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Psychotic disorders in young adults with perinatally acquired HIV: a UK case series
Insights
Young adults with perinatally acquired HIV (PaHIV) have a higher risk of psychosis than their peers. This study found 6.5% experienced psychotic episodes, highlighting the need for integrated mental health care in HIV clinics.
Area of Science:
- Neuroscience
- Psychiatry
- Infectious Diseases
Background:
- Children with perinatally acquired HIV (PaHIV) are increasingly transitioning to adult care.
- Individuals with behaviorally acquired HIV face higher psychosis risks.
- Young adults with PaHIV encounter biological and environmental risk factors for mental health issues.
Purpose of the Study:
- To determine the prevalence of psychotic illness in young adults with perinatally acquired HIV (PaHIV).
- To assess the mental health needs of young adults with PaHIV transitioning to adult care.
Main Methods:
- Retrospective case note review of 184 individuals with PaHIV aged over 18 years at a UK clinic.
- Analysis of patient records to identify instances of psychotic episodes.
Main Results:
- 6.5% (12/184) of young adults with PaHIV experienced at least one psychotic episode.
- The median age of affected individuals was 23 years.
- Nine individuals (75%) developed severe, enduring mental illness requiring long-term care.
Conclusions:
- The prevalence of psychosis in this cohort is significantly higher than in the general UK population (0.5-1.0%).
- Clinical vigilance for mental health in young people with PaHIV is crucial.
- Integrating mental health services within HIV clinics is recommended for this population.
Background:
Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV.
Methods:
We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184).
Results:
In total, 12/184 (6.5%), median age 23 years (interquartile range 21-26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care.
Conclusion:
The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16-34 years, which has been reported to be 0.5-1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.
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