PLoS ONE (Jan 2018)

Influence of geographic origin on AIDS and serious non-AIDS morbidity/mortality during cART among heterosexual HIV-infected men and women in France.

  • Laure-Amélie de Monteynard,
  • Sophie Matheron,
  • Sophie Grabar,
  • Pierre de Truchis,
  • Jacques Gilquin,
  • Juliette Pavie,
  • Odile Launay,
  • Jean-Luc Meynard,
  • Marie-Aude Khuong-Josses,
  • David Rey,
  • Aba Mahamat,
  • Rosemarie Dray-Spira,
  • Anne Simon,
  • Dominique Costagliola,
  • Sophie Abgrall,
  • FHDH-ANRS CO4

DOI
https://doi.org/10.1371/journal.pone.0205385
Journal volume & issue
Vol. 13, no. 10
p. e0205385

Abstract

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BACKGROUND:The influence of geographic origin on the risk of severe illness and death on cART has not been explored in European countries. METHOD:We studied antiretroviral-naïve heterosexual HIV-1-infected individuals enrolled in the FHDH-ANRS CO4 cohort in France who started cART between 2006 and 2011. Individuals originating from France (French natives), sub-Saharan Africa (SSA) and non-French West-Indies (NFW) were studied until 2012. Crude and adjusted rate ratios (aRR) of severe morbid events/deaths (AIDS-related and non-AIDS-related) were calculated using Poisson regression models stratified by sex, comparing each group of migrants to French natives. RESULTS:Among 2334 eligible men, 1379 (59.1%) originated from France, 838 (35.9%) from SSA and 117 (5.0%) from NFW. SSA male migrants had a higher aRR for non-AIDS infections, particularly bacterial infections (aRR 1.56 (95% CI 1.07-2.29), p = 0.0477), than French natives. Among 2596 eligible women, 1347 (51.9%) originated from France, 1131 (43.6%) from SSA, and 118 (4.5%) from NFW. SSA and NFW female migrants had a higher aRR for non-AIDS infections, particularly non-bacterial infections (respectively, 2.04 (1.18-3.53) and 7.87 (2.54-24.4), p = 0.0010), than French natives. We observed no other significant differences related to geographic origin as concerns the aRRs for AIDS-related infections or malignancies, or for other non-AIDS events/deaths such as cardiovascular disease, neurological/psychiatric disorders, non-AIDS malignancies and iatrogenic disorders, in either gender. CONCLUSION:Heterosexual migrants from SSA or NFW living in France have a higher risk of non-AIDS-defining infections than their French native counterparts. Special efforts are needed to prevent infectious diseases among HIV-infected migrants.