The advent of antiretroviral therapy (ART) has transformed HIV from a death sentence into a chronic disease. In one of the largest studies of perinatally infected HIV (PHIV) patients to date, Agwu, et al, found that the proportion of patients on ART has increased and rates of viremia and advanced immunosuppression have decreased. But the rates of both markers in older patients are higher, according to an article in the Fall issue of The Journal of the Pediatric Infectious Diseases Society (JPIDS).
The retrospective study of the HIV Research Network followed 521 patients over an eight-year span, from 2002 to 2010. The median age of care increased from 14 to 18 years. During that time, the proportion of those prescribed ART rose from 67.4% to 84.1% and virologic suppression rose from 35.5% to 63%. Looking at two time scales-the age of the patient vs. the calendar year-the authors saw that the earlier calendar year of patient entry was a greater predictor of higher viremia and advanced immunosuppression over time. This indicates that advances in ART therapy have bisected this population, with those who came after the advent of ART entering adolescence with better virologic control.