Migrants from Sub-Saharan Africa in the Swiss HIV Cohort Study: access to antiretroviral therapy, disease progression and survival.

Details

Serval ID
serval:BIB_07F42BC58A21
Type
Article: article from journal or magazin.
Collection
Publications
Title
Migrants from Sub-Saharan Africa in the Swiss HIV Cohort Study: access to antiretroviral therapy, disease progression and survival.
Journal
Aids
Author(s)
Staehelin C., Rickenbach M., Low N., Egger M., Ledergerber B., Hirschel B., D'Acremont V., Battegay M., Wagels T., Bernasconi E., Kopp C., Furrer H.
Working group(s)
Swiss HIV Cohort Study
ISSN
0269-9370 (Print)
ISSN-L
0269-9370
Publication state
Published
Issued date
2003
Volume
17
Number
15
Pages
2237-2244
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
OBJECTIVE: To examine the proportion of migrants from Sub-Saharan Africa entering the Swiss HIV Cohort Study (SHCS) and to compare these participants with participants from Northwestern Europe for access to antiretroviral therapy, progression to AIDS and survival.
DESIGN: Prospective national cohort study of HIV-1-infected adults from seven HIV centres in Switzerland.
METHODS: Trends in the proportion of participants from Sub-Saharan Africa were followed in 11 872 HIV-infected adults entering the SHCS from 1984 to 2001. Survival methods were used to compare uptake of antiretroviral therapy, survival and progression to AIDS in the 2684 participants from Sub-Saharan Africa and Northwest Europe enrolled from 1997-2001.
RESULTS: There was a steady increase in the proportion of Sub-Saharan African participants over time, reaching 11.9% in 1997-2001. These participants were more likely to be younger, female, to have been infected by heterosexual intercourse and had lower CD4 cell counts at presentation. There were no differences between Sub-Saharan Africans and Northwest Europeans in uptake of triple antiretroviral therapy, progression to AIDS or survival up to 48 months after starting treatment. Tuberculosis was the most frequent AIDS-defining event in Sub-Saharan African patients.
CONCLUSIONS: There is no evidence that access to potent antiretroviral therapy is influenced by geographic origin of participants. The prognosis of Sub-Saharan African patients on triple therapy is equivalent to that of Northwest European patients. Future research should address wider issues about access to specialist health services for HIV-infected people from Sub-Saharan Africa.
Keywords
Acquired Immunodeficiency Syndrome/drug therapy, Acquired Immunodeficiency Syndrome/epidemiology, Adult, Africa South of the Sahara/epidemiology, Age Factors, Anti-Retroviral Agents/therapeutic use, CD4 Lymphocyte Count/methods, Disease Progression, Emigration and Immigration, Europe/epidemiology, Female, HIV Infections/drug therapy, HIV Infections/epidemiology, HIV-1, Health Services Accessibility, Heterosexuality, Humans, Male, Prospective Studies, Sex Factors
Pubmed
Web of science
Create date
29/01/2008 9:52
Last modification date
20/08/2019 13:30
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