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Country of birth is associated with antiretroviral therapy choice in treatment-naive persons with HIV in France.
Palich, Romain; Hentzien, Maxime; Hocqueloux, Laurent; Duvivier, Claudine; Allavena, Clotilde; Huleux, Thomas; Delobel, Pierre; Makinson, Alain; Rey, David; Cuzin, Lise.
Afiliación
  • Palich R; Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM U1136, Paris.
  • Hentzien M; Infectious Diseases, Internal Medicine and Clinical Immunology Department, Centre Hospitalier Universitaire Robert Debré, Reims.
  • Hocqueloux L; Infectious Diseases Department, Centre Hospitalier Régional d'Orléans, Orléans.
  • Duvivier C; AP-HP-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, University Paris Cité, INSERM U1016, CNRS UMR8104, Institut Cochin, IHU Imagine, Institut Pasteur, Institut Pasteur Medical Center, Paris.
  • Allavena C; Infectious Diseases Department, EA1413, CHU Nantes, Nantes.
  • Huleux T; Infectious and Travel Diseases Department, Tourcoing University Hospital, Tourcoing.
  • Delobel P; Infectious and Tropical Diseases Department, Toulouse University Hospital, INSERM U1291, University of Toulouse Paul Sabatier, Toulouse.
  • Makinson A; Infectious Diseases Department, University Hospital Montpellier, INSERM U1175, University of Montpellier, Montpellier.
  • Rey D; HIV Infection Care Center, Strasbourg University Hospital, Strasbourg.
  • Cuzin L; CERPOP, Toulouse University, INSERM UMR1295, UPS, Toulouse, France, Martinique University Hospital, Infectious and Tropical Diseases, Fort de France, France.
AIDS ; 37(9): 1459-1466, 2023 07 15.
Article en En | MEDLINE | ID: mdl-37115905
OBJECTIVES: We aimed to describe factors associated with the choice of first antiretroviral therapy (ART) in persons with HIV (PWH) in France, included the country of birth, as well as the time to undetectable viral load and treatment discontinuation. DESIGN: Observational study conducted from the national Dat'AIDS prospectively collected database. METHODS: We included all adults who started their first ART between 01 January 2014 and 31 December 2020, with a pretherapeutic plasma viral load (pVL) at least 400 copies/ml. Univariable and multivariable logistic regressions were used to analyze PWH characteristics driving to an integrase strand transfer inhibitors (INSTI)-based first prescribed regimen. We also analyzed time to first line discontinuation, and to a first undetectable pVL, using Kaplan-Meier model. RESULTS: We analyzed data from 9094 PWH: 45% MSM, 27% women and 27% heterosexual men; 48% born abroad; 4.7 and 2.8% with concomitant hepatitis B and tuberculosis, respectively. INSTIs were prescribed as first-line therapy in 50% of PWH, which increased over time. Native French PWH were more likely to receive an INSTI-based regimen than PWH born abroad [adjusted prevalence ratio 1.47, 95% confidence interval (CI) 1.33-1.60], as were high pVL at diagnosis, hepatitis B or concomitant tuberculosis. Time before discontinuation of the first ART and reaching a first undetectable pVL was not different according to the place of birth. CONCLUSION: Despite unrestricted access to INSTIs in France, independently from HIV disease parameters, PWH born abroad received INSTIs less frequently as a first regimen than those born in France. Qualitative data are needed to better understand physicians' prescribing practices.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Inhibidores de Integrasa VIH / Minorías Sexuales y de Género / Hepatitis B Tipo de estudio: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: AIDS Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Inhibidores de Integrasa VIH / Minorías Sexuales y de Género / Hepatitis B Tipo de estudio: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adult / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: AIDS Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido