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Journal of Immigrant and Minority Health

, Volume 21, Issue 6, pp 1342–1348 | Cite as

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

  • Jean-Médard Kankou
  • Olivier Bouchaud
  • Nathalie Lele
  • Marguerite Guiguet
  • Bruno Spire
  • Maria Patrizia Carrieri
  • Sophie AbgrallEmail author
  • ANRS-VIHVO Study Group
Original Paper

Abstract

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.

Keywords

HIV Antiretroviral therapy Virological rebound Migrant Travel Sub-Saharan Africa 

Notes

Acknowledgements

We gratefully acknowledge the contributions of all clinical investigators of the VIHVO study: Michele Bentata (CHU Avicenne, Bobigny, France); Bruno Fantin (CHU Beaujon, Clichy, France); Cécile Goujard (CHU Bicêtre, Le Kremlin-Bicêtre, France); Sophie Matheron (CHU Bichat, Paris, France); Odile Launay (CHU Cochin, Paris, France); Vincent Le Moing (CHU de Montpellier, Montpellier, France); Olivier Lortholary (CHU Necker, Paris, France); Paul- Henri Consigny (CHU Pasteur, Paris, France); Matthieu Saada (Hôpital de Perpignan, Perpignan, France); Christine Katlama, Anne Simon (CHU Pitié-Salpétrière, Paris, France); Cédric Arvieux (CHU de Rennes, Rennes, France); Pauline Campa, Pierre-Marie Girard (CHU Saint-Antoine, Paris, France); Marie-Aude Khuong (Hôpital De Lafontaine, Saint- Denis, France); Jean-Michel Molina, Caroline Lascoux-Combe (CHU Saint-Louis, Paris, France); David Rey, Murielle Rondeau (Hôpital Civil, Strasbourg, France); Gilles Pialoux (CHU Tenon, Paris, France); Carine Couzigou, Daniel Vittecoq (CHU Paul Brousse, Villejuif, France); Olivier Patey (Hôpital de Villeneuve Saint Georges, Villeneuve saint Georges, France); Denis Malvy, Thierry Pistone, Philippe Morlat (CHU Bordeaux, Bordeaux, France); Michel Duong, Pascal Chavanet (CHU Dijon, Dijon, France).

Funding

ANRS (France Recherche Nord & Sud Sida-HIV Hépatites) (Grant ANRS-2005-2).

Compliance with Ethical Standards

Conflict of interest

No conflicts of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Jean-Médard Kankou
    • 1
    • 2
  • Olivier Bouchaud
    • 1
    • 3
  • Nathalie Lele
    • 1
  • Marguerite Guiguet
    • 4
  • Bruno Spire
    • 5
    • 6
    • 7
  • Maria Patrizia Carrieri
    • 5
    • 6
    • 7
  • Sophie Abgrall
    • 8
    • 9
    • 10
    Email author
  • ANRS-VIHVO Study Group
  1. 1.APHP, service de maladies infectieuses et tropicalesHôpital AvicenneBobignyFrance
  2. 2.Laboratoire Parcours Santé Systémique, (PSS, EA 4129)Université Claude Bernard Lyon 1LyonFrance
  3. 3.Université Paris 13BobignyFrance
  4. 4.Univ Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136)Université Pierre et Marie Curie, Sorbonne UniversitésParisFrance
  5. 5.INSERM U912 (SE4S)MarseilleFrance
  6. 6.Université Aix Marseille, IRDMarseilleFrance
  7. 7.ORS PACA, Observatoire Régional de la Santé Provences Alpes Côte d’AzurMarseilleFrance
  8. 8.AP-HP, Service de Médecine interne/Immunologie cliniqueHôpital Antoine BéclèreClamartFrance
  9. 9.Université Paris-Saclay, Univ. Paris-Sud, UVSQLe Kremlin-BicêtreFrance
  10. 10.CESP INSERM U1018Le Kremlin-BicêtreFrance

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