A considerable proportion of people with HIV do not achieve long-term viral suppression, with fewer children and adolescents achieving viral suppression than adults, according to a study published online Nov. 30 in The Lancet HIV.
Win Min Han, M.B.B.S., from the Kirby Institute in Sydney, and colleagues conducted a retrospective cohort study involving 21,594 children and adolescents from 106 sites in 22 countries and 255,662 adults from 143 sites in 30 countries to examine the proportions with viral suppression at one, two, and three years after initiating antiretroviral therapy (ART).
The researchers found that the proportion of children and adolescents with viral suppression was 36, 30, and 24 percent at one, two, and three years after ART initiation, respectively, in the intention-to-treat approach; among adults, the corresponding proportions were 44, 36, and 29 percent. After adjusting for missing viral load measurements among those who transferred, were lost to follow-up, or were in follow-up without viral load testing, the corresponding proportions were 64, 62, and 59 percent for children and adolescents, and 79, 72, and 65 percent for adults at one, two, and three years after initiating ART, respectively.
“Estimates of viral suppression that do not account for the sizeable proportion of people with HIV who are lost to follow-up who are connected to care elsewhere and still receiving ART, or estimates that do not account for people with HIV in care who are not tested, are unlikely to reflect the actual proportion who are virally suppressed among those who are accessing care,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.
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