Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States
Background. Our objective was to assess differences in all-cause mortality, as well as AIDS and non-AIDS death rates, among patients started on antiretroviral therapy (ART) according to their geographical origin and ethnicity/race in Europe, Canada, and the United States.Methods. This was a collabor...
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Online Access: | https://hdl.handle.net/20.500.11768/67395 https://doi.org/10.1093/cid/cit111 |
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ftuvssanraffaele:oai:iris.unisr.it:20.500.11768/67395 2024-02-04T10:00:25+01:00 Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States Antiretroviral Therapy Cohort Collaboration (ART-CC) Castagna Antonella Antiretroviral Therapy Cohort Collaboration, (ART-CC) Castagna, Antonella 2013 https://hdl.handle.net/20.500.11768/67395 https://doi.org/10.1093/cid/cit111 eng eng OXFORD UNIV PRESS INC info:eu-repo/semantics/altIdentifier/wos/WOS:000319466600020 volume:56 issue:12 firstpage:1800 lastpage:1809 numberofpages:10 journal:CLINICAL INFECTIOUS DISEASES http://hdl.handle.net/20.500.11768/67395 doi:10.1093/cid/cit111 info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-84878316127 antiretroviral therapy ethnic minoritie HIV infection migrant Adolescent Adult Canada Cohort Studie Emigrants and Immigrant Europe Female Human Kaplan-Meier Estimate Male Residence Characteristic Socioeconomic Factor United State Young Adult Microbiology (medical) Infectious Diseases info:eu-repo/semantics/article 2013 ftuvssanraffaele https://doi.org/20.500.11768/6739510.1093/cid/cit111 2024-01-24T17:40:09Z Background. Our objective was to assess differences in all-cause mortality, as well as AIDS and non-AIDS death rates, among patients started on antiretroviral therapy (ART) according to their geographical origin and ethnicity/race in Europe, Canada, and the United States.Methods. This was a collaboration of 19 cohort studies of human immunodeficiency virus-positive subjects who have initiated ART (ART Cohort Collaboration) between 1998 and 2009. Adjusted mortality hazard ratios (AHRs) were estimated using Cox regression. A competing risk framework was used to estimate adjusted subdistribution hazard ratios for AIDS and non-AIDS mortality.Results. Of 46 648 European patients, 16.3% were from sub-Saharan Africa (SSA), 5.1% Caribbean and Latin America, 1.6% North Africa and Middle East, and 1.7% Asia/West; of 1371 patients from Canada, 14.9% were First Nations and 22.4% migrants, and of 7742 patients from North America, 55.5% were African American and 6.6% Hispanic. Migrants from SSA (AHR, 0.79; 95% confidence interval [CI],. 68-.92) and Asia/West (AHR, 0.62; 95% CI,. 41-.92) had lower mortality than Europeans; these differences appeared mainly attributable to lower non-AIDS mortality. Compared with white Canadians, mortality in Canadian First Nations people (AHR, 1.48; 95% CI,. 96-2.29) was higher, both for AIDS and non-AIDS mortality rates. Among US patients, when compared with whites, African Americans had higher AIDS and non-AIDS mortality, and hazard ratios for all-cause mortality increased with time on ART.Conclusions. The lower mortality observed in migrants suggests "healthy migrant" effects, whereas the higher mortality in First Nations people and African Americans in North America suggests social inequality gaps. © The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. Article in Journal/Newspaper First Nations IRIS UniSR (Università Vita-Salute San Raffaele) Canada Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) Clinical Infectious Diseases 56 12 1800 1809 |
institution |
Open Polar |
collection |
IRIS UniSR (Università Vita-Salute San Raffaele) |
op_collection_id |
ftuvssanraffaele |
language |
English |
topic |
antiretroviral therapy ethnic minoritie HIV infection migrant Adolescent Adult Canada Cohort Studie Emigrants and Immigrant Europe Female Human Kaplan-Meier Estimate Male Residence Characteristic Socioeconomic Factor United State Young Adult Microbiology (medical) Infectious Diseases |
spellingShingle |
antiretroviral therapy ethnic minoritie HIV infection migrant Adolescent Adult Canada Cohort Studie Emigrants and Immigrant Europe Female Human Kaplan-Meier Estimate Male Residence Characteristic Socioeconomic Factor United State Young Adult Microbiology (medical) Infectious Diseases Antiretroviral Therapy Cohort Collaboration (ART-CC) Castagna Antonella Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States |
topic_facet |
antiretroviral therapy ethnic minoritie HIV infection migrant Adolescent Adult Canada Cohort Studie Emigrants and Immigrant Europe Female Human Kaplan-Meier Estimate Male Residence Characteristic Socioeconomic Factor United State Young Adult Microbiology (medical) Infectious Diseases |
description |
Background. Our objective was to assess differences in all-cause mortality, as well as AIDS and non-AIDS death rates, among patients started on antiretroviral therapy (ART) according to their geographical origin and ethnicity/race in Europe, Canada, and the United States.Methods. This was a collaboration of 19 cohort studies of human immunodeficiency virus-positive subjects who have initiated ART (ART Cohort Collaboration) between 1998 and 2009. Adjusted mortality hazard ratios (AHRs) were estimated using Cox regression. A competing risk framework was used to estimate adjusted subdistribution hazard ratios for AIDS and non-AIDS mortality.Results. Of 46 648 European patients, 16.3% were from sub-Saharan Africa (SSA), 5.1% Caribbean and Latin America, 1.6% North Africa and Middle East, and 1.7% Asia/West; of 1371 patients from Canada, 14.9% were First Nations and 22.4% migrants, and of 7742 patients from North America, 55.5% were African American and 6.6% Hispanic. Migrants from SSA (AHR, 0.79; 95% confidence interval [CI],. 68-.92) and Asia/West (AHR, 0.62; 95% CI,. 41-.92) had lower mortality than Europeans; these differences appeared mainly attributable to lower non-AIDS mortality. Compared with white Canadians, mortality in Canadian First Nations people (AHR, 1.48; 95% CI,. 96-2.29) was higher, both for AIDS and non-AIDS mortality rates. Among US patients, when compared with whites, African Americans had higher AIDS and non-AIDS mortality, and hazard ratios for all-cause mortality increased with time on ART.Conclusions. The lower mortality observed in migrants suggests "healthy migrant" effects, whereas the higher mortality in First Nations people and African Americans in North America suggests social inequality gaps. © The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. |
author2 |
Antiretroviral Therapy Cohort Collaboration, (ART-CC) Castagna, Antonella |
format |
Article in Journal/Newspaper |
author |
Antiretroviral Therapy Cohort Collaboration (ART-CC) Castagna Antonella |
author_facet |
Antiretroviral Therapy Cohort Collaboration (ART-CC) Castagna Antonella |
author_sort |
Antiretroviral Therapy Cohort Collaboration (ART-CC) |
title |
Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States |
title_short |
Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States |
title_full |
Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States |
title_fullStr |
Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States |
title_full_unstemmed |
Influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in Canada, Europe, and the United States |
title_sort |
influence of geographical origin and ethnicity on mortality in patients on antiretroviral therapy in canada, europe, and the united states |
publisher |
OXFORD UNIV PRESS INC |
publishDate |
2013 |
url |
https://hdl.handle.net/20.500.11768/67395 https://doi.org/10.1093/cid/cit111 |
long_lat |
ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Canada Meier |
geographic_facet |
Canada Meier |
genre |
First Nations |
genre_facet |
First Nations |
op_relation |
info:eu-repo/semantics/altIdentifier/wos/WOS:000319466600020 volume:56 issue:12 firstpage:1800 lastpage:1809 numberofpages:10 journal:CLINICAL INFECTIOUS DISEASES http://hdl.handle.net/20.500.11768/67395 doi:10.1093/cid/cit111 info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-84878316127 |
op_doi |
https://doi.org/20.500.11768/6739510.1093/cid/cit111 |
container_title |
Clinical Infectious Diseases |
container_volume |
56 |
container_issue |
12 |
container_start_page |
1800 |
op_container_end_page |
1809 |
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1789965694599692288 |