Country of birth does not influence long-term clinical, virologic, and immunological outcome of HIV-infected children living in the Netherlands: a cohort study comparing children born in the Netherlands with children born in Sub-Saharan Africa

Sophie Cohen, Ward P H van Bilsen, Colette Smit, Pieter L A Fraaij, Adilia Warris, Taco W Kuijpers, Sibyl P M Geelen, Tom F W Wolfs, Henriette J Scherpbier, Annemarie M C van Rossum, Dasja Pajkrt

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Immigrant HIV-infected adults in industrialized countries show a poorer clinical and virologic outcome compared with native patients. We aimed to investigate potential differences in clinical, immunological, and virologic outcome in Dutch HIV-infected children born in the Netherlands (NL) versus born in Sub-Saharan Africa (SSA) in a national cohort analysis.

METHODS: We included all HIV-infected children registered between 1996 and 2013. Descriptive statistics, mixed-effects models, and Cox proportional hazard models were used to investigate differences between groups.

RESULTS: In total, 319 HIV-infected children were registered. The majority of these children were born in SSA (n = 148, 47%) or NL (n = 113, 36%) and most were black (n = 158, 61%). Children born in NL were diagnosed at a median age of 1.2 years and initiated combination antiretroviral therapy (cART) at a median age of 2.6 years, compared with 3.7 and 5.3 years, respectively, for children born in SSA (HIV diagnosis: P < 0.001; cART initiation: P < 0.001). Despite a lower initial CD4 T-cell Z-score in children born in SSA, their immunological reconstitution was similar to children from NL. Virologic suppression was achieved in the majority of all cART-treated children (NL: 96%, SSA: 94%). There was no difference in the occurrence or timing of virologic failure.

CONCLUSIONS: Most immigrant HIV-infected children living in NL were born in SSA. Children born in SSA were diagnosed and initiated cART at an older age than children born in NL. Despite initial differences in CD4 T-cell counts and HIV viral load, the long-term immunological and virologic response to cART was similar in both groups.

Original languageEnglish
Pages (from-to)178-185
Number of pages8
JournalJournal of acquired immune deficiency syndromes : JAIDS.
Volume68
Issue number2
DOIs
Publication statusPublished - 1 Feb 2015

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Africa South of the Sahara
Netherlands
Cohort Studies
HIV
Parturition
T-Lymphocytes
Therapeutics
CD4 Lymphocyte Count
Viral Load
Population Groups
Proportional Hazards Models
Developed Countries

Keywords

  • Adult
  • Anti-Retroviral Agents
  • CD4 Lymphocyte Count
  • Child
  • Child, Preschool
  • Cohort Studies
  • Emigrants and Immigrants
  • Ethnic Groups
  • Female
  • HIV Infections
  • Humans
  • Infant
  • Male
  • Netherlands
  • Treatment Outcome
  • Viral Load
  • Comparative Study
  • Journal Article

Cite this

Country of birth does not influence long-term clinical, virologic, and immunological outcome of HIV-infected children living in the Netherlands : a cohort study comparing children born in the Netherlands with children born in Sub-Saharan Africa. / Cohen, Sophie; van Bilsen, Ward P H; Smit, Colette; Fraaij, Pieter L A; Warris, Adilia; Kuijpers, Taco W; Geelen, Sibyl P M; Wolfs, Tom F W; Scherpbier, Henriette J; van Rossum, Annemarie M C; Pajkrt, Dasja.

In: Journal of acquired immune deficiency syndromes : JAIDS. , Vol. 68, No. 2, 01.02.2015, p. 178-185.

Research output: Contribution to journalArticle

Cohen, Sophie ; van Bilsen, Ward P H ; Smit, Colette ; Fraaij, Pieter L A ; Warris, Adilia ; Kuijpers, Taco W ; Geelen, Sibyl P M ; Wolfs, Tom F W ; Scherpbier, Henriette J ; van Rossum, Annemarie M C ; Pajkrt, Dasja. / Country of birth does not influence long-term clinical, virologic, and immunological outcome of HIV-infected children living in the Netherlands : a cohort study comparing children born in the Netherlands with children born in Sub-Saharan Africa. In: Journal of acquired immune deficiency syndromes : JAIDS. . 2015 ; Vol. 68, No. 2. pp. 178-185.
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abstract = "BACKGROUND: Immigrant HIV-infected adults in industrialized countries show a poorer clinical and virologic outcome compared with native patients. We aimed to investigate potential differences in clinical, immunological, and virologic outcome in Dutch HIV-infected children born in the Netherlands (NL) versus born in Sub-Saharan Africa (SSA) in a national cohort analysis.METHODS: We included all HIV-infected children registered between 1996 and 2013. Descriptive statistics, mixed-effects models, and Cox proportional hazard models were used to investigate differences between groups.RESULTS: In total, 319 HIV-infected children were registered. The majority of these children were born in SSA (n = 148, 47{\%}) or NL (n = 113, 36{\%}) and most were black (n = 158, 61{\%}). Children born in NL were diagnosed at a median age of 1.2 years and initiated combination antiretroviral therapy (cART) at a median age of 2.6 years, compared with 3.7 and 5.3 years, respectively, for children born in SSA (HIV diagnosis: P < 0.001; cART initiation: P < 0.001). Despite a lower initial CD4 T-cell Z-score in children born in SSA, their immunological reconstitution was similar to children from NL. Virologic suppression was achieved in the majority of all cART-treated children (NL: 96{\%}, SSA: 94{\%}). There was no difference in the occurrence or timing of virologic failure.CONCLUSIONS: Most immigrant HIV-infected children living in NL were born in SSA. Children born in SSA were diagnosed and initiated cART at an older age than children born in NL. Despite initial differences in CD4 T-cell counts and HIV viral load, the long-term immunological and virologic response to cART was similar in both groups.",
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author = "Sophie Cohen and {van Bilsen}, {Ward P H} and Colette Smit and Fraaij, {Pieter L A} and Adilia Warris and Kuijpers, {Taco W} and Geelen, {Sibyl P M} and Wolfs, {Tom F W} and Scherpbier, {Henriette J} and {van Rossum}, {Annemarie M C} and Dasja Pajkrt",
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T1 - Country of birth does not influence long-term clinical, virologic, and immunological outcome of HIV-infected children living in the Netherlands

T2 - a cohort study comparing children born in the Netherlands with children born in Sub-Saharan Africa

AU - Cohen, Sophie

AU - van Bilsen, Ward P H

AU - Smit, Colette

AU - Fraaij, Pieter L A

AU - Warris, Adilia

AU - Kuijpers, Taco W

AU - Geelen, Sibyl P M

AU - Wolfs, Tom F W

AU - Scherpbier, Henriette J

AU - van Rossum, Annemarie M C

AU - Pajkrt, Dasja

PY - 2015/2/1

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N2 - BACKGROUND: Immigrant HIV-infected adults in industrialized countries show a poorer clinical and virologic outcome compared with native patients. We aimed to investigate potential differences in clinical, immunological, and virologic outcome in Dutch HIV-infected children born in the Netherlands (NL) versus born in Sub-Saharan Africa (SSA) in a national cohort analysis.METHODS: We included all HIV-infected children registered between 1996 and 2013. Descriptive statistics, mixed-effects models, and Cox proportional hazard models were used to investigate differences between groups.RESULTS: In total, 319 HIV-infected children were registered. The majority of these children were born in SSA (n = 148, 47%) or NL (n = 113, 36%) and most were black (n = 158, 61%). Children born in NL were diagnosed at a median age of 1.2 years and initiated combination antiretroviral therapy (cART) at a median age of 2.6 years, compared with 3.7 and 5.3 years, respectively, for children born in SSA (HIV diagnosis: P < 0.001; cART initiation: P < 0.001). Despite a lower initial CD4 T-cell Z-score in children born in SSA, their immunological reconstitution was similar to children from NL. Virologic suppression was achieved in the majority of all cART-treated children (NL: 96%, SSA: 94%). There was no difference in the occurrence or timing of virologic failure.CONCLUSIONS: Most immigrant HIV-infected children living in NL were born in SSA. Children born in SSA were diagnosed and initiated cART at an older age than children born in NL. Despite initial differences in CD4 T-cell counts and HIV viral load, the long-term immunological and virologic response to cART was similar in both groups.

AB - BACKGROUND: Immigrant HIV-infected adults in industrialized countries show a poorer clinical and virologic outcome compared with native patients. We aimed to investigate potential differences in clinical, immunological, and virologic outcome in Dutch HIV-infected children born in the Netherlands (NL) versus born in Sub-Saharan Africa (SSA) in a national cohort analysis.METHODS: We included all HIV-infected children registered between 1996 and 2013. Descriptive statistics, mixed-effects models, and Cox proportional hazard models were used to investigate differences between groups.RESULTS: In total, 319 HIV-infected children were registered. The majority of these children were born in SSA (n = 148, 47%) or NL (n = 113, 36%) and most were black (n = 158, 61%). Children born in NL were diagnosed at a median age of 1.2 years and initiated combination antiretroviral therapy (cART) at a median age of 2.6 years, compared with 3.7 and 5.3 years, respectively, for children born in SSA (HIV diagnosis: P < 0.001; cART initiation: P < 0.001). Despite a lower initial CD4 T-cell Z-score in children born in SSA, their immunological reconstitution was similar to children from NL. Virologic suppression was achieved in the majority of all cART-treated children (NL: 96%, SSA: 94%). There was no difference in the occurrence or timing of virologic failure.CONCLUSIONS: Most immigrant HIV-infected children living in NL were born in SSA. Children born in SSA were diagnosed and initiated cART at an older age than children born in NL. Despite initial differences in CD4 T-cell counts and HIV viral load, the long-term immunological and virologic response to cART was similar in both groups.

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KW - Child, Preschool

KW - Cohort Studies

KW - Emigrants and Immigrants

KW - Ethnic Groups

KW - Female

KW - HIV Infections

KW - Humans

KW - Infant

KW - Male

KW - Netherlands

KW - Treatment Outcome

KW - Viral Load

KW - Comparative Study

KW - Journal Article

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JO - Journal of acquired immune deficiency syndromes : JAIDS.

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SN - 1525-4135

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