Jillian Neary, Irene N Njuguna, A. Wagner, Barbra A Richardson, Daisy J Chebet, Agnes Langat, E. Ngugi, Sara Benki-Nugent, Hellen Moraa, Stephen E. Hawes, J. Overbaugh, Jennifer Slyker, Dara A. Lehman, Dalton C Wamalwa, Grace John-Stewart
{"title":"基于群体的轨迹模型确定肯尼亚感染艾滋病毒儿童的长期艾滋病毒病毒载量趋势","authors":"Jillian Neary, Irene N Njuguna, A. Wagner, Barbra A Richardson, Daisy J Chebet, Agnes Langat, E. Ngugi, Sara Benki-Nugent, Hellen Moraa, Stephen E. Hawes, J. Overbaugh, Jennifer Slyker, Dara A. Lehman, Dalton C Wamalwa, Grace John-Stewart","doi":"10.1097/qai.0000000000003439","DOIUrl":null,"url":null,"abstract":"\n \n Identifying determinants of longitudinal HIV viral load (VL) trajectories using group-based trajectory modeling (GBTM) can inform clinical strategies and mechanisms of non-adherence among children.\n \n \n \n Children under 12 months of age who were newly diagnosed with HIV were enrolled in the Optimizing Pediatric HIV Therapy (OPH; NCT00428116) from 2007-2010. Children initiated antiretroviral therapy (ART) at enrollment, and VL was assessed every 3 months for 24 months post-ART and 6-monthly thereafter up to 8 years of age. VL trajectory groups were defined using GBTM. Fisher’s exact and Kruskal-Wallis tests were used to determine correlates of each trajectory group compared to the sustained-low VL group.\n \n \n \n Five VL trajectory groups were identified among 89 children with 522 VL visits from 6-24 months: sustained-low VL (63% of children), sustained-very-high (16%), sustained-high (9%), low-to-high (7%), and high-with-periods-of-low (6%). Children in the sustained-high group were more frequently on a first-line protease inhibitor (PI)-based regimen (63% vs 38%; p=0.03) and had younger caregivers (median: 22 vs 28 years; p=0.02).\n Among 54 children with 560 VL visits followed from 48-96 months, 5 trajectory groups were identified: sustained-low (74%), mid-range (4%), periods-of-low (7%), high-to-low (7%), and sustained-high (7%). Those in the high-to-low group had younger caregivers (21 vs 29 years; p=0.01).\n \n \n \n GBTM identified unique VL patterns among children with unsuppressed VL. Caregiver and regimen-related characteristics were associated with patterns of non-suppression. Younger caregivers may benefit from tailored counseling to help them support child ART adherence. Palatable regimens are necessary for viral suppression among children with HIV.\n","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":"81 4","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Group-based trajectory modeling to determine long-term HIV viral load trends among children with HIV in Kenya\",\"authors\":\"Jillian Neary, Irene N Njuguna, A. Wagner, Barbra A Richardson, Daisy J Chebet, Agnes Langat, E. Ngugi, Sara Benki-Nugent, Hellen Moraa, Stephen E. Hawes, J. Overbaugh, Jennifer Slyker, Dara A. Lehman, Dalton C Wamalwa, Grace John-Stewart\",\"doi\":\"10.1097/qai.0000000000003439\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n Identifying determinants of longitudinal HIV viral load (VL) trajectories using group-based trajectory modeling (GBTM) can inform clinical strategies and mechanisms of non-adherence among children.\\n \\n \\n \\n Children under 12 months of age who were newly diagnosed with HIV were enrolled in the Optimizing Pediatric HIV Therapy (OPH; NCT00428116) from 2007-2010. Children initiated antiretroviral therapy (ART) at enrollment, and VL was assessed every 3 months for 24 months post-ART and 6-monthly thereafter up to 8 years of age. VL trajectory groups were defined using GBTM. Fisher’s exact and Kruskal-Wallis tests were used to determine correlates of each trajectory group compared to the sustained-low VL group.\\n \\n \\n \\n Five VL trajectory groups were identified among 89 children with 522 VL visits from 6-24 months: sustained-low VL (63% of children), sustained-very-high (16%), sustained-high (9%), low-to-high (7%), and high-with-periods-of-low (6%). Children in the sustained-high group were more frequently on a first-line protease inhibitor (PI)-based regimen (63% vs 38%; p=0.03) and had younger caregivers (median: 22 vs 28 years; p=0.02).\\n Among 54 children with 560 VL visits followed from 48-96 months, 5 trajectory groups were identified: sustained-low (74%), mid-range (4%), periods-of-low (7%), high-to-low (7%), and sustained-high (7%). Those in the high-to-low group had younger caregivers (21 vs 29 years; p=0.01).\\n \\n \\n \\n GBTM identified unique VL patterns among children with unsuppressed VL. Caregiver and regimen-related characteristics were associated with patterns of non-suppression. Younger caregivers may benefit from tailored counseling to help them support child ART adherence. 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Group-based trajectory modeling to determine long-term HIV viral load trends among children with HIV in Kenya
Identifying determinants of longitudinal HIV viral load (VL) trajectories using group-based trajectory modeling (GBTM) can inform clinical strategies and mechanisms of non-adherence among children.
Children under 12 months of age who were newly diagnosed with HIV were enrolled in the Optimizing Pediatric HIV Therapy (OPH; NCT00428116) from 2007-2010. Children initiated antiretroviral therapy (ART) at enrollment, and VL was assessed every 3 months for 24 months post-ART and 6-monthly thereafter up to 8 years of age. VL trajectory groups were defined using GBTM. Fisher’s exact and Kruskal-Wallis tests were used to determine correlates of each trajectory group compared to the sustained-low VL group.
Five VL trajectory groups were identified among 89 children with 522 VL visits from 6-24 months: sustained-low VL (63% of children), sustained-very-high (16%), sustained-high (9%), low-to-high (7%), and high-with-periods-of-low (6%). Children in the sustained-high group were more frequently on a first-line protease inhibitor (PI)-based regimen (63% vs 38%; p=0.03) and had younger caregivers (median: 22 vs 28 years; p=0.02).
Among 54 children with 560 VL visits followed from 48-96 months, 5 trajectory groups were identified: sustained-low (74%), mid-range (4%), periods-of-low (7%), high-to-low (7%), and sustained-high (7%). Those in the high-to-low group had younger caregivers (21 vs 29 years; p=0.01).
GBTM identified unique VL patterns among children with unsuppressed VL. Caregiver and regimen-related characteristics were associated with patterns of non-suppression. Younger caregivers may benefit from tailored counseling to help them support child ART adherence. Palatable regimens are necessary for viral suppression among children with HIV.
期刊介绍:
ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications.
The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.