Repositori institucional URV
Español Català English
TÍTULO:
Inequalities by educational level in response to combination antiretroviral treatment and survival in HIV-positive men and women in Europe - imarina:5130929

Autor/es de la URV:Vidal Marsal, Francisco
Autor según el artículo:Del Amo,J., Lodi S., Dray-Spira R., Wittkop L., Monge S., Braun D., Vehreschild J., Teira R., Campbell C., D'arminio M.A., Zangerle R., Ghosen J., Kourkounti S., Dabis F., Leport C., Meyer L., Termote M., Kirk O., Porter K., Spire B., Chene G., Egger M.
Direcció de correo del autor:francesc.vidal@urv.cat
Identificador del autor:0000-0002-6692-6186
Año de publicación de la revista:2017
Tipo de publicación:Journal Publications
ISSN:02699370
Referencia de l'ítem segons les normes APA:Del Amo,J., Lodi S., Dray-Spira R., Wittkop L., Monge S., Braun D., Vehreschild J., Teira R., Campbell C., D'arminio M.A., Zangerle R., Ghosen J., Kou (2017). Inequalities by educational level in response to combination antiretroviral treatment and survival in HIV-positive men and women in Europe. Aids, 31(2), 253-262. DOI: 10.1097/QAD.0000000000001270
Referencia al articulo segun fuente origial:Aids. 31 (2): 253-262
Resumen:BACKGROUND: Socioeconomic inequality challenges population-level implementation of health interventions. We investigated differences by educational level in clinical, virological, and immunological responses to combined antiretroviral treatment (cART) in HIV-positive men and women in Collaboration of Observational HIV Epidemiological Research in Europe, a European collaboration. METHODS: Data were pooled from 15 cohorts in eight countries of patients initiating cART in 1996-2013 with data on educational level categorized in UNESCO/ISCED classifications. Kaplan-Meier curves, Cox and piecewise linear mixed models were used. RESULTS: Of 24 069 HIV-positive patients, 9% had not completed primary education, 32% had completed primary, 44% secondary, and 15% tertiary education. Overall, 21% were women, who were overrepresented in lower educational strata. During 132 507 person-years of follow-up, 1081 individuals died; cumulative mortality decreased with higher educational level (P < 0.001). Over 122 765 person-years, new AIDS events or death occurred in 2598 individuals; differences by education were more marked than for death alone (P < 0.001). Virological response was achieved by 67% of patients without completed basic education, 85% with completed primary education, 82% with secondary, and 87% with tertiary (P < 0.001). Patients with higher education had higher CD4 cell count at cART initiation and at each time after cART but rate of CD4 cell count recovery did not differ. Differences in mortality and clinical responses were similar for men and women and were not entirely explained by delayed HIV diagnosis and late cART initiation. CONCLUSION: HIV-positive patients with lower educational level had worse responses to cART and survival in European countries with universal healthcare. To maximize the population impact of cART, Europe needs to decrease the socioeconomic divide.
DOI del artículo:10.1097/QAD.0000000000001270
Enlace a la fuente original:https://insights.ovid.com/article/00002030-201701140-00011
Versión del articulo depositado:info:eu-repo/semantics/acceptedVersion
Acceso a la licencia de uso:https://creativecommons.org/licenses/by/3.0/es/
Departamento:Medicina i Cirurgia
URL Documento de licencia:https://repositori.urv.cat/ca/proteccio-de-dades/
Áreas temáticas:Virology
Saúde coletiva
Psicología
Nutrição
Medicine (all)
Medicina veterinaria
Medicina iii
Medicina ii
Medicina i
Interdisciplinar
Infectious diseases
Immunology and allergy
Immunology
General medicine
Farmacia
Educação
Ciências biológicas iii
Ciências biológicas ii
Ciências biológicas i
Biotecnología
Palabras clave:Socioeconomic factors
Mortality
Inequality
Hiv
Cohort studies
Entidad:Universitat Rovira i Virgili
Fecha de alta del registro:2024-09-07
Página inicial:253
Página final:262
Volumen de revista:31
Busca tu registro en:

Archivos desponibles
ArchivoDescripciónFormato
DocumentPrincipalDocumentPrincipalapplication/pdf

Información

© 2011 Universitat Rovira i Virgili