HIV: comprehensive strategies boost care retention but not virologic suppression as youths enter adult care

  • Griffith D & al.
  • Pediatr Infect Dis J
  • 10 Apr 2019

  • International Clinical Digest
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Takeaway

  • Comprehensive retention strategies (CRS) appear to promote successful retention (but not virologic suppression) in non-African-American youth living with HIV (YLHIV) with higher CD4 counts who are transferred to adult care.

Why this matters

  • Multidisciplinary CRS appear to influence successful transition of YLHIV from pediatric to adult care.
  • Provide targeted, ongoing follow-up, ongoing communication to reduce stigma in YLHIV to stabilize virologic control prior to transfer.

Key results

  • 89 patients.
  • 60% (53) successfully transitioned to adult care.
  • Adjusted: non-African-American race (OR, 11.26; 95% CI, 1.32-95.51; P=.02), CD4≥500 cells/mm3 (OR, 5.22; 95% CI, 1.54-17.70; P<.01 perinatal hiv or ci associated with successful transition.>
  • Overall, 51% (45/89) had suppressed viral loads (HIV RNA ≤400 copies/mL) after transfer.
  • Lower success rates observed in youth males who have sex with men (MSM) (23%, 3/13) vs heterosexual risk (60%, 15/25) and PHIV (69%, 35/51).
  • Subgroup analysis showed 96% of YLHIV with successful transfer to adult care completed ≥1 adult clinic visit.

Study design

  • Retrospective cohort of YLHIV transferred to adult care assessing effect of CRS strategies on retention, virologic suppression.
  • Funding: None disclosed.

Limitations

  • Small sample size.
  • No comparative cohort.
  • No longitudinal analysis.
  • Effect bias.

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