A new tool for the paediatric HIV research: general data from the Cohort of the Spanish Paediatric HIV Network (CoRISpe)

José, Ma Isabel De; Jiménez, José Luís; Espiau, María; Fortuny, Clàudia; Navarro, Ma Luisa; Soler‐Palacín, Pere; Ma, Mai‐Juan

doi:10.1186/1471-2334-13-2

Cited by 45 publications

(36 citation statements)

References 39 publications

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“…Indeed, in Southern Africa, we have shown an increase in the proportions of children <1 year and >10 years old initiating cART . In Europe, many older patients presenting for testing and care may be immigrants, predominantly from sub‐Saharan Africa .…”

Section: Discussionmentioning

confidence: 99%

Global temporal changes in the proportion of children with advanced disease at the start of combination antiretroviral therapy in an era of changing criteria for treatment initiation

Cohere

Phacs

2018

J Intern AIDS Soc

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IntroductionThe CD4 cell count and percent at initiation of combination antiretroviral therapy (cART) are measures of advanced HIV disease and thus are important indicators of programme performance for children living with HIV. In particular, World Health Organization (WHO) 2017 guidelines on advanced HIV disease noted that >80% of children aged <5 years started cART with WHO Stage 3 or 4 disease or severe immune suppression. We compared temporal trends in CD4 measures at cART start in children from low‐, middle‐ and high‐income countries, and examined the effect of WHO treatment initiation guidelines on reducing the proportion of children initiating cART with advanced disease.MethodsWe included children aged <16 years from the International Epidemiology Databases to Evaluate acquired immunodeficiency syndrome (AIDS) (IeDEA) Collaboration (Caribbean, Central and South America, Asia‐Pacific, and West, Central, East and Southern Africa), the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE), the North American Pediatric HIV/AIDS Cohort Study (PHACS) and International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) 219C study. Severe immunodeficiency was defined using WHO guidelines. We used generalized weighted additive mixed effect models to analyse temporal trends in CD4 measurements and piecewise regression to examine the impact of 2006 and 2010 WHO cART initiation guidelines.ResultsWe included 52,153 children from fourteen low‐, eight lower middle‐, five upper middle‐ and five high‐income countries. From 2004 to 2013, the estimated percentage of children starting cART with severe immunodeficiency declined from 70% to 42% (low‐income), 67% to 64% (lower middle‐income) and 61% to 43% (upper middle‐income countries). In high‐income countries, severe immunodeficiency at cART initiation declined from 45% (1996) to 14% (2012). There were annual decreases in the percentage of children with severe immunodeficiency at cART initiation after the WHO guidelines revisions in 2006 (low‐, lower middle‐ and upper middle‐income countries) and 2010 (all countries).ConclusionsBy 2013, less than half of children initiating cART had severe immunodeficiency worldwide. WHO treatment initiation guidelines have contributed to reducing the proportion of children and adolescents starting cART with advanced disease. However, considerable global inequity remains, in 2013, >40% of children in low‐ and middle‐income countries started cART with severe immunodeficiency compared to <20% in high‐income countries.

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Section: Discussionmentioning

confidence: 99%

Global temporal changes in the proportion of children with advanced disease at the start of combination antiretroviral therapy in an era of changing criteria for treatment initiation

Cohere

Phacs

2018

J Intern AIDS Soc

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“…Of the 702 enrolled, 211 had reached the age of 18 years (According to data on the website accessed on January 2, 2013). Researchers in Spain have established a Cohort of the Spanish Paediatric HIV Network (CoRISpe) that is following approximately 800 of the 1100–1200 HIV-infected children in Spain [75]. About one-quarter were born outside of Spain, and over one-third are at least 18 years of age.…”

Section: Europementioning

confidence: 99%

The changing epidemiology of the global paediatric HIV epidemic: keeping track of perinatally HIV‐infected adolescents

Sohn¹,

Hazra

2013

Journal of the International AIDS Society

131

127

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The global paediatric HIV epidemic is shifting into a new phase as children on antiretroviral therapy (ART) move into adolescence and adulthood, and face new challenges of living with HIV. UNAIDS reports that 3.4 million children aged below 15 years and 2 million adolescents aged between 10 and 19 years have HIV. Although the vast majority of children were perinatally infected, older children are combined with behaviourally infected adolescents and youth in global reporting, making it difficult to keep track of their outcomes. Perinatally HIV-infected adolescents (PHIVA) are a highly unique patient sub-population, having been infected before development of their immune systems, been subject to suboptimal ART options and formulations, and now face transition from complete dependence on adult caregivers to becoming their own caregivers. As we are unable to track long-term complications and survival of PHIVA through national and global reporting systems, local and regional cohorts are the main sources for surveillance and research among PHIVA. This global review will utilize those data to highlight the epidemiology of PHIVA infection, treatment challenges and chronic disease risks. Unless mechanisms are created to count and separate out PHIVA outcomes, we will have few opportunities to characterize the negative consequences of life-long HIV infection in order to find ways to prevent them.

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“…The largest numbers were in cohorts in France, Italy, Spain and the UK, which together accounted for ca 88% (7,205) of the 8,229 patients. These four countries all have dedicated multisite paediatric cohort studies, with good geographical coverage, with the proportion of perinatal HIV diagnoses included in the Spanish [22] and UK [3] national cohorts approaching 100%. However, the comparability of these countries' estimates to ECDC/WHO data varied considerably.…”

Section: Discussionmentioning

confidence: 99%

Children and young people with perinatal HIV in Europe: epidemiological situation in 2014 and implications for the future

Koch-Institut¹

2016

Eurosurveillance

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Accurate ascertainment of the number of children living with human immunodeficiency virus (HIV) is important to plan paediatric and adolescent health services. In Europe, the first generation of perinatally HIV-infected survivors are transferring to adult care and their health needs are unknown. We undertook an online survey of HIV cohort studies participating in the EuroCoord Network of Excellence to ascertain the number of perinatally HIV-infected (pHIV) patients included, to compare it with those published by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) and to assess the ability of countries to follow up pHIV patients after transfer to adult care. At the end of 2013, 16 countries in EuroCoord reported 8,229 pHIV patients in follow-up in cohorts, compared with 5,160 cumulative diagnoses reported by the ECDC in the same area. Follow-up of pHIV patients after transfer to adult care varied. It is likely that the number of diagnoses of perinatal HIV reported to ECDC is an underestimate, although this varies by country. Further work is needed to refine estimates and encourage follow-up in adult HIV cohorts to investigate long-term outcomes and improve the care of the next generation of children with HIV.

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A new tool for the paediatric HIV research: general data from the Cohort of the Spanish Paediatric HIV Network (CoRISpe)

Cited by 45 publications

References 39 publications

Global temporal changes in the proportion of children with advanced disease at the start of combination antiretroviral therapy in an era of changing criteria for treatment initiation

Global temporal changes in the proportion of children with advanced disease at the start of combination antiretroviral therapy in an era of changing criteria for treatment initiation

The changing epidemiology of the global paediatric HIV epidemic: keeping track of perinatally HIV‐infected adolescents

Children and young people with perinatal HIV in Europe: epidemiological situation in 2014 and implications for the future

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