Late presentation and loss to follow-up of immigrants newly diagnosed with HIV in the HAART era.
To compare clinical characteristics and therapeutic management of newly HIV-diagnosed immigrants to natives. Patients with a first HIV diagnosis from 1996 to 2010 were included. Of 716 new diagnoses, 85 (12 %) were immigrants. Migrants were younger, more frequently females and sexually infected, less likely to voluntarily request testing, and less HCV-coinfected. Late presenters (CD4 <350 or AIDS) were 76 % among migrants versus 56 % in natives (p = 0.006) with an increasing trend over time. HAART was initiated in 76.5 % of natives and 72.4 % of immigrants; the number/type of adverse events and treatment discontinuation were similar. Immigrants received more NNRTIs-based regimens. A similar proportion of patients reached virological suppression at month 1-3-6 after HAART initiation, but 43 % of immigrants versus 27 % of natives resulted lost to follow-up (p < 0.001). Diagnosis of HIV was often delayed among migrants, who also presented a higher rate of lost to follow-up.
Clinic of Infectious Diseases, University of Foggia, Viale L. Pinto 1, 71100, Foggia, Italy, annalisa.saracino@gmail.com.
A
A
Saracino
A
A
Tartaglia
G
G
Trillo
C
C
Muschitiello
C
C
Bellacosa
G
G
Brindicci
L
L
Monno
G
G
Angarano
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D059012:Lost to Follow-Up; D008297:Male; D012307:Risk Factors