Publication:
The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis

Issued Date

2018-03-01

Resource Type

Article

ISSN

15491676
15491277

DOI

10.1371/journal.pmed.1002514

Other identifier(s)

2-s2.0-85045277935

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

PLoS Medicine. Vol.15, No.3 (2018)

Suggested Citation

Amy L. Slogrove, Michael Schomaker, Mary Ann Davies, Paige Williams, Suna Balkan, Jihane Ben-Farhat, Nancy Calles, Kulkanya Chokephaibulkit, Charlotte Duff, Tanoh François Eboua, Adeodata Kekitiinwa-Rukyalekere, Nicola Maxwell, Jorge Pinto, George Seage, Chloe A. Teasdale, Sebastian Wanless, Josiane Warszawski, Kara Wools-Kaloustian, Marcel Yotebieng, Venessa Timmerman, Intira J. Collins, Ruth Goodall, Colette Smith, Kunjal Patel, Mary Paul, Diana Gibb, Rachel Vreeman, Elaine J. Abrams, Rohan Hazra, Russell Van Dyke, Linda Gail Bekker, Lynne Mofenson, Marissa Vicari, Shaffiq Essajee, Martina Penazzato, Gabriel Anabwani, Edith Q. Mohapi, Peter N. Kazembe, Makhosazana Hlatshwayo, Mwita Lumumba, Tessa Goetghebuer, Claire Thorne, Luisa Galli, Annemarie van Rossum, Carlo Giaquinto, Magdalena Marczynska, Laura Marques, Filipa Prata, Luminita Ene, Liubov Okhonskaia, Pablo Rojo, Claudia Fortuny, Lars Naver, Christoph Rudin, Sophie Le Coeur, Alla Volokha, Vanessa Rouzier, Regina Succi, Annette Sohn, Azar Kariminia, Andrew Edmonds, Patricia Lelo, Samuel Ayaya, Patricia Ongwen, Laura F. Jefferys, Sam Phiri, Mwangelwa Mubiana-Mbewe, Shobna Sawry, Lorna Renner, Mariam Sylla, Mark J. Abzug, Myron Levin, James Oleske, Miriam Chernoff, Shirley Traite, Murli Purswani, Ellen G. Chadwick, Ali Judd, Valériane Leroy The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis. PLoS Medicine. Vol.15, No.3 (2018). doi:10.1371/journal.pmed.1002514 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46935

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Title

The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis

Author(s)

Amy L. Slogrove
 Michael Schomaker
 Mary Ann Davies
 Paige Williams
 Suna Balkan
 Jihane Ben-Farhat
 Nancy Calles
 Kulkanya Chokephaibulkit
 Charlotte Duff
 Tanoh François Eboua
 Adeodata Kekitiinwa-Rukyalekere
 Nicola Maxwell
 Jorge Pinto
 George Seage
 Chloe A. Teasdale
 Sebastian Wanless
 Josiane Warszawski
 Kara Wools-Kaloustian
 Marcel Yotebieng
 Venessa Timmerman
 Intira J. Collins
 Ruth Goodall
 Colette Smith
 Kunjal Patel
 Mary Paul
 Diana Gibb
 Rachel Vreeman
 Elaine J. Abrams
 Rohan Hazra
 Russell Van Dyke
 Linda Gail Bekker
 Lynne Mofenson
 Marissa Vicari
 Shaffiq Essajee
 Martina Penazzato
 Gabriel Anabwani
 Edith Q. Mohapi
 Peter N. Kazembe
 Makhosazana Hlatshwayo
 Mwita Lumumba
 Tessa Goetghebuer
 Claire Thorne
 Luisa Galli
 Annemarie van Rossum
 Carlo Giaquinto
 Magdalena Marczynska
 Laura Marques
 Filipa Prata
 Luminita Ene
 Liubov Okhonskaia
 Pablo Rojo
 Claudia Fortuny
 Lars Naver
 Christoph Rudin
 Sophie Le Coeur
 Alla Volokha
 Vanessa Rouzier
 Regina Succi
 Annette Sohn
 Azar Kariminia
 Andrew Edmonds
 Patricia Lelo
 Samuel Ayaya
 Patricia Ongwen
 Laura F. Jefferys
 Sam Phiri
 Mwangelwa Mubiana-Mbewe
 Shobna Sawry
 Lorna Renner
 Mariam Sylla
 Mark J. Abzug
 Myron Levin
 James Oleske
 Miriam Chernoff
 Shirley Traite
 Murli Purswani
 Ellen G. Chadwick
 Ali Judd
 Valériane Leroy

Other Contributor(s)

Elizabeth Glaser Pediatric AIDS Foundation
 Academic Model Providing Access to Healthcare
 Shupyk National Medical Academy of Postgraduate Education
 Centre for Infectious Disease Research in Zambia
 Medical University of Warsaw
 INED Institut National d' Études Démographiques
 Harvard School of Public Health
 Universidade Federal de Minas Gerais
 Centre Hospitalier Universitaire Saint Pierre, Brussels
 University of Colorado School of Medicine
 Columbia University Medical Center
 Baragwanath Hospital
 Organisation Mondiale de la Santé
 Kirby Institute
 The University of North Carolina at Chapel Hill
 Indiana University School of Medicine Indianapolis
 Università degli Studi di Firenze
 Santa Maria Hospital, Lisbon
 Karolinska University Hospital
 University of Ghana
 National Institute of Child Health and Human Development
 Tulane University
 University of Witwatersrand
 Sophia Kinderziekenhuis
 Universidade Federal de Sao Paulo
 Northwestern University Feinberg School of Medicine
 Icahn School of Medicine at Mount Sinai
 Victor Babes National Institute
 UCL Institute of Child Health
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 UNAIDS
 Texas Children's Hospital Houston
 UNICEF
 Medecins Sans Frontieres
 Universitäts-Kinderspital beider Basel
 Rutgers New Jersey Medical School
 Hospital Universitario 12 de Octubre
 Ohio State University
 MRC Clinical Trials Unit
 Universitat de Barcelona
 Inserm
 Chiang Mai University
 University of Cape Town
 Family AIDS Care and Education Services Medical Research Institute
 Baylor International Pediatric AIDS Initiative
 Baylor International Pediatric AIDS Initiative
 Baylor International Pediatric AIDS Initiative
 Baylor International Pediatrics AIDS Initiative
 PENTA Foundation
 SolidarMed Lesotho
 CHU Gabriel Touré
 Centro Hospitalar do Porto
 Baylor International Pediatric AIDS Initiative
 Baylor Pediatric International AIDS Initiative
 Lighthouse Trust
 TREAT Asia/amfAR-The Foundation for AIDS Research
 Republican Hospital of Infectious Diseases
 Pediatric Hospital Kalembe Lembe
 GHESKIO Centers
 Yopougon University Hospital

Abstract

© 2018 The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration et al. Background: Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in “real-life” settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. Methods and findings: Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5–5.2) years for the total cohort and 6.4 (3.6–8.0) years in Europe, 3.7 (2.0–5.4) years in North America, 2.5 (1.2–4.4) years in South and Southeast Asia, 5.0 (2.7–7.5) years in South America and the Caribbean, and 2.1 (0.9–3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3–2.1) years in North America to 7.1 (5.3–8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4–2.6) years in North America to 7.9 (6.0–9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%–2.8%), 15.6% (15.1%–16.0%), and 11.3% (10.9%–11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%–1.1%]) and highest in South America and the Caribbean (4.4% [3.1%–6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%–6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%–13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria. Conclusion: To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/46935

Collections

Scopus 2018