title: Response to combined antiretroviral therapy according to gender and origin in a cohort of naïve HIV-infected patients: GESIDA-5808 study.
abstract: BACKGROUND
  We analyzed differences in response to combined antiretroviral therapy (cART) according to sex and geographic origin in a retrospective comparative study of Spanish-born and immigrant patients initiating cART.
  
  
  METHODS
  The primary endpoint was time to treatment failure (TTF), defined as virological failure, death, opportunistic infection, interruption of cART, or loss to follow-up. Late diagnosis was defined as a CD4+ cell count ≤ 200 cells/mm3 and/or AIDS at initiation of cART. Survival was analyzed using Kaplan-Meier analysis and Cox regression.
  
  
  RESULTS
  We followed 1,090 patients, of whom 318 were women (45.6% immigrant women [IW]). At initiation of treatment, women had a higher CD4+ count than men (217 vs 190 cells/mm3), a lower viral load (4.7 vs 5 log), and fewer were late starters (49% vs 59%). The adjusted risk of TTF between women and men was not significantly different (hazard ratio [HR], 1.10; 95% CI, 0.79-1.53). TTF was shorter among IW than Spanish-born women (124 weeks [95% CI, 64-183] vs 151 [95% CI, 127-174]) and loss to follow-up was double that of Spanish-born women (25.5% vs 11.6%).
  
  
  CONCLUSIONS
  Although response to cART was similar for both sexes, men started treatment later. IW were more frequently lost to follow-up and switched treatment. Measures to improve medical follow-up after initiation of cART should be promoted among this minority group.
authors.affiliation: Tropical Medicine, Infectious Diseases Department, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain. jose.perezmolina@gmail.com
authors.forename: José A
authors.initials: JA
authors.lastname: Pérez-Molina
authors.forename: Marta
authors.initials: M
authors.lastname: Mora Rillo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Suárez-Lozano
authors.forename: Jose L
authors.initials: JL
authors.lastname: Casado-Osorio
authors.forename: Ramón
authors.initials: R
authors.lastname: Teira Cobo
authors.forename: Pablo
authors.initials: P
authors.lastname: Rivas González
authors.forename: Enric
authors.initials: E
authors.lastname: Pedrol Clotet
authors.forename: Asunción
authors.initials: A
authors.lastname: Hernando-Jerez
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Elena
authors.initials: E
authors.lastname: Barquilla Díaz
authors.forename: Herminia
authors.initials: H
authors.lastname: Esteban
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality / Q000821:virology; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012727:Sex Characteristics; D013030:Spain; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents