Universität zu Köln

Monge, S., Jarrin, I., Pantazis, N., Mocroft, A., Sabin, C. A., Touloumi, G., van Sighem, A., Abgrall, S., Dray-Spira, R., Spire, B., Castagna, A., Mussini, C., Zangerle, R., Hessamfar, M., Anderson, J., Hamouda, O., Ehren, K., Obel, N., Kirk, O., de Monteynard, L. A., Antinori, A., Girardi, E., Saracino, A., Calmy, A., De Wit, S., Wittkop, L., Bucher, H. C., Montoliu, A., Raben, D., Prins, M., Meyer, L., Chene, G., Burns, F. and Del Amo, J. (2017). Timing of combined antiretroviral treatment initiation in male and female migrants living with HIV in Western Europe. Aids, 31 (6). S. 835 - 847. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5571

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Abstract

Background: We evaluate differences in timing of cART (combined antiretroviral treatment) initiation by geographical origin in male and female HIV-positive patients in the Collaboration of Observational HIV Epidemiological Research Europe, a large European Collaboration of HIV Cohorts. Methods: We included individuals recruited in Western Europe between January 1997 and March 2013, with known geographical origin and at least 1 CD4(+) cell countmeasurement while cART-naive. Timing of cART was assessed through modified time-to-eventmethods, in which a scale of CD4(+) cell counts was used instead of time, with cART being the outcome. We estimated the median CD4(+) cell count at cART initiation (estimated CD4(+) levels at which the probability of having started cART is 50%) using Kaplan-Meier and adjusted hazard ratios of cART initiation using Cox regression. Results: Of 151 674 individuals, 110 592 (72.9%) were men. Median (95% confidence interval) CD4(+) cell count falls far below 250 cells/ml in all groups and was lowest in sub-Saharan African [SSA: 161 (158-167)], Caribbean men [161 (150-174)] and in Asian women [Asian Continent and Oceania: 185 (165-197)]. Among men, the adjusted probability of cART initiation was lower in migrants compared with natives, but differences depended on initial CD4(+) cell count. For example, in the group with more than 500 CD4(+) at recruitment, they were 45% (36-53%), 30% (17-40%) and 25% (19-30%) lower for Caribbean, Eastern European and SSA men, respectively. In women, no meaningful differences were observed between natives and most migrant groups. However, SSA women had a 31% (24-38%) higher probability of cART initiation when recruited at a CD4(+) more than 500 cells/ml and 9% (4-14%) lower when recruited at CD4(+) less than 100 cells/ml. Conclusion: Most migrant men initiate cART at lower CD4(+) cell count than natives, whereas this does not hold for migrant women.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Monge, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jarrin, I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pantazis, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mocroft, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabin, C. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Touloumi, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Sighem, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Abgrall, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dray-Spira, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Spire, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Castagna, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mussini, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zangerle, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hessamfar, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Anderson, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamouda, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehren, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Obel, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirk, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED de Monteynard, L. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Antinori, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Girardi, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Saracino, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Calmy, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED De Wit, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittkop, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bucher, H. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Montoliu, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Raben, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Prins, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chene, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burns, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Del Amo, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-236297
DOI:	10.1097/QAD.0000000000001411
Journal or Publication Title:	Aids
Volume:	31
Number:	6
Page Range:	S. 835 - 847
Date:	2017
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5571
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SUB-SAHARAN AFRICA; DISEASE PROGRESSION; BASE-LINE; FOLLOW-UP; THERAPY; COHORT; CARE; IMMIGRANTS; ACCESS; INEQUALITIES Multiple languages Immunology; Infectious Diseases; Virology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23629