The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis
| العنوان: | The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis |
|---|---|
| المؤلفون: | Claudia Fortuny, Makhosazana Hlatshwayo, Intira Jeannie Collins, Mwangelwa Mubiana-Mbewe, Venessa Timmerman, Suna Balkan, Marissa Vicari, Elaine J. Abrams, Luisa Galli, Mark J. Abzug, Jorge Pinto, Linda-Gail Bekker, Myron J. Levin, Kulkanya Chokephaibulkit, Regina Célia de Menezes Succi, Shirley Traite, Josiane Warszawski, Laura F. Jefferys, Miriam Chernoff, Rohan Hazra, Sophie Le Coeur, Patricia Lelo, Mariam Sylla, Sebastian Wanless, Chloe A. Teasdale, Tessa Goetghebuer, Edith Q. Mohapi, Mary-Ann Davies, Kunjal Patel, Pablo Rojo, Mwita Lumumba, Paige Williams, Laura Marques, Tanoh Eboua, Valériane Leroy, Vanessa Rouzier, George R. Seage, Shobna Sawry, Amy L. Slogrove, C. Giaquinto, James Oleske, Kara Wools-Kaloustian, Murli Purswani, Ruth L. Goodall, Luminita Ene, Lynne Mofenson, Nancy Calles, Filipa Prata, Rachel Vreeman, Magdalena Marczyńska, Christoph Rudin, Mary Paul, Russell B Van Dyke, Diana Gibb, Samuel Ayaya, Claire Thorne, Martina Penazzato, Ali Judd, Liubov Okhonskaia, Andrew Edmonds, Sam Phiri, Annette H. Sohn, Lars Navér, Gabriel Anabwani, Annemarie M. C. van Rossum, Peter N. Kazembe, Ellen G. Chadwick, Nicola Maxwell, Lorna Renner, Jihane Ben-Farhat, Charlotte Duff, Adeodata Kekitiinwa-Rukyalekere, Patricia Ongwen, Colette Smith, Azar Kariminia, Shaffiq Essajee, Marcel Yotebieng, Alla Volokha, Michael Schomaker |
| المساهمون: | Institut national d'études démographiques (INED), Pediatrics |
| المصدر: | PLOS MEDICINE r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu Fundació Sant Joan de Déu PLoS Medicine, Vol 15, Iss 3, p e1002514 (2018) PLoS Medicine PLoS Medicine, Public Library of Science, 2018, 15 (3), pp.e1002514. ⟨10.1371/journal.pmed.1002514⟩ PLoS Medicine (online), 15(3):e1002514. Public Library of Science Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP PLoS medicine, 15 (3 r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu instname |
| بيانات النشر: | Public Library of Science, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | 0301 basic medicine, RNA viruses, Male, Internationality, International Cooperation, HIV Infections, Pathology and Laboratory Medicine, Global Health, Adolescents, Geographical Locations, Cohort Studies, Families, 0302 clinical medicine, Immunodeficiency Viruses, Interquartile range, Epidemiology, Medicine and Health Sciences, Cumulative incidence, Public and Occupational Health, 030212 general & internal medicine, Longitudinal Studies, Child, Children, education.field_of_study, Medicine (all), General Medicine, global cohort analysis, Vaccination and Immunization, 3. Good health, AIDS, Europe, Geography, Anti-Retroviral Agents, Medical Microbiology, Research Design, Viral Pathogens, Cohort, Viruses, Epidemiological Monitoring, Medicine, Female, epidemiology, Pathogens, Cohort study, Research Article, medicine.medical_specialty, Adolescent, Biochimie, Population, Immunology, Biotechnologie, Antiretroviral Therapy, The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis, [SHS.DEMO]Humanities and Social Sciences/Demography, Research and Analysis Methods, Microbiology, INTERNATIONAL_COMPARISON, 03 medical and health sciences, Antiviral Therapy, SDG 3 - Good Health and Well-being, Retroviruses, medicine, Disease Transmission, Infectious, Humans, education, Microbial Pathogens, Lentivirus, Organisms, Infant, Newborn, Biology and Life Sciences, Biologie moléculaire, HIV, South America, 030112 virology, mortality, Confidence interval, COHORT_ANALYSIS, Age Groups, People and Places, Africa, North America, Observational study, Population Groupings, Biologie cellulaire, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Preventive Medicine, Demography, Follow-Up Studies |
| الوصف: | Background: Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in “real-life” settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. Methods and findings: Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5–5.2) years for the total cohort and 6.4 (3.6–8.0) years in Europe, 3.7 (2.0–5.4) years in North America, 2.5 (1.2–4.4) years in South and Southeast Asia, 5.0 (2.7–7.5) years in South America and the Caribbean, and 2.1 (0.9–3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3–2.1) years in North America to 7.1 (5.3–8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4–2.6) years in North America to 7.9 (6.0–9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%–2.8%), 15.6% (15.1%–16.0%), and 11.3% (10.9%–11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%–1.1%]) and highest in South America and the Caribbean (4.4% [3.1%–6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%–6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%–13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria. Conclusion: To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses. 0 SCOPUS: ar.j info:eu-repo/semantics/published |
| وصف الملف: | application/pdf; 1 full-text file(s): application/pdf; pdf |
| تدمد: | 1549-1277 1549-1676 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8854c17051e3741887c75e481698ca8bTest http://fundanet.fsjd.org/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13841Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8854c17051e3741887c75e481698ca8b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15491277 15491676 |
|---|