Adolescent HIV viral load in an urban hospital in Newark, New Jersey

Kristin Wong; Jason Zucker; Helen Fernandes; David Cennimo

doi:10.1016/j.ijpam.2016.04.001

Adolescent HIV viral load in an urban hospital in Newark, New Jersey

Int J Pediatr Adolesc Med. 2016 Sep;3(3):103-108. doi: 10.1016/j.ijpam.2016.04.001. Epub 2016 May 13.

Authors

Kristin Wong¹, Jason Zucker², Helen Fernandes³, David Cennimo⁴

Affiliations

¹ Departments of Medicine & Pediatrics, Rutgers New Jersey Medical School, H-245, 150 Bergen St., Newark, NJ 07103, United States.
² Departments of Medicine & Pediatrics, Rutgers New Jersey Medical School, I-248, 150 Bergen St., Newark, NJ 07103, United States.
³ Department of Pathology, 150 Bergen St., Newark, NJ 07103, United States.
⁴ Departments of Medicine & Pediatrics, Rutgers New Jersey Medical School, MSB-C645, 185 S. Orange Ave, Newark, NJ 07103, United States.

Abstract

Background and objectives: Human immunodeficiency virus (HIV) in adolescents is a growing concern. Amid psychosocial challenges, adolescents must successfully transition into adult-centered care; however, little is known about outcome measurements within this period. We assessed the trend in adolescent HIV viral loads (VLs) in a community with a high HIV prevalence, allowing physicians to better recognize the challenges of transitioning adolescents with HIV to adult care.

Patients and methods: All HIV RNA VLs from the Molecular Virology Lab at University Hospital in Newark, New Jersey, from 2007 to 2010 were obtained. Patients were divided into pediatric (<13 years of age), adolescent (13-25 years of age), and adult (>25 years of age) age groups. Univariate and multivariate analyses assessed characteristics of patients by age and gender.

Results: A minimum of 40 pediatric, 178 adolescent, and 1335 adult patients were identified per year. There was a statistically significant increase in VLs of adolescents when compared to pediatric patients (P < .02). In 3 of the 4 years, there was a statistically significant increase in the rate of male adolescents reaching undetectable VLs compared to female adolescents. The average VL by age demonstrated increasing VLs from age 12 through age 24, while the percentage of patients reaching undetectable VLs peaked at 80% at age 8 and declined through age 24.

Conclusion: Successful transitional care programs should focus on pediatric needs to address the noticeable decrease in virologic control beginning at 8 years of age and the decreased rate of virologic suppression in females, creating concern for potential gender inequalities and increased risk of vertical transmission.

Keywords: AIDS, acquired immune deficiency syndrome; ART, antiretroviral therapy; Acquired immunodeficiency syndrome; Adolescent HIV; CDC, centers for disease control and prevention; HAART, highly active antiretroviral therapy; HIV, human immunodeficiency virus; NCI, National Cancer Institute; NIH, National Institutes of Health; STIs, sexually transmitted infections; Transitional care; Urban population; VL, viral load; Viral load; Virologic control; WHO, World Health Organization.