Long-Term Virological Treatment Outcomes in Adolescents and Young Adults With Perinatally and Non-Perinatally Acquired Human Immunodeficiency Virus

Author:

Weijsenfeld Annouschka M12,Smit Colette3,Wit Ferdinand W N M23,Mudrikova Tania4,Nellen Jeannine F J B2,van der Valk Marc23,Pajkrt Dasja1

Affiliation:

1. Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Paediatric Infectious Diseases , Amsterdam , The Netherlands

2. Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam , Amsterdam , The Netherlands

3. Stichting HIV Monitoring , Amsterdam , The Netherlands

4. Department of Internal Medicine, University Medical Centre Utrecht , Utrecht , The Netherlands

Abstract

Abstract Background Long-term viral suppression on antiretroviral therapy (ART) is not established among all people with human immunodeficiency virus (PWH). Young adults (18–24 years) are recognized as a group vulnerable for suboptimal virological treatment outcomes. The aim of this study is to evaluate longitudinal virological treatment outcomes and to identify risk factors for virological failure (VF) among young adults with non-perinatally and perinatally acquired human immunodeficiency virus (HIV) in the Netherlands. Methods We included individuals registered in the national ATHENA observational cohort from 2000 until 2020 who had entered care before the age of 25 years, who had received ART for at least 6 months with at least 2 available HIV ribonucleic acid measurements between the age of 18 and 24 years. We compared VF between age groups 12–17, 18–24, and 25–30 years. A multivariable generalized linear mixed model was used to evaluate risk factors for VF. Analyses were stratified by HIV acquisition mode. Results In total, 1174 non-perinatally PWH and 157 perinatally PWH were included. In 2020, VF rate was 7% in non-perinatally PWH young adults and 19% in perinatally PWH young adults. The adjusted risk for VF was significantly higher in those aged 18–24 compared to 25–30 years in both non-perinatally PWH (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.07–1.50) and perinatally PWH (OR, 2.34; 95% CI, 1.48–3.71). Conclusions Young adulthood is a vulnerable period, with increased risk for VF, especially for perinatally PWH. The probability of VF decreased over time, but less for perinatally PWH compared to non-perinatally PWH.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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5. Reducing HIV-related health disparities in the health resources and services Administration's Ryan white HIV/AIDS program;Mandsager;Am J Public Health,2018

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