1. High rates of antiretroviral coverage and virological suppression in HIV-1-infected children and adolescents.
- Author
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Soumah A, Avettand-Fenoel V, Veber F, Moshous D, Mahlaoui N, Blanche S, and Frange P
- Subjects
- Adolescent, Africa South of the Sahara ethnology, Anti-HIV Agents pharmacology, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Child, Child, Adopted, Child, Preschool, Drug Resistance, Viral, Emigrants and Immigrants, Female, France epidemiology, HIV Infections epidemiology, HIV Infections virology, Humans, Infant, Infant, Newborn, Male, Socioeconomic Factors, Thailand ethnology, Vietnam ethnology, Viremia epidemiology, Viremia virology, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV-1 isolation & purification, Viral Load drug effects, Viremia drug therapy
- Abstract
Objectives: To assess the outcome of HIV-infected individuals attending one of the largest French pediatric HIV centers in 2016-2017 and to compare the rates of antiretroviral coverage and virological suppression with the UNAIDS targets., Patients and Methods: The clinical and immuno-virological status of 163 HIV-1-infected children and adolescents attending Necker Hospital in Paris, France, were investigated. Virological suppression was defined as an HIV-1 viral load<50 copies/mL for at least six months. All genotypic resistance tests performed since birth were analyzed., Results: Most patients were born in Sub-Saharan African countries (41.7%) or in France (38.0%). Their median age was 14 years [IQR 7.3-17.0]. Although 33.7% of individuals had a history of AIDS-defining clinical event(s), 86.5% of children/adolescents were free from HIV-related symptoms at their most recent evaluation. Antiretroviral coverage was high (98.2%; mainly including one integrase inhibitor [42.3%] or one protease inhibitor [23.9%]). At the last visit, most patients (82.8%) had normal CD4T lymphocytes counts (≥25%). Although 61.7% of antiretroviral-experienced children had resistance to≥1 drug class and 9.2% had triple-class resistance, 80.3% of patients receiving antiretrovirals for≥6 months (126/157) were virologically suppressed. International adoptees were more frequently virologically suppressed than other patients (96.0% versus 74.6%, P=0.02)., Conclusions: Antiretroviral coverage exceeded the second UNAIDS 90 target aimed at ending the AIDS epidemic. The rate of virological suppression, one of the highest reported in children in high-income countries, is approaching the third UNAIDS 90 target and the rate observed in French HIV-infected adults on antiretrovirals., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
- Published
- 2020
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