Publication: Evaluación de la transición a unidades de adultos de los adolescentes con VIH de transmisión vertical de CoRISpe
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2017-09-12
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Universidad Complutense de Madrid
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Abstract
Introducción: la epidemia de la infección por el virus de la inmunodeficiencia humana (VIH) continúa siendo un grave problema de salud pública a nivel mundial, siendo el sida la principal causa de muerte entre los adolescentes (entre 10 y 19 años) en África y la segunda más común entre los adolescentes globalmente. La mayoría de los niños y niñas que viven con VIH en el mundo se infectaron por transmisión vertical (TV) durante el embarazo, el parto o la lactancia. Sin embargo, gracias a la generalización del uso de la Terapia Antirretroviral de Gran Actividad (TARGA), muchos de ellos han alcanzado la adolescencia y la juventud, por lo que se hace necesario establecer planes de transición desde las consultas o unidades de pediatría hacia las de adultos. Este proceso supone una etapa decisiva en el control de su enfermedad y un reto de abordaje complejo, cuyo objetivo fundamental es conseguir que el adolescente permanezca vinculado al sistema sanitario en lo referente al cuidado de su infección, de forma que pueda mantener un adecuado control de la misma y que, al tiempo, disminuyan las probabilidades de propagar la epidemia en la comunidad. En España, la Cohorte Nacional de Pacientes Pediátricos con VIH (CoRISpe) recoge de forma prospectiva desde 2008 y retrospectiva desde 1995 datos demográficos, sociológicos, clínicos y de laboratorio de pacientes infectados por VIH durante la edad pediátrica de hospitales de casi todo el territorio nacional. El 95,7% de los pacientes de CoRISpe se infectaron por TV...
Introduction: the epidemic of the Human Immunodeficiency Virus (HIV) remains a serious public health problem globally. AIDS remains the leading cause of death among adolescents (10 to 19) globally, and in Africa is the second most common cause of death among adolescents. Most children living with HIV worldwide were infected by vertical transmission (TV) during pregnancy, childbirth or breastfeeding. However, thanks to the widespread use of highly active antiretroviral therapy (HAART), many have reached adolescence and youth, so it is necessary to establish transition plans from pediatric units to the adult units. This process is a decisive step in the control of their disease and a challenge of complex approach whose main objective is to keep the adherence of the adolescents to the health system in relation to the care of their infection, in order to maintain proper control of their disease and, at the same time reducing the chances of spreading the epidemic in the community. In Spain, the national cohort of pediatric patients with HIV (CoRISpe) collected prospectively from 2008 and retrospectively since 1995 demographic, sociological, clinical and laboratory data from HIV-infected patients from pediatric hospitals in almost all the national territory. 95.7% of patients of CoRISpe were prenatally infected. Based on data from this cohort as part of national epidemiological program AIDS Research Network (RIS), in January 2013 the FARO project began to investigate the clinical, immunological and virological situation of adolescents and young adults perinatally infected that had been transferred to units of adult care, as well as to identify possible mistakes in the process of transition...
Introduction: the epidemic of the Human Immunodeficiency Virus (HIV) remains a serious public health problem globally. AIDS remains the leading cause of death among adolescents (10 to 19) globally, and in Africa is the second most common cause of death among adolescents. Most children living with HIV worldwide were infected by vertical transmission (TV) during pregnancy, childbirth or breastfeeding. However, thanks to the widespread use of highly active antiretroviral therapy (HAART), many have reached adolescence and youth, so it is necessary to establish transition plans from pediatric units to the adult units. This process is a decisive step in the control of their disease and a challenge of complex approach whose main objective is to keep the adherence of the adolescents to the health system in relation to the care of their infection, in order to maintain proper control of their disease and, at the same time reducing the chances of spreading the epidemic in the community. In Spain, the national cohort of pediatric patients with HIV (CoRISpe) collected prospectively from 2008 and retrospectively since 1995 demographic, sociological, clinical and laboratory data from HIV-infected patients from pediatric hospitals in almost all the national territory. 95.7% of patients of CoRISpe were prenatally infected. Based on data from this cohort as part of national epidemiological program AIDS Research Network (RIS), in January 2013 the FARO project began to investigate the clinical, immunological and virological situation of adolescents and young adults perinatally infected that had been transferred to units of adult care, as well as to identify possible mistakes in the process of transition...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 14-01-2016