Summary Data
Summary data to the end of March 2011 [1]
A total of 1,699 children were reported to CHIPS by the end of March 2011, comprising virtually all of those receiving HIV-related care in the UK and Ireland from 2006 onwards. The median age at first presentation of those born in the UK and Ireland has remained relatively constant at around 6 months although 11% did not present until ≥5 years. For children born abroard it increased from less than 2 years up to 1991 to 6 years in 1997-2002, 7 years in 2003-2005, and over 9 years in 2006 onwards.. Similarly the age distribution of the cohort has changed considerably over the years. In 1996 the median age was 5.1 years (inter-quartile range, IQR 2.9-7.6) and this increased year on year to 12.4 years (IQR 9.1-15.2) in 2010. Furthermore, the proportion of the cohort aged ≥10 years increased from 11% in 1996 to 70% in 2010.
The rate of hospital admissions in the cohort declined from 0.6 per child year in 2000 to 0.1 in 2009, and 108 children in CHIPS follow up were known to have died, including 6 in 2008, 8 in 2009 and 1 in 2010. Viral load response among those starting ART naïve improved with calender time: 47% suppressed viral load ≤50 c/ml [2] at 12 months in 1997-2000, increasing to 82% for 2009 onwards. Furthermore there was some evidence for an increase in the duration of suppression for children starting ART naïve: in those suppressing viral load ≤400 c/ml within the first 12 months of therapy in 2000-3 24% had rebounded >1000c/ml within a year following suppression, while in 2004-2010 only 17% had rebounded during this time. The greatest improvement was in those aged ≥10 years, where the median time to rebound in 2000-2003 was 1.8 years, while in 2004-2010 this was 4.6 years.
Of the 1,699 children reported to CHIPS, 1,190 were alive and in active follow-up at a CHIPS clinic, and 305 had transferred to adult care . Of the 1,190 remaining in CHIPS, just over half (51%) were female, 48% were born in the UK and Ireland, 79% were of black African ethnicity, and nearly all (97%) were known to be infected through mother-to-child transmission. Half (53%) were being seen at clinics in London, 36% in the rest of England, 4% in Scotland, 1% in Wales, 5% in the Republic of Ireland and <1% in Northern Ireland. A quarter (23%) had progressed to CDC stage B and another 25% to CDC stage C during follow up. At last follow up, 15% remained ART naive, 4% were on mono or dual therapy, and over two-thirds (72%) were on combination therapy. Eight per cent were off all ART after having previously taken it. The median age of the 305 young people who transitioned to adult care was 17 years. Five year projections for perinatally HIV-infected children suggest that numbers will remain relatively stable overall as the number of new diagnoses equates with numbers transferring to adult care.
[1] Numbers are based on reports received rather than children seen to the end of March 2011. 2010/11 data are subject to reporting delay and may therefore be incomplete.
[2] Or ≤ lower limit of detection of the assay if the lower limit was >50 but ≤400c/ml.