12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

MEETING THE NEEDS AND SERVICE DEVELOPMENT FOR THE LONGER TERM FOLLOW-UP OF YOUNG PEOPLE WITH PERINATALLY ACQUIRED HIV INFECTION

HIV Med 2006; 7(Suppl. 1):8 (abstract no. O32)

Caroline Foster¹, Diane Melvin¹, Hermione Lyall¹ and Sarah Fidler^2
1 Family Clinic, St Mary’s Hospital, ² Imperial College, London, UK

OBJECTIVES: Children with perinatally acquired HIV-1 infection are surviving into adult life, transferring to adult services and presenting complex medical and multi-disciplinary problems for adult physicians. Despite careful transition, 4/5 young people initially transferring from our paediatric to adult services failed to attend for regular care. Identifying specific needs of these young people may improve service provision and uptake.

METHODS: Retrospective case-note audit of young people aged 12+ years attending a paediatric HIV clinic.

RESULTS: Two hundred and ten infected children, 74 (35%) aged 12+, of whom 25 (33%) are 16 or older. Of the 74 young people, 13 (18%) are antiretroviral therapy (ART) naïve: median CD4 count 530 × 10⁹/l (range 240–890), median viral load 8466 copies/ml (range 315–120629). Of those currently on ART, 34 (69%) have viral loads of <50 copies/ml, eleven >1000 copies/ml. Median CD4 count for those on ART 560 × 10⁹/l (IQR = 330–710). Six (8%) have CD4 counts below 200 × 10⁹/l, four of whom have no peripheral CD4 cells and multidrug-resistant virus. Two young people are in the terminal-care phase of their illness. Of those on ART, 35 (71%) have received all three major classes; two have failed on the fusion inhibitor T20. Of the 74, 9% have abnormal neurology, most commonly hypertonic diplegia, 11% have significant visual/hearing impairment and 47% have a statement of educational need or additional support in school.

CONCLUSION: A proportion of young people transitioning towards adult services are highly ART-experienced with significant neurodevelopmental concerns. A dedicated long-term follow-up clinic for adults with perinatally acquired HIV infection has been established to try to meet the needs of this complex cohort.

2006-03-29
O32

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