Abstract
Objectives: To investigate risk of AIDS and mortality after transition from paediatric to adult care in a UK cohort of young people with perinatally acquired HIV. Methods: Records of people aged ≥ 13 years on 31 December 2015 in the UK paediatric HIV cohort (Collaborative HIV Paediatric Study) were linked to those of adults in the UK Collaborative HIV Cohort (CHIC) cohort. We calculated time from transition to a new AIDS event/death, with follow-up censored at the last visit or 31 December 2015, whichever was the earliest. Cumulative incidence of and risk factors for AIDS/mortality were assessed using Kaplan–Meier and Cox regression. Results: At the final paediatric visit, the 474 participants [51% female, 80% black, 60% born outside the UK, median (interquartile range) age at antiretroviral therapy (ART) initiation = 9 (5–13) years] had a median age of 18 (17–19) years and CD4 count of 471 (280–663) cell/μL; 89% were prescribed ART and 60% overall had a viral load ≤ 400 copies/mL. Over median follow-up in adult care of 3 (2–6) years, 35 (8%) experienced a new AIDS event (n = 25) or death (n = 14) (incidence = 1.8/100 person-years). In multivariable analyses, lower CD4 count at the last paediatric visit [adjusted hazard ratio = 0.8 (95% confidence interval: 0.7–1.0)/100 cells/μL increment] and AIDS diagnosis in paediatric care [2.7 (1.4–5.5)] were associated with a new AIDS event/mortality in adult care. Conclusions: Young people with perinatally acquired HIV transitioning to adult care with markers of disease progression in paediatric care experienced poorer outcomes in adult care. Increased investment in multidisciplinary specialized services is required to support this population at high risk of morbidity and mortality.
| Original language | English |
|---|---|
| Pages (from-to) | 631-640 |
| Number of pages | 10 |
| Journal | HIV Medicine |
| Volume | 22 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 3 May 2021 |
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In: HIV Medicine, Vol. 22, No. 8, 03.05.2021, p. 631-640.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Mortality and AIDS-defining events among young people following transition from paediatric to adult HIV care in the UK
AU - the Collaborative HIV Paediatric Study (CHIPS) Steering Committee, the UK Collaborative HIV Cohort (UK CHIC) Study Steering Committee
AU - Collins, I. J.
AU - Goodall, R. L.
AU - Hill, T.
AU - Asad, H.
AU - Crichton, S.
AU - Doerholt, K.
AU - Foster, C.
AU - Lyall, H.
AU - Post, F. A.
AU - Welch, S.
AU - Winston, A.
AU - Sabin, C. A.
AU - Judd, A.
AU - Sabin, Caroline
AU - Saunders, John
AU - Mercer, Catherine
AU - Hughes, Gwenda
AU - Mandal, Sema
AU - Rait, Greta
AU - Ijaz, Samreen
AU - Rhodes, Tim
AU - Porter, Kholoud
AU - Rosenberg, William
AU - Bamford, Alasdair
AU - Butler, Karina
AU - Klein, Nigel
AU - McMaster, Paddy
AU - Prime, Katia
AU - Riordan, Andrew
AU - Shackley, Fiona
AU - Kenny, Julia
AU - Shingadia, Delane
AU - Storey, Sharon
AU - Tudor-Williams, Gareth
AU - Turkova, Anna
AU - Cook, Claire
AU - Dobson, Donna
AU - Fairbrother, Keith
AU - Gibb, Diana M.
AU - Harper, Lynda
AU - Le Prevost, Marthe
AU - Van Looy, Nadine
AU - Francis, Kate
AU - Peters, Helen
AU - Thorne, Claire
AU - Thrasyvoulou, L.
AU - Fidler, K.
AU - Bernatoniene, J.
AU - Manyika, F.
AU - Sharpe, G.
AU - Subramaniam, B.
AU - Hague, R.
AU - Price, V.
AU - Flynn, J.
AU - Cardoso, A.
AU - Abou–Rayyah, M.
AU - Klein, N.
AU - Bamford, A.
AU - Shingadia, D.
AU - Yeadon, S.
AU - Segal, S.
AU - Hawkins, S.
AU - Dowie, M.
AU - Bandi, S.
AU - Percival, E.
AU - Eisenhut, M.
AU - Duncan, K.
AU - Anguvaa, L.
AU - Wren, L.
AU - Flood, T.
AU - Pickering, A.
AU - McMaster, P.
AU - Murphy, C.
AU - Daniels, J.
AU - Lees, Y.
AU - Thompson, F.
AU - Williams, A.
AU - Williams, B.
AU - Pope, S.
AU - Libeschutz, Dr S.
AU - Cliffe, L.
AU - Southall, S.
AU - Freeman, A.
AU - Freeman, H.
AU - Christie, S.
AU - Gordon, A.
AU - Rosie Hague, D.
AU - Clarke, L.
AU - Jones, L.
AU - Brown, L.
AU - Greenberg, M.
AU - Benson, C.
AU - Riordan, A.
AU - Ibberson, L.
AU - Shackley, F.
AU - Patel, S.
AU - Hancock, J.
AU - Prime, K.
AU - Sharland, M.
AU - Storey, S.
AU - Lyall, E. G.H.
AU - Seery, P.
AU - Tudor-Williams, G.
AU - Kirkhope, N.
AU - Raghunanan, S.
AU - Kenny, Julia
AU - Callaghan, A.
AU - Bridgwood, A.
AU - McMaster, P.
AU - Evans, J.
AU - Blake, E.
AU - Yannoulias, A.
AU - Ainsworth, Jonathan
AU - Allan, Sris
AU - Anderson, Jane
AU - Babiker, Abdel
AU - Chadwick, David
AU - Churchill, Duncan
AU - Delpech, Valerie
AU - Dunn, David
AU - Gazzard, Brian
AU - Gilson, Richard
AU - Gompels, Mark
AU - Hay, Phillip
AU - Johnson, Margaret
AU - Jose, Sophie
AU - Kegg, Stephen
AU - Leen, Clifford
AU - Martin, Fabiola
AU - Mital, Dushyant
AU - Nelson, Mark
AU - Orkin, Chloe
AU - Palfreeman, Adrian
AU - Phillips, Andrew
AU - Pillay, Deenan
AU - Post, Frank
AU - Pritchard, Jillian
AU - Sabin, Caroline
AU - Schwenk, Achim
AU - Tariq, Anjum
AU - Trevelion, Roy
AU - Ustianowski, Andy
AU - Walsh, John
AU - Jose, Sophie
AU - Phillips, Andrew
AU - Sabin, Caroline
AU - Dunn, David
AU - Shidfar, Shaadi
AU - Orkin, Chloe
AU - Lynch, Janet
AU - Hand, James
AU - Churchill, Duncan
AU - Perry, Nicky
AU - Tilbury, Stuart
AU - Youssef, Elaney
AU - Gazzard, Brian
AU - Nelson, Mark
AU - Wood, Sue
AU - Asboe, David
AU - Mandalia, Sundhiya
AU - Anderson, Jane
AU - Munshi, Sajid
AU - Post, Frank
AU - Adefisan, Ade
AU - Taylor, Chris
AU - Gleisner, Zachary
AU - Ibrahim, Fowzia
AU - Campbell, Lucy
AU - Babiker, Abdel
AU - Dunn, David
AU - Shidfar, Shaadi
AU - da Silva Santamaria, Nicolas
AU - Chadwick, David
AU - Baillie, Kirsty
AU - Gilson, Richard
AU - Brima, Nataliya
AU - Williams, Ian
AU - Ainsworth, Jonathan
AU - Schwenk, Achim
AU - Miller, Sheila
AU - Wood, Chris
AU - Johnson, Margaret
AU - Youle, Mike
AU - Lampe, Fiona
AU - Smith, Colette
AU - Tsintas, Rob
AU - Chaloner, Clinton
AU - Hutchinson, Samantha
AU - Walsh, John
AU - Mackie, Nicky
AU - Weber, Jonathan
AU - Ramzan, Farhan
AU - Carder, Mark
AU - Kerr, Andrew
AU - Morris, Sheila
AU - Gompels, Mark
AU - Allan, Sue
AU - Palfreeman, Adrian
AU - Lewszuk, Adam
AU - Kegg, Stephen
AU - Ogunbiyi, Victoria
AU - Mitchell, Sue
AU - Hay, Phillip
AU - Kemble, Christian
AU - Okolo, Olanike
AU - Watts, Benjamin
AU - Martin, Fabiola
AU - Russell-Sharpe, Sarah
AU - Gravely, Janet
AU - Brewer, Christine
AU - Allan, Sris
AU - Harte, Andrew
AU - Brain, Debra
AU - Tariq, Anjum
AU - Jones, Ron
AU - Radford, Liz
AU - Milgate, Sarah
AU - Pritchard, Jillian
AU - Cumming, Shirley
AU - Atkinson, Claire
AU - Mital, Dushyant
AU - Edgell, Veronica
AU - Allen, Julie
AU - Ustianowski, Andy
AU - Murphy, Cynthia
AU - Gunder, Ilise
AU - Fox, Ashini
AU - Gees, Howard
AU - Mieszek, Michelle
AU - Whitworth, Helen
AU - Anderson, L.
AU - Hembrom, Rajesh
AU - Teke, Jennifer
AU - Box, Roberta
AU - Hatton, Tom
AU - LeGegarat, Christine
AU - Tomlinson, Lee
AU - Price, Ashley
AU - McVittie, Ian
AU - Murtha, Victoria
AU - Shewan, Laura
AU - Apoola, Ade
AU - Connan, Zak
AU - Gregory, Luke
AU - Holding, Kathleen
AU - Chester, Victoria
AU - Mistry, Trusha
AU - Gatford, Catherine
AU - Delpech, Valerie
AU - Trevelion, Roy
N1 - Funding Information: CHIPS is funded by the National Health Service England (London Specialised Commissioning Group) and has received additional support from Abbott Laboratories ( https://Abbott.co.uk/ ), Boehringer Ingelheim, Bristol‐Myers Squibb, GlaxoSmithKline, Gilead Sciences, Janssen and Roche. The MRC Clinical Trials Unit at UCL is supported by the UKRI Medical Research Council ( https://www.mrc.ac.uk ) programme number MC_UU_12023/26. Funding Information: The NIHR HPRU in Blood Borne and Sexually Transmitted Infections Steering Committee: Caroline Sabin (Director), John Saunders (PHE Lead), Catherine Mercer, Gwenda Hughes, Sema Mandal, Greta Rait, Samreen Ijaz, Tim Rhodes, Kholoud Porter, and William Rosenberg. CHIPS Steering Committee: Hermione Lyall (Chair), Alasdair Bamford, Karina Butler, Katja Doerholt, Caroline Foster, Nigel Klein, Paddy McMaster, Katia Prime, Andrew Riordan, Fiona Shackley, Julia Kenny, Delane Shingadia, Sharon Storey, Gareth Tudor-Williams, Anna Turkova, Steve Welch. MRC Clinical Trials Unit at UCL: Intira Jeannie Collins, Claire Cook, Siobhan Crichton, Donna Dobson, Keith Fairbrother, Diana M. Gibb, Lynda Harper, Ali Judd, Marthe Le Prevost, Nadine Van Looy. National Surveillance of HIV in Pregnancy and Childhood: Kate Francis, Helen Peters, Claire Thorne. Hospitals participating in CHIPS in 2019/20: University Hospitals Birmingham NHS Foundation Trust, Birmingham: L Thrasyvoulou, S Welch; Brighton and Sussex University Hospitals NHS Trust: K Fidler; University Hospitals Bristol NHS Foundation Trust, Bristol: J Bernatoniene, F Manyika; Calderdale and Huddersfield NHS Foundation Trust, Halifax: G Sharpe; Derby Teaching Hospitals NHS Foundation Trust: B Subramaniam; Glasgow Royal Hospital for Children, Glasgow: R Hague, V Price; Great Ormond Street Hospital for Children NHS Foundation Trust, London: J Flynn, A Cardoso, M Abou?Rayyah, N Klein, A Bamford, D Shingadia; Oxford University Hospitals NHS Foundation Trust, Oxford: S Yeadon, S Segal; King's College Hospital NHS Foundation Trust, London: S Hawkins; Leeds Teaching Hospitals NHS Trust, Leeds: M Dowie; University Hospitals of Leicester NHS Trust, Leicester: S Bandi, E Percival; Luton and Dunstable Hospital NHS Foundation Trust, Luton: M Eisenhut; K Duncan; Milton Keynes General University Hospital NHS Foundation Trust, Milton Keynes: L Anguvaa, L Wren, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle: T Flood, A Pickering; The Pennine Acute Hospitals NHS Trust, Manchester: P McMaster C Murphy; North Middlesex University Hospital NHS Trust, London: J Daniels, Y Lees; Northampton General Hospital NHS Trust, Northampton: F Thompson; London North West Healthcare NHS Trust, Middlesex: A Williams, B Williams, S Pope; Barts Health NHS trust, London: Dr S Libeschutz; Nottingham University Hospitals NHS Trust, Nottingham: L Cliffe, S Southall; Portsmouth Hospitals NHS Trust, Portsmouth: A Freeman; Raigmore Hospital, Inverness: H Freeman; Royal Belfast Hospital for Sick Children, Belfast: S Christie; Royal Berkshire NHS Foundation Trust, Reading: A Gordon; Royal Children?s Hospital, Aberdeen: D Rosie Hague, L Clarke; Royal Edinburgh Hospital for Sick Children, Edinburgh: L Jones, L Brown; Royal Free NHS Foundation Trust, London: M Greenberg; Alder Hey Children's NHS Foundation Trust, Liverpool: C Benson, A Riordan; Sheffield Children's NHS Foundation Trust, Sheffield: L Ibberson, F Shackley; University Hospital Southampton NHS Foundation Trust, Southampton: S Patel, J Hancock; St George's University Hospitals NHS Foundation Trust, London: K Doerholt, K Prime, M Sharland, S Storey; Imperial College Healthcare NHS Trust, London: EGH Lyall, C Foster, P Seery, G Tudor-Williams, N Kirkhope, S Raghunanan; Guy's and St Thomas' NHS Foundation Trust, London: Dr Julia Kenny, A Callaghan; University Hospitals of North Midlands NHS Trust, Stoke On Trent: A Bridgwood, P McMaster; University Hospital of Wales, Cardiff: J Evans, E Blake; NHS Frimley Health Foundation Trust, Slough: A Yannoulias. The UK CHIC Study Steering Committee: Jonathan Ainsworth, Sris Allan, Jane Anderson, Abdel Babiker, David Chadwick, Duncan Churchill, Valerie Delpech, David Dunn, Brian Gazzard, Richard Gilson, Mark Gompels, Phillip Hay, Teresa Hill, Margaret Johnson, Sophie Jose, Stephen Kegg, Clifford Leen, Fabiola Martin, Dushyant Mital, Mark Nelson, Chloe Orkin, Adrian Palfreeman, Andrew Phillips, Deenan Pillay, Frank Post, Jillian Pritchard, Caroline Sabin, Achim Schwenk, Anjum Tariq, Roy Trevelion, Andy Ustianowski, John Walsh. Central Co-ordination: University College London (Teresa Hill, Sophie Jose, Andrew Phillips, Caroline Sabin); Medical Research Council Clinical Trials Unit at UCL (MRC CTU at UCL), London (David Dunn, Shaadi Shidfar). Participating centres: Barts Health NHS Trust, London (Chloe Orkin, Janet Lynch, James Hand); Brighton and Sussex University Hospitals NHS Trust (Duncan Churchill, Nicky Perry, Stuart Tilbury, Elaney Youssef); Chelsea and Westminster Hospital NHS Foundation Trust, London (Brian Gazzard, Mark Nelson, Sue Wood, David Asboe, Sundhiya Mandalia); Homerton University Hospital NHS Trust, London (Jane Anderson, Sajid Munshi); King?s College Hospital NHS Foundation Trust, London (Frank Post, Ade Adefisan, Chris Taylor, Zachary Gleisner, Fowzia Ibrahim, Lucy Campbell); Medical Research Council Clinical Trials Unit at UCL (MRC CTU at UCL), London (Abdel Babiker, David Dunn, Shaadi Shidfar, Nicolas da Silva Santamaria); Middlesbrough, South Tees Hospitals NHS Foundation Trust (David Chadwick, Kirsty Baillie); Mortimer Market Centre, University College London (Richard Gilson, Nataliya Brima, Ian Williams); North Middlesex University Hospital NHS Trust, London (Jonathan Ainsworth, Achim Schwenk, Sheila Miller, Chris Wood); Royal Free NHS Foundation Trust (Margaret Johnson, Mike Youle, Fiona Lampe, Colette Smith, Rob Tsintas, Clinton Chaloner, Samantha Hutchinson); Imperial College Healthcare NHS Trust, London (John Walsh, Nicky Mackie, Alan Winston, Jonathan Weber, Farhan Ramzan, Mark Carder); The Lothian University Hospitals NHS Trust, Edinburgh (Clifford Leen, Andrew Kerr, Sheila Morris); North Bristol NHS Trust (Mark Gompels, Sue Allan); Leicester, University Hospitals of Leicester NHS Trust (Adrian Palfreeman, Adam Lewszuk); Woolwich, Lewisham and Greenwich NHS Trust (Stephen Kegg, Victoria Ogunbiyi, Sue Mitchell), St George?s Healthcare NHS Trust (Phillip Hay, Christian Kemble, Olanike Okolo, Benjamin Watts); York Teaching Hospital NHS Foundation Trust (Fabiola Martin, Sarah Russell-Sharpe, Janet Gravely, Christine Brewer); Coventry, University Hospitals Coventry and Warwickshire NHS Trust (Sris Allan, Andrew Harte, Debra Brain); Wolverhampton, The Royal Wolverhampton Hospitals NHS Trust (Anjum Tariq, Ron Jones, Liz Radford, Sarah Milgate); Chertsey, Ashford and St Peter?s Hospitals NHS Foundation Trust (Jillian Pritchard, Shirley Cumming, Claire Atkinson); Milton Keynes Hospital NHS Foundation Trust (Dushyant Mital, Veronica Edgell, Julie Allen); The Pennine Acute Hospitals NHS Trust (Andy Ustianowski, Cynthia Murphy, Ilise Gunder); Nottingham University Hospitals Trust (Ashini Fox, Howard Gees, Michelle Mieszek, Helen Whitworth, L Anderson); Kent Community Health NHS Foundation Trust (Rajesh Hembrom, Jennifer Teke, Roberta Box, Tom Hatton, Christine LeGegarat, Lee Tomlinson; the Newcastle upon Tyne Hospitals NHS Foundation Trust (Ashley Price, Ian McVittie, Victoria Murtha, Laura Shewan); Derby Teaching Hospitals NHS Foundation Trust (Ade Apoola, Zak Connan, Luke Gregory, Kathleen Holding, Victoria Chester, Trusha Mistry, Catherine Gatford); Public Health England, London (Valerie Delpech); i-Base (Roy Trevelion). This work was previously presented (orally) at the following conferences: Asad H, Collins IJ, Goodall R, Sabin C, Judd A on behalf of the Collaborative HIV Paediatric Study (CHIPS) Steering Committee and the UK Collaborative HIV Cohort (UK CHIC) Study Steering Committee, Clinical outcomes of young people with perinatal HIV following transfer from paediatric to adult care in the UK, Children?s HIV Association (CHIVA) 13th Annual Conference, London, UK, 2019; and Asad H, Collins IJ, Goodall R, Sabin C, Judd A on behalf of the Collaborative HIV Paediatric Study (CHIPS) Steering Committee and the UK Collaborative HIV Cohort (UK CHIC) Study Steering Committee, Mortality and AIDS-defining events among young people with PHIV following transition to adult care in the UK, 10th International Workshop on HIV Pediatrics, Amsterdam, Netherlands, 2018. Conflict of interest: CS has received financial support from Gilead Sciences and ViiV Healthcare for membership of data safety and monitoring boards, advisory boards and for preparation of educational materials. FP has received honoraria from Gilead, MSD and ViiV, and grant funding (to his institution) from Gilead, ViiV, MSD and Janssen. All other authors declare there are no conflicts of interest. Financial disclosure: This research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with PHE and in collaboration with the London School of Hygiene and Tropical Medicine. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or Public Health England. CHIPS is funded by the National Health Service England (London Specialised Commissioning Group) and has received additional support from Abbott Laboratories (https://Abbott.co.uk/), Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Gilead Sciences, Janssen and Roche. The MRC Clinical Trials Unit at UCL is supported by the UKRI Medical Research Council (https://www.mrc.ac.uk) programme number MC_UU_12023/26. The UK CHIC Study is funded by the Medical Research Council, UK (grant nos G0000199, G0600337, G0900274 and M004236). Funding Information: CS has received financial support from Gilead Sciences and ViiV Healthcare for membership of data safety and monitoring boards, advisory boards and for preparation of educational materials. FP has received honoraria from Gilead, MSD and ViiV, and grant funding (to his institution) from Gilead, ViiV, MSD and Janssen. All other authors declare there are no conflicts of interest. Conflict of interest: Funding Information: The UK CHIC Study is funded by the Medical Research Council, UK (grant nos G0000199, G0600337, G0900274 and M004236). Funding Information: This research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with PHE and in collaboration with the London School of Hygiene and Tropical Medicine. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or Public Health England. Financial disclosure: Publisher Copyright: © 2021 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
PY - 2021/5/3
Y1 - 2021/5/3
N2 - Objectives: To investigate risk of AIDS and mortality after transition from paediatric to adult care in a UK cohort of young people with perinatally acquired HIV. Methods: Records of people aged ≥ 13 years on 31 December 2015 in the UK paediatric HIV cohort (Collaborative HIV Paediatric Study) were linked to those of adults in the UK Collaborative HIV Cohort (CHIC) cohort. We calculated time from transition to a new AIDS event/death, with follow-up censored at the last visit or 31 December 2015, whichever was the earliest. Cumulative incidence of and risk factors for AIDS/mortality were assessed using Kaplan–Meier and Cox regression. Results: At the final paediatric visit, the 474 participants [51% female, 80% black, 60% born outside the UK, median (interquartile range) age at antiretroviral therapy (ART) initiation = 9 (5–13) years] had a median age of 18 (17–19) years and CD4 count of 471 (280–663) cell/μL; 89% were prescribed ART and 60% overall had a viral load ≤ 400 copies/mL. Over median follow-up in adult care of 3 (2–6) years, 35 (8%) experienced a new AIDS event (n = 25) or death (n = 14) (incidence = 1.8/100 person-years). In multivariable analyses, lower CD4 count at the last paediatric visit [adjusted hazard ratio = 0.8 (95% confidence interval: 0.7–1.0)/100 cells/μL increment] and AIDS diagnosis in paediatric care [2.7 (1.4–5.5)] were associated with a new AIDS event/mortality in adult care. Conclusions: Young people with perinatally acquired HIV transitioning to adult care with markers of disease progression in paediatric care experienced poorer outcomes in adult care. Increased investment in multidisciplinary specialized services is required to support this population at high risk of morbidity and mortality.
AB - Objectives: To investigate risk of AIDS and mortality after transition from paediatric to adult care in a UK cohort of young people with perinatally acquired HIV. Methods: Records of people aged ≥ 13 years on 31 December 2015 in the UK paediatric HIV cohort (Collaborative HIV Paediatric Study) were linked to those of adults in the UK Collaborative HIV Cohort (CHIC) cohort. We calculated time from transition to a new AIDS event/death, with follow-up censored at the last visit or 31 December 2015, whichever was the earliest. Cumulative incidence of and risk factors for AIDS/mortality were assessed using Kaplan–Meier and Cox regression. Results: At the final paediatric visit, the 474 participants [51% female, 80% black, 60% born outside the UK, median (interquartile range) age at antiretroviral therapy (ART) initiation = 9 (5–13) years] had a median age of 18 (17–19) years and CD4 count of 471 (280–663) cell/μL; 89% were prescribed ART and 60% overall had a viral load ≤ 400 copies/mL. Over median follow-up in adult care of 3 (2–6) years, 35 (8%) experienced a new AIDS event (n = 25) or death (n = 14) (incidence = 1.8/100 person-years). In multivariable analyses, lower CD4 count at the last paediatric visit [adjusted hazard ratio = 0.8 (95% confidence interval: 0.7–1.0)/100 cells/μL increment] and AIDS diagnosis in paediatric care [2.7 (1.4–5.5)] were associated with a new AIDS event/mortality in adult care. Conclusions: Young people with perinatally acquired HIV transitioning to adult care with markers of disease progression in paediatric care experienced poorer outcomes in adult care. Increased investment in multidisciplinary specialized services is required to support this population at high risk of morbidity and mortality.
KW - AIDS
KW - HIV
KW - mortality
KW - transition
KW - young people
UR - http://www.scopus.com/inward/record.url?scp=85104938914&partnerID=8YFLogxK
U2 - 10.1111/hiv.13096
DO - 10.1111/hiv.13096
M3 - Article
C2 - 33939876
AN - SCOPUS:85104938914
SN - 1464-2662
VL - 22
SP - 631
EP - 640
JO - HIV Medicine
JF - HIV Medicine
IS - 8
ER -