Virologic response of adolescents living with perinatally acquired HIV receiving antiretroviral therapy in the period of early adolescence (10-14 years) in South Africa.
Virologic response of adolescents living with perinatally acquired HIV receiving antiretroviral therapy in the period of early adolescence (10-14 years) in South Africa.
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DOI：
10.1097/qad.0000000000002818
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发表时间：
2021-05-01
期刊：
影响因子：
--
通讯作者：
Davies MA
中科院分区：
文献类型：
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作者：
Nyakato P;Schomaker M;Sipambo N;Technau KG;Fatti G;Rabie H;Tanser F;Eley B;Euvrard J;Wood R;Tsondai PR;Yiannoutsos CT;Cornell M;Davies MA
已注意到，与非围产期获得性艾滋病毒的青少年、儿童或成人相比，接受抗逆转录病毒治疗的围产期获得性艾滋病毒（ALPHIV）青少年的依从性、保留性和病毒学控制较差。我们的目的是描述和检查与青春期早期纵向病毒学反应相关的因素。回顾性队列研究我们纳入了国际流行病学数据库评估艾滋病-南部非洲（IeDEA-SA）合作（2004-2016）的南非队列中9.5岁前开始抗逆转录病毒治疗的ALPHIV；10岁时病毒载量值(VLs) <400拷贝/mL， 10岁后至少进行一次VL检测。我们使用对数线性分位数混合模型来评估与VLs升高（第75分位数）相关的因素。我们纳入了4396例ALPHIV患者，50.7%为男性，抗逆转录病毒治疗开始时的中位年龄（四分位数范围）为6.5（4.5,8.1）岁。其中，74.9%在10岁时使用非核苷类逆转录酶抑制剂（NNRTI）。在调整其他患者特征后，第75分位VLs增加，随着年龄的增加，14岁患者的VLs比10岁高3.13倍（95% CI: 2.66, 3.68），二线蛋白酶抑制剂患者的VLs高3.25倍（95% CI: 2.81, 3.75），二线基于nnrti方案的VLs高1.81倍（与一线基于nnrti方案相比）。性别没有差异。作为10 - 14岁的青少年，他们越来越有可能经历更高的VL值，特别是如果接受二线PI或基于nnrti的方案，这需要坚持支持干预。
Adolescents living with perinatally acquired HIV (ALPHIV) on antiretroviral therapy (ART) have been noted to have poorer adherence, retention and virologic control compared to adolescents with non-perinatally acquired HIV, children or adults. We aimed to describe and examine factors associated with longitudinal virologic response during early adolescence. A retrospective cohort study We included ALPHIV who initiated ART before age 9.5 years in South African cohorts of the International epidemiology Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaboration (2004–2016); with viral load values (VLs) <400 copies/mL at age ten years and at least one VL measurement after age ten years. We used a log-linear quantile mixed model to assess factors associated with elevated (75th quantile) VLs. We included 4,396 ALPHIV, 50.7% were male, with median (interquartile range) age at ART start of 6.5 (4.5, 8.1) years. Of these, 74.9% were on a non-nucleoside reverse transcriptase inhibitor (NNRTI) at age ten years. After adjusting for other patient characteristics, the 75th quantile VLs increased, with increasing age being 3.13-fold (95% CI: 2.66, 3.68) higher at age 14 versus age 10, 3.25-fold (95% CI: 2.81, 3.75) higher for patients on second-line protease-inhibitor and 1.81-fold for second-line NNRTI-based regimens (versus first-line NNRTI-based regimens). There was no difference by sex. As adolescents age between 10 to 14 years, they are increasingly likely to experience higher VL values, particularly if receiving 2nd-line PI or NNRTI-based regimens, which warrants adherence support interventions.
影响因子：
3.7
作者：
Fokam J;Billong SC;Jogue F;Moyo Tetang Ndiang S;Nga Motaze AC;Paul KN;Njom Nlend AE
通讯作者：
Njom Nlend AE