A new NIH study has shown that while adults are well on the path to achieve the goal of achieving viral suppression in 95% of all people with HIV on antiretroviral therapy (ART) by 2030, children and adolescents have fallen behind.¹

For the multiregional, retrospective cohort study, data was collected from 148 IeDEA (International epidemiology Databases to Evaluate AIDS) treatment sites in 31 countries and analyzed to find out the number of children, adolescents and adults who had achieved viral suppression (viral load less than 1000 copies per mL) after 1, 2 and 3 years of starting ART. There were 21,594 children and adolescents from 106 sites in 22 countries and 255,662 adults from 143 sites in 30 countries in the study. “To further estimate viral suppression among people who had fallen out of HIV care during a three-year interval, the investigators looked to a Zambian study of viral suppression rates in a similar population and calculated an adjustment to viral suppression rates in the IeDEA population.”

Analysis of data showed that almost 80% of adults had achieved viral suppression after one year of ART; at 2 years, this number was 72% and 65% showed viral suppression at 3 years. However, the corresponding figures among children and adolescents were lower; 64% had viral suppression after one year of ART, 62% after 2 years and 59% after 3 years.

In 2014, the UNAIDS set out a goal of 95-95-95 for treatment by 2030 to end HIV/AIDS, which means “95% of people living with HIV knowing their HIV status 95% of people who know their status on treatment and 95% of people on treatment with suppressed viral loads”. The results of the study show that while globally progress has been made in reaching the UNAIDS 2030 targets, a lot more needs to be done. A re-look at strategies is required in order to achieve long-lasting viral suppression among children and adolescents with HIV infection.

Reference

1. Han WM, et al. Global estimates of viral suppression in children and adolescents and adults on antiretroviral therapy adjusted for missing viral load measurements: a multiregional, retrospective cohort study in 31 countries. Lancet HIV. December 1 2021;8(12): E766-E775, DOI:https://doi.org/10.1016/S2352-3018(21)00265-4.