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...

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Autores principales: Freitas, Angela Carvalho, Avelino-Silva, Vivian Iida, Gutierrez, Eliana Battaggia, Marques, Heloisa Helena de Souza, Durigon, Giuliana Stravinskas, Segurado, Aluisio Cotrim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
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.
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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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