TY - JOUR
T1 - Immunological and virological response to antiretroviral treatment in migrant and native men and women in Western Europe; is benefit equal for all?
AU - Monge, S.
AU - Mocroft, A.
AU - Sabin, A.
AU - Touloumi, Giota
AU - Sighem, A.
AU - Abgrall, S.
AU - Dray-Spira, R.
AU - Spire, B.
AU - Castagna, A.
AU - Mussini, C.
AU - Zangerle, Robert
AU - Hessamfar, M.
AU - Anderson, J.
AU - Hamouda, O.
AU - Ehren, K.
AU - Obel, Niels
AU - Kirk, Ole
AU - Antinori, Andrea
AU - Girardi, E.
AU - Saracino, A.
AU - Calmy, A.
AU - Wit, S.
AU - Wittkop, L.
AU - Bucher, C.
AU - Montoliu, A.
AU - Raben, D.
AU - Prins, Maria
AU - Meyer, Laurence
AU - Chene, G.
AU - Burns, F.
AU - Amo, Julia
AU - Judd, Ali
AU - Warszawski, Josiane
AU - Dabis, François
AU - Krause, Murielle
AU - Ghosn, Jade
AU - Leport, Catherine
AU - Reiss, Peter
AU - Wit, Ferdinand
AU - Bucher, Heiner
AU - Gibb, Diana
AU - Fätkenheuer, Gerd
AU - Thorne, Claire
AU - Stephan, Christoph
AU - Pérez-Hoyos, Santiago
AU - Bartmeyer, Barbara
AU - Chkhartishvili, Nikoloz
AU - Noguera-Julian, Antoni
AU - Friis-Møller, Nina
AU - Kjaer, Jesper
AU - Migrant Health Working Group for the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) in EuroCoord
PY - 2018
Y1 - 2018
N2 - Objectives: The aim of the study was to evaluate differences in immunovirological response to combination antiretroviral therapy (cART) in migrant and native men and women within a European collaboration of HIV cohorts Collaboration of Observational HIV Epidemiological Research in Europ (COHERE) in EuroCoord, 2004–2013. Methods: Migrants were defined as those with geographical origin (GO) different from the reporting country and were grouped as originating from Western Europe and Western Countries (WEWC), Eastern Europe (EE), North Africa and the Middle East (NAME), sub-Saharan Africa (SSA), Latin America (LA), Caribbean (CRB) and Asia/Oceania (ASIA/OCE). Native (NAT) individuals were defined as those originating from the reporting country. CD4 cell counts were modelled using piecewise linear mixed-effects models with two slopes, whereas models to estimate subdistribution hazard ratios (sHRs) were used for time to virological response (VR) (i.e. time from cART initiation to the first of two successive HIV RNA measurements < 400 HIV-1 RNA copies/ml). Results: Of 32 817 individuals, 25 799 (78.6%) were men. The percentage of migrants was higher in women (48.9%) than in men (21.2%) and migrants from SSA accounted for the largest migrant group (29.9% in men and 63.3% in women). Migrant men and women from SSA started at lower CD4 cell counts than NAT individuals, which remained lower over time. VR was ≥ 85% at 12 months for all groups except CRB women (77.7%). Compared with NAT men and women, lower VR was experienced by NAME [sHR 0.91; 95% confidence interval (CI) 0.86–0.97] and SSA (sHR 0.88; 95% CI 0.82–0.95) men and CRB (sHR 0.77; 85% CI 0.67–0.89) women, respectively. Conclusions: Immunovirological response to cART in Western Europe varies by GO and sex of patients. ART benefits are not equal for all, underlining the point that efforts need to prioritize those most in need.
AB - Objectives: The aim of the study was to evaluate differences in immunovirological response to combination antiretroviral therapy (cART) in migrant and native men and women within a European collaboration of HIV cohorts Collaboration of Observational HIV Epidemiological Research in Europ (COHERE) in EuroCoord, 2004–2013. Methods: Migrants were defined as those with geographical origin (GO) different from the reporting country and were grouped as originating from Western Europe and Western Countries (WEWC), Eastern Europe (EE), North Africa and the Middle East (NAME), sub-Saharan Africa (SSA), Latin America (LA), Caribbean (CRB) and Asia/Oceania (ASIA/OCE). Native (NAT) individuals were defined as those originating from the reporting country. CD4 cell counts were modelled using piecewise linear mixed-effects models with two slopes, whereas models to estimate subdistribution hazard ratios (sHRs) were used for time to virological response (VR) (i.e. time from cART initiation to the first of two successive HIV RNA measurements < 400 HIV-1 RNA copies/ml). Results: Of 32 817 individuals, 25 799 (78.6%) were men. The percentage of migrants was higher in women (48.9%) than in men (21.2%) and migrants from SSA accounted for the largest migrant group (29.9% in men and 63.3% in women). Migrant men and women from SSA started at lower CD4 cell counts than NAT individuals, which remained lower over time. VR was ≥ 85% at 12 months for all groups except CRB women (77.7%). Compared with NAT men and women, lower VR was experienced by NAME [sHR 0.91; 95% confidence interval (CI) 0.86–0.97] and SSA (sHR 0.88; 95% CI 0.82–0.95) men and CRB (sHR 0.77; 85% CI 0.67–0.89) women, respectively. Conclusions: Immunovirological response to cART in Western Europe varies by GO and sex of patients. ART benefits are not equal for all, underlining the point that efforts need to prioritize those most in need.
KW - combination antiretroviral therapy
KW - HIV
KW - immunovirological response
KW - migrants
KW - sex
U2 - 10.1111/hiv.12536
DO - 10.1111/hiv.12536
M3 - Journal article
C2 - 28741837
AN - SCOPUS:85026373652
SN - 1464-2662
VL - 19
SP - 42
EP - 48
JO - HIV Medicine
JF - HIV Medicine
IS - 1
ER -
