Late Presentation and Loss to Follow-Up of Immigrants Newly Diagnosed with HIV in the HAART Era

• Published in: Journal of immigrant and minority health Vol. 16; no. 4; pp. 751 - 755
• Main Authors: Saracino, A., Tartaglia, A., Trillo, G., Muschitiello, C., Bellacosa, C., Brindicci, G., Monno, L., Angarano, G.
• Format: Journal Article
• Language: English
• Published: Boston Springer Science + Business Media 01.08.2014; Springer US; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome (AIDS); Adult; AIDS; Antiretroviral Therapy, Highly Active; BRIEF COMMUNICATION; Communicable Diseases; Comparative Law; Developed Nations; Drug therapy; Emigrants and Immigrants; Female; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - ethnology; Human immunodeficiency virus; Humans; Immigrants; Infections; Infectious diseases; International & Foreign Law; Italy - epidemiology; Lost to Follow-Up; Male; Medical diagnosis; Medicine; Medicine & Public Health; Migrants; Noncitizens; Patients; Private International Law; Public Health; Risk Factors; Sexually transmitted diseases; Sociology; Statistical analysis; STD; Italy; HIV/AIDS; Late presenters; Immigrants; HAART
• ISSN: 1557-1912; 1557-1920
• 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.