Virological outcome among HIV infected patients transferred from pediatric care to adult units in Madrid, Spain (1997–2017)
Carolina Beltrán-Pavez, Miguel Gutiérrez-López, Marina Rubio-Garrido, Ana Valadés-Alcaraz, Luis Prieto, José Tomás Ramos, Santiago Jiménez de Ory, Marisa Navarro, Cristina Díez-Romero, Federico Pulido, Eulalia Valencia, África Holguín, The Madrid Cohort of HIV-Infected Children integrated in the Pediatric Branch of the Spanish National AIDS Network (CoRISpe), CoRISpe Cohort Working Group, María José Mellado, Luis Escosa, Milagros García López Hortelano, Talía Sainz, María Isabel González-Tomé, Pablo Rojo, Daniel Blázquez‐Gamero, Luis Prieto, Cristina Epalza, José Tomás Ramos, Sara Guillén, María Luisa Navarro, Jesús Saavedra, Mar Santos, Begoña Santiago, David Aguilera‐Alonso, Santiago Jiménez de Ory, Itzíar Carrasco, Miguel Ángel Roa, María Penín, Jorge Martínez, Katie Badillo, Eider Oñate, Itziar Pocheville, Elisa Garrote, Elena Colino, Jorge Gómez Sirvent, M. González-Ripoll Garzón, Vicente Román, Raquel Angulo, Olaf Neth, Lola Falcón-Neyra, Pedro Terol, Juan Luis Santos, David Moreno, Francisco Lendínez, Estrella Peromingo, J. Uberos, Beatriz Ruiz, Ana Grande, Francisco J. Romero, Carlos Pérez, Miguel Lillo, Begoña Losada, Mercedes Herranz, Matilde Bustillo Alonso, Pilar Collado, José Antonio Couceiro, Leticia Vila, Consuelo Calviño, Ana Isabel Piqueras, Manuel Oltra, César Gavilán, Elena Montesinos, Marta Dapena, Cristina Álvarez, Beatriz Jiménez, Ana Gloria Andrés, Víctor Marugán, Carlos Ochoa, Santiago Alfayate, Ana Isabel Menasalvas, Y. Ruiz del Prado, Pere Soler‐Palacín, Marie Antoinette Frick, Antonio Mǔr, Nuria López, María Méndez, Lluís Mayol, Teresa Vallmanya, Olga Calavia, Lourdes García, María Teresa Balaguer Coll, Valentí Pineda, Neus Rius, Joaquín Dueñas, Clàudia Fortuny, Antoni Noguera‐Julián, CoRISpe-FARO Cohort Working Group, José Ignacio Bernardino, Marisa Montes, Eulalia Valencia, Rafael Rubio, Federico Pulido, Otilia Bisbal, Gabriel Gaspar Alonso
Abstract
The aim of this transversal study was to describe the virological and immunological features of HIV-infected youths transferred from pediatric to adult care units since 1997 vs. the non-transferred patients from the Madrid Cohort of HIV-infected children and adolescents in Spain. We included 106 non-transferred and 184 transferred patients under clinical follow-up in 17 public hospitals in Madrid by the end of December 2017. Virological and immunological outcomes were compared in transferred vs. non-transferred patients. ART drug resistance mutations and HIV-variants were analyzed in all subjects with available resistance pol genotypes and/or genotypic resistance profiles. Among the study cohort, 133 (72.3%) of 184 transferred and 75 (70.7%) of 106 non-transferred patients had available resistance genotypes. Most (88.9%) of transferred had ART experience at sampling. A third (33.3%) had had a triple-class experience. Acquired drug resistance (ADR) prevalence was significantly higher in pretreated transferred than non-transferred patients (71.8% vs. 44%; p = 0.0009), mainly to NRTI (72.8% vs. 31.1%; p < 0.0001) and PI (29.1% vs. 12%; p = 0.0262). HIV-1 non-B variants were less frequent in transferred vs. non-transferred (6.9% vs. 32%; p < 0.0001). In conclusion, the frequent resistant genotypes found in transferred youths justifies the reinforcement of HIV resistance monitoring after the transition to avoid future therapeutic failures.