期刊
JOURNAL OF THE INTERNATIONAL AIDS SOCIETY
卷 16, 期 -, 页码 -出版社
JOHN WILEY & SONS LTD
DOI: 10.7448/IAS.16.1.18579
关键词
perinatally HIV-infected; adolescents; combination antiretroviral therapy; management; resistance; outcomes
资金
- National Institutes of Allergy and Infectious Diseases [1K23 AI084549]
- Johns Hopkins Ross Clinician Scientist Award
- USAID
- PEPFAR
Three decades into the HIV/AIDS epidemic there is a growing cohort of perinatally HIV-infected adolescents globally. Their survival into adolescence and beyond represent one of the major successes in the battle against the disease that has claimed the lives of millions of children. This population is diverse and there are unique issues related to antiretroviral treatment and management. Drawing from the literature and experience, this paper discusses several broad areas related to antiretroviral management, including: 1) diverse presentation of HIV, (2) use of combination antiretroviral therapy including in the setting of co-morbidities and rapid growth and development, (3) challenges of cART, including nonadherence, resistance, and management of the highly treatment-experienced adolescent patient, (4) additional unique concerns and management issues related to PHIV-infected adolescents, including the consequences of longterm inflammation, risk of transmission, and transitions to adult care. In each section, the experience in both resource-rich and limited settings are discussed with the aim of highlighting the differences and importantly the similarities, to share lessons learnt and provide insight into the multi-faceted approaches that may be needed to address the challenges faced by this unique and resilient population.
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