TY - JOUR
T1 - Adolescents and young adults with early acquired HIV infection in the united states
T2 - unique challenges in treatment and secondary prevention
AU - Yusuf, Hasiya
AU - Agwu, Allison
N1 - Funding Information:
A Agwu receives funding from Johns Hopkins Center for AIDS Research (P30AI094189). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
PY - 2020
Y1 - 2020
N2 - Introduction: Worldwide, children who acquired human immunodeficiency virus (HIV) at an early age, either perinatally or through blood transfusion, are reaching adolescence and adulthood due to successful antiretroviral treatment (ART). While many are thriving, a significant proportion face unprecedented multilevel challenges that can affect their long-term outcomes. Specifically, longstanding and poorly controlled HIV resulting from inadequate early regimens and nonadherence, along with the toxicities of some ART agents, can predispose them to sequelae including HIV-associated complications and other comorbidities. Areas covered: This paper reviews and summarizes the unique issues facing adolescents and young adults with early acquired HIV (AYA-EAHIV), including ART challenges, emerging comorbidities, and complications, including mental health comorbidities, secondary prevention, and transition from pediatric/adolescent to adult care. Expert opinion: AYA-EAHIV are a special population that have lived their entire lives with the physical and psychological toll of HIV mandating targeted and purposeful approaches to optimize their management and outcomes. Multifaceted inclusive and context-specific approaches focusing on heightened research, risk reduction interventions, and ‘outside the box’ thinking will be required to optimize treatment and reduce morbidity and mortality.
AB - Introduction: Worldwide, children who acquired human immunodeficiency virus (HIV) at an early age, either perinatally or through blood transfusion, are reaching adolescence and adulthood due to successful antiretroviral treatment (ART). While many are thriving, a significant proportion face unprecedented multilevel challenges that can affect their long-term outcomes. Specifically, longstanding and poorly controlled HIV resulting from inadequate early regimens and nonadherence, along with the toxicities of some ART agents, can predispose them to sequelae including HIV-associated complications and other comorbidities. Areas covered: This paper reviews and summarizes the unique issues facing adolescents and young adults with early acquired HIV (AYA-EAHIV), including ART challenges, emerging comorbidities, and complications, including mental health comorbidities, secondary prevention, and transition from pediatric/adolescent to adult care. Expert opinion: AYA-EAHIV are a special population that have lived their entire lives with the physical and psychological toll of HIV mandating targeted and purposeful approaches to optimize their management and outcomes. Multifaceted inclusive and context-specific approaches focusing on heightened research, risk reduction interventions, and ‘outside the box’ thinking will be required to optimize treatment and reduce morbidity and mortality.
KW - adherence
KW - adolescent
KW - chronic HIV
KW - comorbidities
KW - Early acquired HIV
KW - perinatal HIV
KW - risk reduction
KW - secondary prevention
KW - virologic suppression
KW - young adult
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U2 - 10.1080/14787210.2021.1829473
DO - 10.1080/14787210.2021.1829473
M3 - Review article
C2 - 32990092
AN - SCOPUS:85094898823
JO - Expert Review of Anti-Infective Therapy
JF - Expert Review of Anti-Infective Therapy
SN - 1478-7210
ER -