Characteristics and response to antiretroviral therapy of HIV-1-infected patients born in Africa and living in France

被引:19
作者
Breton, G.
Lewden, C.
Spire, B.
Salmon, D.
Brun-Vezinet, F.
Duong, M.
Allavena, C.
Leport, C.
Salamon, R.
机构
[1] Univ Paris 07, CHU Bichat, Serv Malad Infect & Trop B, F-75221 Paris 05, France
[2] INSERM, U593, Bordeaux, France
[3] INSERM, U379, F-13258 Marseille, France
[4] Hop Cochin, Serv Med Interne, F-75674 Paris, France
[5] Hop Bichat, Virol Lab, F-75877 Paris, France
[6] Hop Bocage, Serv Malad Infect, Dijon, France
[7] Hop Hotel Dieu, Serv Malad Infect, Nantes, France
关键词
access to treatment; Africa; ART; HIV;
D O I
10.1111/j.1468-1293.2007.00447.x
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background The world-wide AIDS epidemic is reflected in Western Europe in an increasing number of HIV-infected persons who originate from Africa. We describe the characteristics and response to antiretroviral therapy (ART) of HIV-infected patients born in Africa and living in France. Methods Analysis of data from the (Anti PROtease COhorte APROCO) cohort study of HIV-infected patients initiating ART was carried out. Included in the study were 90 patients born in sub-Saharan Africa, 53 in North Africa and 771 in metropolitan France. Results At baseline, there was a higher proportion of women and of the heterosexual transmission route of infection among patients born in sub-Saharan Africa, a higher proportion of injecting drug users among patients born in North Africa and a higher frequency of unemployment and of unstable housing conditions among patients born in both sub-Saharan and North Africa as compared with patients born in France. The median CD4 cell count was lower in patients born in both sub-Saharan and North Africa (sub-Saharan Africa: 197 cells/mu L; North Africa: 222 cells/mu L) than in patients born in France (307 cells/mu L). Median HIV-1 viral loads were similar. After a median follow-up time of 36 months (2506 patient-years), the Kaplan-Meier estimations of probability of survival without new AIDS-defining events were not different. After 36 months of ART, in multivariate analysis, median CD4 cell count, CD4/CD8 ratio and viral load were not statistically different according to birthplace, but the median CD4 percentage was lower in patients born in both sub-Saharan and North Africa. The adherence profiles were similar. Conclusions Although clinical response and adherence to ART did not appear to differ in patients according to their birthplace, the reasons for the more advanced HIV infection observed at ART initiation among patients born in Africa should be further investigated.
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收藏
页码:164 / 170
页数:7
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