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Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and...

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Autores principales: Laut, Kamilla, Shepherd, Leah, Radoi, Roxana, Karpov, Igor, Parczewski, Milosz, Mussini, Cristina, Maltez, Fernando, Losso, Marcelo, Chkhartishvili, Nikoloz, Elinav, Hila, Kovari, Helen, Blaxhult, Anders, Zangerle, Robert, Trofimova, Tatiana, Inglot, Malgorzata, Zilmer, Kai, Kuzovatova, Elena, Staub, Thérèse, Raben, Dorthe, Lundgren, Jens, Mocroft, Amanda, Kirk, Ole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152212/
https://www.ncbi.nlm.nih.gov/pubmed/29845931
http://dx.doi.org/10.2807/1560-7917.ES.2018.23.21.1700382
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author Laut, Kamilla
Shepherd, Leah
Radoi, Roxana
Karpov, Igor
Parczewski, Milosz
Mussini, Cristina
Maltez, Fernando
Losso, Marcelo
Chkhartishvili, Nikoloz
Elinav, Hila
Kovari, Helen
Blaxhult, Anders
Zangerle, Robert
Trofimova, Tatiana
Inglot, Malgorzata
Zilmer, Kai
Kuzovatova, Elena
Staub, Thérèse
Raben, Dorthe
Lundgren, Jens
Mocroft, Amanda
Kirk, Ole
author_facet Laut, Kamilla
Shepherd, Leah
Radoi, Roxana
Karpov, Igor
Parczewski, Milosz
Mussini, Cristina
Maltez, Fernando
Losso, Marcelo
Chkhartishvili, Nikoloz
Elinav, Hila
Kovari, Helen
Blaxhult, Anders
Zangerle, Robert
Trofimova, Tatiana
Inglot, Malgorzata
Zilmer, Kai
Kuzovatova, Elena
Staub, Thérèse
Raben, Dorthe
Lundgren, Jens
Mocroft, Amanda
Kirk, Ole
author_sort Laut, Kamilla
collection PubMed
description Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004–05, 2009–10 and 2014–15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004–05 (67.8%) to 2014–15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004–05, 87.7% in 2014–15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014–15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014–15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13–0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.
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spelling pubmed-61522122018-10-19 Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015 Laut, Kamilla Shepherd, Leah Radoi, Roxana Karpov, Igor Parczewski, Milosz Mussini, Cristina Maltez, Fernando Losso, Marcelo Chkhartishvili, Nikoloz Elinav, Hila Kovari, Helen Blaxhult, Anders Zangerle, Robert Trofimova, Tatiana Inglot, Malgorzata Zilmer, Kai Kuzovatova, Elena Staub, Thérèse Raben, Dorthe Lundgren, Jens Mocroft, Amanda Kirk, Ole Euro Surveill Research Article Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004–05, 2009–10 and 2014–15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004–05 (67.8%) to 2014–15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004–05, 87.7% in 2014–15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014–15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014–15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13–0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA. European Centre for Disease Prevention and Control (ECDC) 2018-05-24 /pmc/articles/PMC6152212/ /pubmed/29845931 http://dx.doi.org/10.2807/1560-7917.ES.2018.23.21.1700382 Text en This article is copyright of The Authors, 2018. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
spellingShingle Research Article
Laut, Kamilla
Shepherd, Leah
Radoi, Roxana
Karpov, Igor
Parczewski, Milosz
Mussini, Cristina
Maltez, Fernando
Losso, Marcelo
Chkhartishvili, Nikoloz
Elinav, Hila
Kovari, Helen
Blaxhult, Anders
Zangerle, Robert
Trofimova, Tatiana
Inglot, Malgorzata
Zilmer, Kai
Kuzovatova, Elena
Staub, Thérèse
Raben, Dorthe
Lundgren, Jens
Mocroft, Amanda
Kirk, Ole
Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015
title Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015
title_full Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015
title_fullStr Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015
title_full_unstemmed Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015
title_short Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015
title_sort persistent disparities in antiretroviral treatment (art) coverage and virological suppression across europe, 2004 to 2015
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152212/
https://www.ncbi.nlm.nih.gov/pubmed/29845931
http://dx.doi.org/10.2807/1560-7917.ES.2018.23.21.1700382
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