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Title: | Virologic response of adolescents living with perinatally acquired HIV receiving antiretroviral therapy in the period of early adolescence (10–14 years) in South Africa |
Authors: | Nyakato, Patience Schomaker, Michael Sipambo, Nosisa Technau, Karl-Günter Fatti, Geoffrey Rabie, Helena Tanser, Frank Eley, Brian Euvrard, Jonathan Wood, Robin Tsondai, Priscilla R. Yiannoutsos, Constantin T. Cornell, Morna Davies, Mary-Ann |
Keywords: | Antiretroviral therapy Early adolescence HIV Perinatal infection Virologic response |
Issue Date: | 2020 |
Publisher: | Wolters Kluwer Health, Inc |
Abstract: | Background and objectives: 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. Design: A retrospective cohort study Methods: We included ALPHIV who initiated ART before age 9.5 years in South African cohorts of the International epidemiology Database to Evaluate AIDS-Southern Africa (IeDEA-SA) collaboration (2004–2016); with viral load (VL) values <400 copies/ml at age 10 years and at least one VL measurement after age 10 years. We used a log-linear quantile mixed model to assess factors associated with elevated (75th quantile) VLs. Results: We included 4396 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 10 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, were 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. Conclusions: As adolescents age between 10 and 14 years, they are increasingly likely to experience higher VL values, particularly if receiving second-line protease inhibitor or NNRTI-based regimens, which warrant adherence support interventions. |
URI: | https://journals.lww.com/aidsonline/Abstract/2021/05010/Virologic_response_of_adolescents_living_with.13.aspx http://ir.mu.ac.ke:8080/jspui/handle/123456789/4708 |
Appears in Collections: | School of Medicine |
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