Viral rebound on antiretroviral therapy in France according to region of origin, sex, and HIV acquisition group. Results from the French Hospital Database on HIV (ANRS CO4-FHDH).

IF 2.8 3区 医学 Q2 INFECTIOUS DISEASES HIV Medicine Pub Date : 2024-11-04 DOI:10.1111/hiv.13729
S Abgrall, H Selinger-Leneman, E Lanoy, A Becker, S Matheron, P de Truchis, J Pavie, A Canestri, M A Khuong, D Rey, F Caby, P Tattevin, R Palich, S Grabar
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Abstract

Background: Assessing the potential increased risk of viral rebound (VR) in migrants requires adequate control for sex and acquisition risk groups.

Methods: People living with HIV1, enrolled in the ANRS CO4-French Hospital Database on HIV, who achieved virological suppression with antiretroviral therapy (ART) initiated between 2006 and 2016 were included. We first compared the risk of VR, with loss to follow-up and death considered as competing events, across origin among the HIV acquisition groups, then across acquisition groups among the different origins, and finally across modality of a variable combining sex, acquisition group, and origin. Models were adjusted for clinical and biological confounding factors.

Results: We included 21 571 French natives (FRA), 10 148 migrants from sub-Saharan Africa (SSA), 1137 migrants from the non-French West Indies (NFWI), and 4205 other migrants (OTHER). The 5-year probability of VR was 19% (95% confidence interval [CI] 19-20) overall, 15% in FRA, 21% in OTHER, 26% in SSA, and 34% in NFWI (p < 0.0001). It was 14% in men who have sex with men (MSM), 23% in heterosexual men, and 23% in women (p < 0.0001). After adjustment, all acquisition groups had a higher risk of VR than MSM from FRA, with men and women from NFWI having the highest risk (adjusted hazard ratio [aHR] 2.46; 95% CI 2.12-2.86 and aHR 2.59; 95% CI 2.20-3.04, respectively). Within each acquisition group, all groups of origin had a higher risk of VR than FRA. Within each region of origin, except the NFWI, heterosexual men had a higher risk of VR than MSM.

Conclusions: After accounting for sex and acquisition group, migration, especially from NFWI, remains prognostic of VR.

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法国抗逆转录病毒疗法的病毒反弹情况(按原籍地区、性别和艾滋病感染群体分列)。法国医院艾滋病数据库(ANRS CO4-FHDH)的结果。
背景:评估移民中可能增加的病毒反弹(VR)风险需要充分控制性别和感染风险群体:评估移民中潜在的病毒反弹(VR)风险增加需要对性别和感染风险群体进行充分控制:我们纳入了ANRS CO4--法国医院艾滋病数据库中登记的艾滋病病毒感染者1,他们在2006年至2016年期间开始接受抗逆转录病毒疗法(ART),并实现了病毒学抑制。我们首先比较了不同艾滋病病毒感染者群体的VR风险(随访丧失和死亡被视为竞争事件),然后比较了不同艾滋病病毒感染者群体的VR风险,最后比较了不同性别、艾滋病病毒感染者群体和艾滋病病毒感染者群体的VR风险。根据临床和生物学混杂因素对模型进行了调整:我们纳入了 21 571 名法国本地人(FRA)、10 148 名来自撒哈拉以南非洲的移民(SSA)、1137 名来自非法属西印度群岛的移民(NFWI)和 4205 名其他移民(OTHER)。总体而言,5 年 VR 概率为 19%(95% 置信区间 [CI]19-20),FRA 为 15%,OTHER 为 21%,SSA 为 26%,NFWI 为 34%(P 结论):在考虑了性别和获得群体后,移民,尤其是从 NFWI 移民,仍然是 VR 的预后因素。
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来源期刊
HIV Medicine
HIV Medicine 医学-传染病学
CiteScore
5.10
自引率
10.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
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