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Do HIV-Infected Immigrants Initiating HAART have Poorer Treatment-Related Outcomes than Autochthonous Patients in Spain? Results of the GESIDA 5808 Study
- Source :
- Current HIV Research. 8:521-530
- Publication Year :
- 2010
- Publisher :
- Bentham Science Publishers Ltd., 2010.
-
Abstract
- Objective: Currently, 12% of the Spanish population is foreign-born, and a third of newly diagnosed HIV-infected patients are immigrants. We determined whether being an immigrant was associated with a poorer response to antiretroviral treatment. Methods: Historical multicenter cohort study of naive patients starting HAART. The primary endpoint was time to treatment failure (TTF) defined as virological failure (VF), death, opportunistic disease, treatment discontinuation (D/C), or missing patient. Secondary endpoints were TTF expressed as observed data (TFO; censoring missing patients) and time to virological failure (TVF; censoring missing patients and D/C not due to VF). A multivariate analysis was performed to control for confounders. Results: A total of 1090 treatment-naive HIV-infected patients (387 immigrants and 703 autochthonous) from 33 hospitals were included. Most immigrants were from Sub-Saharan Africa (28.3%) or South-Central America/Caribbean (31%). Immigrants were significantly younger (34 y vs 39 y), more frequently female (37.5% vs 24.6%), with less HCV coinfection than autochthonous patients (7% vs 31.3%). There were no differences in baseline viral load (4.95 Log(10) vs 4.98 Log(10)), CD4 lymphocyte count (193.5/mu L vs 201.5/mu L), late initiation of HAART (56.4% vs 56.0%), or antiretrovirals used. Cox-regression analysis (HR; 95%CI) did not show differences in TTF (0.89; 0.66-1.20), TFO (0.95; 0.66-1.36), or TVF (1.00; 0.57-1.78) between immigrants and autochthonous patients. Losses to follow-up were more frequent among immigrants (17.8% vs 12.1; p=0.009). Sub-Saharan African patients and immigrant females had a significantly shorter TTF. Conclusions: The response to HAART among immigrant patients was similar to that of autochthonous patients, although they had a higher rate of losses to follow-up. Sub-Saharan Africans and immigrant females may need particular measures to avoid barriers hindering antiviral efficacy. 1.923 JCR (2010) Q3, 23/33 Virology; Q4, 103/134 Immunology, 44/58 Infectious Diseases
- Subjects :
- Male
HIV Infections
Human-Immunodeficiency-Virus
Cohort Studies
Tratamiento médico
Clinical-Features
Haart
Antiretroviral Therapy, Highly Active
European-Union
Diagnosis
Epidemiology
Prevalence
Ethnicity
Risk-Factors
Treatment Failure
Hepatitis-B
media_common
education.field_of_study
Geography
Middle Aged
Viral Load
Hepatitis B
Latin Americans
Treatment Outcome
Infectious Diseases
Coinfection
Medicine
Late
Female
Viral load
Cohort study
Adult
medicine.medical_specialty
Anti-HIV Agents
Endpoint Determination
Sida
Population
Immunology
Antiretroviral Therapy
Emigrants and Immigrants
Ethnic Groups
Immigrants
Virology
Internal medicine
medicine
Humans
media_common.cataloged_instance
European union
education
business.industry
Sub-Saharan Africans
Referral Unit
medicine.disease
CD4 Lymphocyte Count
Discontinuation
Spain
Análisis transnacional
business
Subjects
Details
- ISSN :
- 1570162X
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Current HIV Research
- Accession number :
- edsair.doi.dedup.....accb524572097dfef2b854617caae6ba