Observance du traitement antirétroviral de l'adolescent séropositif pour le VIH

Trocmé, N.; Vaudre, G.; Dollfus, Catherine; Leverger, Guy

doi:10.1016/s0929-693x(02)00113-6

Cited by 23 publications

(10 citation statements)

References 5 publications

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“…Some of our participants chose not to disclose their situation at all to their boyfriends or girlfriends, and in some cases did not even dare to discuss condom use. As also reported by others [12], some of those who had revealed their status had had bad experiences such as having the partner break off the relationship.…”

Section: Discussionmentioning

confidence: 55%

To Say or Not to Say: A Qualitative Study on the Disclosure of Their Condition by Human Immunodeficiency Virus–Positive Adolescents

Michaud¹,

Surı́s²,

Thomas³

et al. 2009

Journal of Adolescent Health

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Section: Discussionmentioning

confidence: 55%

To Say or Not to Say: A Qualitative Study on the Disclosure of Their Condition by Human Immunodeficiency Virus–Positive Adolescents

Michaud¹,

Surı́s²,

Thomas³

et al. 2009

Journal of Adolescent Health

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“…A study of 29 French adolescents living with HIV found that secrecy and silence regarding their HIV diagnosis and treatment was seen as a major barrier to adherence. 22 Patients perceived that their adherence would be better if they didn't have to keep it a secret and were able to share with others. For many perinatally infected young people, HIV is often a taboo subject within the family with added layers of complexity due to family ill-health, maternal HIV, and potential carer role since childhood.…”

Section: Discussionmentioning

confidence: 99%

Importance of Self-Motivation and Social Support in Medication Adherence in HIV-Infected Adolescents in the United Kingdom and Ireland: A Multicentre HYPNet Study

Kim

McDonald

Kim

et al. 2015

AIDS Patient Care and STDs

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Adolescents are a vulnerable population, not only to the acquisition of HIV, but also to poor adherence to antiretroviral therapy (ART) associated with disease progression and a increased risk of onward viral transmission. The aim of the study was to examine the factors that aid or act as barriers to adherence in a UK population of adolescents and young adults receiving ART. A cross-sectional survey was completed of 138 adolescents (12-24 years) across 14 clinical and community sites in the UK and Ireland. Analysis of results was undertaken using Chi-square testing in SPSS. Of the 138 patients, 48% were female, and 52% were born outside of the UK. Fifty-two of the 138 (43%) reported being on ART for at least 8 years. More than a third of the patients have ever interrupted treatment since initiating ART. One hundred four of the 138 (75%) patients self-reported being >85% adherent to medication for 7 day recall. Self-motivation (e.g., having a routine, specific goal) was cited as being most helpful in medication compliance (33%), followed by reminders by friends and family (25%), with 20% identifing no specific factor. Only 15% chose interventions such as an adherence diary or mobile phone reminders as helpful factors, and 1% chose healthcare professional input such as home visits. This study highlights the importance of self-motivation and social support in medication adherence in an HIV-infected adolescent population, in preference to healthcare professional input. Education and motivational strategies may confer the biggest impact on sustained ART adherence amongst this vulnerable group.

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“…During adolescence, monitoring HIV infection is very challenging due to difficulties related to adherence, the risk of treatment failure owing to long-term ART (since childhood), and the complexity of managing this target population who are experiencing changes in their psychosocial, physiological and sexual activities [6,7]. Even though there are few global statistics on ART coverage specific to adolescents, the low coverage rate for children (< 15 years of age) clearly underscores these inequities.…”

Section: Introductionmentioning

confidence: 99%

Archiving of mutations in HIV‐1 cellular reservoirs among vertically infected adolescents is contingent with clinical stages and plasma viral load: Evidence from the EDCTP‐READY study

et al. 2021

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Introduction Globally, HIV‐related adolescent deaths have increased about 50%, especially for those who are vertically infected. This could be driven by archived drug resistance mutations (DRMs) as children grow up, which might jeopardize antiretroviral therapy (ART). Our objective was to compare HIV‐1 genotypic variation between plasma RNA and proviral DNA of vertically infected adolescents (aged 10–19 years) failing ART. Methods A comparative study was conducted in 2019 among 296 adolescents with perinatal HIV infection (ALPHI) failing ART in health facilities of the Centre Region of Cameroon. The WHO clinical stage, CD4 count and plasma viral load (PVL) were measured. For those failing ART (PVL ≥ 1000 copies/mL), RNA (plasma) and proviral DNA (buffy coat) were sequenced in the pol gene at Chantal BIYA International Reference Centre (CIRCB), Yaoundé, Cameroon. HIV‐1 subtypes and DRMs were interpreted using Stanford HIVdb v.8.8 and MEGA‐X. Results Of the 30% (89/296) failing ART, 81 had both RNA and DNA sequences generated and three were excluded for APOBEC mutations: the mean age was 16 ± 3 years; female‐to‐male ratio was 3:5; median PVL was 46 856 copies/mL [interquartile range (IQR): 19 898–271 410]; median CD4 count was 264 cells/μL (IQR: 131–574); and 42% were at WHO clinical stage 3/4. Subtype concordance between RNA and DNA viral strains was 100%, with CRF02_AG being predominant (65%) and two potential new recombinants found (A1/G/K; F1/G). Adolescents with DRMs were significantly higher in plasma than in proviral DNA (92% vs. 86%, p < 0.0001). Prevalent DRMs by drug class (RNA vs. DNA respectively) were at position M184 (74% vs. 67%) for nucleoside reverse transcriptase inhibitors (NRTIs), K103 (63% vs. 59%) for non‐NRTIs, and V82, L76 and M46 (2% vs. 2%) for protease inhibitors. A total of 35% (27/78) of adolescents had concordant DRM profiles in RNA and DNA, while 27% (21/78) had DRMs only in proviral DNA. The presence of archived DRMs was associated with advanced clinical stage 3/4 (OR = 0.14, p = 0.0003) and PVL < 5 Log (Copies/mL) (OR: 4.88, p = 0.006). Conclusions Although plasma RNA remains more sensitive for detecting HIV‐1 DRMs, about a quarter of ALPHI experiencing ART failure in an African setting might have archived DRMs in viral reservoirs, indicating clinically occult resistance. Thus, to ensure effective ART success, proviral DNA profiling (alongside RNA genotyping) would provide additional DRMs for adolescents with advanced clinical stages and/or moderate PVL.

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Observance du traitement antirétroviral de l'adolescent séropositif pour le VIH

Cited by 23 publications

References 5 publications

To Say or Not to Say: A Qualitative Study on the Disclosure of Their Condition by Human Immunodeficiency Virus–Positive Adolescents

To Say or Not to Say: A Qualitative Study on the Disclosure of Their Condition by Human Immunodeficiency Virus–Positive Adolescents

Importance of Self-Motivation and Social Support in Medication Adherence in HIV-Infected Adolescents in the United Kingdom and Ireland: A Multicentre HYPNet Study

Archiving of mutations in HIV‐1 cellular reservoirs among vertically infected adolescents is contingent with clinical stages and plasma viral load: Evidence from the EDCTP‐READY study

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