With the first major generation of young people who contracted HIV from their mothers aging into adulthood, many face considerable challenges maintaining control of the virus. Overall, adolescents and young adults who were perinatally infected with the virus have poorer health compared with other adults living with the virus.
Publishing their findings in JAMA Pediatrics, researchers examined combined data on 1,562 perinatally infected individuals from the Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1072 multicenter cohort studies. The data spanned March 2007 to April 2015.
Today, there are approximately 10,000 U.S. residents who contracted HIV perinatally, the majority of whom are older than 18. A recent study found that new annual cases of mother-to-child transmission of the virus have fallen steadily since the beginning of the 21st century, hitting only 69 in 2013. This figure does not account for international adoptions of children born with the virus, which adds to the total number of children growing up with the virus in the United States.
A total of 52.5 percent of the individuals were female and 65.9 percent were Black. They were followed for a mean 4.9 years.
The proportion of time cohort members spent with a viral load above 400, broken down by age, was: 7 to 12 years old: 22 percent percent; 13 to 17 years old: 30 percent; and 18 to 30 years old: 44 percent. The proportion of time they spent with a CD4 count below 200 was a respective 2 percent, 5 percent and 18 percent.
Despite the fact that these young people were engaged in health care, the death rate among the 18- to 30-year-olds was six to 12 times higher than for HIV-negative youths of the same age, sex and race.
These adolescents and young adults had poorer health outcomes than HIV-positive adults who did not contract the virus perinatally. The most commonly reported health conditions among the members of the study cohort were related to mental health and brain and nervous system development.
The researchers also found high rates of sexually transmitted infections among the females in the study, the presence of which was associated with lower CD4 levels. It is unclear how these two variables are connected, whether there is some biological mechanism for an increased risk for STIs or perhaps if young women who have poorer adherence to antiretroviral (ARV) treatment also engage in riskier sex.
On the bright side, among those young people who maintained good control of the virus through ARV treatment, serious health problems were rare.
To read the study abstract, click here.
To read a press release about the study, click here.
To read a recent POZ cover story on young adults who were born with HIV, click here.