Lars Jørgen Østergaard

Variation in antiretroviral treatment coverage and virological suppression among three HIV key populations

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Kamilla Grønborg Laut, CHIP, Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • Leah Shepherd, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global health, UCL, London, UK.
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  • Magnus Gottfredsson
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  • Dalibor Sedlacek, Charles University Hospital Plzen, AIDS Centre, Plzen, Czech Republic.
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  • Brygida Knysz, Wroclaw Medical University, University of Lower Silesia, Wroclaw, Poland.
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  • Josip Begovac, University Hospital of Infectious Diseases, Zagreb, Croatia.
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  • Roxana Radoi, Clinical Hospital of Infectious Diseases Dr Victor Babes, Bucharest, Romania.
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  • Brigitte Schmied, Pulmologisches Zentrum der Stadt Wien, Vienna, Austria.
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  • Nikoloz Chkhartishvili, Infectious Diseases, AIDS & Clinical Immunology Research Center, Tbilisi, Georgia.
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  • Eric Florence, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
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  • Matti Ristola, Department of Child Neurology, Children's Hospital, Helsinki University Hospital Helsinki, University of Helsinki, Helsinki, Finland.
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  • Gerd Fätkenheuer, University Hospital of Cologne, Cologne, Germany.
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  • Fiona Mulcahy, Neuropsychiatric Genetics Group, Department of Psychiatry, Trinity College Dublin, St James Hospital, Dublin, Ireland.
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  • Patrick Schmid, Kantonsspital St. Gallen, St. Gallen, Switzerland.
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  • Elena Kuzovatova, Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology named after Academician I.N. Blokhina, Nizhny Novgorod, Russia.
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  • Dzmitry Paduta, Regional AIDS Centre, Svetlogorsk, Belarus.
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  • Jelena Smidt, Nakkusosakond Siseklinik, Kohtla-Järve, Estonia.
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  • Pere Domingo, Neurology Department, Hospital de Sant Pau, Barcelona, Spain.
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  • Janos Szlávik, United Szent István and Szent László Hospital, Budapest, Hungary.
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  • Jens Lundgren, CHIP, Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • Amanda Mocroft, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global health, UCL, London, UK.
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  • Ole Kirk, CHIP, Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • EuroSIDA Study Group

OBJECTIVES: We assessed differences in antiretroviral treatment (ART) coverage and virological suppression across three HIV key populations, as defined by self-reported HIV transmission category: sex between men, injection drug use (IDU) and heterosexual transmission.

DESIGN: A multinational cohort study.

METHODS: Within the EuroSIDA study, we assessed region-specific percentages of ART-coverage among those in care and virological suppression (<500 copies/ml) among those on ART, and analysed differences between transmission categories using logistic regression.

RESULTS: Among 12 872 participants followed from 1 July 2014 to 30 June 2016, the percentages of ART-coverage and virological suppression varied between transmission categories, depending on geographical region (global P for interaction: P = 0.0148 for ART-coverage, P = 0.0006 for virological suppression). In Western [adjusted odds ratio (aOR) 1.41 (95% confidence interval 1.14-1.75)] and Northern Europe [aOR 1.68 (95% confidence interval 1.25-2.26)], heterosexuals were more likely to receive ART than MSM, while in Eastern Europe, there was some evidence that infection through IDU [aOR 0.60 (95% confidence interval 0.31-1.14)] or heterosexual contact [aOR 0.58 (95% confidence interval 0.30-1.10)] was associated with lower odds of receiving ART. In terms of virological suppression, people infected through IDU or heterosexual contact in East Central and Eastern Europe were around half as likely as MSM to have a suppressed viral load on ART, while we observed no differences in virological suppression across transmission categories in Western and Northern Europe.

CONCLUSION: In our cohort, patterns of ART-coverage and virological suppression among key populations varied by geographical region, emphasizing the importance of tailoring HIV programmes to the local epidemic.

Original languageEnglish
JournalAIDS (London, England)
Volume32
Issue18
Pages (from-to)2807-2819
Number of pages13
ISSN0269-9370
DOIs
Publication statusPublished - 28 Nov 2018

    Research areas

  • Adult, Anti-Retroviral Agents/therapeutic use, Antiretroviral Therapy, Highly Active/methods, Cohort Studies, Drug Utilization/statistics & numerical data, Europe, Female, Geography, HIV Infections/drug therapy, Humans, Male, Middle Aged, Population Groups, Sexual Behavior, Sustained Virologic Response, Treatment Outcome, Viral Load

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