Universität zu Köln

Monge, S., Jarrin, I., Mocroft, A., Sabin, C. A., Touloumi, G., van Sighem, A., Abgrall, S., Dray-Spira, R., Spire, B., Castagna, A., Mussini, C., Zangerle, R., Hessamfar, M., Anderson, J., Hamouda, O., Ehren, K., Obel, N., Kirk, O., de Monteynard, L. A., Antinori, A., Girardi, E., Saracino, A., Calmy, A., De Wit, S., Wittkop, L., Bucher, H. C., Montoliu, A., Raben, D., Prins, M., Meyer, L., Chene, G., Burns, F. and Del Amo, J. (2015). Mortality in migrants living with HIV in western Europe (1997-2013): a collaborative cohort study. Lancet HIV, 2 (12). S. E540 - 10. SAN DIEGO: ELSEVIER INC. ISSN 2352-3018

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Abstract

Background Many migrants face adverse socioeconomic conditions and barriers to health services that can impair timely HIV diagnosis and access to life-saving treatments. We aimed to assess the differences in overall mortality by geographical origin in HIV-positive men and women using data from COHERE, a large European collaboration of HIV cohorts from 1997 to 2013. Methods In this observational cohort study, we included HIV-positive, antiretroviral-naive people accessing care in western Europe from COHERE. Individuals were eligible if enrolled in a cohort that collected information on geographical origin or ethnic origin from Jan 1, 1997, to March 19, 2013, aged 18-75 years, they had available information about sex, they were not infected perinatally or after the receipt of clotting factor concentrates, and were naive to combination antiretroviral therapy at cohort entry. Migrants' origins were grouped into seven regions: western Europe and similar countries (Australia, Canada, New Zealand, and the USA); eastern Europe; North Africa and the Middle East; sub-Saharan Africa; Latin America; the Caribbean; and Asia and the rest of Oceania (excluding Australia and New Zealand). Crude and adjusted mortality rate ratios were calculated by use of Poisson regression stratified by sex, comparing each group with the native population. Multiple imputation with chained equations was used to account for missing values. Findings Between Oct 25, 1979, and March 19, 2013, we recruited 279 659 individuals to the COHERE collaboration in EuroCoord. Of these 123 344 men and 45 877 women met the inclusion criteria. Our data suggested effect modification by transmission route (p(interaction) = 0.12 for men; p (interaction) = 0.002 for women). No significant difference in mortality was identified by geographical origin in men who have sex with men. In heterosexual populations, most migrant men had mortality lower than or equal to that of native men, whereas no group of migrant women had mortality lower than that in native women. High mortality was identified in heterosexual men from Latin America (rate ratio [RR] 1.46, 95% CI 1.00-2.12, p= 0.049) and heterosexual women from the Caribbean (1.48, 1.29-1.70, p< 0.0001). Compared with that in the native population, mortality in injecting drug users was similar or low for all migrant groups. Interpretation Characteristics of and risks faced by migrant populations with HIV differ for men and women and for populations infected heterosexually, by sex between men, or by injecting drug use. Further research is needed to understand how inequalities are generated and maintained for the groups with higher mortality identified in this study.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Monge, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jarrin, I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mocroft, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabin, C. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Touloumi, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Sighem, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Abgrall, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dray-Spira, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Spire, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Castagna, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mussini, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zangerle, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hessamfar, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Anderson, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamouda, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehren, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Obel, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirk, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED de Monteynard, L. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Antinori, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Girardi, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Saracino, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Calmy, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED De Wit, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittkop, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bucher, H. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Montoliu, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Raben, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Prins, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chene, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burns, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Del Amo, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-386230
DOI:	10.1016/S2352-3018(15)00203-9
Journal or Publication Title:	Lancet HIV
Volume:	2
Number:	12
Page Range:	S. E540 - 10
Date:	2015
Publisher:	ELSEVIER INC
Place of Publication:	SAN DIEGO
ISSN:	2352-3018
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMBINATION ANTIRETROVIRAL THERAPY; SUB-SAHARAN AFRICA; DISEASE PROGRESSION; HIV-1-INFECTED PATIENTS; HEALTH INEQUALITIES; GENDER; POPULATIONS; COUNTRIES; DEATH; AIDS Multiple languages Immunology; Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38623