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Young people in the United Kingdom and Ireland with perinatally acquired HIV: The pediatric legacy for adult services

Foster, C; Judd, A; Tookey, P; Tudor-Williams, G; Dunn, D; Shingadia, D; Butler, K; ... Collaborative HIV Paediat Study CH; + view all (2009) Young people in the United Kingdom and Ireland with perinatally acquired HIV: The pediatric legacy for adult services. AIDS Patient Care and STDs , 23 (3) 159 - 166. 10.1089/apc.2008.0153. Green open access

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Abstract

Children with perinatally acquired HIV-1 infection are surviving into adolescence and increasingly transitioning toward adult services. Planning appropriate services in adult life requires an understanding of their progress through pediatric care. We describe the demographic features, disease progression, antiretroviral therapy (ART), and resistance in young people aged 10 years or more living in the United Kingdom and Ireland reported to the National Study of HIV in Pregnancy and Childhood (NSHPC) with prospective annual follow-up in the Collaborative HIV Paediatric Study (CHIPS) between 1996 and September 2007. Six hundred fifty-four perinatally infected young people were identified; 76% black African, 57% born abroad. Median age at presentation and duration of follow-up was 1 and 11 years, respectively, if born in the United Kingdom/Ireland, and 8 and 5 years if born elsewhere. One hundred sixty-nine (26%) ever had an AIDS-defining illness. Ten died during adolescence. At last follow-up, 64% were on ART, 18% off treatment having previously received ART and 18% were ART naive. Of 518 who had received highly active antiretroviral therapy (HAART), 47% were triple class experienced. At last follow-up 77 (12%) had CD4 counts less than 200 per microliter; of those on HAART, 78% had HIV-1 RNA <= 400 copies per milliliter, median CD4 count 554 (interquartile range [IQR] 324-802). Among 166 with resistance assays on HAART, 52% and 12% had dual- and triple-class HIV-1-associated resistance mutations, respectively. One hundred three (16%) young people had transferred to adult services. Young adults with perinatally acquired HIV-1 infection require coordinated multidisciplinary transitional care services and careful long-term follow-up in adult life.

Type: Article
Title: Young people in the United Kingdom and Ireland with perinatally acquired HIV: The pediatric legacy for adult services
Open access status: An open access version is available from UCL Discovery
DOI: 10.1089/apc.2008.0153
Publisher version: http://dx.doi.org/10.1089/apc.2008.0153
Language: English
Additional information: This is a copy of an article published in the AIDS Patient Care and STDs © 2009 copyright Mary Ann Liebert, Inc.; AIDS Patient Care and STDs is available online at: http://online.liebertpub.com.
Keywords: Active Antiretroviral Therapy, Human-Immunodeficiency-Virus, Infected Children, Adolescents, Mortality, Outcomes, Individuals, Resistance, Adherence, Life
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
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/124097
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