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    Jan 26, 2021
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    High levels of viral repression, malnutrition and second-line ART use in adolescents living with HIV: a mixed methods study from Myanmar

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    Murray et al 2020 High levels ...
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    Authors
    Murray, J
    Whitehouse, K
    Ousley, J
    Bermudez, E
    Soe, TT
    Hilbig, A
    Soe, KP
    Mon, PE
    Tun, KT
    Ei, WLSS
    Cyr, J
    Deglise, C
    Ciglenecki, I
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    Issue Date
    2020-03-20
    Submitted date
    2020-04-17
    
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    Journal
    BMC Infectious Diseases
    Abstract
    BACKGROUND: Adolescents living with HIV/AIDS (ALHIV) are a particularly vulnerable but often overlooked group in the HIV response despite additional disease management challenges. METHODS: All ALHIV (10-19 years), on ART for ≥6 months, presenting to care at a Médecins Sans Frontières (MSF) clinic in Myanmar from January-April 2016 were eligible for the quantitative study component (clinical history, medical examination, laboratory investigation). A subset of these respondents were invited to participate in qualitative interviews. Interviews and focus groups were also conducted with other key informants (care givers, clinicians). RESULTS: Of 177 ALHIV, 56% (100) were aged 9-13 years and 77 (44%) were 14-19. 49% (86) had been orphaned by one parent, and 19% (33) by both. 59% (104) were severely underweight (BMI < 16). 47% presented with advanced HIV (WHO stage III/IV). 93% were virally supressed (< 250 copies/mL). 38 (21%) of ALHIV were on a second-line ART after first-line virological failure. Qualitative interviewing highlighted factors limiting adherence and the central role that HIV counsellors play for both ALHIV patients and caregivers. CONCLUSIONS: Our study shows good clinical, immunological, and virological outcomes for a cohort of Myanmar adolescents living with HIV, despite a majority being severely underweight, presenting with Stage III or IV illness, and the prevalence of comorbid infections (TB). Many treatment and adherence challenges were articulated in qualitative interviewing but emphasized the importance of actively engaging adolescents in their treatment. Comprehensive HIV care for this population must include routine viral load testing and social support programs.
    Publisher
    BioMed Central
    URI
    http://hdl.handle.net/10144/619647
    DOI
    10.1186/s12879-020-04968-x
    PubMed ID
    32197588
    Type
    Article
    Language
    en
    EISSN
    1471-2334
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12879-020-04968-x
    Scopus Count
    Collections
    HIV/AIDS

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