%0 Journal Article
%T The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis
%A Adeodata Kekitiinwa-Rukyalekere
%A Ali Judd
%A Alla Volokha
%A Amy L. Slogrove
%A Andrew Edmonds
%A Annemarie van Rossum
%A Annette Sohn
%A Azar Kariminia
%A Carlo Giaquinto
%A Charlotte Duff
%A Chloe A. Teasdale
%A Christoph Rudin
%A Claire Thorne
%A Claudia Fortuny
%A Colette Smith
%A Diana Gibb
%A Edith Q. Mohapi
%A Elaine J. Abrams
%A Ellen G. Chadwick
%A Filipa Prata
%A Gabriel Anabwani
%A George Seage III
%A Intira J. Collins
%A James Oleske
%A Jihane Ben-Farhat
%A Jorge Pinto
%A Josiane Warszawski
%A Kara Wools-Kaloustian
%A Kulkanya Chokephaibulkit
%A Kunjal Patel
%A Lars Naver
%A Laura F. Jefferys
%A Laura Marques
%A Linda-Gail Bekker
%A Liubov Okhonskaia
%A Lorna Renner
%A Luisa Galli
%A Luminita Ene
%A Lynne Mofenson
%A Magdalena Marczynska
%A Makhosazana Hlatshwayo
%A Marcel Yotebieng
%A Mariam Sylla
%A Marissa Vicari
%A Mark J. Abzug
%A Martina Penazzato
%A Mary Paul
%A Mary-Ann Davies
%A Michael Schomaker
%A Miriam Chernoff
%A Murli Purswani
%A Mwangelwa Mubiana-Mbewe
%A Mwita Lumumba
%A Myron Levin
%A Nancy Calles
%A Nicola Maxwell
%A Pablo Rojo
%A Paige Williams
%A Patricia Lelo
%A Patricia Ongwen
%A Peter N. Kazembe
%A Rachel Vreeman
%A Regina Succi
%A Rohan Hazra
%A Russell Van Dyke
%A Ruth Goodall
%A Sam Phiri
%A Samuel Ayaya
%A Sebastian Wanless
%A Shaffiq Essajee
%A Shirley Traite
%A Shobna Sawry
%A Sophie Le Coeur
%A Suna Balkan
%A Tanoh Franˋois Eboua
%A Tessa Goetghebuer
%A The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration
%A Val谷riane Leroy
%A Vanessa Rouzier
%A Venessa Timmerman
%J -
%D 2018
%R 10.1371/journal.pmed.1002514
%X Background Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in ※real-life§ settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia.   Methods and findings Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5每5.2) years for the total cohort and 6.4 (3.6每8.0) years in Europe, 3.7 (2.0每5.4) years in North America, 2.5 (1.2每4.4) years in South and Southeast Asia, 5.0 (2.7每7.5) years in South America and the Caribbean, and 2.1 (0.9每3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3每2.1) years in North America to 7.1 (5.3每8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4每2.6) years in North America to 7.9 (6.0每9.3) years in sub-Saharan Africa. The
%K Antiretroviral therapy
%K HIV
%K Africa
%K Adolescents
%K Europe
%K North America
%K Cohort studies
%K South America
%U https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002514