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

• Published in: PloS one 2018, Vol.13 (10), p.e0205385-e0205385
• Main Authors: de Monteynard, Laure-Amélie, Matheron, Sophie, Grabar, Sophie, de Truchis, Pierre, Gilquin, Jacques, Pavie, Juliette, Launay, Odile, Meynard, Jean-Luc, Khuong-Josses, Marie-Aude, Rey, David, Mahamat, Aba, Dray-Spira, Rosemarie, Simon, Anne, Costagliola, Dominique, Abgrall, Sophie
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - epidemiology; Acquired Immunodeficiency Syndrome - etiology; Acquired Immunodeficiency Syndrome - mortality; Acquired Immunodeficiency Syndrome - pathology; Adult; Africa South of the Sahara - epidemiology; AIDS; Anti-Retroviral Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Bacterial infections; Cardiovascular diseases; Databases, Factual; Disorders; Drug therapy; Drug Therapy, Combination; Fatalities; Female; France - epidemiology; Gender; Health risks; Heterosexuality; HIV; HIV Infections - complications; HIV Infections - diagnosis; HIV Infections - drug therapy; Human health and pathology; Human immunodeficiency virus; Humans; Incidence; Infections; Infectious diseases; Life Sciences; Male; Medicine and Health Sciences; Mental disorders; Middle Aged; Migrants; Morbidity; Mortality; Neurological diseases; People and Places; Poisson density functions; Poisson Distribution; Regression analysis; Regression models; Risk; Santé publique et épidémiologie; Severity of Illness Index; Sexually transmitted diseases; Statistical analysis; STD; Systematic review; Tropical diseases; West Indies - epidemiology; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0205385

The influence of geographic origin on the risk of severe illness and death on cART has not been explored in European countries. 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. 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. 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.