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.

Centre for Clinical Research Epidemiology Modelling and Evaluation Institute for Global health UCL London UK

Charles University Hospital Plzen AIDS Centre Plzen Czech Republic

CHIP Centre of Excellence for Health Immunity and Infections Department of Infectious Diseases Rigshospitalet University of Copenhagen Copenhagen Denmark

Clinical Hospital of Infectious Diseases Dr Victor Babes Bucharest Romania

Faculty of Medicine School of Health Sciences University of Iceland Department of Infectious Diseases Landspitali University Hospital Reykjavik Iceland

Helsinki University Hospital Helsinki Finland

Hospital Sant Pau Barcelona Spain

Infectious Diseases AIDS and Clinical Immunology Research Center Tbilisi Georgia

Institute of Tropical Medicine Antwerp Belgium

Kantonsspital St Gallen St Gallen Switzerland

Medical University Wroclaw Poland

Nakkusosakond Siseklinik Kohtla Järve Estonia

Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology named after Academician 1 N Blokhina Nizhny Novgorod Russia

Pulmologisches Zentrum der Stadt Wien Vienna Austria

Regional AIDS Centre Svetlogorsk Belarus

St James' Hospital Dublin Ireland

United Szent István and Szent László Hospital Budapest Hungary

University Hospital Cologne Cologne Germany

University Hospital of Infectious Diseases Zagreb Croatia

000      

00000naa a2200000 a 4500

001      

bmc19045204

003      

CZ-PrNML

005      

20200113081845.0

007      

ta

008      

200109s2018 xxk f 000 0|eng||

009      

AR

024    7_

$a 10.1097/QAD.0000000000002035 $2 doi

035    __

$a (PubMed)30289816

040    __

$a ABA008 $b cze $d ABA008 $e AACR2

041    0_

$a eng

044    __

$a xxk

100    1_

$a Laut, Kamilla Grønborg $u CHIP, Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

245    10

$a Variation in antiretroviral treatment coverage and virological suppression among three HIV key populations / $c KG. Laut, L. Shepherd, M. Gottfredsson, D. Sedlacek, B. Knysz, J. Begovac, R. Radoi, B. Schmied, N. Chkhartishvili, E. Florence, M. Ristola, G. Fätkenheuer, F. Mulcahy, P. Schmid, E. Kuzovatova, D. Paduta, J. Smidt, P. Domingo, J. Szlávik, J. Lundgren, A. Mocroft, O. Kirk, EuroSIDA study group,

520    9_

$a 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.

650    _2

$a dospělí $7 D000328

650    _2

$a antiretrovirové látky $x terapeutické užití $7 D044966

650    _2

$a vysoce aktivní antiretrovirová terapie $x metody $7 D023241

650    _2

$a kohortové studie $7 D015331

650    _2

$a spotřeba léčiv $x statistika a číselné údaje $7 D004363

650    _2

$a ženské pohlaví $7 D005260

650    _2

$a zeměpis $7 D005843

650    _2

$a HIV infekce $x farmakoterapie $7 D015658

650    _2

$a lidé $7 D006801

650    _2

$a mužské pohlaví $7 D008297

650    _2

$a lidé středního věku $7 D008875

650    _2

$a populační skupiny $7 D044382

650    _2

$a sexuální chování $7 D012725

650    12

$a setrvalá virologická odpověď $7 D000072230

650    _2

$a výsledek terapie $7 D016896

650    _2

$a virová nálož $7 D019562

651    _2

$a Evropa $7 D005060

655    _2

$a časopisecké články $7 D016428

655    _2

$a práce podpořená grantem $7 D013485

700    1_

$a Shepherd, Leah $u Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global health, UCL, London, UK.

700    1_

$a Gottfredsson, Magnus $u Faculty of Medicine, School of Health Sciences, University of Iceland. Department of Infectious Diseases, Landspitali University Hospital, Reykjavik, Iceland.

700    1_

$a Sedlacek, Dalibor $u Charles University Hospital Plzen, AIDS Centre, Plzen, Czech Republic.

700    1_

$a Knysz, Brygida $u Medical University, Wroclaw, Poland.

700    1_

$a Begovac, Josip $u University Hospital of Infectious Diseases, Zagreb, Croatia.

700    1_

$a Radoi, Roxana $u Clinical Hospital of Infectious Diseases Dr Victor Babes, Bucharest, Romania.

700    1_

$a Schmied, Brigitte $u Pulmologisches Zentrum der Stadt Wien, Vienna, Austria.

700    1_

$a Chkhartishvili, Nikoloz $u Infectious Diseases, AIDS & Clinical Immunology Research Center, Tbilisi, Georgia.

700    1_

$a Florence, Eric $u Institute of Tropical Medicine, Antwerp, Belgium.

700    1_

$a Ristola, Matti $u Helsinki University Hospital, Helsinki, Finland.

700    1_

$a Fätkenheuer, Gerd $u University Hospital Cologne, Cologne, Germany.

700    1_

$a Mulcahy, Fiona $u St James' Hospital, Dublin, Ireland.

700    1_

$a Schmid, Patrick $u Kantonsspital St Gallen, St Gallen, Switzerland.

700    1_

$a Kuzovatova, Elena $u Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology named after Academician I.N. Blokhina, Nizhny Novgorod, Russia.

700    1_

$a Paduta, Dzmitry $u Regional AIDS Centre, Svetlogorsk, Belarus.

700    1_

$a Smidt, Jelena $u Nakkusosakond Siseklinik, Kohtla-Järve, Estonia.

700    1_

$a Domingo, Pere $u Hospital Sant Pau, Barcelona, Spain.

700    1_

$a Szlávik, Janos $u United Szent István and Szent László Hospital, Budapest, Hungary.

700    1_

$a Lundgren, Jens $u CHIP, Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

700    1_

$a Mocroft, Amanda $u Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global health, UCL, London, UK.

700    1_

$a Kirk, Ole $u CHIP, Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

710    2_

$a EuroSIDA study group

773    0_

$w MED00000179 $t AIDS (London, England) $x 1473-5571 $g Roč. 32, č. 18 (2018), s. 2807-2819

856    41

$u https://pubmed.ncbi.nlm.nih.gov/30289816 $y Pubmed

910    __

$a ABA008 $b sig $c sign $y a $z 0

990    __

$a 20200109 $b ABA008

991    __

$a 20200113082217 $b ABA008

999    __

$a ok $b bmc $g 1483473 $s 1083877

BAS    __

$a 3

BAS    __

$a PreBMC

BMC    __

$a 2018 $b 32 $c 18 $d 2807-2819 $e 20181128 $i 1473-5571 $m AIDS $n AIDS $x MED00000179

LZP    __

$a Pubmed-20200109