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Rigshospitalet - en del af Københavns Universitetshospital
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Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

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  • Kamilla Laut
  • Leah Shepherd
  • Roxana Radoi
  • Igor Karpov
  • Milosz Parczewski
  • Cristina Mussini
  • Fernando Maltez
  • Marcelo Losso
  • Nikoloz Chkhartishvili
  • Hila Elinav
  • Helen Kovari
  • Anders Blaxhult
  • Robert Zangerle
  • Tatiana Trofimova
  • Malgorzata Inglot
  • Kai Zilmer
  • Elena Kuzovatova
  • Thérèse Staub
  • Dorthe Raben
  • Jens Lundgren
  • Amanda Mocroft
  • Ole Kirk
  • On Behalf Of The EuroSIDA Study Group
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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.

OriginalsprogEngelsk
Artikelnummer1700382
TidsskriftEurosurveillance
Vol/bind23
Udgave nummer21
Sider (fra-til)12
ISSN1560-7917
DOI
StatusUdgivet - maj 2018

ID: 54658328