 is going to talk about HIV in adolescence and I'm going to make the attempt to pronounce the name and I hope she'll forgive me for all the mistakes I make. So it's Navi Yenso and please welcome to India to make your presentation. Thank you. Hello ladies and gentlemen my name is Nanua Yenso Tifika. You can call me Mina. Today I would like to present a story done in our project. The title is Clinical and Immunoviral Biological Characteristic of HIV Infected Adolescence or ART Immunoma. These people are who contacted this service. MSF is acted in the wide NINDAI region since 2004. MSF project is comprehensive HIV care for high risk group and vulnerable population in the wet districts. In 2015, MIMA had estimated over 200,000 old people living with HIV with HIV prevalence approximately 0.6% Privilege is higher in the high risk group in MSN community 11.6% and if female sex worker 40.6% approximately 5% of the total MSF HIV positive are in Myanmar are adolescents. Many adolescents are born with HIV which means many adolescents will be on ART for most of their life. Leading use of ART can lead to ciphers or virological failures. Adolescents have new peer pressure that they might deal with. For example, some of the adolescents don't like taking pills in France or their friends which can cause problem with adherence. As we presented MSF scientific 2050 as equal HIV positive adolescent in Myanmar are less at presentation, straight or ART longer and less lost to follow-up and respond better immunologically than the adult counterpart. In 2016 cross session study done in our project the method is all adolescents 10 to 90 years or age who presented January to April 2016 were invited to participate all and rule of trial in foreign consent. In this study complete physical examination and laboratory test. Laboratory test consists of CD4 cal, complete blood cal viral test, hepatitis C antibody, HBS AG, cholesterol, creatinine, complete laboratory test. If by no more than 1,000 copies per May, resistant testing was also done. Metal head assessment was also conducted by our trade counselor. This study was approved by the Antigua Review Board of Myanmar Ministry of Health and MSS. The graph shows cohort demographic data in our study 177 and dollars and our participants are all 177, 96 are female. Their media age was 30 by 4 years and their media time in our cohort is 8 by 4 years and their media time or ART is 7 by 1 years. Every CD4 is 728. From the demographic data, not all adolescents start ART at birth, many presents to the clinic as children where they become sick. Out of 177 dollars then, 140 are first line or ART and 37 are on second line and no other line regime. Among all 37 adults on second line, their media time on second line is 1 by 9 years. The reason why they change to the second line was 34 cases reported as first line biological failure and three cases reported as intolerance of first line regime. Out of 177 dollars then, 168, 94 by 9 percent had antiderival viola. 9 adolescents had deterioral viola and genotype. 7 dollars then had resister mutation. The tall blue line shows the size or mutation of genotype. This graph shows the clinical character history of adolescents or ART. 74 adolescents have affidant or libel dystrophies. Libel dystrophy, which means abnormal fat distribution on the body and 7 had neuropathy, which means numbness, sensation or periphery. And 1 dollar then had PHU night school greater than and 6 equal 6, which made many men depraved. Most adolescents have past opportunistic infection before we start study. In our study, 101 of adolescents had previous opportunistic infection. TV is more common. 92 percent adolescents had extra pulmonary TB and 6 percent had oral esophagus caniasis and 1 percent had PCB and 1 percent had disseminated non-TB mycosis. From the social experts or adolescents, out of 177, 127th or adolescent is still going to school. The others working as manual worker, daily worker, tailor, sailor and some just stay at home and help their family. Most of adolescents are often by at least 1 parent. In our study, 119 adolescents are often. Few adolescents reported problematic behaviors, 10 reported about smoking and 40 about drinking alcohol as 1 reported illegal drug use. What we are going to do next is to analyze or quantitative data in WB adolescents. We would like to publish the whole studies or quantitative surveys and qualitative survey. When we will have more results from that interview. The conclusion of our study is, adolescents had good immunologic recoveries or ART and low-level or current biological failures. Low-level or biological failures, but many already changed to second lines. Adolescent and MSI, HIV clinics, adjust well socially and have low-level or depressions. Counseling programs are likely helping their mental health. These are preliminary results of the quantitative surveys. We still need to analyze qualitative surveys where we will have more results from this interview. Thank you to all the MSI clinics and officers who will have to provide the best treatment possible to many people. And thank you to the adolescents and their family who participated in this study. And thank you for listening. So questions? Hello, my name is Annette from Health Promotion and Community Engagement from Amsterdam. And I have a question, because your adolescents do very well in the adherence, and I was wondering even better than the adolescents if I understood well. And I was wondering if you had special programs to support adolescents? Oh, well, yet in our projects, we have, we depend on their age. For the child, we divide as, we call ACG. ACG meet adherence counseling groups. The age from 5, 6, 7, 8 is ACG 1. Like the age, 6, 7, 8, 9, 10, 11 is ACG 2, ACG 3. And over 50 years, the adolescent, we're trying to organize to give the same appointment according to their age. And we have activity, time mobilization, trick every year according to their age. And we have peer, peer support group every, every their appointment date. Thank you for question. Thank you. I am Dr. Dhyan. My question is, as you mentioned, that immunological and virological outcomes were better than adolescents. What about the side effect, like neuropathy, lepolystrophy, from the normal? Thank you. Yes, most of the child, when they take the ART, they take with stability. So, most of the stability, sci-fi with lepolystrophy, in my results, $74.00 I have lepolystrophy, which means different, the abnormal fat distribution. So, when we see the patient, the adolescent is different with other adolescent. Their body structure is not like normal adolescent. It's me, we took far too long to phase out stability before. In our project, we fit in our G4D, we only use combination, fit trust combination. Only one template at night. So, they are here and it's better. They don't need to tie the pay in front of their friends. Just tie at night, only one ties per day. Thank you so much. I'm going to, if there's one last question, if not, then I'm going to go to the next presentation.