Clinical and laboratory characteristics of human immunodeficiency virus-infected adolescents: Experience from a single medical center

Purpose About a third of untreated, perinatally HIV-infected children reach adolescence. We evaluated the durability and effectiveness of non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART) in this population. Methods Data from perinatally HIV-infected, antiretroviral-naïve patients initiated on NNRTI-based ART aged 10–19 years who had ≥6 months of follow-up were analyzed. Competing risk regression was used to assess predictors of NNRTI substitution and clinical failure (WHO stage 3/4 event or death). Viral suppression was defined as a viral load <400 copies/ml. Results Data from 534 adolescents met our inclusion criteria (56.2% female; median age at treatment initiation 11.8 years). After five years of treatment, median height-for-age z-score increased from −2.3 to −1.6 and median CD4+ cell count increased from 131 to 580 cells/mm3. The proportion of patients with viral suppression after 6 months was 87.6% and remained >80% up to five years of follow-up. NNRTI substitution and clinical failure occurred at rates of 4.9 and 1.4 events per 100 patient-years, respectively. Not using cotrimoxazole prophylaxis at ART initiation was associated with NNRTI substitution (HR 1.5 versus using, 95%CI 1.0–2.2, p=0.05). Baseline CD4+ count ≤200 cells/mm3 (HR 3.3 versus >200, 95%CI 1.2–8.9, p=0.02) and not using cotrimoxazole prophylaxis at ART initiation (HR 2.1 versus using, 95%CI 1.0–4.6, p=0.05) were both associated with clinical failure. Conclusions Despite late ART initiation, adolescents achieved good rates of catch-up growth, CD4+ count recovery, and virological suppression. Earlier ART initiation and routine cotrimoxazole prophylaxis in this population may help to reduce current rates of NNRTI substitution and clinical failure.

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Non-Nucleoside Reverse Transcriptase Inhibitor–Based Antiretroviral Therapy in Perinatally HIV-Infected, Treatment-Naïve Adolescents in Asia

Boettiger¹,

Sudjaritruk

Nallusamy

et al. 2016

Journal of Adolescent Health

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Epidemiology of sexually transmitted viral hepatitis in human immunodeficiency virus-positive men who have sex with men in Asia

Lin

Sridhar

Wong

et al. 2015

Journal of the Formosan Medical Association

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Both human immunodeficiency virus (HIV) and viral hepatitis constitute major disease burden globally. As with other parts of the world, the HIV epidemic in Asia impacts mainly on men who have sex with men, one of the at-risk populations for sexually transmitted viral hepatitis. With the increasing availability of effective antiretroviral therapy, HIV-related mortality of people living with HIV has markedly reduced. Liver disease has become an important cause of mortality and morbidity in the HIV-infected population. With the improvement of socioeconomic conditions and availability of healthcare in Asian countries in recent years, the epidemiology of sexually transmitted viral hepatitis among HIV-positive men who have sex with men has also evolved. This review updates the epidemiology of different types of sexually transmitted viral hepatitis in this defined population in Asia.

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Prevalence and associated factors for HIV-1 transmitted drug resistance in voluntary clients for counseling and testing in Southern Taiwan

Weng

Tsai

Lee

et al. 2016

Journal of Microbiology, Immunology and Infection

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Clinical and laboratory characteristics of human immunodeficiency virus-infected adolescents: Experience from a single medical center

Abstract: MSM are the largest risk group in HIV-infected adolescents in southern Taiwan and are characterized by a high prevalence of anogenital warts and low seroprevalence of anti-HAV.

Cited by 6 publications

References 18 publications

Non-Nucleoside Reverse Transcriptase Inhibitor–Based Antiretroviral Therapy in Perinatally HIV-Infected, Treatment-Naïve Adolescents in Asia

Non-Nucleoside Reverse Transcriptase Inhibitor–Based Antiretroviral Therapy in Perinatally HIV-Infected, Treatment-Naïve Adolescents in Asia

Epidemiology of sexually transmitted viral hepatitis in human immunodeficiency virus-positive men who have sex with men in Asia

Prevalence and associated factors for HIV-1 transmitted drug resistance in voluntary clients for counseling and testing in Southern Taiwan

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