1. Virological and Social Outcomes of HIV-Infected Adolescents and Young Adults in The Netherlands Before and After Transition to Adult Care.
- Author
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Weijsenfeld AM, Smit C, Cohen S, Wit FWNM, Mutschelknauss M, van der Knaap LC, van Zonneveld LM, Zomer BJ, Nauta N, Patist JC, Kuipers-Jansen MHJ, Smit EP, Blokhuis C, Pajkrt D, Weijsenfeld AM, Cohen S, Blokhuis C, van der Plas A, Scherpbier HJ, Mutschelknauss M, Nellen FJB, Prins JM, Pajkrt D, Smit C, Wit FWNM, Reiss P, van der Knaap L, Visser E, van Zonneveld LM, Vriesde ME, Bassant NY, van der Ende ME, van Rossum AMC, Driessen GJA, Fraaij PLA, Smit JV, Smit EP, Kastelijns MPW, den Hollander JG, Pogány K, Moons C, Kroon FP, Oude Geerdink E, van der Meche IB, Schouten WEM, Brinkman K, Ter Beest G, Gisolf EH, Richter C, Zomer BJ, Strik-Albers R, van der Flier M, Henriet SS, Koopmans PP, Patist JC, Nauta N, Geelen SPM, Wolfs TFW, Hoepelman IM, Mudrikova T, van der Meulen PA, de Jonge H, Scholvink EH, Bierman WFW, van den Berg JF, Bouwhuis JW, Faber S, van Vonderen M, Schippers JA, Lowe SH, Kuipers-Jansen MHJ, van Kasteren MEE, Brouwer AE, Pronk DC, and Kortmann W
- Subjects
- Adolescent, Age Factors, Antiretroviral Therapy, Highly Active, Child, Child, Preschool, Female, HIV Infections drug therapy, HIV Infections transmission, HIV Infections virology, Humans, Lost to Follow-Up, Male, Netherlands epidemiology, Odds Ratio, Risk Factors, Socioeconomic Factors, Treatment Failure, Treatment Outcome, Young Adult, HIV Infections epidemiology, Transition to Adult Care
- Abstract
Background: As a result of effective combination antiretroviral therapy (cART) and advanced supportive healthcare, a growing number of human immunodeficiency virus (HIV)-infected children survive into adulthood. The period of transition to adult care is often associated with impaired adherence to treatment and discontinuity of care. We aimed to evaluate virological and social outcomes of HIV-infected adolescents and young adults (AYAs) before and after transition, and explore which factors are associated with virological failure., Methods: We included 59 HIV-infected AYAs from the Netherlands who had entered into pediatric care and transitioned from pediatric to adult healthcare. We used HIV RNA load and cART data from the Dutch Stichting HIV Monitoring database (1996-2014), and collected social and treatment data from patients' medical records from all Dutch pediatric HIV treatment centers and 14 Dutch adult treatment centers involved. We evaluated risk factors for virological failure (VF) in a logistic regression model adjusted for repeated measurements., Results: HIV VF occurred frequently during the study period (14%-36%). During the transition period (from 18 to 19 years of age) there was a significant increase in VF compared with the reference group of children aged 12-13 years (odds ratio, 4.26 [95% confidence interval, 1.12-16.28]; P = .03). Characteristics significantly associated with VF were low educational attainment and lack of autonomy regarding medication adherence at transition., Conclusions: HIV-infected AYAs are vulnerable to VF, especially during the transition period. Identification of HIV-infected adolescents at high risk for VF might help to improve treatment success in this group., (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.)
- Published
- 2016
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