Imperial College London
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ProfessorAlanWinston

Faculty of Medicine, Department of Infectious Disease

Professor of Genito-Urinary Medicine
 
 
 
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Contact

 

+44 (0)20 3312 1603a.winston

 
 
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Location

 

Winston Churchill WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Asad:2021:10.1111/hiv.13096,
author = {Asad, H and Collins, IJ and Goodall, RL and Crichton, S and Hill, T and Doerholt, K and Foster, C and Lyall, H and Post, FA and Welch, S and Winston, A and Sabin, CA and Judd, A and Collaborative, HIV Paediatric Study CHIPS Steering Committee and the, UK Collaborative HIV Cohort UK CHIC Study Steering Committee},
doi = {10.1111/hiv.13096},
journal = {HIV Medicine},
pages = {631--640},
title = {Mortality and AIDS-defining events among young people following transition from paediatric to adult HIV care in the UK},
url = {http://dx.doi.org/10.1111/hiv.13096},
volume = {22},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
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.
AU  - Asad,H
AU  - Collins,IJ
AU  - Goodall,RL
AU  - Crichton,S
AU  - Hill,T
AU  - Doerholt,K
AU  - Foster,C
AU  - Lyall,H
AU  - Post,FA
AU  - Welch,S
AU  - Winston,A
AU  - Sabin,CA
AU  - Judd,A
AU  - Collaborative,HIV Paediatric Study CHIPS Steering Committee
AU  - the,UK Collaborative HIV Cohort UK CHIC Study Steering Committee
DO  - 10.1111/hiv.13096
EP  - 640
PY  - 2021///
SN  - 1464-2662
SP  - 631
TI  - Mortality and AIDS-defining events among young people following transition from paediatric to adult HIV care in the UK
T2  - HIV Medicine
UR  - http://dx.doi.org/10.1111/hiv.13096
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33939876
UR  - http://hdl.handle.net/10044/1/96324
VL  - 22
ER  -
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