{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:08:01Z","timestamp":1790629681314,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HD074051"],"award-info":[{"award-number":["R01HD074051"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,8]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n \n Adolescents with perinatally acquired\n HIV<\/jats:styled-content>\n (\n PHIV<\/jats:styled-content>\n ) are at risk of chronic disease due to long\u2010standing immune suppression,\n HIV<\/jats:styled-content>\n disease and antiretroviral therapy (\n ART<\/jats:styled-content>\n ) exposure. However, there are few data on multisystem disease in this population. We investigated the overlapping burden of neurocognitive, cardiovascular, respiratory and\/or renal impairment among\n PHIV positive<\/jats:styled-content>\n (\n PHIV<\/jats:styled-content>\n +) adolescents.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this cross\u2010sectional analysis, participants aged 9 to 14 years on\n ART<\/jats:styled-content>\n for >6\u00a0months were recruited from seven sites across Cape Town from July 2013 through March 2015, together with age\u2010matched\n HIV\u2010negative<\/jats:styled-content>\n (\n HIV\u2010<\/jats:styled-content>\n ) adolescents. Impairment at enrolment was assessed across neurocognitive functioning (using the youth\u2010International\n HIV<\/jats:styled-content>\n Dementia Scale); cardiac function (echocardiogram abnormality); respiratory function (abnormal spirometry) and renal function (abnormal glomerular filtration rate).\n <\/jats:p>\n <\/jats:sec>\n \n Results and Discussion<\/jats:title>\n \n Overall, 384\n PHIV<\/jats:styled-content>\n + and 95\n HIV\u2010<\/jats:styled-content>\n adolescents were included (mean age, 11.9\u00a0years; 49% female). Median age of\n ART<\/jats:styled-content>\n initiation was 4.2\u00a0years (\n IQR<\/jats:styled-content>\n : 1.7 to 7.6) and median\n CD<\/jats:styled-content>\n 4 count was 709 (\n IQR<\/jats:styled-content>\n : 556 to 944) with 302 (79%) of\n PHIV<\/jats:styled-content>\n + adolescents virologically suppressed. Abacavir and Zidovudine were the most commonly used nucleoside reverse transcriptase inhibitors (\n NRTI<\/jats:styled-content>\n s) with 60% of adolescents on non\u2010nucleoside reverse transcriptase inhibitors (\n NNRTI<\/jats:styled-content>\n ) and 38% on a protease inhibitor (\n PI<\/jats:styled-content>\n ). Among\n PHIV<\/jats:styled-content>\n + adolescents, 167 (43.5%) had single system impairment only, 110 (28.6%) had two systems involved, and 39 (10.2%) had three or four systems involved.\n PHIV<\/jats:styled-content>\n + participants had more 2\u2010system and 3\u2010system impairment than\n HIV\u2010<\/jats:styled-content>\n , 110 (28.6%) versus 17 (17.9%),\n p\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 0.03 and 39 (10.2%) versus 3 (4.3%),\n p\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 0.03.\n PHIV<\/jats:styled-content>\n + participants who had failed a year of school (73.8% vs. 46.4%,\n p\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 0.00) and with a viral load >1000\u00a0copies\/mL at enrolment (16.8% vs. 8.1%,\n p\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 0.03) were more likely to have dual or multisystem impairment. Of those with cardiac impairment, 86.7% had an additional system impaired. Similarly, in those with neurocognitive impairment, almost 60% had additional systems impaired and of those with respiratory impairment, 74% had additional systems impaired.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Despite relatively early\n ART<\/jats:styled-content>\n initiation, there is a substantial burden of multisystem chronic impairment among\n PHIV<\/jats:styled-content>\n + adolescents. This phenomenon needs to be further explored as this population ages and begins to engage in adult lifestyle factors that may compound these impairments.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jia2.25386","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T03:25:22Z","timestamp":1566530722000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Multisystem impairment in South African adolescents with Perinatally acquired\n HIV<\/scp>\n on antiretroviral therapy (\n ART<\/scp>\n )"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-3128","authenticated-orcid":false,"given":"Lisa J","family":"Frigati","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Child Health University of Cape Town Cape Town South Africa"},{"name":"Department of Paediatrics and Child Health Stellenbosch University Cape Town South 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University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesl","family":"Z\u00fchlke","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nourse","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan J","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6963-3557","authenticated-orcid":false,"given":"Jaqueline","family":"Hoare","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health 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