Phatharajit Phatharodom, Alan Maleesatharn, Tavitiya Sudjaritruk, Suwimon Khusuwan, Kathy Petoumenos, Linda Aurpibul, Romanee Chaiwarith, Michelle L. Giles, Du Tuan Quy, Smita Nimkar, Alvina Widhani, Junko Tanuma, Matthew Law, Annette H. Sohn, Kulkanya Chokephaibulkit, IeDEA Asia-Pacific
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Young adults with available data who had been on antiretroviral therapy (ART) for at least 1 year were included. Analyses were conducted at ages 18 and 25 years and compared by route of HIV acquisition. Factors associated with viral suppression (<200 copies/ml) at age 25 were identified using logistic regression.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>There were 1333 individuals included at age 18 (96% with PHIV: 46% male) and 305 at age 25 (27% with PHIV; 75% male). Compared to those with sexually acquired HIV at age 18, those with PHIV had a longer median duration of ART (10 vs. 4 years, <i>p<</i>0.001), higher current CD4 count (606 vs. 462 cells/mm<sup>3</sup>, <i>p =</i> 0.001), were shorter (height 158 vs. 166 cm, <i>p<</i>0.001), with more hypercholesterolemia (20% vs. 5%, <i>p</i> = 0.031) and hypertriglyceridemia (29% vs. 6% mg/dl, <i>p</i> = 0.003). At age 25, differences in duration of ART (15 vs. 3 years, <i>p<</i>0.001), male height (165 vs. 173 cm, <i>p =</i> 0.009) and proportion with hypertriglyceridemia (38% vs. 15%, <i>p =</i> 0.002) were observed. HIV viral suppression did not vary by mode of acquisition (89% vs. 87% at age 18; 91% vs. 85% at age 25). At age 25, living in Thailand (adjusted odds ratio [AOR] 6.05, 95% confidence interval [CI] 1.95−18.80) and use of integrase inhibitor-based regimens (AOR 5.20, 95% CI 1.62−16.65) or protease inhibitor-based regimens (AOR 2.62, 95% CI 1.01−6.79) were associated with viral suppression.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Young adults with PHIV who survived to ages 18 and 25 were more likely to have stunted growth but had similar viral suppression to those with sexually acquired HIV in our regional cohorts. However, viral suppression rates remained lower for all relative to the UNAIDS goal of 95%, and measures to improve treatment outcomes are needed for young adults.</p>\n </section>\n </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 4","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26400","citationCount":"0","resultStr":"{\"title\":\"Differences in clinical characteristics between adolescents and young adults with perinatally and sexually acquired HIV in the Asia-Pacific region\",\"authors\":\"Phatharajit Phatharodom, Alan Maleesatharn, Tavitiya Sudjaritruk, Suwimon Khusuwan, Kathy Petoumenos, Linda Aurpibul, Romanee Chaiwarith, Michelle L. Giles, Du Tuan Quy, Smita Nimkar, Alvina Widhani, Junko Tanuma, Matthew Law, Annette H. 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引用次数: 0
摘要
我们评估了亚太地区围产期获得性艾滋病毒（PHIV）的年轻成年人与通过性传播感染艾滋病毒的人的长期艾滋病毒相关健康结果。方法：我们使用来自国际流行病学数据库评估艾滋病（IeDEA）亚太联盟的三个儿童和成人队列的数据进行了一项横断面研究。这项研究包括了从1991年到2021年收集的12个国家的数据。有可用资料的接受抗逆转录病毒治疗（ART）至少1年的年轻人被纳入研究。对18岁和25岁人群进行分析，并按感染途径进行比较。使用逻辑回归确定25岁时病毒抑制相关因素（<；200拷贝/ml）。结果18岁1333人（96%感染hiv，男性46%），25岁305人(27%感染hiv；75%的男性)。与18岁时性获得性艾滋病毒感染者相比，艾滋病毒感染者抗逆转录病毒治疗的中位持续时间更长（10年vs. 4年，p = 0.001），当前CD4计数较高（606个vs. 462个细胞/mm3， p = 0.001），较短（身高158个vs. 166厘米，p = 0.001），较高的高胆固醇血症（20% vs. 5%, p = 0.031）和高甘油三酯血症（29% vs. 6% mg/dl, p = 0.003）。25岁时，观察到ART持续时间（15年vs. 3年，p = 0.001）、男性身高（165厘米vs. 173厘米，p = 0.009）和高甘油三酯血症比例（38% vs. 15%, p = 0.002）的差异。HIV病毒抑制没有因获得方式而异(在18岁时为89%对87%；91% vs. 25岁时的85%)。25岁时，生活在泰国（调整优势比[AOR] 6.05, 95%可信区间[CI] 1.95 ~ 18.80）和使用整合酶抑制剂为主的方案（AOR 5.20, 95% CI 1.62 ~ 16.65）或蛋白酶抑制剂为主的方案（AOR 2.62, 95% CI 1.01 ~ 6.79）与病毒抑制相关。结论：在我们的区域队列中，存活至18岁和25岁的PHIV年轻成人更有可能发育迟缓，但病毒抑制与性获得性HIV感染者相似。然而，与联合国艾滋病规划署95%的目标相比，所有人的病毒抑制率仍然较低，需要采取措施改善年轻人的治疗结果。
Differences in clinical characteristics between adolescents and young adults with perinatally and sexually acquired HIV in the Asia-Pacific region
Introduction
We assessed the long-term HIV-related health outcomes of young adults with perinatally acquired HIV (PHIV) compared with those who acquired HIV through sexual transmission in the Asia-Pacific region.
Methods
We conducted a cross-sectional study using data from three paediatric and adult cohorts within the International epidemiology Databases to Evaluate AIDS (IeDEA) Asia-Pacific consortium. This study included data from 12 countries, collected between 1991 and 2021. Young adults with available data who had been on antiretroviral therapy (ART) for at least 1 year were included. Analyses were conducted at ages 18 and 25 years and compared by route of HIV acquisition. Factors associated with viral suppression (<200 copies/ml) at age 25 were identified using logistic regression.
Results
There were 1333 individuals included at age 18 (96% with PHIV: 46% male) and 305 at age 25 (27% with PHIV; 75% male). Compared to those with sexually acquired HIV at age 18, those with PHIV had a longer median duration of ART (10 vs. 4 years, p<0.001), higher current CD4 count (606 vs. 462 cells/mm3, p = 0.001), were shorter (height 158 vs. 166 cm, p<0.001), with more hypercholesterolemia (20% vs. 5%, p = 0.031) and hypertriglyceridemia (29% vs. 6% mg/dl, p = 0.003). At age 25, differences in duration of ART (15 vs. 3 years, p<0.001), male height (165 vs. 173 cm, p = 0.009) and proportion with hypertriglyceridemia (38% vs. 15%, p = 0.002) were observed. HIV viral suppression did not vary by mode of acquisition (89% vs. 87% at age 18; 91% vs. 85% at age 25). At age 25, living in Thailand (adjusted odds ratio [AOR] 6.05, 95% confidence interval [CI] 1.95−18.80) and use of integrase inhibitor-based regimens (AOR 5.20, 95% CI 1.62−16.65) or protease inhibitor-based regimens (AOR 2.62, 95% CI 1.01−6.79) were associated with viral suppression.
Conclusions
Young adults with PHIV who survived to ages 18 and 25 were more likely to have stunted growth but had similar viral suppression to those with sexually acquired HIV in our regional cohorts. However, viral suppression rates remained lower for all relative to the UNAIDS goal of 95%, and measures to improve treatment outcomes are needed for young adults.
期刊介绍：
The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.
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