Chronic comorbidities in children and adolescents with perinatally acquired HIV infection in sub-Saharan Africa in the era of antiretroviral therapy.
Journal: The Lancet. Child & adolescent health
Volume: 4
Issue: 9
Year of Publication: 2020
Affiliated Institutions:
SA-MRC Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa; Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Department of HIV, Hepatitis and STIs, World Health Organization, Geneva, Switzerland.
Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Biomedical Research and Training Institute, Harare, Zimbabwe.
Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Biomedical Research and Training Institute, Harare, Zimbabwe; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
Nuffield Department of Medicine, University of Oxford, Oxford, UK.
SA-MRC Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
Biomedical Research and Training Institute, Harare, Zimbabwe; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: rashida.ferrand@lshtm.ac.uk.
Abstract summary
Globally, 1·7 million children are living with HIV, of which 90% are in sub-Saharan Africa. The remarkable scale-up of combination antiretroviral therapy has resulted in increasing numbers of children with HIV surviving to adolescence. Unfortunately, in sub-Saharan Africa, HIV diagnosis is often delayed with children starting antiretroviral therapy late in childhood. There have been increasing reports from low-income settings of children with HIV who have multisystem chronic comorbidities despite antiretroviral therapy. Many of these chronic conditions show clinical phenotypes distinct from those in adults with HIV, and result in disability and reduced quality of life. In this Review, we discuss the spectrum and pathogenesis of comorbidities in children with HIV in sub-Saharan Africa. Prompt diagnosis and treatment of perinatally acquired HIV infection is a priority. Additionally, there is a need for increased awareness of the burden of chronic comorbidities. Diagnostic and therapeutic strategies need to be collectively developed if children with HIV are to achieve their full potential.
Authors & Co-authors:
Frigati Lisa J LJ
Ameyan Wole W
Cotton Mark F MF
Gregson Celia L CL
Hoare Jacqueline J
Jao Jennifer J
Majonga Edith D ED
Myer Landon L
Penazzato Martina M
Rukuni Ruramayi R
Rowland-Jones Sarah S
Zar Heather J HJ
Ferrand Rashida A RA
Study Outcome
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