Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Establishing a hepatitis C continuum of care among HIV/hepatitis C virus-coinfected individuals in EuroSIDA

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. HIV infection is independently associated with a higher concentration of alpha-1 antitrypsin

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. The extent of B-cell activation and dysfunction preceding lymphoma development in HIV-positive people

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Predictors of Ischemic and Hemorrhagic Strokes Among People Living With HIV: The D:A:D International Prospective Multicohort Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Serum creatinine and estimated glomerular filtration rates in HIV positive and negative adults in Ethiopia

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark - the SHADE

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Non-Hodgkin lymphoma risk in adults living with HIV across five continents

    Research output: Contribution to journalJournal articleResearchpeer-review

  • A Judd
  • R Lodwick
  • A Noguera-Julian
  • D M Gibb
  • K Butler
  • D Costagliola
  • C Sabin
  • A van Sighem
  • B Ledergerber
  • C Torti
  • A Mocroft
  • D Podzamczer
  • M Dorrucci
  • S De Wit
  • N Obel
  • F Dabis
  • A Cozzi-Lepri
  • F García
  • N H Brockmeyer
  • J Warszawski
  • M I Gonzalez-Tome
  • C Mussini
  • G Touloumi
  • R Zangerle
  • J Ghosn
  • A Castagna
  • G Fätkenheuer
  • C Stephan
  • L Meyer
  • M A Campbell
  • G Chene
  • A Phillips
  • Pursuing Later Treatment Options II (PLATO II) Project Team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord
  • Ole Kirk
View graph of relations

OBJECTIVES: The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection.

METHODS: We analysed individual patient data from cohorts in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). A total of 5972 participants starting antiretroviral therapy (ART) from 1998, aged < 20 years at the start of ART for those with perinatal infection and 15-29 years for those with heterosexual infection, with ART containing at least two nucleoside reverse transcriptase inhibitors (NRTIs) and a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (bPI), were followed from ART initiation until the most recent viral load (VL) measurement. Virological failure of a drug was defined as VL > 500 HIV-1 RNA copies/mL despite ≥ 4 months of use. TCVF was defined as cumulative failure of two NRTIs, an NNRTI and a bPI.

RESULTS: The median number of weeks between diagnosis and the start of ART was higher in participants with perinatal HIV infection compared with participants with heterosexually acquired HIV infection overall [17 (interquartile range (IQR) 4-111) vs. 8 (IQR 2-38) weeks, respectively], and highest in perinatally infected participants aged 10-14 years [49 (IQR 9-267) weeks]. The cumulative proportion with TCVF 5 years after starting ART was 9.6% [95% confidence interval (CI) 7.0-12.3%] in participants with perinatally acquired infection and 4.7% (95% CI 3.9-5.5%) in participants with heterosexually acquired infection, and highest in perinatally infected participants aged 10-14 years when starting ART (27.7%; 95% CI 13.2-42.1%). Across all participants, significant predictors of TCVF were those with perinatal HIV aged 10-14 years, African origin, pre-ART AIDS, NNRTI-based initial regimens, higher pre-ART viral load and lower pre-ART CD4.

CONCLUSIONS: The results suggest a beneficial effect of starting ART before adolescence, and starting young people on boosted PIs, to maximize treatment response during this transitional stage of development.

Original languageEnglish
JournalHIV Medicine
Volume18
Issue number3
Pages (from-to)171–180
ISSN1464-2662
DOIs
Publication statusPublished - 2017

ID: 49202590