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Survival of HIV-1 vertically infected children

Davies, M-A; Gibb, D; Turkova, A; (2016) Survival of HIV-1 vertically infected children. Current Opinion in HIV and AIDS , 11 (5) pp. 455-464. 10.1097/COH.0000000000000303. Green open access

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Abstract

PURPOSE OF REVIEW: It is 20 years since the start of the combination antiretroviral therapy (cART) era and more than 10 years since cART scale-up began in resource-limited settings. We examined survival of vertically HIV-infected infants and children in the cART era. RECENT FINDINGS: Good survival has been achieved on cART in all settings with up to 10-fold mortality reductions compared with before cART availability. Although mortality risk remains high in the first few months after cART initiation in young children with severe disease, it drops rapidly thereafter even for those who started with advanced disease, and longer term mortality risk is low. However, suboptimal retention on cART in routine programs threatens good survival outcomes and even on treatment children continue to experience high comorbidity risk; infections remain the major cause of death. Interventions to address infection risk include a cotrimoxazole prophylaxis, isoniazid preventive therapy, routine childhood and influenza immunization, and improving maternal survival. SUMMARY: Pediatric survival has improved substantially with cART and HIV-infected children are aging into adulthood. It is important to ensure access to diagnosis and early cART, good program retention as well as optimal comorbidity prophylaxis and treatment to achieve the best possible long-term survival and health outcomes for vertically infected children.

Type: Article
Title: Survival of HIV-1 vertically infected children
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/COH.0000000000000303
Publisher version: http://doi.org/10.1097/COH.0000000000000303
Language: English
Additional information: © 2016 Wolters Kluwer Health, Inc. All rights reserved. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Adolescent, Adult, Anti-Retroviral Agents, Child, Child, Preschool, HIV Infections, Humans, Incidence, Infant, Infectious Disease Transmission, Vertical, Survival Analysis, Young Adult
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10044973
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