Abstract

Impact of treatment adherence on the effectiveness of antiretroviral therapy in adolescents and young adult with HIV acquired in infancy

N.P.M. Rubini, C.L.A. Llerena, M.C.V. Azevedo, F.S. Sion, C.A. Morais-de-Sá

Federal University of Rio de Janeiro State, Immunology, Rio de Janeiro, Brazil

Background: Adolescents and young adults with HIV infection acquired in infancy have special characteristics, such as severe immunodeficiency, exposure to various antiretroviral regimes and difficulty adhering to treatment, which can compromise the effectiveness of antiretroviral therapy (ART). Our objective was to investigate the rate of virological efficacy and the factors related to the success of ART in this population.
Methods: We conducted a cross-sectional study in adolescent and young adult with HIV acquired by vertical or blood transmission in infancy. Patients were divided into two groups: Group A - effective suppression of viral replication (viral load < 200cps/ml) and Group B - virologic failure. The groups were comparatively analyzed with respect to age, gender, CDC classification, number of antiretroviral regimes and adherence to treatment.
Results: We analyzed 71 patients: 36 (51%) were male and 41 (58%) were classified in categories C and / or 3. We observed effective suppression of viral replication in 41% of the patients. The comparative analysis is below:
Comparative ana...[tab_01]
Conclusions: We observed a low rate of virological efficacy of ART in adolescents and young adult with HIV acquired in infancy. Despite the large percentage of patients with severe immune impairment and exposure to multiple ARV combinations, these factors did not affect the effective suppression of viral replication. Our data indicate that the main factor determining the success of ART in adolescents and young people with HIV infection acquired in infancy is the adherence to treatment.