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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.
Children living with HIV in Europe: do migrants have worse treatment outcomes?
Chappell E.;Kohns Vasconcelos M.;Goodall R. L.;Galli L.;Goetghebuer T.;Noguera-Julian A.;Rodrigues L. C.;Scherpbier H.;Smit C.;Bamford A.;Crichton S.;Navarro M. L.;Ramos J. T.;Warszawski J.;Spolou V.;Chiappini E.;Venturini E.;Prata F.;Kahlert C.;Marczynska M.;Marques L.;Naver L.;Thorne C.;Gibb D. M.;Giaquinto C.;Judd A.;Collins I. J.;Goodall R.;Rodrigues L.;Duff C.;Goodall R.;Gomezpena D.;Jackson C.;Lundin R.;Mangiarini L.;Milanzi E.;Nardone A.;Hainaut M.;Van der Kelen E.;Delforge M.;Le Chenadec J.;Ramos E.;Dialla O.;Wack T.;Laurent C.;Ait si Selmi L.;Leymarie I.;Ait Benali F.;Brossard M.;Boufassa L.;Floch-Tudal C.;Firtion G.;Hau I.;Chace A.;Bolot P.;Blanche S.;Granier M.;Labrune P.;Lachassine E.;Dollfus C.;Levine M.;Fourcade C.;Heller-Roussin B.;Runel-Belliard C.;Tricoire J.;Monpoux F.;Chirouze C.;Reliquet V.;Brouard J.;Kebaili K.;Fialaire P.;de Villeneuve A.;Lalande M.;de Flandres J.;Mazingue F.;Partisani M. L.;de Martino M.;Angelo Tovo P.;Gabiano C.;Carloni I.;Larovere D.;Baldi F.;Miniaci A.;Pession A.;Badolato R.;Panto G.;Anastasio E.;Montagnani C.;Bianchi L.;Allodi A.;Di Biagio A.;Grignolo S.;Giacomet V.;Marchisio P.;Banderali G.;Tagliabue C.;Cellini M.;Bruzzese E.;Di Costanzo P.;Lo Vecchio A.;Dona D.;Rampon O.;Romano A.;Dodi I.;Esposito S.;Zuccaro V.;Zanaboni D.;Consolini R.;Bernardi S.;Genovese O.;Cristiano L.;Mazza A.;Garazzino S.;Mignone F.;Silvestro E.;Portelli V.;Kinderziekenhuis E.;van der Kuip M.;Pajkrt D.;Scherpbier H. J.;de Boer C.;Weijsenfeld A. M.;Jurriaans S.;Back N. K. T.;Zaaijer H. L.;Berkhout B.;Cornelissen M. T. E.;Schinkel C. J.;Wolthers K. C.;Fraaij P. L. A.;van Rossum A. M. C.;Vermont C. L.;van der Knaap L. C.;Visser E.;Boucher C. A. B.;Koopmans M. P. G.;van Kampen J. J. A.;Henriet S. S. V.;van Aerde M. K.;Strik-Albers R.;Rahamat-Langendoen J.;Stelma F. F.;Burger D.;Scholvinck E. H.;de Groot-de Jonge H.;Niesters H. G. M.;van Leer-Buter C. C.;Knoester M.;Bont L. J.;Geelen S. P. M.;Loeffen Y. G. T.;Wolfs T. F. W.;Nauta N.;Schuurman R.;Hofstra L. M.;Wensing A. M. J.;Reiss P.;Zaheri S.;Boyd A. C.;Bezemer D. O.;van Sighem A. I.;Smit C.;Wit F. W. M. N.;Hillebregt M. M. J.;Woudstra T. J.;Bergsma D.;van de Sande L.;Rutkens T.;van der Vliet S.;Lelivelt K. J.;Scheijgrond A.;de Groot L.;van den Akker M.;Bakker Y.;EI Berkaoui A.;Bezemer M.;Bretin N.;Djoechro E.;Groters M.;Kruijne E.;Lelivelt K. J.;Lodewijk C.;Lucas E.;Munjishvili L.;Paling F.;Peeck B.;Ree C.;Regtop R.;Ruijs Y.;Schoorl M.;Schnorr P.;Tuijn E.;Veenenberg L.;Visser K. M.;Witte E. C.;Ruijs Y.;Popielska J.;Pokorska-Spiewak M.;Oldakowska A.;Zawadka K.;Coupland U.;Doroba M.;Teixeira C.;Fernandes A.;Soler-Palacin P.;Antoinette Frick M.;Perez-Hoyos S.;Mur A.;Lopez N.;Mendez M.;Mayol L.;Vallmanya T.;Calavia O.;Garcia L.;Coll M.;Pineda V.;Rius N.;Rovira N.;Duenas J.;Fortuny C.;Jose Mellado M.;Escosa L.;Garcia Hortelano M.;Sainz T.;Gonzalez-Tome M. I.;Rojo P.;Blazquez D.;Prieto-Tato L.;Epalza C.;Tomas Ramos J.;Guillen S.;Navarro M. L.;Saavedra J.;Santos M.;Santiago B.;de Ory S. J.;Carrasco I.;Munoz-Fernandez M. A.;Angel Roa M.;Penin M.;Martinez J.;Badillo K.;Onate E.;Pocheville I.;Garrote E.;Colino E.;Gomez Sirvent J.;Garzon M.;Roman V.;Angulo R.;Neth O.;Falcon L.;Terol P.;Luis Santos J.;Moreno D.;Lendinez F.;Peromingo E.;Uberos J.;Ruiz B.;Grande A.;Jose Romero F.;Perez C.;Lillo M.;Losada B.;Herranz M.;Bustillo M.;Collado P.;Antonio Couceiro J.;Vila L.;Calvino C.;Isabel Piqueras A.;Oltra M.;Gavilan C.;Montesinos E.;Dapena M.;Alvarez C.;Jimenez B.;Gloria Andres A.;Marugan V.;Ochoa C.;Alfayate S.;Isabel Menasalvas A.;del Prado Y. R.;NaverNaver L.;Soeria-Atmadja S.;Belfrage E.;Hagas V.;Aebi-Popp K.;Anagnostopoulos A.;Battegay M.;Baumann M.;Bernasconi E.;Boni J.;Braun D. L.;Bucher H. C.;Calmy A.;Cavassini M.;Ciuffi A.;Crisinel P. A.;Duppenthaler A.;Dollenmaier G.;Egger M.;Elzi L.;Fehr J.;Fellay J.;Francini K.;Furrer H.;Fux C. A.;Gunthard H. F.;Haerry D.;Hasse B.;Hirsch H. H.;Hoffmann M.;Hosli I.;Huber M.;Kaiser L.;Keiser O.;Klimkait T.;Kottanattu L.;Kouyos R. D.;Kovari H.;Ledergerber B.;Martinetti G.;Martinez de Tejada B.;Marzolini C.;Metzner K. J.;Muller N.;Nicca D.;Paioni P.;Pantaleo G.;Perreau M.;Polli C.;Rauch A.;Rudin C.;Scherrer A. U.;Schmid P.;Speck R.;Stockle M.;Sultan-Beyer L.;Tarr P.;Thanh Lecompte M.;Trkola A.;Vernazza P.;Wagner N.;Wandeler G.;Weber R.;Yerly S.;Lyall H.;Butler K.;Doerholt K.;Doherty C.;Foster C.;Harrison I.;Kenny J.;Klein N.;Letting G.;McMaster P.;Murau F.;Nsangi E.;Prime K.;Riordan A.;Shackley F.;Shingadia D.;Storey S.;Tudor-Williams G.;Turkova A.;Welch S.;Cook C.;Dobson D.;Fairbrother K.;Gibb D. M.;Prevost M. L.;Van Looy N.;Peters H.;Francis K.;Thrasyvoulou L.;Welch S.;Fidler K.;Bernatoniene J.;Manyika F.;Sharpe G.;Subramaniam B.;Hague R.;Price V.;Flynn J.;Cardoso A.;Abou - Rayyah M.;Klein N.;Bamford A.;Shingadia D.;Yeadon S.;Segal S.;Hawkins S.;Dowie M.;Bandi S.;Percival E.;Eisenhut M.;Duncan K.;Anguvaa L.;Wren L.;Flood T.;Pickering A.;McMaster P.;Murphy C.;Daniels J.;Lees Y.;Thompson F.;Williams A.;Williams B.;Pope S.;Libeschutz S.;Cliffe L.;Southall S.;Freeman A.;Freeman H.;Christie S.;Gordon A.;Rosie Hague D.;Clarke L.;Jones L.;Brown L.;Greenberg M.;Benson C.;Riordan A.;Ibberson L.;Shackley F.;Patel S.;Hancock J.;Doerholt K.;Prime K.;Sharland M.;Storey S.;Lyall E. G. H.;Foster C.;Seery P.;Tudor-Williams G.;Kirkhope N.;Raghunanan S.;Kenny J.;Callaghan A.;Bridgwood A.;McMaster P.;Evans J.;Blake E.;Yannoulias A.
2021-01-01
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.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11379/555357
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
