Long-term maintenance of virologic suppression in native and migrant HIV-1 naïve patients: an Italian cohort study. Issue 9 (2nd September 2021)

• Record Type: Journal Article
• Authors: Lagi, Filippo; Kiros, Seble Tekle; Di Giambenedetto, Simona; Lombardi, Francesca; Pecorari, Monica; Borghi, Vanni; Lepore, Luciana; Monno, Laura; Setti, Maurizio; Micheli, Valeria; Bagnarelli, Patrizia; Paolini, Elisabetta; Bai, Francesca; Bartoloni, Alessandro; Sterrantino, Gaetana
• Is Part Of: AIDS care. Volume 33:Issue 9(2021)
• Page Start: 1159
• Page End: 1166
• Publication Date: 2021-09-02
• Subjects: Migrants -- Italy -- Africans -- HIV-1 -- virologic failure -- naïve; AIDS (Disease) -- Social aspects -- Periodicals; AIDS (Disease) -- Psychological aspects -- Periodicals; AIDS (Disease) -- Patients -- Care -- Periodicals; Acquired Immunodeficiency Syndrome; 362.1969792
• DOI: 10.1080/09540121.2020.1839011
• Languages: English
• ISSNs: 0954-0121

Abstract

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.