416. Adolescent Viral Load in an Urban Hospital in Newark, New Jersey 2007-2010 
Session: Poster Abstract Session: Pediatric HIV
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Adolescent Viral Load IDWeek 2013.pdf (386.4 kB)
  • Background:   Human Immunodeficiency Virus (HIV) in the adolescent community is a growing concern.  Adolescents often engage in high risk sexual behavior, and individuals aged 15 to 19 have the highest reported rates of sexually transmitted infections (STI).  25% of all people with HIV in the United States contracted HIV during their teenage years and in 2009, 39% of new infections were identified in patients age 13-29.  By reviewing the HIV Viral Load (VL) data from University Hospital we assessed the trend in adolescent HIV VLs in a community with a high HIV prevalence.

    Methods:   All HIV RNA VL from the Molecular Virology Lab at the University Hospital in Newark, New Jersey from 2007-2010 were obtained.  Patients were divided into pediatric (<13), adolescent (13-25), and adult (>25).  Univariate and multivariate analyses were done to assess characteristics of patients by age, gender, and race.

    Results: A minimum of 40 pediatric, 178 adolescent and 1335 adult patients were identified per year.  There was a statistically significant increase in the viral load of adolescents when compared to pediatric patients (42% increase, P<.02) and in adults when compared to adolescents (195% increase, P<.0002).  In 3 of the 4 years there was a statistically significant increase in the percentage of male adolescents reaching undetectable VL then female adolescents.  Average VL by age demonstrates an increasing VL from age 12 through age 24, while the percentage of patients reaching undetectable VL peaks at 80% at age 8 and begins trending down through age 24.  

    Conclusion: Pediatric patients develop a noticeable decrease in virologic control between ages 8 and 11 which continues into their years of sexual activity.  This increased viral load in already infected patients puts others at higher risk and may contribute to adolescents having the fastest growing rate of new HIV infections.  The decreased rate of virologic suppression in females of child bearing age is additionally concerning as it presents an increased risk of vertical transmission. The development of adolescent HIV clinics, with dedicated services focused on the unique needs of this population, is one potential method of improving virologic control in this high risk group.

    Jason Zucker, MD1, Helen Fernandes, PhD2 and David Cennimo, MD1, (1)Medicine and Pediatrics, New Jersey Medical School, Newark, NJ, (2)Molecular Diagnostics Lab, New Jersey Medical School, Newark, NJ

    Disclosures:

    J. Zucker, None

    H. Fernandes, None

    D. Cennimo, None

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