ABSTRACT

Introduction

Worldwide, children who acquired human immunodeficiency virus (HIV) at an early age, either perinatally or through blood transfusion, are reaching adolescence and adulthood due to successful antiretroviral treatment (ART). While many are thriving, a significant proportion face unprecedented multilevel challenges that can affect their long-term outcomes. Specifically, longstanding and poorly controlled HIV resulting from inadequate early regimens and nonadherence, along with the toxicities of some ART agents, can predispose them to sequelae including HIV-associated complications and other comorbidities.

Areas covered

This paper reviews and summarizes the unique issues facing adolescents and young adults with early acquired HIV (AYA-EAHIV), including ART challenges, emerging comorbidities, and complications, including mental health comorbidities, secondary prevention, and transition from pediatric/adolescent to adult care.

Expert opinion

AYA-EAHIV are a special population that have lived their entire lives with the physical and psychological toll of HIV mandating targeted and purposeful approaches to optimize their management and outcomes. Multifaceted inclusive and context-specific approaches focusing on heightened research, risk reduction interventions, and ‘outside the box’ thinking will be required to optimize treatment and reduce morbidity and mortality.

中文翻译：

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美国早期感染艾滋病毒的青少年和年轻人：治疗和二级预防的独特挑战

 抽象的

 介绍

在世界范围内，由于成功的抗逆转录病毒治疗（ART），在早期通过围产期或通过输血感染人类免疫缺陷病毒（HIV）的儿童正在进入青春期和成年期。尽管许多企业正在蓬勃发展，但其中很大一部分面临着前所未有的多层次挑战，这可能会影响其长期成果。具体而言，由于早期治疗方案不足和不依从而导致艾滋病毒长期存在且控制不佳，再加上某些抗逆转录病毒疗法药物的毒性，可能会使他们容易出现后遗症，包括艾滋病毒相关并发症和其他合并症。

 覆盖领域

本文回顾并总结了早期感染艾滋病毒 (AYA-EAHIV) 的青少年和年轻人面临的独特问题，包括 ART 挑战、新出现的合并症和并发症，包括心理健康合并症、二级预防以及从儿科/青少年到成人护理的过渡。

 专家意见

AYA-EAHIV 是一个特殊人群，他们一生都承受着艾滋病毒带来的身心损害，要求采取有针对性和有目的的方法来优化其管理和结果。需要采取多方面的包容性和针对具体情况的方法，重点是加强研究、降低风险干预措施和“跳出框框”思维，以优化治疗并降低发病率和死亡率。