AI Article Synopsis
- The study evaluated the health outcomes of 163 HIV-infected children and adolescents at a major pediatric HIV center in France during 2016-2017, focusing on their antiretroviral treatment and viral load suppression rates compared to UNAIDS targets.
- Most participants were from Sub-Saharan Africa or France, with a high antiretroviral coverage of 98.2%, and a significant number (80.3%) achieved virological suppression, despite some showing resistance to HIV medications.
- The findings indicate that the high rate of treatment coverage and viral load suppression surpasses the second UNAIDS target and is nearing the third target for virological suppression among children in high-income settings.
Article 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.
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| http://dx.doi.org/10.1016/j.medmal.2019.10.006 | DOI Listing |
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