Long-term maintenance of virologic suppression in native and migrant HIV-1 naïve patients: an Italian cohort study

Lagi, F.; Kiros, S.Tekle.; Di Giambenedetto, S.; Lombardi, F.; Pecorari, M.; Borghi, V.; Lepore, L.; Monno, L.; Setti, M.; Micheli, V.; Bagnarelli, P.; Paolini, E.; Bai, F.; Bartoloni, A.; Sterrantino, G.

Aids Care 2020: 1-8


ISSN/ISBN: 0954-0121
PMID: 33172289
DOI: 10.1080/09540121.2020.1839011
Accession: 072064827

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Little is known about long-term maintenance of virologic suppression in HIV migrants in Italy. The study aims to compare virologic failure rates and associated factors among antiretroviral therapy (ART)-naïve migrants and natives enrolled in the ARCA database since 2007 who achieved virologic suppression within 18 months from the beginning of the ART. Kaplan-Meier method assessed the probability of virologic suppression and failure. Cox regression model was used for multivariate analysis. Of 2515 patients, 2020 (80.3%) were Italian, 286 (10.6%) migrants from low-income countries, of whom 201 (75.0%) from Africa, and 227 (9.0%) from high-income-countries. The median follow-up was 4.5 years (IQR 2.5-7). No difference was observed in the time of achievement of virological suppression in the three groups (log-rank: p = 0.5687). Higher probability of virologic failure was observed in Africans compared to Italians, to patients from high-income-countries and from low-income-countries other than Africans (Log-rank = p < 0.001). In the adjusted analysis, a higher virologic failure risk was found in Africans only compared to Italians. [HR 4.01; 95% CI 2.44-6.56, p < 0.001]. In Italy, African migrants are less likely to maintain virologic suppression compared to natives and other migrants. Targeted interventions could be needed for foreigners, especially for Africans.