J 2017

Ethnicity predicts viral rebound after travel to the tropics in HIV-infected travelers to the tropics in the Swiss HIV Cohort Study

GEBRESELASSIE, H.M., David KRAUS, C.A. FUX, S. HAUBITZ, A. SCHERRER et. al.

Basic information

Original name

Ethnicity predicts viral rebound after travel to the tropics in HIV-infected travelers to the tropics in the Swiss HIV Cohort Study

Authors

GEBRESELASSIE, H.M. (231 Ethiopia), David KRAUS (203 Czech Republic, belonging to the institution), C.A. FUX (756 Switzerland), S. HAUBITZ (756 Switzerland), A. SCHERRER (756 Switzerland), C. HATZ (756 Switzerland), O. VEIT (756 Switzerland), M. STOECKLE (756 Switzerland), J. FEHR (756 Switzerland), S. DE LUCIA (756 Switzerland), M. CAVASSINI (756 Switzerland), E. BERNASCONI (756 Switzerland), P. SCHMID (756 Switzerland), H. FURRER (756 Switzerland) and C. STAEHELIN (756 Switzerland)

Edition

HIV MEDICINE, HOBOKEN, USA, WILEY, 2017, 1464-2662

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30303 Infectious Diseases

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.932

RIV identification code

RIV/00216224:14310/17:00097373

Organization unit

Faculty of Science

DOI

UT WoS

000406693900004

Keywords in English

adherence; HIV; travel; virological failure; visiting friends and relatives

Tags

Tags

International impact, Reviewed
Změněno: 3/4/2018 14:47, Ing. Nicole Zrilić

Abstract

V originále

Objectives The number of HIV-infected individuals from developed countries travelling to tropical and subtropical areas has increased as a result of the clinical and survival benefits of combination antiretroviral therapy. The aim of our study was to describe the traveler population in the SHCS and to determine the frequency of viral rebound in virologically suppressed individuals after a travel episode to the tropics compared to non-travelers. Methods Swiss HIV Cohort Study participants with at least one follow-up visit between 1 January 1989 and 28 February 2015 were eligible for inclusion in the study. The primary outcome was the occurrence of viral rebound (viral load > 200 HIV-1 RNA copies/mL) after a travel episode compared with a nontravel episode in previously suppressed individuals ( 200 copies/mL). All virologically suppressed patients contributed multiple travel or nontravel episodes to the analysis. Logistic regression was performed including factors associated with viral rebound. Results We included 16 635 patients in the study, of whom 6084 (36.5%) had ever travelled to the tropics. Travel frequency increased over time, with travellers showing better HIV parameters than nontravellers [less advanced Centers for Disease Control and Prevention (CDC) stage and higher CD4 count nadir]. Viral rebound was seen in 477 (3.9%) of 12 265 travel episodes and in 5121 (4.5%) of 114 884 nontravel episodes [unadjusted odds ratio (OR) 0.87; 95% confidence interval (CI) 0.78-0.97]. Among these 477 post-travel viral rebounds, 115 had a resistance test performed and 51 (44%) of these showed new resistance mutations. Compared with European and North American patients, the odds for viral rebound were significantly lower in Southeast Asian (OR 0.67; 95% CI 0.51-0.88) and higher in sub-Saharan African (SSA) patients (OR 1.41; 95% CI 1.22-1.62). Travel further increased the odds of viral rebound in SSA patients (OR 2.00; 95% CI 1.53-2.61). Conclusions Region of origin is the main risk factor for viral rebound rather than travel per se. Pre-travel adherence counselling should focus on patients of SSA origin.