TY - JOUR

T1 - Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

AU - EuroSIDA Study Group

AU - Laut, Kamilla

AU - Shepherd, Leah

AU - Radoi, Roxana

AU - Karpov, Igor

AU - Parczewski, Milosz

AU - Mussini, Cristina

AU - Maltez, Fernando

AU - Losso, Marcelo

AU - Chkhartishvili, Nikoloz

AU - Elinav, Hila

AU - Kovari, Helen

AU - Blaxhult, Anders

AU - Zangerle, Robert

AU - Trofimova, Tatiana

AU - Inglot, Malgorzata

AU - Zilmer, Kai

AU - Kuzovatova, Elena

AU - Staub, Thérèse

AU - Raben, Dorthe

AU - Lundgren, Jens

AU - Mocroft, Amanda

AU - Kirk, Ole

N1 - Funding Information: EuroSIDA was supported by the European Union’s Seventh Framework Programme for research, technological development and demonstration under EuroCoord grant agreement no. 260694. Current support includes unrestricted grants by ViiV Healthcare LLC, GlaxoSmithKline R&D Limited, Janssen Scientific Affairs, Janssen R&D, Bristol-Myers Squibb Company, Merck Sharp & Dohme Corp, Gilead Sciences. The participation of centres from Switzerland was supported by The Swiss National Science Foundation (grant 148522). The study is also supported by a grant (grant number DNRF126) from the Danish National Research Foundation. Publisher Copyright: © 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.

PY - 2018/5/24

Y1 - 2018/5/24

N2 - Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004—05, 2009—10 and 2014—15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004—05 (67.8%) to 2014—15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004—05, 87.7% in 2014—15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014—15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014—15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13—0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.

AB - Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004—05, 2009—10 and 2014—15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004—05 (67.8%) to 2014—15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004—05, 87.7% in 2014—15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014—15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014—15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13—0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.

UR - http://www.scopus.com/inward/record.url?scp=85048017363&partnerID=8YFLogxK

U2 - 10.2807/1560-7917.ES.2018.23.21.1700382

DO - 10.2807/1560-7917.ES.2018.23.21.1700382

M3 - Article

C2 - 29845931

AN - SCOPUS:85048017363

VL - 23

JO - Eurosurveillance

JF - Eurosurveillance

SN - 1560-7917

IS - 21

M1 - 1700382

ER -