Dhairyawan, R;
Okhai, H;
Hill, T;
Sabin, CA;
UK Collaborative HIV Cohort (UK CHIC) Study;
(2021)
Differences in HIV clinical outcomes amongst heterosexuals in the United Kingdom by ethnicity.
AIDS
, 35
(11)
pp. 1813-1821.
10.1097/QAD.0000000000002942.
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Abstract
OBJECTIVE: We investigated differences in clinical outcomes in heterosexual participants, by ethnicity in the UK Collaborative HIV Cohort Study from 2000-2017. DESIGN: Cohort analysis. METHODS: Logistic/Proportional hazard regression assessed ethnic group differences in CD4+ cell count at presentation, engagement-in-care, combination antiretroviral therapy (cART) initiation, viral suppression and rebound. RESULTS: Of 12,302 participants (median age: 37 [interquartile range: 31, 44] years, 52.5% women, total follow-up: 85,846 person-years), 64.4% were Black African, 19.1% White, 6.3% Black Caribbean, 3.6% Black Other, 3.3% South Asian/Other Asian and 3.4% Other/Mixed. CD4+ cell count at presentation amongst participants from non-White groups were lower than the White group. Participants were engaged-in-care for 79.6% of follow-up time, however Black and Other/Mixed groups were less likely to be engaged-in-care than the White group (adjusted odds ratios vs. White: Black African: 0.70 [95% confidence interval 0.63, 0.79], Black Caribbean: 0.74 [0.63, 0.88], Other/Mixed: 0.78 [0.62, 0.98], Black Other: 0.81 [0.64, 1.02]). Of 8,867 who started cART, 79.1% achieved viral suppression, with no differences by ethnicity in cART initiation or viral suppression. Viral rebound (22.2%) was more common in the Black Other (1.95 [1.37, 2.77]), Black African (1.85 [1.52, 2.24]), Black Caribbean (1.73 [1.28, 2.33]), South Asian/Other Asian (1.35 [0.90, 2.03]) and Other/Mixed (1.09 [0.69, 1.71]) groups than in White participants. CONCLUSIONS: Heterosexual people from Black, Asian and minority ethnic groups presented with lower CD4+ cell counts, spent less time engaged-in-care and were more likely to experience viral rebound than White people. Work to understand and address these differences is needed.
| Type: | Article |
|---|---|
| Title: | Differences in HIV clinical outcomes amongst heterosexuals in the United Kingdom by ethnicity |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000002942 |
| Publisher version: | http://doi.org/10.1097/QAD.0000000000002942 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10128644 |
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