Jean-Médard Kankou, Sophie Abgrall et al. « Factors Associated with Virological Rebound in HIV-Positive Sub-Saharan Migrants Living in France After Traveling Back to Their Native Country », Journal of Immigrant and Minority Health, Fév. 2019

  • Titre complet : « Factors Asso­ciated with Viro­lo­gical Rebound in HIV-Posi­tive Sub-Saharan Migrants Living in France After Trave­ling Back to Their Native Country : ANRS-VIHVO 2006–2009 Study »
  • Site de la revue Journal of Immi­grant and Mino­rity Health


In France, around 25% of the esti­mated number of people living with HIV are migrants, of whom three quar­ters are from sub-Saharan Africa (SSA). Our objec­tive was to deter­mine factors asso­ciated with viro­lo­gical rebound (VR) at the occa­sion of a tran­sient stay to the country of origin. HIV-posi­tive migrants from SSA parti­ci­pa­ting to the ANRS-VIHVO adhe­rence study between 2006 and 2009, on effec­tive ART with controlled pre-travel HIV‑1 plasma viral load (VL), were included. Outcome was VR, defined as VL ≥ 50 copies/​ml at the post-travel visit during the week follo­wing the return to France. Among 237 persons (61.6% female, median age 41 years (IQR, 35–47), median time on ART 4.2 years (IQR, 2.2–7.1), 27 (11.4%) expe­rienced VR. The main purpose of the travel was to visit family and median time spent abroad was 5.3 weeks (IQR, 4.1–8.8). The travel was extended longer than anti­ci­pated by at least 1 week in 42 indi­vi­duals (17.7%). In multi­va­riable logistic model, risk factors for VR were male sex [adjusted OR (aOR) 5.1 ; 95% CI 1.6–16.2)], no employ­ment in France (aOR 2.0 ; 1.2–3.5), self-reported non-adhe­rence during the trip (aOR 14.9 ; 4.9–45.9) and PI-contai­ning regimen (aOR 4.6 ; 1.2–17.6). In another analysis not inclu­ding self-reported adhe­rence, trave­ling during Ramadan while respec­ting the fast (aOR 3.3 ; 1.2–9.6) and exten­sion of the stay (aOR 3.0 ; 1.1–7.8) were asso­ciated with VR. Viro­lo­gical rebound was partly explained by struc­tural barriers to adhe­rence such as exten­sion of the travel and inade­quate mana­ge­ment of Ramadan fasting. Indi­vi­duals’ jour­neys should be care­fully planned with health care providers.