Mortality and losses to follow‐up among adolescents living with HIV in the IeDEA global cohort collaboration

• DOI: 10.1002/jia2.25215
• Publication Date: 2018-12-13T09:10:31Z
• Authors: Azar Kariminia; Matthew Law; Mary‐Ann Davies; Michael Vinikoor; Kara Wools‐Kalous...; Valeriane Leroy; Andrew Edmonds; Catherine McGowan; Rachel Vreeman; Lee Fairlie; Samuel Ayaya; Marcel Yotebieng; Elom Takassi; Jorge Pinto; Adebola Adedimeji; Karen Malateste; Daisy M Machado; Martina Penazzato; Rohan Hazra; Annette H Sohn
• Keywords: Male; Databases, Factual; Epidemiology; Health Professions; HIV Infections; HIV Epidemiology; FOS: Health sciences; Pediatrics; Cohort Studies; 0302 clinical medicine; Sociology; Child; Internal medicine; Research Articles; Global Maternal and Child Health Outcomes; Cohort; Human immunodeficiency virus (HIV); FOS: Sociology; 3. Good health; Infectious Diseases; Anti-Retroviral Agents; Caribbean Region; General Health Professions; Medicine; Female; Cohort study; Asia; Family medicine; Adolescent; Hazard ratio; Adolescent Health; HIV Transmission; Proportional hazards model; Young Adult; 03 medical and health sciences; Health Sciences; Humans; Proportional Hazards Models; Demography; Prevention and Treatment of HIV/AIDS Infection; Confidence interval; HIV; Central America; South America; Pediatrics, Perinatology and Child Health; [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie; Lost to Follow-Up; Adolescent Sexual Health and Behavior Patterns; Follow-Up Studies

Abstract Introduction We assessed mortality and losses to follow‐up ( LTFU ) during adolescence in routine care settings the International epidemiology Databases Evaluate AIDS (Ie DEA consortium. Methods Cohorts Asia‐Pacific, Caribbean, Central, South America, sub‐Saharan Africa (Central, East, Southern, West) contributed data, included adolescents living with HIV ALHIV enrolled from January 2003 aged 10 19 years (period of adolescence) while under up database closure (June 2016). Follow‐up started at age or first clinic visit, whichever was later. Entering <15 a proxy for perinatal infection, entering ≥15 represented infection acquired adolescence. Competing risk regression used assess associations death among those ever receiving triple‐drug antiretroviral therapy (triple‐ ART ). Results Of 61,242 270 clinics 34 countries analysis, 69% (n = 42,138) entered (53% female), 31% 19,104) (81% female). During adolescence, 3.9% died, 30% were 8.1% transferred. For perinatally versus four‐year cumulative incidences 5.4% 26% respectively (both p < 0.001). Overall, there higher hazards females (adjusted sub‐hazard ratio (as HR 1.19, 95% confidence interval CI 1.07 1.33), starting treatment ≥5 (highest as ≥15: 8.72, 5.85 13.02), mostly urban 1.40, 1.13 1.75) rural 1.39, 1.03 1.87) compared settings. observed 1.12, 1.17), 11.11, 9.86 12.53), district hospitals 1.27, 1.18 1.37) 1.21, 1.29), triple‐ after 2006 2011 2016 1.84, 1.71 1.99). Conclusions Both worse years. should be evaluated apart younger children adults identify population‐specific reasons .