Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

Eurosida Study Group

doi:10.2807/1560-7917.ES.2018.23.21.1700382

Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

Eurosida Study Group

Department of Clinical Medicine

7 Citations (Scopus)

36 Downloads (Pure)

Abstract

Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004—05, 2009—10 and 2014—15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004—05 (67.8%) to 2014—15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004—05, 87.7% in 2014—15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014—15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014—15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13—0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.

Original language	English
Article number	1700382
Journal	Eurosurveillance
Volume	23
Issue number	21
Number of pages	12
ISSN	1025-496X
DOIs	https://doi.org/10.2807/1560-7917.ES.2018.23.21.1700382
Publication status	Published - 2018

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Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015Final published version, 291 KBLicence: CC BY

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@article{78ea0862e50640e990d741768fafd56f,

title = "Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015",

abstract = "Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004—05, 2009—10 and 2014—15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004—05 (67.8%) to 2014—15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004—05, 87.7% in 2014—15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014—15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014—15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13—0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.",

author = "Kamilla Laut and Leah Shepherd and Roxana Radoi and Igor Karpov and Milosz Parczewski and Cristina Mussini and Fernando Maltez and Marcelo Losso and Nikoloz Chkhartishvili and Hila Elinav and Helen Kovari and Anders Blaxhult and Robert Zangerle and Tatiana Trofimova and Malgorzata Inglot and Kai Zilmer and Elena Kuzovatova and Th{\'e}r{\`e}se Staub and Dorthe Raben and Jens Lundgren and Amanda Mocroft and Ole Kirk and {Eurosida Study Group}",

year = "2018",

doi = "10.2807/1560-7917.ES.2018.23.21.1700382",

language = "English",

volume = "23",

journal = "Eurosurveillance",

issn = "1025-496X",

publisher = "Centre Europeen pour la Surveillance Epidemiologique du SIDA",

number = "21",

}

TY - JOUR

T1 - Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

AU - Laut, Kamilla

AU - Shepherd, Leah

AU - Radoi, Roxana

AU - Karpov, Igor

AU - Parczewski, Milosz

AU - Mussini, Cristina

AU - Maltez, Fernando

AU - Losso, Marcelo

AU - Chkhartishvili, Nikoloz

AU - Elinav, Hila

AU - Kovari, Helen

AU - Blaxhult, Anders

AU - Zangerle, Robert

AU - Trofimova, Tatiana

AU - Inglot, Malgorzata

AU - Zilmer, Kai

AU - Kuzovatova, Elena

AU - Staub, Thérèse

AU - Raben, Dorthe

AU - Lundgren, Jens

AU - Mocroft, Amanda

AU - Kirk, Ole

AU - Eurosida Study Group

PY - 2018

Y1 - 2018

N2 - Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004—05, 2009—10 and 2014—15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004—05 (67.8%) to 2014—15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004—05, 87.7% in 2014—15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014—15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014—15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13—0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.

AB - Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004—05, 2009—10 and 2014—15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004—05 (67.8%) to 2014—15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004—05, 87.7% in 2014—15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014—15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014—15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13—0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.

U2 - 10.2807/1560-7917.ES.2018.23.21.1700382

DO - 10.2807/1560-7917.ES.2018.23.21.1700382

M3 - Journal article

C2 - 29845931

AN - SCOPUS:85048017363

SN - 1025-496X

VL - 23

JO - Eurosurveillance

JF - Eurosurveillance

IS - 21

M1 - 1700382

ER -

Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

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