Mortality and AIDS‐defining events among young people following transition from paediatric to adult HIV care in the UK. Issue 8 (3rd May 2021)

• Record Type: Journal Article
• Authors: Asad, H; Collins, IJ; Goodall, RL; Crichton, S; Hill, T; Doerholt, K; Foster, C; Lyall, H; Post, FA; Welch, S; Winston, A; Sabin, CA; Judd, A
• Other Names: Sabin Caroline investigator.; Saunders John investigator.; Mercer Catherine investigator.; Hughes Gwenda investigator.; Mandal Sema investigator.; Rait Greta investigator.; Ijaz Samreen investigator.; Rhodes Tim investigator.; Porter Kholoud investigator.; Rosenberg William investigator.; Bamford Alasdair investigator.; Butler Karina investigator.; Klein Nigel investigator.; McMaster Paddy investigator.; Prime Katia investigator.; Riordan Andrew investigator.; Shackley Fiona investigator.; Kenny Julia investigator.; Shingadia Delane investigator.; Storey Sharon investigator.; Tudor‐Williams Gareth investigator.; Turkova Anna investigator.; Cook Claire investigator.; Dobson Donna investigator.; Fairbrother Keith investigator.; Gibb Diana M investigator.; Harper Lynda investigator.; Le Prevost Marthe investigator.; Van Looy Nadine investigator.; Francis Kate investigator.; Peters Helen investigator.; Thorne Claire investigator.; Thrasyvoulou L investigator.; Fidler K investigator.; Bernatoniene J investigator.; Manyika F investigator.; Sharpe G investigator.; Subramaniam B investigator.; Hague R investigator.; Price V investigator.; Flynn J investigator.; Cardoso A investigator.; Abou–Rayyah M investigator.; Klein N investigator.; Bamford A investigator.; Shingadia D investigator.; Yeadon S investigator.; Segal S investigator.; Hawkins S investigator.; Dowie M investigator.; Bandi S investigator.; Percival E investigator.; Eisenhut M investigator.; Duncan K investigator.; Anguvaa L investigator.; Wren L investigator.; Flood T investigator.; Pickering A investigator.; McMaster P investigator.; Murphy C investigator.; Daniels J investigator.; Lees Y investigator.; Thompson F investigator.; Williams A investigator.; Williams B investigator.; Pope S investigator.; Libeschutz Dr S investigator.; Cliffe L investigator.; Southall S investigator.; Freeman A investigator.; Freeman H investigator.; Christie S investigator.; Gordon A investigator.; Rosie Hague D investigator.; Clarke L investigator.; Jones L investigator.; Brown L investigator.; Greenberg M investigator.; Benson C investigator.; Riordan A investigator.; Ibberson L investigator.; Shackley F investigator.; Patel S investigator.; Hancock J investigator.; Prime K investigator.; Sharland M investigator.; Storey S investigator.; Lyall EGH investigator.; Seery P investigator.; Tudor‐Williams G investigator.; Kirkhope N investigator.; Raghunanan S investigator.; Kenny Julia investigator.; Callaghan A investigator.; Bridgwood A investigator.; McMaster P investigator.; Evans J investigator.; Blake E investigator.; Yannoulias A investigator.; Ainsworth Jonathan investigator.; Allan Sris investigator.; Anderson Jane investigator.; Babiker Abdel investigator.; Chadwick David investigator.; Churchill Duncan investigator.; Delpech Valerie investigator.; Dunn David investigator.; Gazzard Brian investigator.; Gilson Richard investigator.; Gompels Mark investigator.; Hay Phillip investigator.; Johnson Margaret investigator.; Jose Sophie investigator.; Kegg Stephen investigator.; Leen Clifford investigator.; Martin Fabiola investigator.; Mital Dushyant investigator.; Nelson Mark investigator.; Orkin Chloe investigator.; Palfreeman Adrian investigator.; Phillips Andrew investigator.; Pillay Deenan investigator.; Post Frank investigator.; Pritchard Jillian investigator.; Sabin Caroline investigator.; Schwenk Achim investigator.; Tariq Anjum investigator.; Trevelion Roy investigator.; Ustianowski Andy investigator.; Walsh John investigator.; Jose Sophie investigator.; Phillips Andrew investigator.; Sabin Caroline investigator.; Dunn David investigator.; Shidfar Shaadi investigator.; Orkin Chloe investigator.; Lynch Janet investigator.; Hand James investigator.; Churchill Duncan investigator.; Perry Nicky investigator.; Tilbury Stuart investigator.; Youssef Elaney investigator.; Gazzard Brian investigator.; Nelson Mark investigator.; Wood Sue investigator.; Asboe David investigator.; Mandalia Sundhiya investigator.; Anderson Jane investigator.; Munshi Sajid investigator.; Post Frank investigator.; Adefisan Ade investigator.; Taylor Chris investigator.; Gleisner Zachary investigator.; Ibrahim Fowzia investigator.; Campbell Lucy investigator.; Babiker Abdel investigator.; Dunn David investigator.; Shidfar Shaadi investigator.; da Silva Santamaria Nicolas investigator.; Chadwick David investigator.; Baillie Kirsty investigator.; Gilson Richard investigator.; Brima Nataliya investigator.; Williams Ian investigator.; Ainsworth Jonathan investigator.; Schwenk Achim investigator.; Miller Sheila investigator.; Wood Chris investigator.; Johnson Margaret investigator.; Youle Mike investigator.; Lampe Fiona investigator.; Smith Colette investigator.; Tsintas Rob investigator.; Chaloner Clinton investigator.; Hutchinson Samantha investigator.; Walsh John investigator.; Mackie Nicky investigator.; Weber Jonathan investigator.; Ramzan Farhan investigator.; Carder Mark investigator.; Leen Clifford investigator.; Kerr Andrew investigator.; Morris Sheila investigator.; Gompels Mark investigator.; Allan Sue investigator.; Palfreeman Adrian investigator.; Lewszuk Adam investigator.; Kegg Stephen investigator.; Ogunbiyi Victoria investigator.; Mitchell Sue investigator.; Hay Phillip investigator.; Kemble Christian investigator.; Okolo Olanike investigator.; Watts Benjamin investigator.; Martin Fabiola investigator.; Russell‐Sharpe Sarah investigator.; Gravely Janet investigator.; Brewer Christine investigator.; Allan Sris investigator.; Harte Andrew investigator.; Brain Debra investigator.; Tariq Anjum investigator.; Jones Ron investigator.; Radford Liz investigator.; Milgate Sarah investigator.; Pritchard Jillian investigator.; Cumming Shirley investigator.; Atkinson Claire investigator.; Mital Dushyant investigator.; Edgell Veronica investigator.; Allen Julie investigator.; Ustianowski Andy investigator.; Murphy Cynthia investigator.; Gunder Ilise investigator.; Fox Ashini investigator.; Gees Howard investigator.; Mieszek Michelle investigator.; Whitworth Helen investigator.; Anderson L investigator.; Hembrom Rajesh investigator.; Teke Jennifer investigator.; Box Roberta investigator.; Hatton Tom investigator.; LeGegarat Christine investigator.; Tomlinson Lee investigator.; Price Ashley investigator.; McVittie Ian investigator.; Murtha Victoria investigator.; Shewan Laura investigator.; Apoola Ade investigator.; Connan Zak investigator.; Gregory Luke investigator.; Holding Kathleen investigator.; Chester Victoria investigator.; Mistry Trusha investigator.; Gatford Catherine investigator.; Delpech Valerie investigator.; Trevelion Roy investigator.;
• Is Part Of: HIV medicine. Volume 22:Issue 8(2021)
• Page Start: 631
• Page End: 640
• Publication Date: 2021-05-03
• Subjects: AIDS -- HIV -- mortality -- transition -- young people; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.13096
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: To investigate risk of AIDS and mortality after transition from paediatric to adult care in a UK cohort of young people with perinatally acquired HIV. Methods: Records of people aged ≥ 13 years on 31 December 2015 in the UK paediatric HIV cohort (Collaborative HIV Paediatric Study) were linked to those of adults in the UK Collaborative HIV Cohort (CHIC) cohort. We calculated time from transition to a new AIDS event/death, with follow‐up censored at the last visit or 31 December 2015, whichever was the earliest. Cumulative incidence of and risk factors for AIDS/mortality were assessed using Kaplan–Meier and Cox regression. Results: At the final paediatric visit, the 474 participants [51% female, 80% black, 60% born outside the UK, median (interquartile range) age at antiretroviral therapy (ART) initiation = 9 (5–13) years] had a median age of 18 (17–19) years and CD4 count of 471 (280–663) cell/μL; 89% were prescribed ART and 60% overall had a viral load ≤ 400 copies/mL. Over median follow‐up in adult care of 3 (2–6) years, 35 (8%) experienced a new AIDS event ( n = 25) or death ( n = 14) (incidence = 1.8/100 person‐years). In multivariable analyses, lower CD4 count at the last paediatric visit [adjusted hazard ratio = 0.8 (95% confidence interval: 0.7–1.0)/100 cells/μL increment] and AIDS diagnosis in paediatric care [2.7 (1.4–5.5)] were associated with a new AIDS event/mortality in adult care. Conclusions: Young people with perinatally acquired HIV transitioning to adult care with markers of disease progression in paediatric care experienced poorer outcomes in adult care. Increased investment in multidisciplinary specialized services is required to support this population at high risk of morbidity and mortality.