Global HIV viral suppression rates too low among children and
adolescents

Date:
November 30, 2021
Source:
University of New South Wales
Summary:
An analysis in the lead up to World AIDS Day reveals that HIV is
'virally suppressed' in only 59 per cent of children and adolescents
on treatment.



FULL STORY ========================================================================== Globally, less than two thirds of children living with HIV who are
taking treatment are 'virally suppressed', according to new research
from UNSW Sydney's Kirby Institute and the global IeDEA consortium,
published today in The Lancet HIV.


========================================================================== Viral suppression for HIV means that treatments are working effectively
to protect health and prevent the transmission of HIV to others. UNAIDS
has set a target of achieving 95% viral suppression among all people
living with HIV on treatment by 2030.

"We estimate viral suppression one, two and three years after people
start taking antiviral treatment, so that we can understand how well
the treatments are working overtime," said Professor Matthew Law from
the Kirby Institute.

"The data among adults on treatment in our studies show that after
accounting for people being lost to care, viral suppression was achieved
in an estimated 79% of adults at 1 year, and 65% at 3 years. However,
viral suppression is poorer among children at an estimated 64% at 1
year and 59% at 3 years." Dr Azar Kariminia from the Kirby Institute,
who is senior author on the study, says children and adolescents face
unique barriers to achieving viral suppression. "It can be challenging
for them to take treatment regularly, and children rely on caregivers
who are often having to manage their own medical needs. There are also
a range of factors that stem from stigma and discrimination, including
a fear of disclosing the child's HIV status." This study is part of a
major research collaboration called IeDEA, the International epidemiology Databases to Evaluate AIDS, which draws together HIV epidemiological data
and expertise across seven regions: North America; the Caribbean and
Central and South America; Central, East, Southern and Western Africa;
and the Asia-Pacific. The Kirby Institute co-leads IeDEA Asia-Pacific
with the Foundation for AIDS Research's (amfAR) TREAT Asia program. IeDEA
is funded by the United States National Institutes of Health.

For this study, the researchers analysed data from 21,594
children/adolescents and 255,662 adults from 148 sites in 31 countries,
who initiated treatment between 2010 and 2019.



==========================================================================
Dr Annette Sohn, from amfAR's TREAT Asia program, is Co Principal
Investigator for IeDEA Asia-Pacific (along with Professor Matthew Law from
the Kirby Institute). She says that "while there has been substantial
progress in the global response to HIV, the needs of children and
adolescents often fall behind those of adults. Our efforts must extend
beyond ensuring access to paediatric medicines to address the social
and developmental challenges they face in growing up with HIV if we are
to achieve the WHO targets by 2030." The need for global scale up of
viral load testing Viral load testing is essential to find out whether
HIV treatments are working effectively. It is recommended by WHO at six
and 12 months following the initiation of treatment, and then every 12
months thereafter.

While viral load testing is common in high-income countries, scaling
up accessible viral load testing in resource-limited settings remains
a challenge.

Funded through the Australian Government's Department of Foreign Affairs
and Trade's Centre for Health Security, the Kirby Institute and the
Papua New Guinea Institute of Medical Research (PNGIMR) are partnering
with the PNG government and a consortium of partners are implementing a
program called 'ACT- UP PNG' which will scale up HIV viral load testing
in two provinces where HIV rates are very high.



==========================================================================
"Our work is ensuring that infants and children are afforded the same
access to testing and treatment as other people with HIV," says Dr Janet
Gare from the PNGIMR and a Co-Principal Investigator on ACTUP-PNG.

Rather than providing viral load testing in faraway laboratories, ACT-UP
PNG provides same-day molecular point-of-care testing and return of
results in HIV clinics.

"This brings HIV viral load testing closer to patients, which
currently includes children aged 10 and older, and adolescents," says Dr
Gare. "However, we are also pioneering the implementation of a diagnostic platform that will allow the same access to timely HIV viral load testing
and results for infants 6-8 weeks of age, and children up to 9 years,
who are currently unable to be included in point-of-care methods.

Scientia Associate Professor Angela Kelly-Hanku, who holds joint
appointments with the Kirby Institute and PNGIMR, says that leveraging
these technologies will make it easier to test for viral suppression in
infants and children.

"We cannot end AIDS without addressing the inequalities that exist
between paediatric and adult HIV programs. Projects like ACT-UP make
a real difference and bring us closer to achieving the UNAIDS targets." ========================================================================== Story Source: Materials provided by University_of_New_South_Wales. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Win Min Han, Matthew G Law, Matthias Egger, Kara Wools-Kaloustian,
Richard Moore, Catherine McGowan, Nagalingesawaran Kumarasamy,
Sophie Desmonde, Andrew Edmonds, Mary-Ann Davies, Constantin
Yiannoutsos, Keri N Althoff, Claudia P Cortes, Thahira Jamal
Mohamed, Antoine Jaquet, Kathryn Anastos, Jonathan Euvrard, Barbara
Castelnuovo, Kate Salters, Lara Esteves Coelho, Didier K Ekouevi,
Brian Eley, Lameck Diero, Elizabeth Zaniewski, Nathan Ford, Annette
H Sohn, Azar Kariminia. Global estimates of viral suppression in
children and adolescents and adults on antiretroviral therapy
adjusted for missing viral load measurements: a multiregional,
retrospective cohort study in 31 countries. The Lancet HIV, 2021;
8 (12): e766 DOI: 10.1016/S2352-3018(21)00265-4 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/11/211130101503.htm

--- up 2 weeks, 5 days, 2 hours, 54 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1:317/3)