Parisey Marion, Louni Françoise, Bouvet Elisabeth, Landman Roland, Charpentier Charlotte, Lariven Sylvie, Joly Véronique, Villemant Agnès, Mackoumbou-Nkouka Claude, Yazdanpanah Yazdan, Burdet Charles
1 Department of Infectious Diseases, Bichat Hospital, AP-HP, Paris, France.
2 COREVIH Île-de-France Nord, Paris, France.
AIDS Res Hum Retroviruses. 2019 Jul;35(7):628-633. doi: 10.1089/AID.2018.0292. Epub 2019 Jun 19.
North Africa is one of the rare regions where the HIV epidemic is growing. In France, 5% of the migrants discovering their HIV infection are from North Africa. The objective of this study was to compare the sociodemographic characteristics and outcomes of North African and French HIV-infected patients. This study was conducted in the HIV clinic of Bichat Hospital (Paris, France). The North African HIV-infected patients were born in Algeria, Tunisia, or Morocco or had lived there for more than 6 months. They were matched for age and gender (1:2) to patients born in France who had never lived outside France for more than 6 months. Sociodemographic, clinical, and immunovirological characteristics of North African and French patients were compared using conditional logistic regression. Among 4,738 eligible patients, 285 North Africans were identified. CD4 levels at HIV diagnosis were not significantly different between North African and French patients, but were more frequently <200/mm in the former than the latter at treatment initiation ( = .02). CDC stage 3 disease occurred more frequently in the first 3 years of care in our center in North African patients than in French patients ( = .01), and control of the HIV viral load over the 12 months preceding inclusion was better in French patients ( = .0001). There was no difference regarding loss to care. These results highlight possible issues in adherence to antiretroviral treatment in North African patients, which may be related to differences in the acceptability of the disease.
北非是艾滋病疫情仍在蔓延的少数地区之一。在法国，5%新发现感染艾滋病病毒的移民来自北非。本研究的目的是比较北非和法国艾滋病病毒感染患者的社会人口学特征及治疗结果。本研究在比沙医院（法国巴黎）的艾滋病诊所开展。感染艾滋病病毒的北非患者出生于阿尔及利亚、突尼斯或摩洛哥，或在这些国家居住超过6个月。按照年龄和性别（1:2）将他们与出生在法国且从未在法国境外居住超过6个月的患者进行匹配。使用条件逻辑回归比较北非和法国患者的社会人口学、临床及免疫病毒学特征。在4738名符合条件的患者中，确定了285名北非患者。艾滋病病毒诊断时的CD4水平在北非和法国患者之间无显著差异，但在开始治疗时，前者CD4水平<200/mm的情况比后者更常见（P = 0.02）。在本中心接受治疗的前3年，北非患者发生美国疾病控制与预防中心（CDC）3期疾病的情况比法国患者更常见（P = 0.01），且在纳入研究前的12个月里，法国患者对艾滋病病毒载量的控制情况更好（P = 0.0001）。在失访方面没有差异。这些结果凸显了北非患者在抗逆转录病毒治疗依从性方面可能存在的问题，这可能与对该疾病的接受度差异有关。
