Children living with HIV in Europe: do migrants have worse treatment outcomes?
| Title: | Children living with HIV in Europe: do migrants have worse treatment outcomes? |
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| Authors: | Elizabeth Chappell 1; Malte Kohns Vasconcelos 2 3 4; Ruth L Goodall 1; Luisa Galli 5; Tessa Goetghebuer 6; Antoni Noguera-Julian 7 8 9 10; Laura C Rodrigues 2; Henriette Scherpbier 11; Colette Smit 12; Alasdair Bamford 1 13 14; Siobhan Crichton 1; Marissa Luisa Navarro 10 15 16 17; Jose T Ramos 18; Josiane Warszawski 19 20; Vana Spolou 21; Elena Chiappini 5; Elisabetta Venturini 5; Filipa Prata 22; Christian Kahlert 23; Magdalena Marczynska 24; Laura Marques 25; Lars Naver 26; Claire Thorne 14; Diana M Gibb 1; Carlo Giaquinto 27; Ali Judd 1; Intira Jeannie Collins 1; European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC); Ruth Goodall; Laura Rodrigues; Charlotte Duff; Daniel Gomezpena; Charlotte Jackson; Rebecca Lundin; Laura Mangiarini; Edith Milanzi; Alessandra Nardone; Marc Hainaut; Evelyne Van der Kelen; Marc Delforge; Jerome Le Chenadec; Elisa Ramos; Olivia Dialla; Thierry Wack; Corine Laurent; Lamya Ait Si Selmi; Isabelle Leymarie; Fazia Ait Benali; Maud Brossard; Leila Boufassa; Corinne Floch-Tudal; Ghislaine Firtion; Isabelle Hau; Anne Chace; Pascal Bolot; Stéphane Blanche; Michèle Granier; Philippe Labrune; Eric Lachassine; Catherine Dollfus; Martine Levine; Corinne Fourcade; Brigitte Heller-Roussin; Camille Runel-Belliard; Joëlle Tricoire; Fabrice Monpoux; Catherine Chirouze; Véronique Reliquet; Jacques Brouard; Kamila Kebaili; Pascale Fialaire; Arnaud de Villeneuve; Muriel Lalande; Jeanne de Flandres; Françoise Mazingue; Maria Luisa Partisani; Maurizio de Martino; Pier Angelo Tovo; Clara Gabiano; Ines Carloni; Domenico Larovere; Francesco Baldi; Angela Miniaci; Andrea Pession; Raffaele Badolato; Grazia Pantò; Elisa Anastasio; Carlotta Montagnani; Leila Bianchi; Alessandra Allodi; Antonio Di Biagio; Sara Grignolo; Vania Giacomet; Paola Marchisio; Giuseppe Banderali; Claudia Tagliabue; Monica Cellini; Eugenia Bruzzese; Pasquale Di Costanzo; Andrea Lo Vecchio; Daniele Donà; Osvalda Rampon; Amelia Romano; Icilio Dodi; Susanna Esposito; Valentina Zuccaro; Domenico Zanaboni; Rita Consolini; Stefania Bernardi; Orazio Genovese; Letizia Cristiano; Antonio Mazza; Silvia Garazzino; Federica Mignone; Erika Silvestro; Vincenzo Portelli |
| Contributors: | 1, Elizabeth Chappell; 2 3 4, Malte Kohns Vasconcelo; L Goodall 1, Ruth; 5, Luisa Galli; 6, Tessa Goetghebuer; 9 10, Antoni Noguera-Julian 7 8; C Rodrigues 2, Laura; Scherpbier 11, Henriette; Smit 12, Colette; 1 13 14, Alasdair Bamford; 1, Siobhan Crichton; Luisa Navarro 10 15 16 17, Marissa; T Ramos 18, Jose; Warszawski 19 20, Josiane; Spolou 21, Vana; 5, Elena Chiappini; 5, Elisabetta Venturini; Prata 22, Filipa; Kahlert 23, Christian; Marczynska 24, Magdalena; Marques 25, Laura; Naver 26, Lar; Thorne 14, Claire; M Gibb 1, Diana; Giaquinto 27, Carlo; 1, Ali Judd; 1, Intira Jeannie Collin; Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC), European; Goodall, Ruth; Rodrigues, Laura; Duff, Charlotte; Gomezpena, Daniel; Jackson, Charlotte; Lundin, Rebecca; Mangiarini, Laura; Milanzi, Edith; Nardone, Alessandra; Hainaut, Marc; Van der Kelen, Evelyne; Delforge, Marc; Le Chenadec, Jerome; Ramos, Elisa; Dialla, Olivia; Wack, Thierry; Laurent, Corine; Ait Si Selmi, Lamya; Leymarie, Isabelle; Ait Benali, Fazia; Brossard, Maud; Boufassa, Leila; Floch-Tudal, Corinne; Firtion, Ghislaine; Hau, Isabelle; Chace, Anne; Bolot, Pascal; Blanche, Stéphane; Granier, Michèle; Labrune, Philippe; Lachassine, Eric; Dollfus, Catherine; Levine, Martine; Fourcade, Corinne; Heller-Roussin, Brigitte; Runel-Belliard, Camille; Tricoire, Joëlle; Monpoux, Fabrice; Chirouze, Catherine; Reliquet, Véronique; Brouard, Jacque; Kebaili, Kamila; Fialaire, Pascale; de Villeneuve, Arnaud; Lalande, Muriel; de Flandres, Jeanne; Mazingue, Françoise; Luisa Partisani, Maria; de Martino, Maurizio; Angelo Tovo, Pier; Gabiano, Clara; Carloni, Ine; Larovere, Domenico; Baldi, Francesco; Miniaci, Angela; Pession, Andrea; Badolato, Raffaele; Pantò, Grazia; Anastasio, Elisa; Montagnani, Carlotta; Bianchi, Leila; Allodi, Alessandra; Di Biagio, Antonio; Grignolo, Sara; Giacomet, Vania; Marchisio, Paola; Banderali, Giuseppe; Tagliabue, Claudia; Cellini, Monica; Bruzzese, Eugenia; DI COSTANZO, Pasquale |
| Publication Year: | 2022 |
| Collection: | IRIS Università degli Studi di Napoli Federico II |
| Description: | 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. |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/wos/WOS:000702313900001; volume:23; issue:2; firstpage:186; lastpage:196; numberofpages:11; journal:HIV MEDICINE; https://hdl.handle.net/11588/867702 |
| DOI: | 10.1111/hiv.13177 |
| Availability: | https://hdl.handle.net/11588/867702; https://doi.org/10.1111/hiv.13177; https://onlinelibrary.wiley.com/doi/10.1111/hiv.13177 |
| Accession Number: | edsbas.1D0D564D |
| Database: | BASE |