Influence of Geographical Origin and Ethnicity on Mortality in Patients on Antiretroviral Therapy in Canada, Europe, and the United States

摘要: Background. Our objective was to assess differences in all-cause mortality, as well AIDS and non-AIDS death rates, among patients started on antiretroviral therapy (ART) according their geographical origin ethnicity/race Europe, Canada, the United States. Methods. This a collaboration of 19 cohort studies human immunodeficiency virus–positive subjects who have initiated ART (ART Cohort Collaboration) between 1998 2009. Adjusted mortality hazard ratios (AHRs) were estimated using Cox regression. A competing risk framework used estimate adjusted subdistribution for mortality. Results. Of 46 648 European patients, 16.3% from sub-Saharan Africa (SSA), 5.1% Caribbean Latin America, 1.6% North Middle East, 1.7% Asia/West; 1371 14.9% First Nations 22.4% migrants, 7742 55.5% African American 6.6% Hispanic. Migrants SSA (AHR, 0.79; 95% confidence interval [CI], .68–.92) Asia/West 0.62; CI, .41–.92) had lower than Europeans; these appeared mainly attributable Compared with white Canadians, Canadian people 1.48; .96– 2.29) higher, both rates. Among US when compared whites, Americans higher increased time ART. Conclusions. The observed migrants suggests “healthy migrant” effects, whereas America social inequality gaps.