The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.

<h4>Background</h4>Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in &qu...

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Main Authors: Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration, Amy L Slogrove, Michael Schomaker, Mary-Ann Davies, Paige Williams, Suna Balkan, Jihane Ben-Farhat, Nancy Calles, Kulkanya Chokephaibulkit, Charlotte Duff, Tanoh François Eboua, Adeodata Kekitiinwa-Rukyalekere, Nicola Maxwell, Jorge Pinto, George Seage, Chloe A Teasdale, Sebastian Wanless, Josiane Warszawski, Kara Wools-Kaloustian, Marcel Yotebieng, Venessa Timmerman, Intira J Collins, Ruth Goodall, Colette Smith, Kunjal Patel, Mary Paul, Diana Gibb, Rachel Vreeman, Elaine J Abrams, Rohan Hazra, Russell Van Dyke, Linda-Gail Bekker, Lynne Mofenson, Marissa Vicari, Shaffiq Essajee, Martina Penazzato, Gabriel Anabwani, Edith Q Mohapi, Peter N Kazembe, Makhosazana Hlatshwayo, Mwita Lumumba, Tessa Goetghebuer, Claire Thorne, Luisa Galli, Annemarie van Rossum, Carlo Giaquinto, Magdalena Marczynska, Laura Marques, Filipa Prata, Luminita Ene, Liubov Okhonskaia, Pablo Rojo, Claudia Fortuny, Lars Naver, Christoph Rudin, Sophie Le Coeur, Alla Volokha, Vanessa Rouzier, Regina Succi, Annette Sohn, Azar Kariminia, Andrew Edmonds, Patricia Lelo, Samuel Ayaya, Patricia Ongwen, Laura F Jefferys, Sam Phiri, Mwangelwa Mubiana-Mbewe, Shobna Sawry, Lorna Renner, Mariam Sylla, Mark J Abzug, Myron Levin, James Oleske, Miriam Chernoff, Shirley Traite, Murli Purswani, Ellen G Chadwick, Ali Judd, Valériane Leroy
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Language:English
Published: Public Library of Science (PLoS) 2018-03-01
Series:PLoS Medicine
Online Access:https://doi.org/10.1371/journal.pmed.1002514
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author Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration
Amy L Slogrove
Michael Schomaker
Mary-Ann Davies
Paige Williams
Suna Balkan
Jihane Ben-Farhat
Nancy Calles
Kulkanya Chokephaibulkit
Charlotte Duff
Tanoh François Eboua
Adeodata Kekitiinwa-Rukyalekere
Nicola Maxwell
Jorge Pinto
George Seage
Chloe A Teasdale
Sebastian Wanless
Josiane Warszawski
Kara Wools-Kaloustian
Marcel Yotebieng
Venessa Timmerman
Intira J Collins
Ruth Goodall
Colette Smith
Kunjal Patel
Mary Paul
Diana Gibb
Rachel Vreeman
Elaine J Abrams
Rohan Hazra
Russell Van Dyke
Linda-Gail Bekker
Lynne Mofenson
Marissa Vicari
Shaffiq Essajee
Martina Penazzato
Gabriel Anabwani
Edith Q Mohapi
Peter N Kazembe
Makhosazana Hlatshwayo
Mwita Lumumba
Tessa Goetghebuer
Claire Thorne
Luisa Galli
Annemarie van Rossum
Carlo Giaquinto
Magdalena Marczynska
Laura Marques
Filipa Prata
Luminita Ene
Liubov Okhonskaia
Pablo Rojo
Claudia Fortuny
Lars Naver
Christoph Rudin
Sophie Le Coeur
Alla Volokha
Vanessa Rouzier
Regina Succi
Annette Sohn
Azar Kariminia
Andrew Edmonds
Patricia Lelo
Samuel Ayaya
Patricia Ongwen
Laura F Jefferys
Sam Phiri
Mwangelwa Mubiana-Mbewe
Shobna Sawry
Lorna Renner
Mariam Sylla
Mark J Abzug
Myron Levin
James Oleske
Miriam Chernoff
Shirley Traite
Murli Purswani
Ellen G Chadwick
Ali Judd
Valériane Leroy
author_facet Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration
Amy L Slogrove
Michael Schomaker
Mary-Ann Davies
Paige Williams
Suna Balkan
Jihane Ben-Farhat
Nancy Calles
Kulkanya Chokephaibulkit
Charlotte Duff
Tanoh François Eboua
Adeodata Kekitiinwa-Rukyalekere
Nicola Maxwell
Jorge Pinto
George Seage
Chloe A Teasdale
Sebastian Wanless
Josiane Warszawski
Kara Wools-Kaloustian
Marcel Yotebieng
Venessa Timmerman
Intira J Collins
Ruth Goodall
Colette Smith
Kunjal Patel
Mary Paul
Diana Gibb
Rachel Vreeman
Elaine J Abrams
Rohan Hazra
Russell Van Dyke
Linda-Gail Bekker
Lynne Mofenson
Marissa Vicari
Shaffiq Essajee
Martina Penazzato
Gabriel Anabwani
Edith Q Mohapi
Peter N Kazembe
Makhosazana Hlatshwayo
Mwita Lumumba
Tessa Goetghebuer
Claire Thorne
Luisa Galli
Annemarie van Rossum
Carlo Giaquinto
Magdalena Marczynska
Laura Marques
Filipa Prata
Luminita Ene
Liubov Okhonskaia
Pablo Rojo
Claudia Fortuny
Lars Naver
Christoph Rudin
Sophie Le Coeur
Alla Volokha
Vanessa Rouzier
Regina Succi
Annette Sohn
Azar Kariminia
Andrew Edmonds
Patricia Lelo
Samuel Ayaya
Patricia Ongwen
Laura F Jefferys
Sam Phiri
Mwangelwa Mubiana-Mbewe
Shobna Sawry
Lorna Renner
Mariam Sylla
Mark J Abzug
Myron Levin
James Oleske
Miriam Chernoff
Shirley Traite
Murli Purswani
Ellen G Chadwick
Ali Judd
Valériane Leroy
author_sort Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration
collection DOAJ
description <h4>Background</h4>Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in "real-life" settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia.<h4>Methods and findings</h4>Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5-5.2) years for the total cohort and 6.4 (3.6-8.0) years in Europe, 3.7 (2.0-5.4) years in North America, 2.5 (1.2-4.4) years in South and Southeast Asia, 5.0 (2.7-7.5) years in South America and the Caribbean, and 2.1 (0.9-3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3-2.1) years in North America to 7.1 (5.3-8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4-2.6) years in North America to 7.9 (6.0-9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%-2.8%), 15.6% (15.1%-16.0%), and 11.3% (10.9%-11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%-1.1%]) and highest in South America and the Caribbean (4.4% [3.1%-6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%-6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%-13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria.<h4>Conclusion</h4>To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses.
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spelling doaj-art-84c71bfb1d04428fac3aac5e22be3e2c2025-08-20T03:25:45ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762018-03-01153e100251410.1371/journal.pmed.1002514The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort CollaborationAmy L SlogroveMichael SchomakerMary-Ann DaviesPaige WilliamsSuna BalkanJihane Ben-FarhatNancy CallesKulkanya ChokephaibulkitCharlotte DuffTanoh François EbouaAdeodata Kekitiinwa-RukyalekereNicola MaxwellJorge PintoGeorge SeageChloe A TeasdaleSebastian WanlessJosiane WarszawskiKara Wools-KaloustianMarcel YotebiengVenessa TimmermanIntira J CollinsRuth GoodallColette SmithKunjal PatelMary PaulDiana GibbRachel VreemanElaine J AbramsRohan HazraRussell Van DykeLinda-Gail BekkerLynne MofensonMarissa VicariShaffiq EssajeeMartina PenazzatoGabriel AnabwaniEdith Q MohapiPeter N KazembeMakhosazana HlatshwayoMwita LumumbaTessa GoetghebuerClaire ThorneLuisa GalliAnnemarie van RossumCarlo GiaquintoMagdalena MarczynskaLaura MarquesFilipa PrataLuminita EneLiubov OkhonskaiaPablo RojoClaudia FortunyLars NaverChristoph RudinSophie Le CoeurAlla VolokhaVanessa RouzierRegina SucciAnnette SohnAzar KariminiaAndrew EdmondsPatricia LeloSamuel AyayaPatricia OngwenLaura F JefferysSam PhiriMwangelwa Mubiana-MbeweShobna SawryLorna RennerMariam SyllaMark J AbzugMyron LevinJames OleskeMiriam ChernoffShirley TraiteMurli PurswaniEllen G ChadwickAli JuddValériane Leroy<h4>Background</h4>Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in "real-life" settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia.<h4>Methods and findings</h4>Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5-5.2) years for the total cohort and 6.4 (3.6-8.0) years in Europe, 3.7 (2.0-5.4) years in North America, 2.5 (1.2-4.4) years in South and Southeast Asia, 5.0 (2.7-7.5) years in South America and the Caribbean, and 2.1 (0.9-3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3-2.1) years in North America to 7.1 (5.3-8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4-2.6) years in North America to 7.9 (6.0-9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%-2.8%), 15.6% (15.1%-16.0%), and 11.3% (10.9%-11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%-1.1%]) and highest in South America and the Caribbean (4.4% [3.1%-6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%-6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%-13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria.<h4>Conclusion</h4>To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses.https://doi.org/10.1371/journal.pmed.1002514
spellingShingle Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration
Amy L Slogrove
Michael Schomaker
Mary-Ann Davies
Paige Williams
Suna Balkan
Jihane Ben-Farhat
Nancy Calles
Kulkanya Chokephaibulkit
Charlotte Duff
Tanoh François Eboua
Adeodata Kekitiinwa-Rukyalekere
Nicola Maxwell
Jorge Pinto
George Seage
Chloe A Teasdale
Sebastian Wanless
Josiane Warszawski
Kara Wools-Kaloustian
Marcel Yotebieng
Venessa Timmerman
Intira J Collins
Ruth Goodall
Colette Smith
Kunjal Patel
Mary Paul
Diana Gibb
Rachel Vreeman
Elaine J Abrams
Rohan Hazra
Russell Van Dyke
Linda-Gail Bekker
Lynne Mofenson
Marissa Vicari
Shaffiq Essajee
Martina Penazzato
Gabriel Anabwani
Edith Q Mohapi
Peter N Kazembe
Makhosazana Hlatshwayo
Mwita Lumumba
Tessa Goetghebuer
Claire Thorne
Luisa Galli
Annemarie van Rossum
Carlo Giaquinto
Magdalena Marczynska
Laura Marques
Filipa Prata
Luminita Ene
Liubov Okhonskaia
Pablo Rojo
Claudia Fortuny
Lars Naver
Christoph Rudin
Sophie Le Coeur
Alla Volokha
Vanessa Rouzier
Regina Succi
Annette Sohn
Azar Kariminia
Andrew Edmonds
Patricia Lelo
Samuel Ayaya
Patricia Ongwen
Laura F Jefferys
Sam Phiri
Mwangelwa Mubiana-Mbewe
Shobna Sawry
Lorna Renner
Mariam Sylla
Mark J Abzug
Myron Levin
James Oleske
Miriam Chernoff
Shirley Traite
Murli Purswani
Ellen G Chadwick
Ali Judd
Valériane Leroy
The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.
PLoS Medicine
title The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.
title_full The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.
title_fullStr The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.
title_full_unstemmed The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.
title_short The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis.
title_sort epidemiology of adolescents living with perinatally acquired hiv a cross region global cohort analysis
url https://doi.org/10.1371/journal.pmed.1002514
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AT jihanebenfarhat epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT nancycalles epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT kulkanyachokephaibulkit epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT charlotteduff epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT tanohfrancoiseboua epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT adeodatakekitiinwarukyalekere epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT nicolamaxwell epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT jorgepinto epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT georgeseage epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT chloeateasdale epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT sebastianwanless epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT josianewarszawski epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT karawoolskaloustian epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT marcelyotebieng epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT venessatimmerman epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT intirajcollins epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT ruthgoodall epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT colettesmith epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT kunjalpatel epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT marypaul epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT dianagibb epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT rachelvreeman epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT elainejabrams epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT rohanhazra epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT russellvandyke epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT lindagailbekker epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT lynnemofenson epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT marissavicari epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT shaffiqessajee epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT martinapenazzato epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT gabrielanabwani epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT edithqmohapi epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT peternkazembe epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT makhosazanahlatshwayo epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT mwitalumumba epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT tessagoetghebuer epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT clairethorne epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT luisagalli epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT annemarievanrossum epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT carlogiaquinto epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT magdalenamarczynska epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT lauramarques epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT filipaprata epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT luminitaene epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT liubovokhonskaia epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT pablorojo epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT claudiafortuny epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT larsnaver epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT christophrudin epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT sophielecoeur epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT allavolokha epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT vanessarouzier epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT reginasucci epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT annettesohn epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT azarkariminia epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT andrewedmonds epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT patricialelo epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT samuelayaya epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT patriciaongwen epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT laurafjefferys epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT samphiri epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT mwangelwamubianambewe epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT shobnasawry epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT lornarenner epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT mariamsylla epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT markjabzug epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT myronlevin epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT jamesoleske epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT miriamchernoff epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT shirleytraite epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT murlipurswani epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT ellengchadwick epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT alijudd epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis
AT valerianeleroy epidemiologyofadolescentslivingwithperinatallyacquiredhivacrossregionglobalcohortanalysis