Optimizing antiretroviral therapy in adolescents with perinatally acquired HIV-1 infection

Abstract

In resourced settings with access to highly active antiretroviral therapy, perinatally acquired HIV-1 infection has become a chronic disease of childhood with increasing numbers of adolescents surviving to adulthood and transitioning from pediatric to adult services. Advances in antiretroviral therapy, reductions in side effects, new classes and new drugs within existing antiretroviral classes offer enormous benefits, although issues around adherence during adolescence persist. The longer term impact of exposure to HIV and antiretroviral therapy throughout childhood are becoming apparent, with growing concern over neurocognitive, cardiovascular, renal and bone health. Careful follow-up of this early perinatal cohort as they enter adulthood will inform the future management of the growing numbers of adolescents surviving worldwide as access to therapy increases.

Keywords::

• adherence
• adolescents
• antiretroviral therapy
• bone toxicity
• cardiovascular risk
• neurocognitive function
• perinatally acquired HIV
• toxicity

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.