Virologic and Immunologic Response to Highly Active Antiretroviral Therapy in Indigenous and Nonindigenous HIV-1???Infected Patients in The Netherlands

Abstract

In nonindigenous patients, treatment with HAART was equally successful in terms of the increase in CD4 cell count but was substantially less effective in achieving a plasma HIV-1 RNA level below 50 copies/mL. Further investigations should explore differences in adherence and pharmacokinetics in these patient groups.

Heterogeneous response to HAART across a diverse population of people living with HIV: results from the ANRS-EN12-VESPA Study

“…Our finding of an increased risk of treatment failure among heterosexual migrants in France is consistent with data from the Netherlands suggesting that migrants followed in a clinic in Amsterdam have poorer virologic and clinical responses to HAART compared to the nonmigrants [13]. On the other hand, migrants were not found to have an impaired response to HAART neither in Denmark [23] nor in London [24].…”

“…A lower beneficial impact of HAART on the risk of disease progression and/or death has been reported among persons with a history of injecting drug use (IDU) [4] and among migrants [13], while homosexual men may have benefited from HAART more than the others [14].…”

Coming and going: Some aspects of care for migrants with HIV in the UK

“…49 However, treatment responses may not be equivalent in the longer term, with data from Holland showing equivalence in CD4 count increases with HAART in indigenous and non-indigenous patients, but virological response (plasma HIV-1 RNA level below 50 copies/mL) at 48e96 weeks was less good in non-indigenous patients. 50 Similar findings have been reported from France where migrants consistently appear to be at increased risk of treatment failure using various endpoint measures, compared with other people with HIV. 51 The high rates of late presentation amongst migrants means that antiretroviral medication is frequently initiated in patients with advanced disease.…”

Standard Care Impact on Effects of Highly Active Antiretroviral Therapy Adherence Interventions

“…First, something other than nonadherence caused the difference in treatment effectiveness, such as patients' clinical status at the start of the treatment. 32 Second, the adher- R ig s b y e t a l 5 8 G o u ja r d e t a l 4 4 J o n e s e t a l 4 8 D il o r io e t a l 4 1 P r a d ie r e t a l 5 4 W o h l e t a l 6 4 H o lz e m e r e t a l 4 5 J a v a n b a k h t e t a l 4 6 R a th b u n e t a l 5 5 T u ld r à e t a l 6 2 K o e n ig e t a l 4 9 v a n S e r v e ll e n e t a l 2 5 S m it h e t a l 6 1 M u r p h y e t a l 2 3 R e m ie n e t a l 2 4 Low SCC Expected rate difference for Remien et al under:…”