Open AccessAntiretroviral treatment, management challenges and outcomes in perinatally HIV‐infected adolescents
Author(s) -
Agwu Allison L,
Fairlie Lee
Publication year - 2013
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.16.1.18579
Subject(s) - medicine , antiretroviral therapy , human immunodeficiency virus (hiv) , population , disease management , cart , antiretroviral treatment , disease , intensive care medicine , family medicine , pediatrics , viral load , environmental health , pathology , parkinson's disease , engineering , mechanical engineering
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.