Children living with HIV in Europe: do migrants have worse treatment outcomes?. Issue 2 (1st October 2021)

• Record Type: Journal Article
• Authors: Chappell, Elizabeth; Kohns Vasconcelos, Malte; Goodall, Ruth L.; Galli, Luisa; Goetghebuer, Tessa; Noguera‐Julian, Antoni; Rodrigues, Laura C.; Scherpbier, Henriette; Smit, Colette; Bamford, Alasdair; Crichton, Siobhan; Navarro, Marissa Luisa; Ramos, Jose T.; Warszawski, Josiane; Spolou, Vana; Chiappini, Elena; Venturini, Elisabetta; Prata, Filipa; Kahlert, Christian; Marczynska, Magdalena; Marques, Laura; Naver, Lars; Thorne, Claire; Gibb, Diana M.; Giaquinto, Carlo; Judd, Ali; Collins, Intira Jeannie
• Other Names: Goodall Ruth investigator.; Rodrigues Laura investigator.; Duff Charlotte investigator.; Goodall Ruth investigator.; Gomezpena Daniel investigator.; Jackson Charlotte investigator.; Lundin Rebecca investigator.; Mangiarini Laura investigator.; Milanzi Edith investigator.; Nardone Alessandra investigator.; Hainaut Marc investigator.; Van der Kelen Evelyne investigator.; Delforge Marc investigator.; Le Chenadec Jerome investigator.; Ramos Elisa investigator.; Dialla Olivia investigator.; Wack Thierry investigator.; Laurent Corine investigator.; Ait si Selmi Lamya investigator.; Leymarie Isabelle investigator.; Ait Benali Fazia investigator.; Brossard Maud investigator.; Boufassa Leila investigator.; Floch‐Tudal Corinne investigator.; Firtion Ghislaine investigator.; Hau Isabelle investigator.; Chace Anne investigator.; Bolot Pascal investigator.; Blanche Stéphane investigator.; Granier Michèle investigator.; Labrune Philippe investigator.; Lachassine Eric investigator.; Dollfus Catherine investigator.; Levine Martine investigator.; Fourcade Corinne investigator.; Heller‐Roussin Brigitte investigator.; Runel‐Belliard Camille investigator.; Tricoire Joëlle investigator.; Monpoux Fabrice investigator.; Chirouze Catherine investigator.; Reliquet Véronique investigator.; Brouard Jacques investigator.; Kebaili Kamila investigator.; Fialaire Pascale investigator.; de Villeneuve Arnaud investigator.; Lalande Muriel investigator.; de Flandres Jeanne investigator.; Mazingue Françoise investigator.; Partisani Maria Luisa investigator.; de Martino Maurizio investigator.; Angelo Tovo Pier investigator.; Gabiano Clara investigator.; Carloni Ines investigator.; Larovere Domenico investigator.; Baldi Francesco investigator.; Miniaci Angela investigator.; Pession Andrea investigator.; Badolato Raffaele investigator.; Pantò Grazia investigator.; Anastasio Elisa investigator.; Montagnani Carlotta investigator.; Bianchi Leila investigator.; Allodi Alessandra investigator.; Di Biagio Antonio investigator.; Grignolo Sara investigator.; Giacomet Vania investigator.; Marchisio Paola investigator.; Banderali Giuseppe investigator.; Tagliabue Claudia investigator.; Cellini Monica investigator.; Bruzzese Eugenia investigator.; Di Costanzo Pasquale investigator.; Lo Vecchio Andrea investigator.; Donà Daniele investigator.; Rampon Osvalda investigator.; Romano Amelia investigator.; Dodi Icilio investigator.; Esposito Susanna investigator.; Zuccaro Valentina investigator.; Zanaboni Domenico investigator.; Consolini Rita investigator.; Bernardi Stefania investigator.; Genovese Orazio investigator.; Cristiano Letizia investigator.; Mazza Antonio investigator.; Garazzino Silvia investigator.; Mignone Federica investigator.; Silvestro Erika investigator.; Portelli Vincenzo investigator.; Kinderziekenhuis Emma investigator.; van der Kuip M. investigator.; Pajkrt D investigator.; Scherpbier H.J. investigator.; de Boer C. investigator.; Weijsenfeld A.M. investigator.; Jurriaans S. investigator.; Back N.K.T. investigator.; Zaaijer H.L. investigator.; Berkhout B. investigator.; Cornelissen M.T.E. investigator.; Schinkel C.J. investigator.; Wolthers K.C. investigator.; Fraaij P.L.A. investigator.; van Rossum A.M.C. investigator.; Vermont C.L. investigator.; van der Knaap L.C. investigator.; Visser E investigator.; Boucher C.A.B. investigator.; Koopmans M.P.G. investigator.; van Kampen J.J.A. investigator.; Henriet S.S.V. investigator.; van Aerde M. K. investigator.; Strik‐Albers R investigator.; Rahamat‐Langendoen J investigator.; Stelma F.F. investigator.; Burger D investigator.; Schölvinck E.H. investigator.; de Groot‐de Jonge H investigator.; Niesters H.G.M. investigator.; van Leer‐Buter C.C. investigator.; Knoester M investigator.; Bont L.J. investigator.; Geelen S.P.M. investigator.; Loeffen Y.G.T. investigator.; Wolfs T.F.W. investigator.; Nauta N. investigator.; Schuurman R investigator.; Hofstra L.M. investigator.; Wensing A.M.J. investigator.; Reiss P investigator.; Zaheri S investigator.; Boyd A.C. investigator.; Bezemer D.O. investigator.; van Sighem A.I. investigator.; Smit C. investigator.; Wit F.W.M.N. investigator.; Hillebregt M.M.J. investigator.; Woudstra T.J. investigator.; Bergsma D investigator.; van de Sande L. investigator.; Rutkens T investigator.; van der Vliet S. investigator.; Lelivelt K.J investigator.; Scheijgrond A investigator.; de Groot L investigator.; van den Akker M. investigator.; Bakker Y. investigator.; EI Berkaoui A. investigator.; Bezemer M. investigator.; Brétin N. investigator.; Djoechro E. investigator.; Groters M. investigator.; Kruijne E. investigator.; Lelivelt K.J. investigator.; Lodewijk C. investigator.; Lucas E. investigator.; Munjishvili L. investigator.; Paling F. investigator.; Peeck B. investigator.; Ree C. investigator.; Regtop R. investigator.; Ruijs Y. investigator.; Schoorl M. investigator.; Schnörr P. investigator.; Tuijn E. investigator.; Veenenberg L. investigator.; Visser K.M. investigator.; Witte E.C. investigator.; Ruijs Y investigator.; Popielska Jolanta investigator.; Pokorska‐Śpiewak Maria investigator.; Ołdakowska Agnieszka investigator.; Zawadka Konrad investigator.; Coupland Urszula investigator.; Doroba Małgorzata investigator.; Teixeira Carla investigator.; Fernandes Alexandre investigator.; Soler‐Palacín Pere investigator.; Antoinette Frick Maria investigator.; Pérez‐Hoyos Santiago investigator.; Mur Antonio investigator.; López Núria investigator.; Méndez María investigator.; Mayol Lluís investigator.; Vallmanya Teresa investigator.; Calavia Olga investigator.; García Lourdes investigator.; Coll Maite investigator.; Pineda Valentí investigator.; Rius Neus investigator.; Rovira Núria investigator.; Dueñas Joaquín investigator.; Fortuny Clàudia investigator.; José Mellado María investigator.; Escosa Luis investigator.; García Hortelano Milagros investigator.; Sainz Talía investigator.; González‐Tomé María Isabel investigator.; Rojo Pablo investigator.; Blázquez Daniel investigator.; Prieto‐Tato Luis investigator.; Epalza Cristina investigator.; Tomás Ramos José investigator.; Guillén Sara investigator.; Navarro María Luisa investigator.; Saavedra Jesús investigator.; Santos Mar investigator.; Santiago Begoña investigator.; de Ory Santiago Jimenez investigator.; Carrasco Itzíar investigator.; Muñoz‐Fernández Mª Angeles investigator.; Ángel Roa Miguel investigator.; Penín María investigator.; Martínez Jorge investigator.; Badillo Katie investigator.; Oñate Eider investigator.; Pocheville Itziar investigator.; Garrote Elisa investigator.; Colino Elena investigator.; Gómez Sirvent Jorge investigator.; Garzón Mónica investigator.; Román Vicente investigator.; Angulo Raquel investigator.; Neth Olaf investigator.; Falcón Lola investigator.; Terol Pedro investigator.; Luis Santos Juan investigator.; Moreno David investigator.; Lendínez Francisco investigator.; Peromingo Estrella investigator.; Uberos José investigator.; Ruiz Beatriz investigator.; Grande Ana investigator.; José Romero Francisco investigator.; Pérez Carlos investigator.; Lillo Miguel investigator.; Losada Begoña investigator.; Herranz Mercedes investigator.; Bustillo Matilde investigator.; Collado Pilar investigator.; Antonio Couceiro José investigator.; Vila Leticia investigator.; Calviño Consuelo investigator.; Isabel Piqueras Ana investigator.; Oltra Manuel investigator.; Gavilán César investigator.; Montesinos Elena investigator.; Dapena Marta investigator.; Álvarez Cristina investigator.; Jiménez Beatriz investigator.; Gloria Andrés Ana investigator.; Marugán Víctor investigator.; Ochoa Carlos investigator.; Alfayate Santiago investigator.; Isabel Menasalvas Ana investigator.; del Prado Yolanda Ruiz investigator.; NavérNavér Lars investigator.; Soeria‐Atmadja Sandra investigator.; Belfrage Erik investigator.; Hagås Vendela investigator.; Aebi‐Popp K investigator.; Anagnostopoulos A investigator.; Battegay M investigator.; Baumann M investigator.; Bernasconi E investigator.; Böni J investigator.; Braun DL investigator.; Bucher HC investigator.; Calmy A investigator.; Cavassini M investigator.; Ciuffi A investigator.; Crisinel PA investigator.; Duppenthaler A investigator.; Dollenmaier G investigator.; Egger M investigator.; Elzi L investigator.; Fehr J investigator.; Fellay J investigator.; Francini K investigator.; Furrer H investigator.; Fux CA investigator.; Günthard HF investigator.; Haerry D investigator.; Hasse B investigator.; Hirsch HH investigator.; Hoffmann M investigator.; Hösli I investigator.; Huber M investigator.; Kaiser L investigator.; Keiser O investigator.; Klimkait T investigator.; Kottanattu L investigator.; Kouyos RD investigator.; Kovari H investigator.; Ledergerber B investigator.; Martinetti G investigator.; Martinez de Tejada B investigator.; Marzolini C investigator.; Metzner KJ investigator.; Müller N investigator.; Nicca D investigator.; Paioni P investigator.; Pantaleo G investigator.; Perreau M investigator.; Polli Ch investigator.; Rauch A investigator.; Rudin C investigator.; Scherrer AU investigator.; Schmid P investigator.; Speck R investigator.; Stöckle M investigator.; Sultan‐Beyer L investigator.; Tarr P investigator.; Thanh Lecompte M investigator.; Trkola A investigator.; Vernazza P investigator.; Wagner N investigator.; Wandeler G investigator.; Weber R investigator.; Yerly S investigator.; Lyall Hermione investigator.; Butler Karina investigator.; Doerholt Katja investigator.; Doherty Conor investigator.; Foster Caroline investigator.; Harrison Ian investigator.; Kenny Julia investigator.; Klein Nigel investigator.; Letting Gillian investigator.; McMaster Paddy investigator.; Murau Fungai investigator.; Nsangi Edith investigator.; Prime Katia investigator.; Riordan Andrew investigator.; Shackley Fiona investigator.; Shingadia Delane investigator.; Storey Sharon investigator.; Tudor‐Williams Gareth investigator.; Turkova Anna investigator.; Welch Steve investigator.; Cook Claire investigator.; Dobson Donna investigator.; Fairbrother Keith investigator.; Gibb Diana M. investigator.; Prevost Marthe Le investigator.; Van Looy Nadine investigator.; Peters Helen investigator.; Francis Kate investigator.; Thrasyvoulou L investigator.; Welch S investigator.; Fidler K investigator.; Bernatoniene J investigator.; Manyika F investigator.; Sharpe G investigator.; Subramaniam B investigator.; Hague R investigator.; Price V investigator.; Flynn J investigator.; Cardoso A investigator.; Abou – Rayyah M investigator.; Klein N investigator.; Bamford A investigator.; Shingadia D investigator.; Yeadon S investigator.; Segal S investigator.; Hawkins S investigator.; Dowie M investigator.; Bandi S investigator.; Percival E investigator.; Eisenhut M investigator.; Duncan K investigator.; Anguvaa L investigator.; Wren L investigator.; Flood T investigator.; Pickering A investigator.; McMaster P investigator.; Murphy C investigator.; Daniels J investigator.; Lees Y investigator.; Thompson F investigator.; Williams A investigator.; Williams B investigator.; Pope S investigator.; Libeschutz S investigator.; Cliffe L investigator.; Southall S investigator.; Freeman A investigator.; Freeman H investigator.; Christie S investigator.; Gordon A investigator.; Rosie Hague D investigator.; Clarke L investigator.; Jones L investigator.; Brown L investigator.; Greenberg M investigator.; Benson C investigator.; Riordan A investigator.; Ibberson L investigator.; Shackley F investigator.; Patel S investigator.; Hancock J investigator.; Doerholt K investigator.; Prime K investigator.; Sharland M investigator.; Storey S investigator.; Lyall EGH investigator.; Foster C investigator.; Seery P investigator.; Tudor‐Williams G investigator.; Kirkhope N investigator.; Raghunanan S investigator.; Kenny Julia investigator.; Callaghan A investigator.; Bridgwood A investigator.; McMaster P investigator.; Evans J investigator.; Blake E investigator.; Yannoulias A investigator.;
• Is Part Of: HIV medicine. Volume 23:Issue 2(2022)
• Page Start: 186
• Page End: 196
• Publication Date: 2021-10-01
• Subjects: children -- Europe -- HIV -- migrant -- mortality; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.13177
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract: Objectives: To assess the effect of migrant status on treatment outcomes among children living with HIV in Europe. Methods: Children aged < 18 years at the start of antiretroviral therapy (ART) in European paediatric HIV observational cohorts where ≥ 5% of children were migrants (defined as born abroad) were included. Three outcomes were considered: (i) severe immunosuppression‐for‐age; (ii) viraemic viral load (≥ 400 copies/mL) at 1 year after ART initiation; and (iii) AIDS/death after ART initiation. The effect of migrant status was assessed using univariable and multivariable logistic and Cox models. Results: Of 2620 children included across 12 European countries, 56% were migrants. At ART initiation, migrant children were older than domestic‐born children (median 6.1 vs. 0.9 years, p < 0.001), with slightly higher proportions being severely immunocompromised (35% vs. 33%) and with active tuberculosis (2% vs. 1%), but a lower proportion with an AIDS diagnosis (14% vs. 19%) (all p < 0.001). At 1 year after beginning ART, a lower proportion of migrant children were viraemic (18% vs. 24%) but there was no difference in multivariable analysis ( p = 0.702), and no difference in severe immunosuppression ( p = 0.409). However, there was a trend towards higher risk of AIDS/death in migrant children (adjusted hazard ratio = 1.51, 95% confidence interval: 0.96–2.38, p = 0.072). Conclusions: After adjusting for characteristics at ART initiation, migrant children have virological and immunological outcomes at 1 year of ART that are comparable to those who are domestic‐born, possibly indicating equity in access to healthcare in Europe. However, there was some evidence of a difference in AIDS‐free survival, which warrants further monitoring.