Response to HAART according to sex and origin (immigrant vs autochthonous) in a cohort of patients who initiate antiretroviral treatment

Purpose

Although poorly studied, gender differences can affect the efficacy of HAART. Immigrant women (IW) may also be at risk of treatment failure due to greater marginalization, cultural differences, or reduced access to health care. This subanalysis examined differences in baseline characteristics and response to HAART according to sex and geographic origin.

Methods

Subanalysis of GES-5808 (retrospective comparative study autochthonous/immigrant patients initiating HAART Jan05-Dec06). Late diagnosis was defined as a CD4+ count ≥200, and/or AIDS at initiation of HAART. The primary endpoint was time to treatment failure (TTF), which was defined as virological failure (VF), death, opportunistic infection (OI), interruption of HAART, or loss to follow-up. Survival was analyzed using a univariate (Kaplan-Meier) and multivariate (Cox regression) approach.

Results

Patient Characteristics at Initiation of HAART (Table 1)

Table 1

Conclusions

Response to HAART was similar in both sexes. Men started HAART later and women had higher loss to follow-up and more treatment switches. This was even more common among IW. Earlier diagnosis is necessary for men; measures to improve adherence should be promoted among women, especially IW.