2006-2015 年期间，纽约市围生期 HIV 感染人群向成人医疗服务的过渡。
Transition from paediatric to adult care among persons with perinatal HIV infection in New York City, 2006-2015.
机构信息
Bureau of HIV Prevention and Control, New York City Department of Health and Mental Hygiene, New York, New York, USA.
出版信息
AIDS. 2018 Aug 24;32(13):1821-1828. doi: 10.1097/QAD.0000000000001923.
OBJECTIVE
The aim of this study was to evaluate the transition process from paediatric to adult care among persons with perinatal HIV infection in New York City (NYC).
DESIGN
A retrospective prepost study and a matched exposed/unexposed nested cohort study.
METHODS
Using data from the NYC HIV registry, a retrospective prepost study was performed among persons who transitioned from paediatric to adult care to assess pre and posttransition retention in care (≥1 CD4 cell count/viral load in a 12-month period), CD4 cell count and viral suppression (≤200 copies/ml). A 1 : 3 matched exposed/unexposed nested cohort study was conducted to assess pre and posttransition 1-year mortality by matching persons who transitioned to adult care and persons who remained in paediatric care on calendar year (±1 year) and age at transition (±1 year).
RESULTS
A total of 735 persons with perinatal HIV infection transitioned to adult care in NYC during 2006-2015, of whom 53.9% were women, 57.7% black and 37.1% Hispanic. Pretransition (Year 0), and posttransition Year 1, Year 2 and Year 3 proportions of persons with CD4 cell count at least 500 cells/μl were 35.2, 38.3, 38.9 and 39.0%, respectively, and viral suppression were 45.9, 48.6, 51.1 and 51.8%, respectively. One-year mortality rates before and after transition were 2.3/1000 and 55.8/1000, respectively.
CONCLUSION
Persons with perinatal HIV infection in NYC who transitioned from paediatric to adult care saw improvements in CD4 cell count and viral suppression after transition. The increase in mortality after transition was likely caused by the conditions before or leading to the transition.
目的
本研究旨在评估纽约市（NYC）围生期 HIV 感染者从儿科向成人护理过渡的过程。
设计
回顾性前后研究和匹配的暴露/未暴露嵌套队列研究。
方法
利用纽约市 HIV 登记处的数据，对从儿科向成人护理过渡的患者进行回顾性前后研究，以评估过渡前后的保留率（12 个月内至少有 1 次 CD4 细胞计数/病毒载量）、CD4 细胞计数和病毒抑制率（≤200 拷贝/ml）。通过匹配在过渡时的年份（±1 年）和年龄（±1 年），对过渡到成人护理的患者和留在儿科护理的患者进行 1：3 匹配的暴露/未暴露嵌套队列研究，以评估过渡前后 1 年的死亡率。
结果
2006 年至 2015 年间，共有 735 名围生期 HIV 感染者在纽约市过渡到成人护理，其中 53.9%为女性，57.7%为黑人，37.1%为西班牙裔。在过渡前（第 0 年）和第 1 年、第 2 年和第 3 年，CD4 细胞计数至少为 500 个/μl 的患者比例分别为 35.2%、38.3%、38.9%和 39.0%，病毒抑制率分别为 45.9%、48.6%、51.1%和 51.8%。过渡前后的 1 年死亡率分别为 2.3/1000 和 55.8/1000。
结论
从儿科向成人护理过渡的纽约市围生期 HIV 感染者在过渡后 CD4 细胞计数和病毒抑制率有所改善。过渡后死亡率的增加可能是由于过渡前或过渡期间的状况导致的。
Zotero 插件