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Clin Infect Dis. 2012 Jan 1;54(1):111-8. doi: 10.1093/cid/cir814. Epub 2011 Nov 21.

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

Collaborators (144)

Del Amo J, Meyer L, Bucher HC, Chêne G, Hamouda O, Pillay D, Prins M, Rosinska M, Sabin C, Touloumi G, Porter K, Olson A, Coughlin K, Walker S, Babiker A, Bucher HC, De Luca A, Fisher M, Muga R, Zangerle R, Kelleher A, Cooper D, Grey P, Finlayson R, Bloch M, Kelleher T, Ramacciotti T, Gelgor L, Cooper D, Smith D, Gill J, Tartu Ü, Lutsar I, Chêne G, Dabis F, Thiebaut R, Masquelier B, Costagliola D, Guiguet M, Vanhems P, Chaix ML, Ghosn J, Meyer L, Boufassa F, Hamouda O, Ku C, Bartmeyer B, Touloumi G, Pantazis N, Katsarou O, Paparizos V, Gargalianos-Kakolyris P, Lazanas M, Rezza G, Dorrucci M, d'Arminio Monforte A, De Luca A, Prins M, Geskus R, van der Helm J, Sannes M, Brubakk O, Kran AM, Rosinska M, Muga R, Tor J, de Olalla PG, Cayla J, del Amo J, Moreno S, Monge S, Del Amo J, del Romero J, Pérez S, Bucher HC, Rickenbach M, Francioli P, Malyuta R, Murphy G, Sabin C, Porter K, Johnson A, Phillips A, Babiker A, Pillay D, Morrison C, Salata R, Mugerwa R, Chipato T, Amornkul P, Chêne G, Costagliola D, Del Amo J, Giaquinto C, Gibb D, Grarup J, Kirk O, Ledergerber B, Meyer L, Panteleev A, Phillips A, Porter K, Sabin C, Thorne C, Welch S, Aboulker JP, Albert J, Asandi S, Chêne G, Costagliola D, d'Arminio Monforte A, DeWit S, De Wolf F, Gatell J, Del Amo J, Giaquinto C, Hamouda O, Koch R, Karpov I, Ledergerber B, Lundgren J, Malyuta R, Møller C, Phillips A, Porter K, Prins M, Rakhmanova A, Rockstroh J, Rosinska M, Thorne C, Touloumi G, Volny Anne A, Cooper D, Dedes N, Fenton K, Pizzuti D, Vitoria M, Coughlin K, Ellefson M, Faggion S, Frost R, Reynolds M, Schwimmer C, Scott M.

Author information

1
National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain. ijarrin@isciii.es

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.

PMID:
22109944
DOI:
10.1093/cid/cir814
[Indexed for MEDLINE]
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