Uptake of combination antiretroviral therapy and HIV disease progression according to geographical origin in seroconverters in Europe, Canada, and Australia

Inma Jarrin, Nikos Pantazis, M John Gill, Ronald Geskus, Santiago Perez-Hoyos, Laurence Meyer, Maria Prins, Giota Touloumi, Anne Johnson, Osamah Hamouda, Patricia García de Olalla, Kholoud Porter, Julia del Amo, CASCADE Collaboration in EuroCoord, Ole Kirk

    15 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    JournalClinical Infectious Diseases
    Volume54
    Issue number1
    Pages (from-to)111-8
    Number of pages8
    ISSN1058-4838
    DOIs
    Publication statusPublished - 1 Jan 2012

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