Virological outcome among HIV infected patients transferred from pediatric care to adult units in Madrid, Spain (1997-2017)

The aim of this transversal study was to describe the virological and immunological features of HIV-infected youths transferred from pediatric to adult care units since 1997 vs. the non-transferred patients from the Madrid Cohort of HIV-infected children and adolescents in Spain. We included 106 non...

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Detalles Bibliográficos
Autores: Beltrán Pávez, Carolina, Gutiérrez López, Miguel, Rubio Garrido, Marina, Valadés Alcaraz, Ana, Prieto, Luis, Ramos, José Tomas, Jiménez de Ory, Santiago, Navarro, Marisa, Díez-Romero, Cristina, Pulido, Federico, Valencia, Eulalia, Holguín, África, Noguera Julian, Antoni
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/186712
Acceso en línea:https://hdl.handle.net/2445/186712
Access Level:acceso abierto
Palabra clave:Infeccions per VIH
Resistència als medicaments
Adolescents
HIV infections
Drug resistance
Teenagers
Descripción
Sumario:The aim of this transversal study was to describe the virological and immunological features of HIV-infected youths transferred from pediatric to adult care units since 1997 vs. the non-transferred patients from the Madrid Cohort of HIV-infected children and adolescents in Spain. We included 106 non-transferred and 184 transferred patients under clinical follow-up in 17 public hospitals in Madrid by the end of December 2017. Virological and immunological outcomes were compared in transferred vs. non-transferred patients. ART drug resistance mutations and HIV-variants were analyzed in all subjects with available resistance pol genotypes and/or genotypic resistance profiles. Among the study cohort, 133 (72.3%) of 184 transferred and 75 (70.7%) of 106 non-transferred patients had available resistance genotypes. Most (88.9%) of transferred had ART experience at sampling. A third (33.3%) had had a triple-class experience. Acquired drug resistance (ADR) prevalence was significantly higher in pretreated transferred than non-transferred patients (71.8% vs. 44%; p = 0.0009), mainly to NRTI (72.8% vs. 31.1%; p < 0.0001) and PI (29.1% vs. 12%; p = 0.0262). HIV-1 non-B variants were less frequent in transferred vs. non-transferred (6.9% vs. 32%; p < 0.0001). In conclusion, the frequent resistant genotypes found in transferred youths justifies the reinforcement of HIV resistance monitoring after the transition to avoid future therapeutic failures.