1
|
Soumah A, Avettand-Fenoel V, Veber F, Moshous D, Mahlaoui N, Blanche S, Frange P. High rates of antiretroviral coverage and virological suppression in HIV-1-infected children and adolescents. Med Mal Infect 2019; 50:269-273. [PMID: 31722862 DOI: 10.1016/j.medmal.2019.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/06/2019] [Accepted: 10/09/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the outcome of HIV-infected individuals attending one of the largest French pediatric HIV centers in 2016-2017 and to compare the rates of antiretroviral coverage and virological suppression with the UNAIDS targets. PATIENTS AND METHODS The clinical and immuno-virological status of 163 HIV-1-infected children and adolescents attending Necker Hospital in Paris, France, were investigated. Virological suppression was defined as an HIV-1 viral load<50 copies/mL for at least six months. All genotypic resistance tests performed since birth were analyzed. RESULTS Most patients were born in Sub-Saharan African countries (41.7%) or in France (38.0%). Their median age was 14 years [IQR 7.3-17.0]. Although 33.7% of individuals had a history of AIDS-defining clinical event(s), 86.5% of children/adolescents were free from HIV-related symptoms at their most recent evaluation. Antiretroviral coverage was high (98.2%; mainly including one integrase inhibitor [42.3%] or one protease inhibitor [23.9%]). At the last visit, most patients (82.8%) had normal CD4T lymphocytes counts (≥25%). Although 61.7% of antiretroviral-experienced children had resistance to≥1 drug class and 9.2% had triple-class resistance, 80.3% of patients receiving antiretrovirals for≥6 months (126/157) were virologically suppressed. International adoptees were more frequently virologically suppressed than other patients (96.0% versus 74.6%, P=0.02). CONCLUSIONS Antiretroviral coverage exceeded the second UNAIDS 90 target aimed at ending the AIDS epidemic. The rate of virological suppression, one of the highest reported in children in high-income countries, is approaching the third UNAIDS 90 target and the rate observed in French HIV-infected adults on antiretrovirals.
Collapse
Affiliation(s)
- A Soumah
- Unité d'immunologie, hématologie et rhumatologie pédiatrique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - V Avettand-Fenoel
- Laboratoire de microbiologie clinique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; CNRS 8104/Inserm U1016, institut Cochin, université Paris Descartes, 22, rue Méchain, 75014 Paris, France
| | - F Veber
- Unité d'immunologie, hématologie et rhumatologie pédiatrique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - D Moshous
- Unité d'immunologie, hématologie et rhumatologie pédiatrique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Inserm UMR1163, institut Imagine, Sorbonne Paris Cité, université Paris Descartes, 24, boulevard du Montparnasse, 75015 Paris, France
| | - N Mahlaoui
- Unité d'immunologie, hématologie et rhumatologie pédiatrique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Inserm UMR1163, institut Imagine, Sorbonne Paris Cité, université Paris Descartes, 24, boulevard du Montparnasse, 75015 Paris, France; Centre de référence des déficits immunitaires héréditaires (CEREDIH), hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - S Blanche
- Unité d'immunologie, hématologie et rhumatologie pédiatrique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; EA7323, Sorbonne Paris Cité, université Paris Descartes, 12, rue de l'École de médecine, 75006 Paris, France
| | - P Frange
- Unité d'immunologie, hématologie et rhumatologie pédiatrique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Laboratoire de microbiologie clinique, hôpital Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; EHU 7328, institut Imagine, Sorbonne Paris Cité, université Paris Descartes, 149, rue de Sèvres, 75015 Paris, France.
| |
Collapse
|