Increased risk of virologic failure to the first antiretroviral regimen in HIV-infected migrants compared to natives: Data from the ICONA cohort
- Creators
- Saracino, A.
- Lorenzini, P.
- Lo Caputo, S.
- Girardi, E.
- Castelli, F.
- Bonfanti, P.
- Rusconi, S.
- Caramello, P.
- Abrescia, N.
- Mussini, C.
- Monno, L.
- d'Arminio Monforte, A.
- Moroni, M.
- Andreoni, M.
- Angarano, G.
- Antinori, A.
- Cauda, R.
- Di Perri, G.
- Galli, M.
- Iardino, R.
- Ippolito, G.
- Lazzarin, A.
- Perno, C. F.
- von Schloesser, F.
- Viale, P.
- Castagna, A.
- Cozzi-Lepri, A.
- Puoti, M.
- Ammassari, A.
- Balotta, C.
- Bonora, S.
- Borderi, M.
- Capobianchi, M. R.
- Ceccherini-Silberstein, F.
- Cingolani, A.
- Cinque, P.
- De Luca, A.
- Di Biagio, A.
- Gianotti, N.
- Gori, A.
- Guaraldi, G.
- Lapadula, G.
- Lichtner, M.
- Madeddu, G.
- Maggiolo, F.
- Marchetti, G.
- Marcotullio, S.
- Quiros Roldan, E.
- Cicconi, P.
- Fanti, I.
- Galli, L.
- Shanyinda, M.
- Tavelli, A.
- Giacometti, A.
- Costantini, A.
- Mazzoccato, S.
- Santoro, C.
- Suardi, C.
- Vanino, E.
- Verucchi, G.
- Minardi, C.
- Quirino, T.
- Abeli, C.
- Manconi, P. E.
- Piano, P.
- Vecchiet, J.
- Falasca, K.
- Sighinolfi, L.
- Segala, D.
- Mazzotta, F.
- Cassola, G.
- Viscoli, C.
- Alessandrini, A.
- Piscopo, R.
- Mazzarello, G.
- Mastroianni, C.
- Belvisi, V.
- Caramma, I.
- Chiodera, A.
- Castelli, A. P.
- Rizzardini, G.
- Ridolfo, A. L.
- Piolini, R.
- Salpietro, S.
- Carenzi, L.
- Moioli, M. C.
- Tincati, C.
- Puzzolante, C.
- Chirianni, A.
- Borgia, G.
- Guida, M. G.
- Gargiulo, M.
- Gentile, I.
- Orlando, R.
- Baldelli, F.
- Francisci, D.
- Parruti, G.
- Ursini, T.
- Magnani, G.
- Ursitti, M. A.
- Vullo, V.
- d'Avino, A.
- Gallo, L.
- Nicastri, E.
- Acinapura, R.
- Capozzi, M.
- Libertone, R.
- Tebano, 1G.
- Zaccarelli, M.
- Viviani, F.
- Sasset, L.
- Mura, M. S.
- Rossetti, B.
- Orofino, G. C.
- Sciandra, M.
- Bassetti, M.
- Londero, A.
- Pellizzer, G.
- Manfrin, V.
- Others:
- Saracino, A.
- Lorenzini, P.
- Lo Caputo, S.
- Girardi, E.
- Castelli, F.
- Bonfanti, P.
- Rusconi, S.
- Caramello, P.
- Abrescia, N.
- Mussini, C.
- Monno, L.
- d'Arminio Monforte, A.
- Moroni, M.
- Andreoni, M.
- Angarano, G.
- Antinori, A.
- Cauda, R.
- Di Perri, G.
- Galli, M.
- Iardino, R.
- Ippolito, G.
- Lazzarin, A.
- Perno, C. F.
- von Schloesser, F.
- Viale, P.
- Castagna, A.
- Cozzi-Lepri, A.
- Puoti, M.
- Ammassari, A.
- Balotta, C.
- Bonora, S.
- Borderi, M.
- Capobianchi, M. R.
- Ceccherini-Silberstein, F.
- Cingolani, A.
- Cinque, P.
- De Luca, A.
- Di Biagio, A.
- Gianotti, N.
- Gori, A.
- Guaraldi, G.
- Lapadula, G.
- Lichtner, M.
- Madeddu, G.
- Maggiolo, F.
- Marchetti, G.
- Marcotullio, S.
- Quiros Roldan, E.
- Cicconi, P.
- Fanti, I.
- Galli, L.
- Shanyinda, M.
- Tavelli, A.
- Giacometti, A.
- Costantini, A.
- Mazzoccato, S.
- Santoro, C.
- Suardi, C.
- Vanino, E.
- Verucchi, G.
- Minardi, C.
- Quirino, T.
- Abeli, C.
- Manconi, P. E.
- Piano, P.
- Vecchiet, J.
- Falasca, K.
- Sighinolfi, L.
- Segala, D.
- Mazzotta, F.
- Cassola, G.
- Viscoli, C.
- Alessandrini, A.
- Piscopo, R.
- Mazzarello, G.
- Mastroianni, C.
- Belvisi, V.
- Caramma, I.
- Chiodera, A.
- Castelli, A. P.
- Rizzardini, G.
- Ridolfo, A. L.
- Piolini, R.
- Salpietro, S.
- Carenzi, L.
- Moioli, M. C.
- Tincati, C.
- Puzzolante, C.
- Chirianni, A.
- Borgia, G.
- Guida, M. G.
- Gargiulo, M.
- Gentile, I.
- Orlando, R.
- Baldelli, F.
- Francisci, D.
- Parruti, G.
- Ursini, T.
- Magnani, G.
- Ursitti, M. A.
- Vullo, V.
- D'Avino, A.
- Gallo, L.
- Nicastri, E.
- Acinapura, R.
- Capozzi, M.
- Libertone, R.
- Tebano, 1g.
- Zaccarelli, M.
- Viviani, F.
- Sasset, L.
- Mura, M. S.
- Rossetti, B.
- Orofino, G. C.
- Sciandra, M.
- Bassetti, M.
- Londero, A.
- Pellizzer, G.
- Manfrin, V.
Description
Migrant and Italian HIV-infected patients (n = 5773) enrolled in the ICONA cohort in 2004-2014 were compared for disparities in access to an initial antiretroviral regimen and/or risk of virologic failure (VF), and determinants of failure were evaluated. Variables associated with initiating antiretroviral therapy (ART) were analysed. Primary endpoint was time to failure after at least 6 months of ART and was defined as: VF, first of two consecutive virus loads (VL) >200 copies/mL; treatment discontinuation (TD) for any reason; and treatment failure as confirmed VL >200 copies/mL or TD. A Poisson multivariable analysis was performed to control for confounders. Migrants presented significantly lower CD4 counts and more frequent AIDS events at baseline. When adjusting for baseline confounders, migrants presented a lower likelihood to begin ART (odds ratio 0.80, 95% confidence interval (CI) 0.67-0.95, p 0.012). After initiating ART, the incidence VF rate was 6.4 per 100 person-years (95% CI 4.8-8.5) in migrants and 2.7 in natives (95% CI 2.2-3.3). Multivariable analysis confirmed that migrants had a higher risk of VF (incidence rate ratio 1.90, 95% CI 1.25-2.91, p 0.003) and treatment failure (incidence rate ratio 1.16, 95% CI 1.01-1.33, p 0.031), with no differences for TD. Among migrants, variables associated with VF were age, unemployment and use of a boosted protease inhibitor-based regimen versus nonnucleoside reverse transcriptase inhibitors. Despite the use of more potent and safer drugs in the last 10 years, and even in a universal health care setting, migrants living with HIV still present barriers to initiating ART and an increased risk of VF compared to natives.
Additional details
- URL
- http://hdl.handle.net/11567/875104
- URN
- urn:oai:iris.unige.it:11567/875104
- Origin repository
- UNIGE