Determinants and Outcomes of Late Presentation of HIV Infection in Migrants in Catalonia, Spain: PISCIS Cohort 2004–2016

Conway, Anna; Esteve, Anna; Fernández-Quevedo, Manuel; Casabona, Jordi

doi:10.1007/s10903-018-0834-2

Cited by 6 publications

(6 citation statements)

References 30 publications

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“…In addition, late presentation can have a negative impact on the control of the pandemic, increasing the risk of onward HIV transmission in individuals that are not aware of their HIV status. Besides, late presentation to HIV care was shown to be the main reason for virological failure [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

et al. 2021

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To control the Human Immunodeficiency Virus (HIV) pandemic, the World Health Organization (WHO) set the 90-90-90 target to be reached by 2020. One major threat to those goals is late presentation, which is defined as an individual presenting a TCD4+ count lower than 350 cells/mm3 or an AIDS-defining event. The present study aims to identify determinants of late presentation in Europe based on the EuResist database with HIV-1 infected patients followed-up between 1981 and 2019. Our study includes clinical and socio-demographic information from 89851 HIV-1 infected patients. Statistical analysis was performed using RStudio and SPSS and a Bayesian network was constructed with the WEKA software to analyze the association between all variables. Among 89,851 HIV-1 infected patients included in the analysis, the median age was 33 (IQR: 27.0–41.0) years and 74.4% were males. Of those, 28,889 patients (50.4%) were late presenters. Older patients (>56), heterosexuals, patients originated from Africa and patients presenting with log VL >4.1 had a higher probability of being late presenters (p < 0.001). Bayesian networks indicated VL, mode of transmission, age and recentness of infection as variables that were directly associated with LP. This study highlights the major determinants associated with late presentation in Europe. This study helps to direct prevention measures for this population.

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Section: Introductionmentioning

confidence: 99%

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

et al. 2021

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“…Lower socio-economic status, regardless of the condition, was more frequent for migrants than non-migrants. It is well known that the level of hardship is high after immigration [25,26] and that migrants are at higher risk for late HIV diagnosis, delayed ART initiation and lower virological response on cART than non-migrants in European countries [27,28]. After adjustment, only a bad financial status was associated with viral rebound among the various assessed socioeconomic variables.…”

Section: Discussionmentioning

confidence: 97%

“…A total of 499 individuals were included in this analysis (Figure 1), among whom 288 (57.7%) were natives of France, 158 (31.7%) were natives of SSA, either Central Africa (n=80), West Africa (n=71) or East Africa (n=7), and 53 (10.6%) were natives of another country, either Europe (n=18), South America (n=16), North Africa (n=12) or South-East Asia/Middle East (n=7). The median (IQR) age at arrival in France was 29 years (25-34) for migrants from SSA (n=124) and 27 (24)(25)(26)(27)(28)(29)(30)(31) a Antiretroviral therapy (ART) regimens were defined as consisting of at least three drugs, combining two nucleoside reverse transcriptase inhibitors and one boosted protease inhibitor or unboosted atazanavir, one non-nucleoside reverse transcriptase inhibitor (nevirapine, efavirenz, etravirine or rilpivirine), one integrase inhibitor (raltegravir or dolutegravir) and/or one entry/fusion inhibitor. pVL, plasma viral load.…”

Section: Study Populationmentioning

confidence: 99%

Elevated Risk of Viral Rebound on ART in Migrants Living in France: Role of Socioeconomic Factors

Abgrall¹,

Raho‐Moussa²,

Seng³

et al. 2018

Antiviral Therapy

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Background: In Western countries, viral rebound on antiretroviral therapy (ART) appears to occur more frequently in migrants. We aimed to assess the respective roles of socioeconomic factors and migration on viral rebound in people living with HIV (PLHIV) in France. Methods: We included PLHIV in France, enrolled from 2004 to 2008 in the French ANRS-COPANA cohort, who started a first ART and achieved undetectability (<50 copies/ml) within 1 year. Determinants of viral rebound were assessed using Cox models including geographical origin, HIV transmission group, and clinicobiological and sociodemographic data. Results: Of 499 included individuals, 288 were born in France, 158 in sub-Saharan Africa (SSA) and 53 in another country. Kaplan-Meier probabilities of viral rebound-free survival were similar for men having sex with men (MSM) and heterosexuals born in France, and lower in migrants from SSA or other countries (P<0.001). The crude hazard ratio (HR) of viral rebound was 2.49 (95% CI, 1.59, 3.90) in migrants from SSA and 1.78 (0.94, 3.88) in migrants from other countries compared with MSM born in France. Educational level, financial difficulties and HIV status disclosure had the biggest impact on the difference between the crude and adjusted HRs for viral rebound in migrants. In multivariable analysis, viral rebound was no longer associated with geographical origin, but with protease inhibitor-containing ART, a VACS index ≥35 as a potential indicator of frailty, poor financial status (difficulties or debts) and non-disclosure to friend(s). Conclusions: Socioeconomic factors affect outcomes on ART, even in the context of free access to HIV care and treatment. Patient-centred strategies should be encouraged with the intervention of social workers to address basic needs and promote social support for more socially vulnerable individuals.Sustained viral suppression on antiretroviral therapy (ART) is one of the necessary conditions to achieve the 90:90:90 UNAIDS target. In Europe, 85% (interquartile range [IQR] 76-91) of people living with HIV (PLHIV) achieve viral suppression on ART [1] with high disparities between HIV transmission groups [2][3][4][5]. In France, the overall rate of viral success is similar to that in Western Europe, and the same disparities are described with lower viral response on first ART in migrants [6][7][8], possibly due to lower socio-economic conditions or different cultural factors [3,5,9,10].After a viral response has been obtained on first ART, migrants from sub-Saharan Africa (SSA) also appear to have higher rates of viral rebound than people originating from Northwestern Europe [11], and a possible role of lower sociocultural factors has been suggested [9]. In France, access to health care and treatment is free and universal for people living with HIV, regardless of their

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“…In some studies ( 17 , 32 ), there may be higher late presentation of HIV infection among migrant people compared with permanent residents. On the contrary, the patients with newly diagnosed HIV/AIDS who were Suzhou registered residents, were more likely to be late presentation in our study.…”

Section: Discussionmentioning

confidence: 99%

Real-world data in late presentation of HIV infection in Suzhou, China: Results from four consecutive cross-sectional surveys, 2017–2020

Shen²,

Wang³

et al. 2023

Front. Public Health

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ObjectivesThis study aimed to examine the real prevalence of late presentation of HIV infection and to identify factors associated with late HIV presentation among patients with newly diagnosed HIV/AIDS in Suzhou, China.MethodsPatients with newly diagnosed HIV/AIDS who registered in national AIDS surveillance system from 2017 to 2020 were included in this study. Late presentation (LP) of HIV infection was defined as HIV diagnosis with a CD4 count < 350 cells/μL or an AIDS-defining event. Multivariable logistic regression analyses were used to identify factors associated with LP.ResultsA total of 2,300 patients were enrolled. 1,325 were classified as late presenters, showing a high percentage of 57.6% (95% CI: 54.5–60.7%) and a rise (P = 0.004) over the four-year period. Patients with newly diagnosed HIV/AIDS who were older than 24 years of age (aOR = 1.549, P = 0.001 for 25-39 years; aOR = 2.389, P < 0.001 for 40 years and older), were Suzhou registered residents (aOR = 1.259, P = 0.026), and were from inpatient and outpatient (aOR = 1.935, P < 0.001) were more likely to be late presentation.ConclusionsThis study showed a high percentage and a rise of late presentation of HIV infection among patients with newly diagnosed HIV/AIDS in Suzhou, China, which is a challenge for future prevention and control of AIDS. Targeted measures should be urgently implemented to reduce late HIV diagnosis.

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Determinants and Outcomes of Late Presentation of HIV Infection in Migrants in Catalonia, Spain: PISCIS Cohort 2004–2016

Cited by 6 publications

References 30 publications

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

Determinants of HIV-1 Late Presentation in Patients Followed in Europe

Elevated Risk of Viral Rebound on ART in Migrants Living in France: Role of Socioeconomic Factors

Real-world data in late presentation of HIV infection in Suzhou, China: Results from four consecutive cross-sectional surveys, 2017–2020

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