In:
HIV Medicine, Wiley, Vol. 23, No. 2 ( 2022-02), p. 186-196
Abstract:
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.
Type of Medium:
Online Resource
ISSN:
1464-2662
,
1468-1293
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
2020341-X
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