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Chan School of Public Health","doi-asserted-by":"publisher","award":["P01HD103133","HD052102"],"award-info":[{"award-number":["P01HD103133","HD052102"]}],"id":[{"id":"10.13039\/100008548","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tulane University School of Medicine","award":["HD052104"],"award-info":[{"award-number":["HD052104"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Data on mortality, clinical events, viral load (VL), and immunosuppression among young adults aging with perinatally acquired human immunodeficiency virus (YAPHIV) are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among YAPHIV \u2265 18 years in the Pediatric HIV\/AIDS Cohort Study, we calculated incident mortality, CDC-C\/WHO-4 rates, and proportion of person-years (PY) with elevated VL (\u2265200\u2005copies\/mL) and immunosuppression (CD4 &amp;lt; 200\u2005cells\/mm3) by age strata 18\u201321, 22\u201325, 26\u201329, and \u226530 years. We compared mortality rates to the US population and identified predictors of mortality\/CDC-C\/WHO-4 events at age \u2265 25 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six hundred seventeen participants had median follow-up of 6.5 years; at baseline, 63% were 18\u201321 years, 61% were female, 63% self-reported as Black, median CD4 count was 561\u2005cells\/mm3, and 66% had VL &amp;lt; 200\u2005copies\/mL. Mortality was highest at \u226530 years (8.1 per 1000PY [95% CI: 3.0, 22.0]). Black YAPHIV had mortality rates at least 7.1 (3.0, 17.1) times higher than white non-Hispanic persons in the US population. Proportion of elevated VL person-time decreased while low CD4 person-time increased as participants aged. Among 307 participants followed after age \u2265 25 years, elevated VL, low CD4, and prior CDC-C\/WHO-4 event strongly predicted risk of incident mortality\/CDC-C\/WHO-4 event (C-index: 0.94); risk at 3 years of follow-up was 19% (0%, 45%) among those with all 3 characteristics. Other important predictors were poor treatment adherence, current cannabis use, lack of current employment\/education, and stressful events (C-index: 0.81).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is excess mortality with age for YAPHIV, particularly for Black YAPHIV. Interdisciplinary interventions are needed to improve treatment outcomes for YAPHIV at highest identified risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf624","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:14:55Z","timestamp":1760012095000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Outcomes of Young Adults With Perinatal Human Immunodeficiency Virus (HIV) Infection in the United States and Puerto Rico"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2116-0129","authenticated-orcid":false,"given":"Leah","family":"Kern","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of California , San Diego, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Jaramillo-Underwood","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. 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