjaritruk
 Lam Van Nguyen
 Viet Chau Do
 Nagalingeswaran Kumarasamy
 Nik Khairulddin Nik Yusoff
 Nia Kurniati
 Moy Siew Fong
 Dewi Kumara Wati
 Revathy Nallusamy
 Annette H. Sohn
 Matthew G. Law
 Thahira Jamal Mohamed

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
 National Center for HIV/AIDS
 Children's Hospital 1
 Hospital Raja Perempuan Zainab II
 Foundation for AIDS Research
 Chiangrai Prachanukroh Hospital
 Hospital Likas
 Penang Hospital

Abstract

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. Objectives: The aim of this study was to describe characteristics of perinatally HIV-infected adolescents (PHIVAs), factors associated with mortality, and outcomes at transition. Design: Ongoing observational database collating clinical data on HIV-infected children and adolescents in Asia. Methods: Data from 2001 to 2016 relating to adolescents (10-19 years) with perinatal HIV infection were analysed to describe characteristics at adolescent entry and transition and combination antiretroviral therapy (cART) regimens across adolescence. A competing risk regression analysis was used to determine characteristics at adolescent entry associated with mortality. Outcomes at transition were compared on the basis of age at cART initiation. Results: Of 3448 PHIVA, 644 had reached transition. Median age at HIV diagnosis was 5.5 years, cART initiation 7.2 years and transition 17.9 years. At adolescent entry, 35.0% hadCD4+ cell count less than 500 cells/ml and 51.1% had experience da WHO stage III/IV clinical event. At transition, 38.9% had CD4+ cell count less than 500copies/ml, and 53.4% had experienced a WHO stage III/IV clinical event. Mortality ratewas 0.71 per 100 person-years, with HIV RNA >1000copies/ml, CD4+ cell count less than 500cells/ml, height-for-ageorweight-for-agez-score less than - 2, historyofa WHO stage III/IV clinical event or hospitalization and at least second cART associated with mortality. For transitioning PHIVA, those who commenced cART age less than 5 years had better virologic and immunologic outcomes, though were more likely to be on at least second cART. Conclusion: Delayed HIV diagnosis and cART initiation resulted in considerable morbidity and poor immune status by adolescent entry. Durable first-line cART regimens to optimize disease control are key to minimizing mortality. Early cART initiation provides the best virologic and immunologic outcomes at transition.

Keyword(s)

Immunology and Microbiology
 Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/46081

Collections

Scopus 2018