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Linkage to and retention in care following healthcare transition from pediatric to adult HIV care

机译：从儿科到成人HIV保健的医疗过渡之后，与保健的联系和保留

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Outcomes following healthcare transition (HCT) from pediatric to adult HIV care are not well described. We sought to describe clinical outcomes following HCT within our institution among young adults with behavioral-acquired (N = 31) and perinatally-acquired (N = 19) HIV. We conducted a retrospective cohort study among HIV-infected adults who attempted transition from pediatric to adult HIV care within our institution. The primary end point was retention in care, defined as the completion of at least two visits over 12 months following linkage to adult care. Additional end points include time to linkage to adult care, and changes in CD4 + T cell count and HIV RNA across time. Outcomes were compared between perinatal and behavioral HIV cohorts. Binary data were analyzed using the Fisher exact test and continuous data were analyzed using the Mann-Whitney test. Forty-three (86%) of 50 patients were successfully linked to adult care. The median time to linkage was 98 days. Fifty percent of patients achieved full retention in care at 12 months post-linkage. Though those with behavioral-acquired HIV attempted transfer at an older age, the groups did not differ in rates of linkage and retention in adult care. CD4 + T cell counts and rates of viral suppression did not differ between pre- and post-HCT periods. Despite high rates of successful linkage to adult care in our study population, rates of retention in adult HIV care following HCT were low. These results imply that challenges remain in the adult HIV care setting toward improving the HCT process.
机译：从儿科到成人HIV保健的医疗保健过渡（HCT）后的结果并未得到很好的描述。我们力图描述在我们机构中接受行为获得性（N = 31）和围产期获得性（N = 19）HIV的年轻成年人进行HCT后的临床结局。我们对我们机构内尝试从儿科向成人HIV护理过渡的HIV感染成人进行了一项回顾性队列研究。主要终点是保留护理，定义为与成人护理联动后在12个月内完成至少两次访问。其他终点包括与成人护理联系的时间，以及CD4 + T细胞计数和HIV RNA随时间的变化。比较围产期和行为HIV人群的结果。使用Fisher精确检验分析二进制数据，使用Mann-Whitney检验分析连续数据。 50例患者中有43例（86％）与成人护理成功相关。链接的中位时间为98天。链接后12个月，百分之五十的患者获得了完全的护理。尽管那些具有行为习得性艾滋病毒的人试图在年龄较大的时候进行转移，但这些人群在成人护理中的联系和保留率没有差异。 HCT前后，CD4 + T细胞计数和病毒抑制率无差异。尽管在我们的研究人群中与成人护理成功建立联系的比率很高，但是HCT后在成人HIV护理中的保留率很低。这些结果表明，成人HIV护理环境仍面临着改善HCT流程的挑战。

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