Author: Anna Turkova, Evgeny Voronin, Yulia Plotnikova, Anna Samarina, Edith Milanzi, Vladimir Rozenberg, Liubov Okhonskaia, Inga Latysheva, Aleksey Plynsky, Elena Fertikh, Siobhan Crichton, Charlotte Jackson, Ali Judd, Intira J Collins, on behalf of the European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC)
Published in: 12th International Workshop on HIV Pediatrics
Background:
The cascade of care summarises the 90-90-90 UNAIDS targets, of 90% of HIV+ people knowing their status, of whom 90% receive antiretroviral treatment (ART), of whom 90% are virally suppressed
By 2019, there were 1,068,839 people diagnosed with HIV in Russia, of whom 50% were on ART, and of those 76% were virally suppressed1.
However, there is less data on the HIV care continuum in children and adolescents with HIV in Russia
Objective:
To summarise the cascade of care in children and adolescents living with HIV in three Russian clinics.
Method:
We included data on children/adolescents aged <18 years at HIV diagnosis from three Russian clinics within the European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC).
Follow-up data from first presentation to HIV care until death, loss to follow-up, transfer to adult care or last visit (data cut-off 1/10/2016) were included.
As all patients were already diagnosed with HIV, we adapted the cascade of care as follows: (a) initiated ART, (b) virally suppressed (VS) ≤1000 copies/ml and (c) having good WHO immune status* at last visit. The analysis was restricted to patients in active paediatric follow-up (FU) in 2015-2016 and had ≥12 months of FU.
Characteristics of patients and cascade results were stratified by age of HIV diagnosis:
i.Diagnosed during “childhood” (age <10) and
ii.Diagnosed during “adolescence” (age ≥10)
The proportion with VS and good immune status* at 12(±3) months after ART start was also summarized overall and by calendar year of ART start.
Results:
- Of 922 patients followed in the 3 centres, 703 had ≥12 months FU and were in care in 2015/16 and included in this analysis. Of these:
- 655 (93%) were diagnosed in childhood, of whom 94% had perinatally acquired HIV (Table 1)
- 48 (7%) were diagnosed in adolescence, of whom 27% had perinatally acquired HIV, 25% sexually-acquired, and 48% had other or unknown mode of transmission
- 94% (618/655) in the childhood group initiated ART compared to 81% (39/48) in the adolescent group.
- At ART initiation, the median age was 2.2 years and 16.1 years in the childhood and adolescence group, respectively. 52% and 58% had advanced or severe WHO immunosuppression at ART start, respectively (Table 1).