Laure-Amélie de Monteynard, Sophie Abgrall et al., “Influence of geographic origin on AIDS and serious non-AIDS morbidity/​mortality during cART among heterosexual HIV-infected men and women in France”, PLOS One, oct. 2018

Article dans PLOS One à retrouver en accès libre sur le site de la revue


Back­ground : The influence of geogra­phic origin on the risk of severe illness and death on cART has not been explored in Euro­pean countries.

Method : We studied anti­re­tro­viral-naïve hete­ro­sexual HIV-1-infected indi­vi­duals enrolled in the FHDH-ANRS CO4 cohort in France who started cART between 2006 and 2011. Indi­vi­duals origi­na­ting from France (French natives), sub-Saharan Africa (SSA) and non-French West-Indies (NFW) were studied until 2012. Crude and adjusted rate ratios (aRR) of severe morbid events/​deaths (AIDS-related and non-AIDS-related) were calcu­lated using Poisson regres­sion models stra­ti­fied by sex, compa­ring each group of migrants to French natives.

Results : Among 2334 eligible men, 1379 (59.1%) origi­nated from France, 838 (35.9%) from SSA and 117 (5.0%) from NFW. SSA male migrants had a higher aRR for non-AIDS infec­tions, parti­cu­larly bacte­rial infec­tions (aRR 1.56 (95% CI 1.07–2.29), p = 0.0477), than French natives. Among 2596 eligible women, 1347 (51.9%) origi­nated from France, 1131 (43.6%) from SSA, and 118 (4.5%) from NFW. SSA and NFW female migrants had a higher aRR for non-AIDS infec­tions, parti­cu­larly non-bacte­rial infec­tions (respec­ti­vely, 2.04 (1.18–3.53) and 7.87 (2.54–24.4), p = 0.0010), than French natives. We observed no other signi­fi­cant diffe­rences related to geogra­phic origin as concerns the aRRs for AIDS-related infec­tions or mali­gnan­cies, or for other non-AIDS events/​deaths such as cardio­vas­cular disease, neurological/​psychiatric disor­ders, non-AIDS mali­gnan­cies and iatro­genic disor­ders, in either gender. Conclu­sion : Hete­ro­sexual migrants from SSA or NFW living in France have a higher risk of non-AIDS-defi­ning infec­tions than their French native coun­ter­parts. Special efforts are needed to prevent infec­tious diseases among HIV-infected migrants.