Please use this identifier to cite or link to this item: http://cmuir.cmu.ac.th/jspui/handle/6653943832/63698
Title: Disease- and Treatment-related Morbidity in Adolescents With Perinatal HIV Infection in Asia
Authors: Adam W. Bartlett
Thahira Jamal Mohamed
Tavitiya Sudjaritruk
Nia Kurniati
Revathy Nallusamy
Rawiwan Hansudewechakul
Penh Sun Ly
Khanh Huu Truong
Pagakrong Lumbiganon
Thanyawee Puthanakit
Kulkanya Chokephaibulkit
Lam Van Nguyen
Viet Chau Do
Nagalingeswaran Kumarasamy
Nik Khairulddin Nik Yusoff
Moy Siew Fong
Dewi Kumara Wati
Annette H. Sohn
Azar Kariminia
Keywords: Medicine
Issue Date: 1-Mar-2019
Abstract: BACKGROUND: Perinatally HIV-infected adolescents (PHIVA) are exposed to a chronic systemic infection and long-term antiretroviral therapy (ART), leaving them susceptible to morbidities associated with inflammation, immunodeficiency and drug toxicity. METHODS: Data collected 2001 to 2016 from PHIVA 10-19 years of age within a regional Asian cohort were analyzed using competing risk time-to-event and Poisson regression analyses to describe the nature and incidence of morbidity events and hospitalizations and identify factors associated with disease-related, treatment-related and overall morbidity. Morbidity was defined according to World Health Organization clinical staging criteria and U.S. National Institutes of Health Division of AIDS criteria. RESULTS: A total 3,448 PHIVA contributed 17,778 person-years. Median age at HIV diagnosis was 5.5 years, and ART initiation was 6.9 years. There were 2,562 morbidity events and 307 hospitalizations. Cumulative incidence for any morbidity was 51.7%, and hospitalization was 10.0%. Early adolescence was dominated by disease-related infectious morbidity, with a trend toward noninfectious and treatment-related morbidity in later adolescence. Higher overall morbidity rates were associated with a CD4 count <350 cells/µL, HIV viral load ≥10,000 copies/mL and experiencing prior morbidity at age <10 years. Lower overall morbidity rates were found for those 15-19 years of age compared with 10-14 years and those who initiated ART at age 5-9 years compared with <5 or ≥10 years. CONCLUSIONS: Half of our PHIVA cohort experienced a morbidity event, with a trend from disease-related infectious events to treatment-related and noninfectious events as PHIVA age. ART initiation to prevent immune system damage, optimize virologic control and minimize childhood morbidity are key to limiting adolescent morbidity.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061251641&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/63698
ISSN: 15320987
Appears in Collections:CMUL: Journal Articles

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