Saracino A, Tartaglia A, Trillo G, Muschitiello C, Bellacosa C, Brindicci G, Monno L, Angarano G
Clinic of Infectious Diseases, University of Foggia, Viale L. Pinto 1, 71100, Foggia, Italy,
J Immigr Minor Health. 2014 Aug;16(4):751-5. doi: 10.1007/s10903-013-9863-z.
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.
比较新诊断出感染艾滋病毒的移民与本地人的临床特征和治疗管理情况。纳入1996年至2010年首次诊断出感染艾滋病毒的患者。在716例新诊断病例中,85例(12%)为移民。移民更年轻,女性比例更高且多通过性传播感染,自愿要求检测的可能性更小,同时合并丙型肝炎病毒感染的情况也更少。移民中晚期就诊者(CD4<350或患艾滋病)占76%,而本地人中这一比例为56%(p=0.006),且随着时间推移呈上升趋势。76.5%的本地人及72.4%的移民开始接受高效抗逆转录病毒治疗(HAART);不良事件的数量/类型及治疗中断情况相似。移民接受基于非核苷类逆转录酶抑制剂(NNRTIs)的治疗方案更多。在开始HAART治疗后的第1、3、6个月,达到病毒学抑制的患者比例相似,但43%的移民失访,而本地人失访率为27%(p<0.001)。在移民中,艾滋病毒的诊断常常延迟,且失访率也更高。