Outcomes following healthcare
transition (HCT) from pediatric to adult HIV care are not well described. We
sought to describe clinical outcomes following HCT within our institution among
young adults with behavioral-acquired (N = 31) and perinatally-acquired
(N = 19) HIV.
We conducted a retrospective cohort study among HIV-infected
adults who attempted transition from pediatric to adult HIV care within our
institution. The primary end point was retention in care, defined as the
completion of at least two visits over 12 months following linkage to adult
care. Additional end points include time to linkage to adult care, and changes
in CD4 + T cell count and HIV RNA across time. Outcomes were compared between
perinatal and behavioral HIV cohorts. Binary data were analyzed using the
Fisher exact test and continuous data were analyzed using the Mann-Whitney
test.
Forty-three (86%) of 50 patients were successfully linked to adult care.
The median time to linkage was 98 days. Fifty percent of patients achieved full
retention in care at 12 months post-linkage. Though those with
behavioral-acquired HIV attempted transfer at an older age, the groups did not
differ in rates of linkage and retention in adult care. CD4 + T cell counts and
rates of viral suppression did not differ between pre- and post-HCT periods.
Despite high rates of successful linkage to adult care in our study population,
rates of retention in adult HIV care following HCT were low. These results
imply that challenges remain in the adult HIV care setting toward improving the
HCT process.
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By:
- 1 Institute of Human Virology , University of Maryland School of Medicine (http://medschool.umaryland.edu/), Baltimore , MD , USA.
- 2 Division of Pediatrics , University of Maryland School of Medicine , Baltimore , MD , USA.
- AIDS Care. 2016 Jan 13:1-5.
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