Jackson, Charlotte;
Crichton, Siobhan;
Judd, Ali;
Bamford, Alasdair;
Goulder, Philip;
Klein, Nigel;
Marques, Laura;
... European Pregnancy and Paediatric Infections Cohort, Collaboration; + view all
(2025)
Long-term non-progression in children living with HIV: estimates from international cohort data.
AIDS
10.1097/QAD.0000000000004136.
(In press).
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Abstract
OBJECTIVES: To estimate the probability of long-term nonprogression (LTNP) in the absence of antiretroviral treatment (ART) in children with perinatally acquired HIV, and the impact of LTNP definitions on these estimates. DESIGN: Analysis of longitudinal routine care data (follow-up to 2016) collected through a collaboration of cohorts of children in routine HIV care across Europe and Thailand. METHODS: LTNP was defined as reaching age 8 years without disease progression (defined as an AIDS diagnosis or immunosuppression based on WHO immunosuppression-for-age thresholds, age-adjusted CD4+z-scores or CD4+ counts). ART initiation was treated as a competing risk (children initiating ART before age 8 were not considered to have LTNP). We included children born domestically in six national HIV cohorts (n = 2481). Additional analyses included domestic-born children enrolled in national cohorts in infancy (aged <12 months, n = 1144, six cohorts), or all domestic-born children in national and nonnational cohorts (n = 4542, 18 cohorts). Results were stratified by birth year. RESULTS: Among children born domestically in national cohorts in 2004-2007, the probability [95% confidence interval (CI)] of LTNP at age 8 years was 10% (6-15%) based on WHO immunosuppression-for-age criteria. This was lower for children born earlier when ART use was less frequent. Results were similar using other immunosuppression thresholds. Estimates were lower when restricted to domestic-born children in national cohorts enrolled in infancy, and higher when including all domestic-born children. CONCLUSION: Up to 10% of children born during 2004-2007 had LTNP at age 8. Our findings may help identify participants with LTNP for research into posttreatment control and HIV cure.
| Type: | Article |
|---|---|
| Title: | Long-term non-progression in children living with HIV: estimates from international cohort data |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000004136 |
| Publisher version: | https://doi.org/10.1097/qad.0000000000004136 |
| Language: | English |
| Additional information: | © 2025 Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (http://creativecommons.org/licenses/by/4.0). |
| Keywords: | HIV; Children; Europe; Thailand; HIV long-term non-progression |
| 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/10204660 |
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