Factors Associated with Morbidity and Mortality Among Sexually Active Asian Adolescents and Young Adults with Perinatally Acquired HIV
Issued Date
2023-06-01
Resource Type
ISSN
08892229
eISSN
19318405
Scopus ID
2-s2.0-85162112690
Pubmed ID
36515173
Journal Title
AIDS Research and Human Retroviruses
Volume
39
Issue
6
Start Page
285
End Page
293
Rights Holder(s)
SCOPUS
Bibliographic Citation
AIDS Research and Human Retroviruses Vol.39 No.6 (2023) , 285-293
Suggested Citation
Singtoroj T., Teeraananchai S., Chokephaibulkit K., Phanuphak N., Gatechompol S., Hansudewechakul R., Dang H.L.D., Tran D.N.H., Kerr S., Sohn A.H. Factors Associated with Morbidity and Mortality Among Sexually Active Asian Adolescents and Young Adults with Perinatally Acquired HIV. AIDS Research and Human Retroviruses Vol.39 No.6 (2023) , 285-293. 293. doi:10.1089/aid.2021.0169 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/87699
Title
Factors Associated with Morbidity and Mortality Among Sexually Active Asian Adolescents and Young Adults with Perinatally Acquired HIV
Author's Affiliation
Siriraj Hospital
Children's Hospital No. 1 Ho Chi Minh City
Kasetsart University
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine, Chulalongkorn University
Institute of HIV Research and Innovation
TREAT Asia/amfAR - The Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Hung Vuong Hospital
Children's Hospital No. 1 Ho Chi Minh City
Kasetsart University
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine, Chulalongkorn University
Institute of HIV Research and Innovation
TREAT Asia/amfAR - The Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Hung Vuong Hospital
Other Contributor(s)
Abstract
We assessed morbidity and mortality among Thai and Vietnamese adolescents and young adults with perinatally acquired human immunodeficiency virus (PHIV) compared with matched HIV-negative peers, 12-24 years of age. Data on serious adverse events (SAEs) were prospectively collected between 2013 and 2018 according to U.S. NIH Division of AIDS criteria. Of 288 youth, 142 had PHIV and 146 were HIV negative. At enrollment, the overall median age was 19 (interquartile range [IQR] 17-20) years, 67% were female, and 95% were Thai. Almost all PHIV youth (99%) were receiving antiretroviral therapy; 50% self-reported adherence ≥95%. Median CD4 was 579 (IQR 404-800) cells/mm3, and 24% had HIV-RNA ≥1,000 copies/mL. During follow-up, 31 (22%) PHIV youth and 9 (6%) HIV-negative youth had at least one SAE. The overall crude SAE rate was 4.66 (3.42-6.35) per 100 person-years (PY); 7.22 (5.08-10.26) per 100 PY among youth with PHIV and 2.10 (1.09-4.03) per 100 PY in HIV-negative youth (p < .001). All seven deaths that occurred were among those with PHIV and primarily due to opportunistic infections (e.g., pneumocystis pneumonia, tuberculous meningitis). In multivariate analyses, having PHIV, being <20 years of age, and having anogenital high-risk human papillomavirus (HPV) infection with types 16 and/or 18 increased risk of SAEs. Among PHIV youth, CD4 count <350 cells/mm3, HIV-RNA ≥1,000 copies/mL, advanced WHO stages, and having anogenital HPV 16 and/or 18 infection predicted higher incidence of SAEs; no prior use of alcohol was protective. These data emphasize the need for tailored interventions for adolescents with PHIV to prevent long-term morbidity and mortality.