Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.

<h4>Introduction</h4>Mortality rates within the first year of combination antiretroviral therapy (cART) initiation are several-fold higher in resource-limited countries than in resource-replete settings. However studies in western countries examining virologic, immunologic and clinical r...

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Autores principales:	Deidra D Parrish, Meridith Blevins, Samuel E Stinnette, Peter F Rebeiro, Bryan E Shepherd, Timothy R Sterling, Catherine C McGowan, C William Wester
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2e92d8a9ae104c389d4dce1f8f9f2e49
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spelling	oai:doaj.org-article:2e92d8a9ae104c389d4dce1f8f9f2e492021-11-18T08:04:28ZVirologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.1932-620310.1371/journal.pone.0052336https://doaj.org/article/2e92d8a9ae104c389d4dce1f8f9f2e492012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23284994/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>Mortality rates within the first year of combination antiretroviral therapy (cART) initiation are several-fold higher in resource-limited countries than in resource-replete settings. However studies in western countries examining virologic, immunologic and clinical responses after cART initiation in indigenous versus non-indigenous populations have shown mixed results. This study aimed to determine whether there is a difference in these outcomes in a United States setting between foreign-born and US-born patients.<h4>Methods</h4>This retrospective observational cohort study of HIV-1 infected adults in one urban clinic in the United States compared virologic suppression, immune recovery and rates of AIDS defining events (ADEs) within the first year of cART using linear mixed effect models, log rank tests and Cox proportional hazard models. Data were analyzed for 94 foreign-born and 1242 US-born patients.<h4>Results</h4>Foreign-born patients were younger (31.7 years versus 38.5 years), more often female (38.3% versus 27.1%), less often injection drug users (3.2% versus 9.5%) or men who have sex with men (19.0% versus 54.5%), and had higher loss to follow-up rates (14.9% versus 6.2%). No significant differences were detected between the groups in suppression of plasma HIV-1 RNA, CD4+ cell recovery or development of ADEs.<h4>Conclusions</h4>During the first year on cART, virologic suppression, immune recovery and development of ADEs were comparable between foreign-born and US-born patients in care in a US clinic. Differential rates of loss to follow-up warrant further investigation in the foreign-born population.Deidra D ParrishMeridith BlevinsSamuel E StinnettePeter F RebeiroBryan E ShepherdTimothy R SterlingCatherine C McGowanC William WesterPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 12, p e52336 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Deidra D Parrish Meridith Blevins Samuel E Stinnette Peter F Rebeiro Bryan E Shepherd Timothy R Sterling Catherine C McGowan C William Wester Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.
description	<h4>Introduction</h4>Mortality rates within the first year of combination antiretroviral therapy (cART) initiation are several-fold higher in resource-limited countries than in resource-replete settings. However studies in western countries examining virologic, immunologic and clinical responses after cART initiation in indigenous versus non-indigenous populations have shown mixed results. This study aimed to determine whether there is a difference in these outcomes in a United States setting between foreign-born and US-born patients.<h4>Methods</h4>This retrospective observational cohort study of HIV-1 infected adults in one urban clinic in the United States compared virologic suppression, immune recovery and rates of AIDS defining events (ADEs) within the first year of cART using linear mixed effect models, log rank tests and Cox proportional hazard models. Data were analyzed for 94 foreign-born and 1242 US-born patients.<h4>Results</h4>Foreign-born patients were younger (31.7 years versus 38.5 years), more often female (38.3% versus 27.1%), less often injection drug users (3.2% versus 9.5%) or men who have sex with men (19.0% versus 54.5%), and had higher loss to follow-up rates (14.9% versus 6.2%). No significant differences were detected between the groups in suppression of plasma HIV-1 RNA, CD4+ cell recovery or development of ADEs.<h4>Conclusions</h4>During the first year on cART, virologic suppression, immune recovery and development of ADEs were comparable between foreign-born and US-born patients in care in a US clinic. Differential rates of loss to follow-up warrant further investigation in the foreign-born population.
format	article
author	Deidra D Parrish Meridith Blevins Samuel E Stinnette Peter F Rebeiro Bryan E Shepherd Timothy R Sterling Catherine C McGowan C William Wester
author_facet	Deidra D Parrish Meridith Blevins Samuel E Stinnette Peter F Rebeiro Bryan E Shepherd Timothy R Sterling Catherine C McGowan C William Wester
author_sort	Deidra D Parrish
title	Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.
title_short	Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.
title_full	Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.
title_fullStr	Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.
title_full_unstemmed	Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.
title_sort	virologic, immunologic and clinical responses in foreign-born versus us-born hiv-1 infected adults initiating antiretroviral therapy: an observational cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/2e92d8a9ae104c389d4dce1f8f9f2e49
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Virologic, immunologic and clinical responses in foreign-born versus US-born HIV-1 infected adults initiating antiretroviral therapy: an observational cohort study.

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