1. Disclosure of HIV status and associated clinical outcomes of children and adolescents living with HIV in Asia.
- Author
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Sornillo, Johanna Beulah, Ditangco, Rossana, Lumbiganon, Pagakrong, Vu, Thien An, Le, Oanh Ngoc, Truong, Khanh Huu, Nguyen, Lam Van, Do, Viet Chau, Ounchanum, Pradthana, Wati, Dewi Kumara, Puthanakit, Thanyawee, Kurniati, Nia, Lapphra, Keswadee, Sudjaritruk, Tavitiya, Kumarasamy, Nagalingeswaran, Jamal Mohamed, Thahira A, Nik Yusoff, Nik Khairulddin, Fong, Siew Moy, Nallusamy, Revathy A., and Sohn, Annette H.
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MORTALITY prevention , *HIV infection prognosis , *HIV infections , *DISCLOSURE , *EVALUATION of medical care , *DISEASE progression , *PATIENT aftercare , *COMBINATION drug therapy , *ANTIRETROVIRAL agents , *PATIENT compliance , *PSYCHOLOGY of HIV-positive persons , *LONGITUDINAL method , *PROPORTIONAL hazards models , *CHILD mortality , *THERAPEUTICS , *CHILDREN , *ADOLESCENCE - Abstract
Disclosure of HIV status is an important part of pediatric care. We studied disclosure and clinical outcomes in a multi-country Asian cohort of children and adolescents with HIV. Those 6–19 years of age who initiated combination antiretroviral therapy (cART) between 2008 and 2018, and who had at least one follow-up clinic visit were included. Data up to December 2019 were analyzed. Cox and competing risk regression analyses were used to assess the effect of disclosure on disease progression (WHO clinical stage 3 or 4), loss to follow-up (LTFU; > 12 months), and death. Of 1913 children and adolescents (48% female; median [IQR] age 11.5 [9.2–14.7] years at last clinic visit), 795 (42%) were disclosed to about their HIV status at a median age of 12.9 years (IQR: 11.8–14.1). During follow-up, 207 (11%) experienced disease progression, 75 (3.9%) were LTFU, and 59 (3.1%) died. There were lower hazards of disease progression (adjusted hazard ratio [aHR] 0.43 [0.28–0.66]) and death (aHR 0.36 [0.17–0.79]) for those disclosed to compared with those who were not. Disclosure and its appropriate implementation should be promoted in pediatric HIV clinics in resource-limited settings. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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