HIV Viral Suppression Lagging in Children, Adolescents Worldwide

Adults with human immunodeficiency virus (HIV) receiving antiretroviral therapy are nearing the global target of 95% achieving viral suppression, but progress among children and adolescents is slower. Researchers published study results in The Lancet HIV.

The study was an analysis of data from the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium for 21,594 children and adolescents and 255,662 adults from 148 treatment sites in 31 countries. Researchers estimated the proportions of children and adolescents, as well as adults, with viral suppression at 1, 2, and 3 years after initiating antiretroviral therapy. Having fewer than 1000 copies of HIV per milliliter of blood was considered viral suppression.

After figuring percentages of patients with viral suppression based on data from those who were in follow-up and with viral load measurements for up to 3 years of antiretroviral therapy, researchers factored in viral suppression among people who had left care during the 3-year follow-up. To do so, they used a Zambian study of viral suppression rates in a similar population and calculated an adjustment to account for missing viral load measurements.

All in all, the study estimated that the proportion of adults with viral suppression was 79% at 1 year, 72% at 2 years, and 65% at 3 years after antiretroviral therapy initiation. Among children and adolescents, proportions with viral suppression were lower: 64% at 1 year, 62% at 2 years, and 59% at 3 years after antiretroviral therapy initiation.

“Substantial efforts are still needed to reach the viral suppression target for children and adolescents,” researchers advised.

References:

1. Han WM, Law MG, Egger M, et al. Global estimates of viral suppression in children and adolescents and adults on antiretroviral therapy adjusted for missing viral load measurements: a multiregional, retrospective cohort study in 31 countries. Lancet HIV. 2021;8(12):e766-e775. doi:10.1016/S2352-3018(21)00265-4
2. Too many people with HIV fail to achieve durable viral suppression. News release. NIH/National Institute of Allergy and Infectious Diseases; November 29, 2021. Accessed December 13, 2021.