在法居住、返乡的撒哈拉以南 HIV 感染者的旅行相关健康事件及其危险因素：法国 ANRS VIHVO 队列研究。

Travel-related health events and their risk factors in HIV-infected sub-Saharan migrants living in France and visiting their native country: The ANRS VIHVO cohort study.

机构信息

CHU Bordeaux, Department for Infectious and Tropical Diseases, 33000, Bordeaux, France; Inserm U1219, Infectious Diseases in Lower Income Countries (IDLIC), Université de Bordeaux, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.

Inserm U1219, Infectious Diseases in Lower Income Countries (IDLIC), Université de Bordeaux, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.

出版信息

Travel Med Infect Dis. 2019 May-Jun;29:40-47. doi: 10.1016/j.tmaid.2019.03.010. Epub 2019 Apr 2.

DOI:10.1016/j.tmaid.2019.03.010

PMID:30951905

Abstract

BACKGROUND

Literature on health events in HIV-infected travellers is scarce, particularly in sub-Saharan African (SSA) migrants.

METHODS

We investigated health events in HIV-infected SSA migrants living in France during and after travel to their native country. All had a pre-travel plasma viral load (pVL) below 200 copies/mL and were on stable combined antiretroviral therapy (cART). Logistic regression models were used to assess the risk factors for at least one adverse health event or febrile event.

RESULTS

Among 264 HIV migrants, pre-travel median CD4 count was 439/mm3 and 27 migrants (6%) experienced a low-level viremia between 50 and 200 copies/mL. One hundred (38%) experienced at least one event (13 experienced two events). The most common events were gastrointestinal, including diarrhoea (n = 29, 26%), respiratory events (n = 20, 18%), and malaria (n = 17, 15%; 1 death). In multivariable analysis, a pre-travel low-level viremia and a lack of pre-travel medical advice significantly increased the risk for any event (OR 4.31, 95% CI, 1.41-13.1; and OR 3.62, 95% CI, 1.38-9.47; respectively). A lack of pre-travel advice significantly increased the risk for febrile event.

CONCLUSIONS

Early and tailored counselling on pre-travel medical advice regarding diarrhoea and vector-borne diseases prophylactic measures in HIV-infected SSA migrants should be emphasised before travel to Africa.

摘要

背景

有关 HIV 感染者旅行者健康事件的文献很少，尤其是在撒哈拉以南非洲（SSA）移民中。

方法

我们研究了居住在法国的 HIV 感染的 SSA 移民在旅行期间和之后的健康事件。所有患者的旅行前血浆病毒载量（pVL）均低于 200 拷贝/毫升，且均接受稳定的联合抗逆转录病毒治疗（cART）。使用逻辑回归模型评估至少发生一次不良健康事件或发热事件的风险因素。

结果

在 264 名 HIV 移民中，旅行前的中位 CD4 计数为 439/mm3，27 名（6%）患者在旅行期间出现了 50-200 拷贝/mL 的低水平病毒血症。100 名（38%）患者至少发生了一次事件（13 名患者发生了两次事件）。最常见的事件是胃肠道疾病，包括腹泻（29 例，26%）、呼吸道疾病（20 例，18%）和疟疾（17 例，15%；1 例死亡）。多变量分析显示，旅行前低水平病毒血症和缺乏旅行前医疗建议显著增加了发生任何事件的风险（OR 4.31，95%CI，1.41-13.1；OR 3.62，95%CI，1.38-9.47）。缺乏旅行前建议显著增加了发热事件的风险。