The Outcomes of Transition from Pediatrics to Adult Care among Adolescents and Young Adults with HIV at a Tertiary Care Center in Bangkok

Author:

Rungmaitree Supattra1,Thamniamdee Nuchanat1,Sachdev Saranya2,Phongsamart Wanatpreeya1,Lapphra Keswadee1,Wittawatmongkol Orasri1,Maleesatharn Alan1,Khumcha Benjawan1,Hoffman Risa M.3,Chokephaibulkit Kulkanya14ORCID

Affiliation:

1. Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

2. International Health Policy Program, Nonthaburi, Thailand

3. Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, California, USA

4. Siriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Abstract

Background: Adolescents and young adults with HIV (AYHIV) are at high-risk of loss to follow up and virologic failure, particularly during transition from pediatric to adult clinics. Methods: We reviewed the medical records of AYHIV to characterize retention and virologic suppression following their transition. Results: 101 AYHIV, 97% perinatally infected, were transferred at the median age of 20 (IQR: 19-21) years. At 1-year post-transition, 92.1% were retained in care and 73.3% had viral suppression and at 2-years the retention and viral suppression were 87.1% and 76.7%, respectively. Factors associated with viral suppression were transition at ≥ 20 years of age (aOR 4.38, 95% CI 1.41-13.65) and receiving first-line ART regimen, compared to second- or third-line regimens, at transition (aOR 6.05, 95% CI 1.55-23.58). Conclusion: Transition outcomes of AYHIV in our setting were suboptimal. There is a need for interventions to support AYHIV transition during this vulnerable period.

Publisher

SAGE Publications

Subject

Infectious Diseases,Dermatology,Immunology

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