Original Article
Changes in Advanced Immunosuppression and Detectable HIV Viremia Among Perinatally HIV-Infected Youth in the Multisite United States HIV Research Network Allison L. Agwu,1,2 John A. Fleishman,3 Richard Rutstein,4 P. Todd Korthuis,5,6 and Kelly Gebo2 1
Division of Pediatric Infectious Diseases, Department of Pediatrics, and 2Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, and 3Center for Financing, Access, and Cost Trends, Agency for Health Care Research and Quality, Rockville, Maryland; 4Division of General Pediatrics, Children’s Hospital of Philadelphia, Pennsylvania; and Departments of 5Internal Medicine, and 6Public Health and Preventive Medicine, Oregon Health and Science University, Portland Corresponding Author: Allison L. Agwu, MD, ScM, 200 N Wolfe St, Rm 3145 Baltimore, MD 21287. E-mail:
[email protected]. Received September 20, 2012; accepted January 31, 2013; electronically published March 12, 2013.
Background. Due to successful antiretroviral therapy (ART), perinatally human immunodeficiency virus (PHIV)–infected children are reaching adolescence and young adulthood. Adolescence is characterized by factors (eg, increased risk-taking) that may hamper management. We examined PHIV-infected youth in a multisite US cohort, assessing factors associated with changes in advanced immunosuppression and detectable viremia over time. Methods. We conducted a retrospective study of 521 PHIV-infected youth, 12 years and older, followed at 16 HIV clinics in the HIV Research Network between 2002 and 2010. We assessed demographic and clinical factors associated with CD4
