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

VL - 19

SP - 42

EP - 48

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 1

ER -