Immunological and virological response to antiretroviral treatment in migrant and native men and women in Western Europe; is benefit equal for all? HIV Medicine
Monge et al. on behalf of COHERE in EuroCoord aimed to evaluate differences in immunovirological response to combination antiretroviral therapy (cART) in migrant and native men and women.
Of 32’817 individuals, 25’799 (78.6%) were men. The percentage of migrants was higher in women (48.9%) than in men (21.2%) and migrants from sub-Saharan Africa accounted for the largest migrant group (29.9% in men and 63.3% in women). Migrant men and women from sub-Saharan Africa started at lower CD4 cell counts than native individuals, which remained lower over time. Virological response was ≥ 85% at 12 months for all groups except Caribbean women (77.7%). Compared with native individuals men and women, lower virological response was experienced by North Africa and the Middle East (subdistribution hazard ratios [sHR] 0.91] and sub-Saharan Africa (sHR 0.88) men and Caribbean (sHR 0.77) women, respectively.
In conclusion, immunovirological response to cART in Western Europe varies by geographical origin and sex of patients. The study-results have implications for clinical management and policy changes regarding earlier HIV testing and cART entitlement; they can help clinicians be alert to particular groups, especially women, who will require extra support with their treatments.