Cohort of Young Adults Infected With HIV Since Birth or During Childhood
Condition: HIV Infection; Young Adult
MeSH terms: HIV Infections
Study type: Interventional

Summary: 
      Background: With the improvement of the prognosis for HIV-infected infants, thanks to the
      availability of antiretroviral therapies, young adults infected with HIV since birth are
      becoming an emerging group among the HIV-infected population. Morbidity, mortality and
      immunovirological evolution in these young adults need to be studied in a large population
      and compared to patients infected with HIV later in adulthood or to the general population in
      terms of mortality. Moreover, the study of accelerated or premature ageing, linked to HIV
      and/or antiretroviral therapy, is particularly interesting in this population.

      Objectives: To study the transition to adulthood and the further evolution of HIV-1 or -2
      perinatally infected young adults: 1) To study the teenager to adult transition in terms of
      clinical and immunovirological status, schooling and professional integration, sexuality and
      reproductive life, transition from paediatrics to adult departments; 2) To study prognosis,
      morbidity and mortality according to age, infection stage at the time of antiretroviral
      initiation and therapeutic history; 3) To study the incidence and expression of adverse
      events and the potential link to antiretroviral therapies; 4) To study the markers of a
      potential premature ageing, from the metabolic, cardiovascular and immunological points of
      view.
    

Detailed description: 
      Methods: A national multicenter cohort of young adults, infected with HIV since birth or
      during childhood, including a common module and a physiopathological module (metabolic,,
      cardiovascular and immunological). A control group of HIV-uninfected young adults is included
      for comparison in the latter module. Patients aged between 18 and 25 years of age, whose HIV
      diagnosis was made before the age of 13 are eligible for ANRS CO19 COVERTE. This cohort is an
      extension of the EPF cohort (ANRS CO10), in which follow-up stops at the age 18, with an
      extension to adults with a HIV diagnosis established before the age of 13. Questionnaires are
      filled out by physicians once a year. Self-administered questionnaires are also carried out.
      Blood sampling and specific biological exams are collected and a biobank constituted. In the
      physiopathological module, specific exams are carried out at inclusion and after 3 years of
      follow-up: metabolic and immunological exams, OGTT, CT-scan and DXA-scan, and cardiovascular
      explorations (carotid intima-media thickness, pulse wave velocity …). An estimated 400
      enrolments during the first 3 years is expected in the common module and an estimated 200
      HIV-infected subjects and 75 uninfected controls is expected in the physiopathological
      module.

      Expected results: The follow-up of young adults in this cohort will bring new data on the
      long term efficacy of antiretroviral treatment and their adverse events, from the metabolic,
      cardiovascular and immunological, point of view, be they linked or not to HIV infection per
      se. This analysis will take into account the characteristics of this population, as compared
      to adults infected during adulthood: an early exposure to HIV and antiretroviral treatment, a
      different social context, difficulties in care, and a different exposure to risk factors for
      adverse events and complications. We will evaluate the impact of the transition to adulthood
      and of the transition from paediatrics to adult departments, on clinical prognosis,
      adherence, professional and schooling integration, sexuality, social life.
    

Intervention name(s): blood sampling, specific biological exams and biobank and self administered questionnaires
Intervention type(s): Biological
Intervention description(s): HIV INFECTION at inclusion and annually up to 06 years follow-up
clinical and therapeutic evaluation by physician
biological: blood sampling, specific biological exams and biobank
self administered questionnaires
In the physiopathological module: at inclusion and after 3 years follow up: OGTT, CT Scan, Dexa Scan, cardiovascular explorations (carotid intima media thickness, pulse wave velocity, transthoracic echocardiography)
HIV UNINFECTED at inclusion and after 3 years follow up
clinical evaluation by physician
biological: blood sampling, specific biological exams and biobank
self administered questionnaires
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: teenagers to adult transition; comparison