UNASSIGNED : More perinatally HIV-infected children in Asia are reaching adolescence.
UNASSIGNED : We analyzed data from July 1991 to March 2011 reported by 18 clinics in six countries of children age >12 years.
UNASSIGNED : Of 1,254 adolescents, 33 (2.6%) died, and 52 (4.2%) were lost to follow-up within 2.4-year (3566 person-years) median follow-up period. Of 1,061 adolescents under active follow-up, 485 (46%) were male, median (IQR) age was 14.7 (13.3-16.4) years, 73% had lost a parent(s), 93% attended school, and 62% were aware of their HIV status. At the most recent evaluation, 93% were receiving highly active antiretroviral therapy (ART), 71% (N=737/1035) had CD4 ≥500 cells/mm3 and 86% (N=718/830) had viral load (VL) <400 copies/mL. Current CD4 >200 cells/mm, no previous WHO stage 3 or 4, and being on a first-line regimen were independently associated with recent VL <400 copies/mL. Current age <15 years, VL <400 copies/ml, CD4 15-24% (vs. <10%) at ART initiation, no previous WHO stage 3 or 4, and ART duration of >1 year were associated with recent CD4 ≥500 cells/mm.Primary causes of death after age 12 were opportunistic infections (N=15/33) and other AIDS- or treatment-related conditions (N=9/33). Those at age 12 with CD4 <200 vs. ≥500 cells/mm3 and those with VL ≥10,000 vs. <10,000 copies/mL were 17.4 and 4.76 times more likely to die in adolescence, respectively.
UNASSIGNED : Adolescents in this cohort have been successfully maintained in HIV care. Initiating treatment at earlier stages of disease was associated with immune recovery and virologic suppression during adolescence.