HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil
BACKGROUND: HIV-infected children surviving until adulthood have been transitioning to adult outpatient health care service in Brazil since the late 2000's. Deterioration of clinical condition is expected during this period, as reported among youths with non-communicable chronic diseases. Despi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427935/ https://www.ncbi.nlm.nih.gov/pubmed/31479628 http://dx.doi.org/10.1016/j.bjid.2019.07.004 |
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author | Freitas, Angela Carvalho Avelino-Silva, Vivian Iida Gutierrez, Eliana Battaggia Marques, Heloisa Helena de Souza Durigon, Giuliana Stravinskas Segurado, Aluisio Cotrim |
author_facet | Freitas, Angela Carvalho Avelino-Silva, Vivian Iida Gutierrez, Eliana Battaggia Marques, Heloisa Helena de Souza Durigon, Giuliana Stravinskas Segurado, Aluisio Cotrim |
author_sort | Freitas, Angela Carvalho |
collection | PubMed |
description | BACKGROUND: HIV-infected children surviving until adulthood have been transitioning to adult outpatient health care service in Brazil since the late 2000's. Deterioration of clinical condition is expected during this period, as reported among youths with non-communicable chronic diseases. Despite their young age, they are long-term hosts of the virus, have prolonged exposure to antiretroviral therapy and have suffered from the social determinants and stigma of HIV infection since early childhood. OBJECTIVES: This study aimed to 1) describe demographic and clinical characteristics at the first appointment at adult care service following pediatric care of a cohort of Brazilian youths living with HIV since childhood; and 2) retrospectively address adherence and clinical variables in the last two years of pediatric follow-up. METHODS: Descriptive study. RESULTS: 41 consecutive patients referred to adult outpatient care from a pediatric HIV unit were enrolled, median age 19 years, and median lifetime CD4 + nadir 117 cell/mm(3); 89% reported previous AIDS-defining conditions. At first laboratory assessment in adult care, only 46% had undetectable (<400 copies/ml) HIV viral load and the median CD4 + count was 250 cell/mm(3). CONCLUSION: Youths living with HIV at the transition from pediatric to adult care had poor treatment adherence, low lifetime CD4 + cell nadir, low CD4 cell count and detectable HIV viral load. Health care providers should closely monitor these adolescents in a youth friendly environment, prepared for open communication about all aspects of their health. |
format | Online Article Text |
id | pubmed-9427935 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-94279352022-09-01 HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil Freitas, Angela Carvalho Avelino-Silva, Vivian Iida Gutierrez, Eliana Battaggia Marques, Heloisa Helena de Souza Durigon, Giuliana Stravinskas Segurado, Aluisio Cotrim Braz J Infect Dis Original Article BACKGROUND: HIV-infected children surviving until adulthood have been transitioning to adult outpatient health care service in Brazil since the late 2000's. Deterioration of clinical condition is expected during this period, as reported among youths with non-communicable chronic diseases. Despite their young age, they are long-term hosts of the virus, have prolonged exposure to antiretroviral therapy and have suffered from the social determinants and stigma of HIV infection since early childhood. OBJECTIVES: This study aimed to 1) describe demographic and clinical characteristics at the first appointment at adult care service following pediatric care of a cohort of Brazilian youths living with HIV since childhood; and 2) retrospectively address adherence and clinical variables in the last two years of pediatric follow-up. METHODS: Descriptive study. RESULTS: 41 consecutive patients referred to adult outpatient care from a pediatric HIV unit were enrolled, median age 19 years, and median lifetime CD4 + nadir 117 cell/mm(3); 89% reported previous AIDS-defining conditions. At first laboratory assessment in adult care, only 46% had undetectable (<400 copies/ml) HIV viral load and the median CD4 + count was 250 cell/mm(3). CONCLUSION: Youths living with HIV at the transition from pediatric to adult care had poor treatment adherence, low lifetime CD4 + cell nadir, low CD4 cell count and detectable HIV viral load. Health care providers should closely monitor these adolescents in a youth friendly environment, prepared for open communication about all aspects of their health. Elsevier 2019-08-31 /pmc/articles/PMC9427935/ /pubmed/31479628 http://dx.doi.org/10.1016/j.bjid.2019.07.004 Text en © 2019 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Freitas, Angela Carvalho Avelino-Silva, Vivian Iida Gutierrez, Eliana Battaggia Marques, Heloisa Helena de Souza Durigon, Giuliana Stravinskas Segurado, Aluisio Cotrim HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil |
title | HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil |
title_full | HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil |
title_fullStr | HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil |
title_full_unstemmed | HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil |
title_short | HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil |
title_sort | hiv-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in são paulo city, brazil |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427935/ https://www.ncbi.nlm.nih.gov/pubmed/31479628 http://dx.doi.org/10.1016/j.bjid.2019.07.004 |
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