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10th Anniversary Conference Of The British HIV Association [BHIVA]15 – 17 April 2004, City Hall, Cardiff, UK |
[AUTHOR(S):] CJ Foster, EGH Lyall, K Dierholt, T Duong, PA Tookey, M Sharland, G Tudor-Williams, V Novelli, K Butler, A Riordan, DM Gibb
For the Collaborative HIV Paediatric Study (CHIPS)
BHIVA Conf 2004 Apr 15-17;10:O17
AIM: To describe the demographics, presentation, treatment and outcome for adolescents in CHIPS.
METHODS: Review of data on HIV-infected adolescents ≥12 years at one of 18 centres in UK/Ireland in the CHIPS cohort from 1985 to 2003.
RESULTS: Of 759 children, 179 (24%) are adolescents (12–19 years), with a median age at last follow-up of 14 [interquartile ratio (IQR) 13–16) years; 56% were female, 61% black African and 27% Caucasian. The median age at presentation was 5.7 years (IQR 1.9–10.7); 15 (8%) children were followed from birth, 67 (37%) were identified after the diagnosis of a family member, three at adoption screening and 71 (40%) presented symptomatically [39 in Centers for Disease Control and Prevention (CDC) category B, 18 in category C]. The median CD4 count at diagnosis was 21% (IQR 12–30%). At the last follow-up, 36 (20%) had never received antiretroviral therapy, 114 (64%) were on highly active antiretroviral therapy (HAART), only 66 (46%) of whom started HAART as their first regimen; the remainder received prior mono- and/or dual therapy. Among 143 treated children, the median number of antiretrovirals was five (range 1–13) and 51 (36%) received all three drug classes. The median CD4 count at last follow-up among those treated was 22% (IQR 14–28%), with 20 (14%) having a CD4 count of <10%. 60 (42%) had <400 HIV-1 RNA copies/ml, 31 (66%) having <50 copies/ml. The median current CD4 count in treatment-naïve adolescents was 24% (IQR 19–24%). Since 1996, four adolescents have died, aged 12–14.6 years. 20 transferred to adult services at a median age of 17.0 years (15.3–18.8).
CONCLUSIONS: HIV-infected children are surviving into adult life. In this cohort, many have been heavily pretreated with antiretroviral therapy with suboptimal responses, and will challenge therapeutics in adult services.
PRESENTING AUTHOR: CJ Foster
040415
O17
Copyright © 2004 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD