Uptake of combination antiretroviral therapy and HIV disease progression according to geographical origin in seroconverters in Europe, Canada, and Australia

Jarrin, Inma, Pantazis, Nikos, Gill, M John, Geskus, Ronald, Perez-Hoyos, Santiago, Meyer, Laurence, Prins, Maria, Touloumi, Giota, Johnson, Anne, Hamouda, Osamah, de Olalla, Patricia García, Porter, Kholoud, del Amo, Julia, Fisher, Martin and The CASCADE Collaboration in EuroCoord, (2012) Uptake of combination antiretroviral therapy and HIV disease progression according to geographical origin in seroconverters in Europe, Canada, and Australia. Clinical Infectious Diseases, 54 (1). pp. 111-118. ISSN 1058-4838

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Abstract

BACKGROUND

We examined differences by geographical origin (GO) in time from HIV seroconversion (SC) to AIDS, death, and initiation of antiretroviral therapy (cART).

METHODS

Data from HIV seroconverter cohorts in Europe, Australia and Canada (CASCADE) was used; GO was classified as: western countries (WE), North Africa and Middle East (NAME), sub-Saharan Africa (SSA), Latin America (LA), and Asia (ASIA). Differences by GO were assessed using Cox models. Administrative censoring date was 30 June 2008.

RESULTS

Of 16 941 seroconverters, 15 548 were from WE, 158 NAME, 762 SSA, 349 LA, and 124 ASIA. We found no differences by GO in risks of AIDS (P = .99) and death (P = .12), although seroconverters from NAME (adjusted hazard ratio [aHR]: 0.57; 95% CI: 0.33-.94) and SSA (aHR: 0.74; 95% CI: 0.50-1.10) appeared to have lower mortality than WE. Chances of initiating cART differed by GO (P < .001): seroconverters from SSA were more likely to initiate cART than WE (aHR: 1.48; 95% CI: 1.26-1.74), but not after adjustment for CD4 at SC (aHR: 1.11; 95% CI: 0.88-1.40).

CONCLUSIONS

In settings with universal access to healthcare, GO does not play a major role in HIV disease progression.

Item Type: Article
Additional Information: Martin Fisher is part of the CASCADE Collaboration in EuroCoord, but is not a named author on the article.
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0643 Communicable diseases and public health > RA0644 Individual diseases or groups of diseases, A-Z > RA0644.A25 AIDS. HIV infections
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Depositing User: Ellen Thomas
Date Deposited: 13 Dec 2013 14:24
Last Modified: 23 Dec 2013 12:27
URI: http://sro.sussex.ac.uk/id/eprint/47096
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