Clinical and socio-psychological characteristics of young people entering adulthood with perinatal HIV infection

Introduction. At the present stage, the main goal of treating children with HIV infection is to significantly improve the quality and life expectancy of an infected child, reduce morbidity and mortality, and create and maintain at a high level all conditions and opportunities for full and productive life in adulthood. In 2023, the proportion of adolescents among children with HIV infection increased and reached 57%. This group of children requires special attention from specialist doctors due to their agerelated physiological and psychological characteristics, which affects their commitment to monitoring and treatment. Children with HIV infection have a high degree of immaturity of the central nervous system at birth, HIV disrupts the formation of important structures such as myelination, synapse formation, and cortical maturation. Neurocognitive deficits can be detected in HIV-infected children both in preschool and school age. ART does not lead to an improvement in cognitive processes, even with normalization of indicato immunity and undetectable viral load. According to literature data, the constant use of ART in young people and the absence of substance abuse were significant factors influencing suppressed viral load and employment.

The aim: to present the clinical and socio-psychological characteristics of patients with perinatal HIV infection.

Materials and methods. 100 patients with perinatal HIV infection were monitored, of which 44 were male (44.0%) and 56 were female (56.0%). The average age was 20.6±1.6 years (the patients ranged in age from 17 to 24 years). HIV infection was diagnosed between the ages of one month and 15 years (7.0±0.5 years). ART was also started at the age of one to 15 years (6.2±0.6 years). According to the stages of HIV infection, patients were distributed as follows: stage 4A — 28 (28.0%), stage 4B — 6 (6.0%) and stage 4B-66 (66.0%) (Russian classification, 2006).

Results and discussion. All observed patients receive ART, and with 86 young people (86.0%) have a high commitment and undetectable high blood pressure, while 14 (14.0%) take therapy irregularly. Patients with low adherence, compared with young people who regularly take ART, have significantly higher levels of HIV RNA in their blood, low CD4 lymphocyte counts (moderate immunodeficiency), and all patients in this group have stage 4B HIV infection with CNS damage, later diagnosis of perinatal HIV infection, and are being educated in government institutions. or in foster families with only basic general education, neurocognitive impairments are noted during psychological tests. Despite regular use of ART medications, in the group of patients with a high commitment to monitoring and treatment, almost one in three young people has a low commitment, according to the Morisky-Green questionnaire, which requires more careful monitoring by doctors, relatives, psychologists and social services.

Conclusions. The group of young people with perinatal HIV infection with low commitment to follow-up and treatment is the most vulnerable in terms of the unfavorable course and prognosis of HIV infection, employment, as well as the risk of HIV transmission to sexual partners and their children.

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