Little is known about long-term maintenance of virologic suppression in HIV migrants in Italy. The study aims to compare virologic failure rates and associated factors among antiretroviral therapy (ART)-naïve migrants and natives enrolled in the ARCA database since 2007 who achieved virologic suppression within 18 months from the beginning of the ART. Kaplan-Meier method assessed the probability of virologic suppression and failure. Cox regression model was used for multivariate analysis. Of 2515 patients, 2020 (80.3%) were Italian, 286 (10.6%) migrants from low-income countries, of whom 201 (75.0%) from Africa, and 227 (9.0%) from high-income-countries. The median follow-up was 4.5 years (IQR 2.5–7). No difference was observed in the time of achievement of virological suppression in the three groups (log-rank: p = 0.5687). Higher probability of virologic failure was observed in Africans compared to Italians, to patients from high-income-countries and from low-income-countries other than Africans (Log-rank = p < 0.001). In the adjusted analysis, a higher virologic failure risk was found in Africans only compared to Italians. [HR 4.01; 95% CI 2.44–6.56, p < 0.001]. In Italy, African migrants are less likely to maintain virologic suppression compared to natives and other migrants. Targeted interventions could be needed for foreigners, especially for Africans.

Lagi, F., Kiros, S. T., Di Giambenedetto, S., Lombardi, F., Pecorari, M., Borghi, V., Lepore, L., Monno, L., Setti, M., Micheli, V., Bagnarelli, P., Paolini, E., Bai, F., Bartoloni, A., Sterrantino, G., Long-term maintenance of virologic suppression in native and migrant HIV-1 naïve patients: an Italian cohort study, <<AIDS CARE>>, 2021; 33 (9): 1159-1166. [doi:10.1080/09540121.2020.1839011] [http://hdl.handle.net/10807/193248]

Long-term maintenance of virologic suppression in native and migrant HIV-1 naïve patients: an Italian cohort study

Di Giambenedetto, Simona;Lombardi, Francesca;Pecorari, Mauro;
2021

Abstract

Little is known about long-term maintenance of virologic suppression in HIV migrants in Italy. The study aims to compare virologic failure rates and associated factors among antiretroviral therapy (ART)-naïve migrants and natives enrolled in the ARCA database since 2007 who achieved virologic suppression within 18 months from the beginning of the ART. Kaplan-Meier method assessed the probability of virologic suppression and failure. Cox regression model was used for multivariate analysis. Of 2515 patients, 2020 (80.3%) were Italian, 286 (10.6%) migrants from low-income countries, of whom 201 (75.0%) from Africa, and 227 (9.0%) from high-income-countries. The median follow-up was 4.5 years (IQR 2.5–7). No difference was observed in the time of achievement of virological suppression in the three groups (log-rank: p = 0.5687). Higher probability of virologic failure was observed in Africans compared to Italians, to patients from high-income-countries and from low-income-countries other than Africans (Log-rank = p < 0.001). In the adjusted analysis, a higher virologic failure risk was found in Africans only compared to Italians. [HR 4.01; 95% CI 2.44–6.56, p < 0.001]. In Italy, African migrants are less likely to maintain virologic suppression compared to natives and other migrants. Targeted interventions could be needed for foreigners, especially for Africans.
2021
Inglese
Lagi, F., Kiros, S. T., Di Giambenedetto, S., Lombardi, F., Pecorari, M., Borghi, V., Lepore, L., Monno, L., Setti, M., Micheli, V., Bagnarelli, P., Paolini, E., Bai, F., Bartoloni, A., Sterrantino, G., Long-term maintenance of virologic suppression in native and migrant HIV-1 naïve patients: an Italian cohort study, <<AIDS CARE>>, 2021; 33 (9): 1159-1166. [doi:10.1080/09540121.2020.1839011] [http://hdl.handle.net/10807/193248]
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