Incidence of Postsuppression Virologic Rebound in Perinatally HIV-Infected Asian Adolescents on Stable Combination Antiretroviral Therapy

Sudjaritruk T 1 , Aurpibul L 2 , Ly PS 3 , Le TPK 4 , Bunupuradah T 5 , Hansudewechakul R 6 Show all authors , Lumbiganon P 7 , Chokephaibulkit K 8 , Nik Yusoff NK 9 , Nguyen LV 10 , Mohd Razali KA 11 , Fong MS 12 , Nallusamy RA 13 , Kurniati N 14 , Do VC 15 , Boettiger DC 16 , Sohn AH 17 , Kariminia A 16

Affiliations 

  • 1 Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. Electronic address: tavitiya.s@cmu.ac.th
  • 2 Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
  • 3 National Centre for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia
  • 4 Infectious Disease Department, Children's Hospital 1, Ho Chi Minh City, Vietnam
  • 5 HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
  • 6 Department of Pediatrics, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 7 Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • 8 Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 9 Department of Pediatrics, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
  • 10 Infectious Disease Department, National Hospital of Pediatrics, Hanoi, Vietnam
  • 11 Department of Pediatrics, Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  • 12 Department of Pediatrics, Hospital Likas, Kota Kinabalu, Malaysia
  • 13 Department of Pediatrics, Penang Hospital, Georgetown, Penang, Malaysia
  • 14 Department of Child Health, Cipto Mangunkusumo - Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • 15 Infectious Disease Department, Children's Hospital 2, Ho Chi Minh City, Vietnam
  • 16 Faculty of Medicine, The Kirby Institute, UNSW Australia, Sydney, Australia
  • 17 TREAT Asia/amfAR-The Foundation for AIDS Research, Bangkok, Thailand
J Adolesc Health, 2017 Jul;61(1):91-98.
PMID: 28343759 DOI: 10.1016/j.jadohealth.2017.01.014

Abstract

PURPOSE: To assess the incidence and predictors of postsuppression virologic rebound (VR) among adolescents on stable combination antiretroviral therapy in Asia.

METHODS: Perinatally HIV-infected Asian adolescents (10-19 years) with documented virologic suppression (two consecutive viral loads [VLs] <400 copies/mL ≥6 months apart) were included. Baseline was the date of the first VL <400 copies/mL at age ≥10 years or the 10th birthday for those with prior suppression. Cox proportional hazards models were used to identify predictors of postsuppression VR (VL >1,000 copies/mL).

RESULTS: Of 1,379 eligible adolescents, 47% were males. At baseline, 22% were receiving protease inhibitor-containing regimens; median CD4 cell count (interquartile range [IQR]) was 685 (448-937) cells/mm3; 2% had preadolescent virologic failure (VF) before subsequent suppression. During adolescence, 180 individuals (13%) experienced postsuppression VR at a rate of 3.4 (95% confidence interval: 2.9-3.9) per 100 person-years, which was consistent over time. Median time to VR during adolescence (IQR) was 3.3 (2.1-4.8) years. Wasting (weight-for-age z-score

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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