High mortality in adolescents and young adults with perinatally-acquired HIV in Thailand during the transition to adulthood.
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| Title: | High mortality in adolescents and young adults with perinatally-acquired HIV in Thailand during the transition to adulthood. |
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| Authors: | Ounchanum, Pradthana, Aurpibul, Linda, Teeraananchai, Sirinya, Lumbiganon, Pagakrong, Songtaweesin, Wipaporn Natalie, Sudjaritruk, Tavitiya, Chokephaibulkit, Kulkanya, Rungmaitree, Supattra, Kosalaraksa, Pope, Suwanlerk, Tulathip, Ross, Jeremy L., Sohn, Annette H., Puthanakit on behalf of the Thai PAPAYA study team, Thanyawee |
| Source: | AIDS Care. Jul2024, Vol. 36 Issue 7, p964-973. 10p. |
| Subjects: | Infectious disease transmission, HIV infection prognosis, HIV integrase inhibitors, Research funding, HIV-positive persons, Questionnaires, HIV infections, Treatment effectiveness, Descriptive statistics, Patient care, Longitudinal method, Protease inhibitors, Vertical transmission (Communicable diseases), Reverse transcriptase inhibitors, Medical records, Acquisition of data, Anti-HIV agents, Survival analysis (Biometry), Confidence intervals, Transition to adulthood, AIDS, Adolescence, Adults |
| Geographic Terms: | Thailand |
| Abstract: | Transitioning from pediatric to adult care remains a challenge for adolescents and young adults with perinatally-acquired HIV (AYA-PHIV). We assessed treatment outcomes and mortality among Thai AYA-PHIV. The study included AYA-PHIV who reached age 18–24 years who started antiretroviral treatment during childhood at five pediatric HIV clinics across Thailand. From November 2020–July 2021, data were gathered from a cohort database, medical records, and the Thai National AIDS Program. Of 811 eligible AYA-PHIV, 93% were alive; median age 22.3 years (IQR 20.6–23.7), treatment duration 16.1 years (IQR 13.4–18.0). Current HIV care was provided in adults (71%) and pediatric clinics (29%). Treatment regimens included non-nucleoside reverse transcriptase inhibitors (55%), protease inhibitors (36%), and integrase inhibitors (8%); 78% had HIV RNA <200 copies/ml. Of the 7.0% who died, median age at death was 20.8 years (IQR 20.6–22.1); 88% were AIDS-related death. Mortality after age 18 was 1.76 per 100-person years (95% confidence interval 1.36–2.28). Those with CD4 <200 cell/mm3 at age 15 had higher risk of mortality (adjusted hazard ratio 6.16, 95% CI 2.37–16.02). In conclusion, the high mortality among Thai AYA-PHIV indicated the need for better systems to support AYA-PHIV during the transition to adulthood. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Transitioning from pediatric to adult care remains a challenge for adolescents and young adults with perinatally-acquired HIV (AYA-PHIV). We assessed treatment outcomes and mortality among Thai AYA-PHIV. The study included AYA-PHIV who reached age 18–24 years who started antiretroviral treatment during childhood at five pediatric HIV clinics across Thailand. From November 2020–July 2021, data were gathered from a cohort database, medical records, and the Thai National AIDS Program. Of 811 eligible AYA-PHIV, 93% were alive; median age 22.3 years (IQR 20.6–23.7), treatment duration 16.1 years (IQR 13.4–18.0). Current HIV care was provided in adults (71%) and pediatric clinics (29%). Treatment regimens included non-nucleoside reverse transcriptase inhibitors (55%), protease inhibitors (36%), and integrase inhibitors (8%); 78% had HIV RNA <200 copies/ml. Of the 7.0% who died, median age at death was 20.8 years (IQR 20.6–22.1); 88% were AIDS-related death. Mortality after age 18 was 1.76 per 100-person years (95% confidence interval 1.36–2.28). Those with CD4 <200 cell/mm3 at age 15 had higher risk of mortality (adjusted hazard ratio 6.16, 95% CI 2.37–16.02). In conclusion, the high mortality among Thai AYA-PHIV indicated the need for better systems to support AYA-PHIV during the transition to adulthood. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 09540121 |
| DOI: | 10.1080/09540121.2024.2325100 |
