Clinical profile and disease progression of HIV in adolescents and young adults in Vadodara, India.

Abstract

Introduction:Adolescents are vulnerable to HIV for many reasons. Unfortunately, there are little data available on adolescents and young adults who have contracted HIV. Only few studies have been conducted in India with an aim to assess the clinical presentation, disease progression, and clinical profile of HIV in adolescents.Materials and Methods:There was a cohort study conducted at the antiretroviral therapy (ART) center at a teaching hospital in Western India. The study participants were kept under observation for 1 year. The end point of the cohort analysis was HIV disease progression. Patient details such as sociodemographic profile, CD4 counts at presentation, date of initiation of ART, WHO clinical stage of HIV at presentation, episodes of opportunistic infections, and laboratory investigations were recorded. Descriptive statistics and survival analysis were used for analyzing disease progression, improvement in health conditions, and factors affecting the same.Results:Of 155 participants, 100 were followed up till the end of the study. Seventy-two percent participants were adolescents and 53% were female. The mean age at presentation was 16.7 years, and the common modes of transmission were mother-to-child transmission (MTCT) (48%), heterosexual relationships (23%), and blood transfusion (12%). CD4 counts at presentation were <350 cells/mm3 among 70 participants. Among those infected through MTCT, the median survival duration was 15 years (95% confidence interval: 12.98–17.07). The risk of progression of the disease among young adults was thrice than that of adolescents (P < 0.05).Conclusion:HIV/AIDS screening and health services shall be tailored to address the special needs of adolescents and young adults. Teaching hospitals shall explore opportunities for student-involved longitudinal research studies to better understand the source of HIV infection, treatment seeking behavior, disease progression and outcome in a comprehensive manner.