Youth with HIV less likely than adults to achieve viral suppression

February 10, 2020

Despite similar rates of enrollment into medical care, youth with HIV have much lower rates of viral suppression--reducing HIV to undetectable levels--compared to adults, according to an analysis funded by the National Institutes of Health. Among more than 1,000 youth, most of whom were newly enrolled in care at treatment centers throughout the United States, 12% had attained viral suppression, far lower than the 32% to 63% observed in studies of adults over age 24. The findings suggest that after they enroll in an HIV treatment program, a low proportion of youth adhere to care regimens. The study appears in the Journal of Acquired Immune Deficiency Syndrome.

"Our findings indicate an urgency for research on how best to tailor HIV intervention services to the needs of youth," said the study's first author, Bill G. Kapogiannis, M.D., of the Maternal and Pediatric Infectious Diseases Branch at NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The analysis was funded by NICHD, the National Institute on Drug Abuse and the National Institute of Mental Health.

The researchers analyzed data from the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN), an NIH-supported network of 13 sites dedicated to the health and care of youth with and at risk for HIV. The youth were enrolled in care through the SMILE (Strategic Multisite Initiative for the Identification, Linkage and Engagement in Care of Youth) Collaborative, a network of clinics at each ATN site that offers diagnostic services and referral to treatment facilities.

Among the 1,411 youth ages 12 to 24 years who were referred to the ATN sites, 75% were enrolled in care, with 34% remaining in care and beginning anti-HIV (antiretroviral) treatment and 12% achieving viral suppression after a median interval of nearly 5 months. Viral suppression occurs when antiretroviral therapy reduces a person's HIV in the blood to an undetectable level. Maintaining viral suppression for at least 6 months after a person's first test finds no detectable levels of the virus prevents the sexual transmission of HIV and allows people with HIV to remain healthy.

On average, youth who were referred to care within a shorter time frame after an HIV diagnosis were more likely to achieve viral suppression. Compared to youth referred to care after three months, those referred within one to six weeks were 2.5 times more likely to reach viral suppression. Those referred from six weeks to three months were roughly twice as likely to reach viral suppression.

To ensure the shortest possible time to enrollment in care, the study authors stressed the importance of enlisting trained peer counselors and of maintaining frequent contact with youth through text and social media messages. They added that additional strategies to ensure that youth enroll and remain in care are urgently needed.
-end-
The ATN is funded by NICHD, the National Institute on Drug Abuse, the National Institute of Mental Health and the National Institute on Minority Health and Health Disparities.

SMILE is a collaboration between NICHD, ATN, the Centers for Disease Control and Prevention and the Health Services and Resources Administration.

Reference

Kapogiannis, BG, et al. The HIV continuum of care for adolescents and young adults attending 13 urban U.S. HIV care centers of the NICHD-ATN-CDC-HRSA SMILE Collaborative. Journal of Acquired Immune Deficiency Syndrome. 2020.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD leads research and training to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all. For more information, visit http://www.nichd.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov

NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.