학술논문
The cascade of care for children and adolescents with HIV in the UK and Ireland, 2010 to 2016
Document Type
Report
Author
Chappell, Elizabeth; Lyall, Hermione; Riordan, Andrew; Thorne, Claire; Foster, Caroline; Butler, Karina; Prime, Katia; Bamford, Alasdair; Peters, Helen; Judd, Ali; Collins, Intira J.; Doerholt, Katja; Klein, Nigel; Menson, Esse; Mcmaster, Paddy; Shackley, Fiona; Kenny, Julia; Shingadia, Delane; Storey, Sharon; Tudor?Williams, Gareth; Turkova, Anna; Welch, Steve; Cook, Claire; Crichton, Siobhan; Dobson, Donna; Fairbrother, Keith; Gibb, Diana M.; Harper, Lynda; Le Prevost, Marthe; Van Looy, Nadine; Francis, Kate; Walsh, A; Thrasyvoulou, L; Welch, S; Laycock, N; Bernatoniene, J; Manyika, F; Sharpe, G; Lewis, P; Welch, S; Subramaniam, B; Hutchinson, L; Ward, P; Sloper, K; Fidler, K; Hague, R; Price, V; Clapson, M; Flynn, J; Cardoso, A; Abou, M; Klein, N; Shingadia, D; Ainsley?Walker, P; Tovey, P; Gurtin, D; Garside, Jp; Fall, A; Yeadon, S; Segal, S; Ball, C; Hawkins, S; Dowie, M; Bandi, S; Percival, E; Eisenhut, M; Roy, Pk; Kavanagh, C; Mcmaster, P; Murphy, C; Daniels, J; Lees, Y; Thompson, F; Williams, B; Cliffe, L; Myth, A; Southall, S; Freeman, H; Fidler, K; Christie, S; Gordon, A; Rogahn, D; Harris, S; Hutchinson, L; Collinson, A; Hutchinson, L; Jones, L; Offerman, B; Greenberg, M; Benson, C; Riordan, A; O'Connor, R; Brown, N; Ibberson, L; Shackley, F; Faust, Sn; Hancock, J; Doerholt, K; Sharland, M; Storey, S; Gorman, S; Lyall, Egh; Monrose, C; Seery, P; Tudor?Williams, G; Menson, E; Broomhall, J; Hutchinson, L; Scott, D; Stroobant, J; Bridgwood, A; Mcmaster, P; Evans, J; Blake, E; Yannoulias, A; O'Callaghan, M
Source
Journal of the International AIDS Society. September 2019, Vol. 22 Issue 9
Subject
Language
English
ISSN
1758-2652
Abstract
Abstract: Introduction: The UNAIDS 90?90?90 targets for the cascade of care are widely used to monitor the success of HIV care programmes but there are few studies in children. We assessed the cascade for children and adolescents living with HIV in the national Collaborative HIV Paediatric Study (CHIPS) in the UK and Ireland. Methods: Utilizing longitudinal data from CHIPS we compared the cascade of care for 2010, 2013 and 2016. Among children diagnosed with HIV and not known to be lost to follow?up at the start of each calendar year, we summarized the proportion in active paediatric care during that year (defined as having ?1 clinic visit, CD4 or viral load measurement, or change to antiretroviral therapy (ART) regimen), and of these, the proportion on ART at last visit in that year. Among those on ART, the proportion with viral suppression ( Results: Of children in paediatric HIV care at the start of 2010, 2013 and 2016 (n = 1249, 1157, 905 respectively), the proportion in active care during that calendar year was high throughout at 97 to 99%. Of those in active care, the proportion on ART increased from 79% to 85% and 92% respectively (p < 0.001). Among those on ART, the proportion with viral suppression and good immune status was stable at 83% to 86% and 85% to 88%, respectively, across the years. Among children in care in 2016, those aged ?15 years were less likely to be virally suppressed (79% vs. 91%, p < 0.001) or to have good immune status (78% vs. 94%, p < 0.001) compared to younger children; there were no differences by place of birth or sex. Conclusions: Children and adolescents in the UK and Ireland national cohort had high retention in care. The proportion on ART increased significantly over time although there was no change in viral suppression or good immune status. Poorer outcomes among adolescents highlight the need for targeted support for this population.
Introduction The HIV cascade of care is a model which outlines the steps from HIV infection that individuals must pass through to achieve viral suppression, with intermediate stages including diagnosis, [...]
Introduction The HIV cascade of care is a model which outlines the steps from HIV infection that individuals must pass through to achieve viral suppression, with intermediate stages including diagnosis, [...]