TY - JOUR
T1 - Uptake of combination antiretroviral therapy and HIV disease progression according to geographical origin in seroconverters in Europe, Canada, and Australia
AU - Jarrin, Inma
AU - Pantazis, Nikos
AU - Gill, M John
AU - Geskus, Ronald
AU - Perez-Hoyos, Santiago
AU - Meyer, Laurence
AU - Prins, Maria
AU - Touloumi, Giota
AU - Johnson, Anne
AU - Hamouda, Osamah
AU - de Olalla, Patricia García
AU - Porter, Kholoud
AU - del Amo, Julia
AU - CASCADE Collaboration in EuroCoord
AU - Kirk, Ole
PY - 2012/1/1
Y1 - 2012/1/1
N2 - Background. We examined differences by geographical origin (GO) in time from HIV seroconversion (SC) to AIDS, death, and initiation of antiretroviral therapy (cART). Methods. Data from HIV seroconverter cohorts in Europe, Australia and Canada (CASCADE) was used; GO was classified as: western countries (WE), North Africa and Middle East (NAME), sub-Saharan Africa (SSA), Latin America (LA), and Asia (ASIA). Differences by GO were assessed using Cox models. Administrative censoring date was 30 June 2008. Results. Of 16941 seroconverters, 15548 were from WE, 158 NAME, 762 SSA, 349 LA, and 124 ASIA. We found no differences by GO in risks of AIDS (P=.99) and death (P=.12), although seroconverters from NAME (adjusted hazard ratio [aHR]: 0.57; 95% CI: 0.33-.94) and SSA (aHR: 0.74; 95% CI: 0.50-1.10) appeared to have lower mortality than WE. Chances of initiating cART differed by GO (P<.001): seroconverters from SSA were more likely to initiate cART than WE (aHR: 1.48; 95% CI: 1.26-1.74), but not after adjustment for CD4 at SC (aHR: 1.11; 95% CI: 0.88-1.40). Conclusions. In settings with universal access to healthcare, GO does not play a major role in HIV disease progression.
AB - Background. We examined differences by geographical origin (GO) in time from HIV seroconversion (SC) to AIDS, death, and initiation of antiretroviral therapy (cART). Methods. Data from HIV seroconverter cohorts in Europe, Australia and Canada (CASCADE) was used; GO was classified as: western countries (WE), North Africa and Middle East (NAME), sub-Saharan Africa (SSA), Latin America (LA), and Asia (ASIA). Differences by GO were assessed using Cox models. Administrative censoring date was 30 June 2008. Results. Of 16941 seroconverters, 15548 were from WE, 158 NAME, 762 SSA, 349 LA, and 124 ASIA. We found no differences by GO in risks of AIDS (P=.99) and death (P=.12), although seroconverters from NAME (adjusted hazard ratio [aHR]: 0.57; 95% CI: 0.33-.94) and SSA (aHR: 0.74; 95% CI: 0.50-1.10) appeared to have lower mortality than WE. Chances of initiating cART differed by GO (P<.001): seroconverters from SSA were more likely to initiate cART than WE (aHR: 1.48; 95% CI: 1.26-1.74), but not after adjustment for CD4 at SC (aHR: 1.11; 95% CI: 0.88-1.40). Conclusions. In settings with universal access to healthcare, GO does not play a major role in HIV disease progression.
U2 - 10.1093/cid/cir814
DO - 10.1093/cid/cir814
M3 - Journal article
C2 - 22109944
SN - 1058-4838
VL - 54
SP - 111
EP - 118
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -