Abstract
Objectives
To assess the effect of migrant status on treatment outcomes among children living with HIV in Europe.
Methods
Children aged < 18 years at the start of antiretroviral therapy (ART) in European paediatric HIV observational cohorts where ≥ 5% of children were migrants (defined as born abroad) were included. Three outcomes were considered: (i) severe immunosuppression‐for‐age; (ii) viraemic viral load (≥ 400 copies/mL) at 1 year after ART initiation; and (iii) AIDS/death after ART initiation. The effect of migrant status was assessed using univariable and multivariable logistic and Cox models.
Results
Of 2620 children included across 12 European countries, 56% were migrants. At ART initiation, migrant children were older than domestic‐born children (median 6.1 vs. 0.9 years, p < 0.001), with slightly higher proportions being severely immunocompromised (35% vs. 33%) and with active tuberculosis (2% vs. 1%), but a lower proportion with an AIDS diagnosis (14% vs. 19%) (all p < 0.001). At 1 year after beginning ART, a lower proportion of migrant children were viraemic (18% vs. 24%) but there was no difference in multivariable analysis (p = 0.702), and no difference in severe immunosuppression (p = 0.409). However, there was a trend towards higher risk of AIDS/death in migrant children (adjusted hazard ratio = 1.51, 95% confidence interval: 0.96–2.38, p = 0.072).
Conclusions
After adjusting for characteristics at ART initiation, migrant children have virological and immunological outcomes at 1 year of ART that are comparable to those who are domestic‐born, possibly indicating equity in access to healthcare in Europe. However, there was some evidence of a difference in AIDS‐free survival, which warrants further monitoring.
Keywords: children, Europe, HIV, migrant, mortality
INTRODUCTION
Migrants are a key population affected by HIV across Europe [1]. Migrant adults diagnosed with HIV in Europe are more likely to have advanced disease with low CD4 count and/or AIDS diagnoses at first presentation or at initiation of antiretroviral therapy (ART) compared with their domestic‐born counterparts [2, 3, 4]. Once on treatment, they may experience a higher risk of disease progression and poorer retention in care [5, 6, 7, 8].
There are, however, few comparable data in children living with HIV in Europe. With improved access to prevention of vertical transmission services in Europe over the last two decades, fewer children born domestically have HIV, and an increasing proportion of children living with HIV in Europe in recent years were born abroad, mostly in sub‐Saharan Africa [9, 10]. Understanding the health outcomes of this group is therefore of increasing importance. The largest European study to date investigating outcomes in migrant children is from the Netherlands. That study reported a higher risk of low CD4 count at diagnosis but comparable immunological and virological outcomes on ART in those born in sub‐Saharan Africa compared with domestic‐born children [11]; however it was limited by inclusion of patients from only one country, so further research across Europe is required.
In this study, we utilized patient‐level data from paediatric HIV observational cohorts in the European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC) to describe characteristics of migrant and domestic‐born children receiving routine HIV care across Europe, and to assess the effect of migrant status on immunological and virological outcomes after ART initiation and AIDS‐free survival.
METHODS
The inclusion criteria for this analysis were age < 18 years and treatment‐naïve at initiation of combination antiretroviral therapy (ART) [defined as three or more drugs from two or more classes (excluding unboosted protease inhibitors (PIs)), or three or more nucleoside reverse transcriptase inhibitors (NRTIs) including abacavir] from 1996 onwards, with follow‐up data through to 1 October 2016.
Migrant status was defined as having been born outside of the country of the cohort versus domestic‐born, and children with unknown migrant status were excluded. This analysis was restricted to cohorts where ≥ 5% of patients were migrants (12 cohorts of 16 were included; excluded cohorts were from Romania, Russia, Thailand, Ukraine). Individual patient‐level demographic, clinical and ART‐related data were pooled using a modified HIV Cohort Data Exchange Protocol (www.hicdep.org).
Univariable and multivariable analysis was used to explore the effect of migrant status on three outcomes: (i) severe immunosuppression and (ii) non‐suppressed viral load (VL) at 1 year after ART initiation, using logistic regression; and (iii) among children AIDS‐free at the start of ART, AIDS‐free survival after ART initiation, using Cox models.
Severe immunosuppression for age was based on the World Health Organization (WHO) definition: CD4 < 25% for children aged < 1 year; < 20% for 1 to < 3 years; < 15% for 3 to < 5 years; < 200 cells/µL or < 15% for ≥ 5 years [12]. Non‐suppressed VL was defined as ≥ 400 HIV RNA copies/mL, and ≥ 50 copies/mL in sensitivity analyses. The closest CD4 and VL measurements to 1 year after ART initiation, within a window between 9 and 15 months, were used. Patients with < 1 year of follow‐up after ART initiation were excluded from this analysis.
Analysis of AIDS‐free survival was restricted to children who were AIDS‐free at ART initiation. We assessed time to first AIDS‐defining event [Centers for Disease Control and Prevention (CDC) 2014 definition [13]] or death as a combined outcome due to few events. Children were considered at risk from ART initiation and were censored at the earliest of last visit in paediatric care or 21st birthday. In sensitivity analysis, children with prior AIDS diagnoses were included, with an outcome of new AIDS event/death.
In multivariable analyses, estimates of the effect of migrant status were adjusted for the following potential confounders: sex; year of birth; mode of HIV acquisition; initial ART regimen; region; calendar year, age, weight‐for‐age z‐score (WAZ), and severe immunosuppression at ART initiation. For WAZ and severe immunosuppression, measurements between 6 months before and 1 month after ART initiation were used. WAZ was based on the British 1990 growth charts [14]. Interactions between migrant status and year of birth, and non‐proportional hazards for the analysis of AIDS‐free survival were considered. Missing CD4 and weight values at ART initiation were imputed, with 20 imputed datasets created, applying Rubin's rules [15]. Sensitivity analyses compared outcomes among migrants born in sub‐Saharan Africa against those who were domestic‐born. All analyses were performed using Stata 15.0 (StataCorp, College Station, TX, USA).
RESULTS
Of 2651 children followed in the eligible cohorts, 31 (1%) were excluded due to unknown migrant status. Of the remaining 2620, 1474 (56%) children were migrants; the proportion of migrants within each country ranged from 5% in Greece and Poland to 98% in Sweden (Table 1). Of 1161 migrant children with recorded country of birth, 980 (84%) were born in sub‐Saharan Africa, 71 (6%) in Europe and 110 (9%) elsewhere. The median (interquartile range, IQR) durations of follow‐up on ART among migrant and domestic‐born children were 6.2 (3.4–9.2) and 7.8 (4.1–11.4) years, respectively (p < 0.001).
TABLE 1.
Demographics, characteristics at antiretroviral therapy (ART) initiation and follow‐up status, by migrant status
| Domestic‐born (N = 1146; 44%) | Migrant (N = 1474; 56%) | p | |
|---|---|---|---|
| n (%) or median (IQR) | |||
| Demographics | |||
| Country of current residence | |||
| Belgium | 9 (11%) | 72 (89%) | < 0.001 |
| France | 91 (71%) | 37 (29%) | |
| Greece | 18 (95%) | 1 (5%) | |
| Italy | 160 (55%) | 130 (45%) | |
| The Netherlands | 50 (24%) | 162 (76%) | |
| Poland | 54 (95%) | 3 (5%) | |
| Portugal | 24 (73%) | 9 (27%) | |
| Spain | 173 (60%) | 117 (40%) | |
| Sweden | 2 (2%) | 84 (98%) | |
| Switzerland | 27 (66%) | 14 (34%) | |
| UK and Ireland | 538 (39%) | 845 (61%) | |
| Female sex | 633 (55%) | 752 (51%) | 0.050 |
| Ethnicity | |||
| Black | 440 (38%) | 983 (67%) | < 0.001 |
| Other | 373 (33%) | 144 (10%) | |
| Missing | 333 (29%) | 347 (24%) | |
| Mode of HIV acquisition | |||
| Vertical | 1108 (97%) | 1258 (85%) | < 0.001 |
| Other | 8 (1%) | 66 (4%) | |
| Missing | 30 (3%) | 150 (10%) | |
| Year of birth | |||
| < 2003 | 638 (56%) | 1131 (77%) | < 0.001 |
| ≥ 2003 | 508 (44%) | 343 (23%) | |
| Place of birth | |||
| Sub‐Saharan Africa | – | 980 (66%) | – |
| Europe | – | 71 (6%) | |
| Other | – | 110 (7%) | |
| Missing | – | 313 (21%) | |
| Age at HIV diagnosis (years) | |||
| N | 916 | 1244 | < 0.001 |
| Median (IQR) | 0.8 (0.2–3.2) | 6.2 (2.8–10.0) | |
| Characteristics at ART initiation | |||
| Calendar year | |||
| Before 2004 | 371 (32%) | 354 (24%) | < 0.001 |
| 2004–2007 | 360 (31%) | 457 (31%) | |
| 2008 or later | 415 (36%) | 663 (45%) | |
| Time between HIV diagnosis and ART initiation (months) | |||
| N | 916 | 1244 | 0.001 |
| Median (IQR) | 2.0 (0.6–22.0) | 3.9 (0.9–26.4) | |
| Age (years) | |||
| Median (IQR) | 1.8 (0.3–7.6) | 8.2 (4.0–12.0) | < 0.001 |
| ≤ 2 | 658 (57%) | 285 (19%) | < 0.001 |
| 3–10 | 290 (25%) | 620 (42%) | |
| ≥ 11 | 198 (18%) | 569 (39%) | |
| Severe immunosuppression | |||
| Yes | 379 (33%) | 519 (35%) | < 0.001 |
| No | 573 (50%) | 567 (38%) | |
| Missing | 194 (17%) | 388 (26%) | |
| Severe wasting (weight for age z‐score < −2) | |||
| Yes | 131 (11%) | 119 (8%) | 0.001 |
| No | 602 (53%) | 735 (50%) | |
| Missing | 413 (36%) | 620 (42%) | |
| Tuberculosis disease | 7 (1%) | 36 (2%) | < 0.001 |
| AIDS diagnosis | 219 (19%) | 210 (14%) | 0.003 |
| Initial ART regimen | |||
| Boosted PI‐based | 407 (36%) | 494 (34%) | 0.016 |
| NNRTI‐based | 658 (57%) | 911 (62%) | |
| NRTI only | 42 (4%) | 30 (2%) | |
| Other | 39 (3%) | 39 (3%) | |
| Follow‐up status | |||
| Duration of follow‐up (years) | |||
| Median (IQR) | 7.8 (4.1–11.4) | 6.2 (3.4–9.2) | < 0.001 |
| Follow‐up status | |||
| Still in paediatric care | 635 (55%) | 724 (49%) | < 0.001 |
| Transferred to adult care | 207 (18%) | 455 (31%) | |
| Censored at 21st birthday | 86 (8%) | 72 (5%) | |
| Dropped out | 60 (5%) | 89 (6%) | |
| Lost to follow‐up | 141 (12%) | 111 (8%) | |
| Died | 17 (1%) | 23 (2%) | |
Abbreviations: IQR, interquartile range; NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, non‐NRTI; PI, protease inhibitor.
Migrant children were, on average, born in earlier calendar years than domestic‐born children (77% vs. 56% born before 2003, p < 0.001), significantly older at HIV diagnosis [median (IQR) age, 6.1 (2.7–9.9) vs. 0.9 (0.2–3.3) years, p < 0.001], and at ART initiation [8.2 (4.0–12.0) vs. 1.8 (0.3–7.6) years, p < 0.001]. More migrant children had missing CD4 at ART initiation (26% vs. 17%); among those with data available, a larger proportion were severely immunocompromised compared with domestic‐born children (48% vs. 40%, p < 0.001). A lower proportion of migrant children had an AIDS diagnosis by ART initiation (14% vs. 19%, p = 0.003), and active tuberculosis was rare in all children starting ART but was slightly more common in migrant children (2% vs. 1%, p < 0.001).
Non‐suppressed VL and severe immunosuppression at 1 year after ART start
At 1 year on ART, lower proportions of migrant children had available VL and CD4 measurements compared with domestic‐born children [74% and 85% had a VL available, respectively (p < 0.001), and 73% and 82% had a CD4 measurement (p < 0.001); Table 2].
TABLE 2.
Effect of migrant status on non‐suppressed viral load, severe immunosuppression and first AIDS event/death at 1 year after antiretroviral therapy (ART) initiation
| Number with outcome available | Number meeting outcome | Univariable | Multivariable a | |||||
|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p‐value | aOR | 95% CI | p‐value | |||
| Non‐suppressed viral load (≥ 400 copies/mL) at 1 year after ART initiation | ||||||||
| Domestic‐born | 906/1065 (85%) | 216/906 (24%) | 1 | – | 0.002 | 1 | – | 0.702 |
| Migrant | 1016/1367 (74%) | 183/1016 (18%) | 0.70 | 0.56–0.88 | 0.95 | 0.71–1.26 | ||
| Severe immunosuppression at 1 year after ART initiation | ||||||||
| Domestic‐born | 869/1065 (82%) | 53/869 (6%) | 1 | – | 0.174 | 1 | – | 0.409 |
| Migrant | 999/1367 (73%) | 77/999 (8%) | 1.29 | 0.90–1.85 | 0.82 | 0.52–1.30 | ||
| HR | 95% CI | p‐value | aHR | 95% CI | P‐value | |||
|---|---|---|---|---|---|---|---|---|
| First AIDS event/death | ||||||||
| Domestic‐born | – | 49/918 (5%) | 1 | – | 0.206 | 1 | – | 0.072 |
| Migrant | – | 81/1255 (6%) | 1.26 | 0.88–1.79 | 1.51 | 0.96–2.38 | ||
Abbreviations: (a)HR, (adjusted) hazard ratio; (a)OR, (adjusted) odds ratio; CI, confidence interval.
Adjusted for: sex; grouped year of birth; mode of HIV acquisition; initial ART regimen; region; and grouped year of cART initiation, age group, weight‐for‐age z‐score and severe immunosuppression at ART initiation.
Among those with a VL measurement at 1 year, 18% of migrant children versus 24% of domestic‐born children had VL ≥ 400 copies/mL (Table 2) [odds ratio (OR) = 0.70 for migrant children vs. domestic‐born, 95% confidence interval (CI): 0.56–0.88, p = 0.002]. However, this difference did not remain in multivariable analysis [adjusted OR (aOR) = 0.95, 95% CI: 0.71–1.26, p = 0.702], with adjustment for age and calendar year of ART initiation being the biggest confounders. Results were similar in sensitivity analyses using VL ≥ 50 copies/mL (aOR = 1.02, 95% CI: 0.81–1.28) (data not shown).
Among those with a CD4 measurement available at 1 year, similar proportions of migrant and domestic‐born children had severe immunosuppression (8% and 6%, respectively; p > 0.1 in univariable and multivariable analyses).
In multivariable analysis there was no evidence of an interaction between migrant status and year of birth on either outcome (both p > 0.4).
Results when considering only migrants born in sub‐Saharan Africa were similar (Table S1).
AIDS‐free survival after ART start
Of the 2620 children initiating ART, 423 (16%) were excluded from the main analysis of AIDS‐free survival as they already had an AIDS diagnosis when beginning ART, and a further 24 children (13 domestic‐born and 11 migrant) were excluded due to unknown date of an AIDS‐defining event. Among the remaining 2173 children who were AIDS‐free at ART initiation, 120 (6%; 47 domestic‐born and 73 migrants) had an AIDS event and 15 died (1%; three domestic‐born and 12 migrant – of whom five also had an AIDS event). Overall, 5% of domestic‐born and 6% of migrant children experienced the composite outcome of AIDS/death by the end of follow‐up. The most common AIDS events were encephalopathy (40%) and tuberculosis (21%) among domestic‐born and migrant children respectively (Table S2). Of the 15 deaths, six (40%) were caused by an HIV‐related infection, four (27%) had another HIV‐related cause, three (20%) were not directly HIV‐related and the cause was unknown for the remaining two (13%), with no difference in cause by migrant status (p = 0.577) (Table S3).
At 5 years after ART initiation, the probability of AIDS‐free survival was 94% (95% CI: 93–95%), with no difference by migrant status (log‐rank test p = 0.206) (Figure S1). The rates of AIDS/death after starting ART were 7.4 (95% CI: 5.6–9.8) per 1000 patient‐years of follow up among domestic‐born, and 10.6 (8.5–13.1) among migrant children (p = 0.052). In multivariable analysis, there was some evidence of an independent effect of migrant status on risk of AIDS/death [adjusted hazard ratio (aHR) = 1.51, 95% CI: 0.96–2.38, p = 0.072; Table 2]. There was no evidence of non‐proportional hazards. In sensitivity analysis including children with an AIDS diagnosis prior to ART initiation, the trend was weaker (aHR = 1.24, 95% CI: 0.86–1.78, p = 0.251; data not shown). In sensitivity analysis restricted to migrants born in sub‐Saharan Africa there was evidence of an increased risk of AIDS/death (aHR = 1.84, 95% CI: 1.12–3.01, p = 0.017) (Table S1).
DISCUSSION
This study is one of the largest to date to explore the effect of migrant status on clinical outcomes on ART in children living with HIV across Europe, with data on over 2600 children from 12 countries. Migrants in this study were predominantly from sub‐Saharan Africa, and were older at treatment initiation with a slightly higher proportion with poor immunological status at ART start compared with domestic‐born children, comparable to findings reported in other paediatric studies [16]. However, the clinical outcomes in terms of immune and virological response at 1 year after ART initiation were similar between migrant and domestic‐born children, after adjustment for key characteristics, in particular age and calendar year of ART initiation. These findings are consistent with a stand‐alone analysis from the Dutch paediatric HIV cohort (patients from which were included here), which reported no difference by migrant status in long‐term immune and viral response by 5 years on ART [11]. However, in our cohort, in the adjusted analysis there was some evidence of a trend towards increased risk of AIDS or death among migrant children who were AIDS‐free at ART initiation, indicating a possible difference in longer‐term clinical outcomes on ART in this larger multi‐country cohort. This difference was greater when analysis was restricted to migrants born in sub‐Saharan Africa. Further monitoring is required, in particular as children and adolescents move into young adulthood and transition to adult HIV care [17]. In addition, tuberculosis represented a higher proportion of the reported AIDS events among migrants, highlighting the need for screening and treatment of latent tuberculosis infection in this population.
Many adult HIV studies in western Europe have reported that migrants are at higher risk of late diagnosis and ART initiation (as observed in our cohort), although this does not always translate to poorer outcomes on treatment. One large study reported no difference in mortality by migrant status among men who have sex with men and heterosexual men, but higher risk of death was observed among migrant women with heterosexual mode of HIV acquisition from some geographical regions, and increased risk among migrant people who inject drugs [5]. This probably reflects important differences in health access and health‐seeking behaviour across different adult populations. A study of pregnant women with HIV in Europe also reported a higher risk of late HIV diagnosis and low CD4 among migrant women as compared with domestic‐born populations; however, there was no difference in detectable VL at delivery once on ART [18]. This may suggest equity in continuing access to care once initially linked.
This study has several limitations. First, there may be survivor bias of migrant children who survived the high mortality period of early infancy without ART [19], and were well enough to migrate. This may contribute to the lack of observed difference in the clinical outcomes in our study [20]. Further, we have not considered differences in access to ART. Second, migrant children were less likely to have CD4 and VL data available at ART initiation; if these data were not missing in a random way, this may have biased our multivariable model results, in either direction. Similarly, there may have been missing AIDS events and incomplete ART history, particularly in the migrant population, for whom ART use in their country of origin may not have been reported. Third, children classified as a migrant here represent a heterogeneous population from a range of countries/regions with no data on socioeconomic, orphan/adoption status available. Further, we have not considered second‐generation migrants. Finally, the analyses did not explore longer‐term immune and virological response, or differences in non‐HIV‐related conditions.
In conclusion, despite generally poorer characteristics at initiation, early immunological and virological response to treatment were similar between migrant and domestic‐born children living with HIV in Europe after adjustment for key characteristics. However, there was some evidence of an increased risk of AIDS with longer duration on ART among migrant children, which warrants further monitoring.
CONFLICT OF INTEREST
CT reports grant funding via the Penta Foundation from ViiV Healthcare and Merck and receipt of honoraria/consultation fees from ViiV Healthcare. IJC and AJ report grants from Abbvie, Gilead Sciences and ViiV Healthcare through the Penta Foundation, and from the Collaborative Initiative for Paediatric HIV Education and Research and Penta Foundation outside the submitted work; all monies were paid to their institution. EC reports grant funding via Penta Foundation from ViiV Healthcare.
AUTHOR CONTRIBUTIONS
MVK, RLG, IJC, LCR conceived the project. AJ, IJC, RLG, SC, EC, LG, TG, ANJ, HS, CS, AB, MLN, JTR, JW, VS, EC, EV, FP, CK, MM, LM, LN and CT contributed to the collection of the data. The statistical analysis was conducted by MVK and EC. All authors are members of the EPPICC Migrant Project Team or Writing Committee, critically appraised the manuscript, and approved its submission.
Supporting information
Figure S1 Kaplan–Meier plot of AIDS‐free survival after ART initiation, by migrant status
Table S1 First AIDS event after ART initiation, by migrant status
Table S2 Causes of death, by migrant status
Table S3 Effect of migrant status on non‐suppressed viral load, severe immunosuppression and first AIDS event/death at 1 year after ART initiation, restricted to only migrants born in sub‐Saharan Africa.
ACKNOWLEDGMENTS
This article is based on MKV's dissertation in part fulfilment of the requirements for the degree of an MSc in Epidemiology at the London School of Hygiene and Tropical Medicine in 2016.
Project team (ordered by contribution, apart from last author): Elizabeth Chappell (EPPICC statistician); Malte Kohns Vasconcelos; Ruth Goodall (EPPICC senior statistician); Luisa Galli (Italian Register for HIV infection in children, Italy); Tessa Goetghebuer (Hospital St Pierre Cohort, Brussels, Belgium); Antoni Noguera‐Julian (CoRISPE‐cat cohort, Spain); Laura Rodrigues; Henriette Scherpbier (ATHENA paediatric cohort, Netherlands); Ali Judd (EPPICC paediatric co‐lead); Intira Jeannie Collins (EPPICC paediatric co‐lead)
Other writing group members (ordered alphabetically by cohort name): Colette Smit, (ATHENA paediatric cohort, Netherlands); Alasdair Bamford, Siobhan Crichton (Collaborative HIV Paediatric Study (CHIPS) and Integrated Screening Outcome Surveillance Service (ISOSS), UK and Ireland); Marissa Navarro Gomez, Jose T. Ramos (CoRISPE‐S, rest of Spain cohort, Spain); Josiane Warszawski (French Perinatal Cohort Study, France); Vana Spolou (Greece Cohort, Greece); Elena Chiappini, Elisabetta Venturini (Italian Register for HIV infection in children, Italy); Filipa Prata (Hospital de Santa Maria/CHULN, Lisbon, Portugal); Christian Kahlert (Swiss Mother and Child HIV Cohort Study, Switzerland); Magdalena Marczynska (Polish paediatric cohort, Poland); Laura Marques (Centro Hospitalar do Porto, Portugal); Lars Naver (Karolinska University Hospital, Stockholm, Sweden); Claire Thorne (European Collaborative Study); Diana M. Gibb, Carlo Giaquinto (EPPICC/Penta Foundation)
EPPICC/PENTA Co‐ordinating Team: Elizabeth Chappell, Intira Jeannie Collins, Siobhan Critchton, Charlotte Duff, Carlo Giaquinto, Ruth Goodall, Daniel Gomezpena, Charlotte Jackson, Ali Judd, Rebecca Lundin, Laura Mangiarini, Edith Milanzi, Alessandra Nardone, Claire Thorne
Collaborating cohorts
Belgium: Hopital St Pierre Cohort, Brussels: Tessa Goetghebuer, MD, PhD; Marc Hainaut, MD PhD; Evelyne Van der Kelen, research nurse; Marc Delforge, data manager.
France: French Perinatal Cohort Study/Enquête Périnatale Française, ANRS EPF‐CO10. Coordinating center, INSERM U1018, team 4: Josiane Warszawski, Jerome Le Chenadec, Elisa Ramos, Olivia Dialla, Thierry Wack, Corine Laurent, Lamya Ait si Selmi, Isabelle Leymarie, Fazia Ait Benali, Maud Brossard, Leila Boufassa.
Participating sites (hospital name, city, main investigator): Hôpital Louis Mourier, Colombes, Dr Corinne Floch‐Tudal; Groupe Hospitalier Cochin Tarnier Port‐Royal, PARIS, Dr Ghislaine Firtion; Centre Hospitalier Intercommunal, Creteil, Dr Isabelle Hau; Centre Hospitalier Général, Villeneuve Saint Georges, Dr Anne Chace; Centre Hospitalier Général‐ Hôpital Delafontaine, Saint‐Denis, Dr Pascal Bolot; Groupe Hospitalier Necker, Paris, Pr Stéphane Blanche; Centre hospitalier Francilien Sud, Corbeil Essonne, Dr Michèle Granier; Hôpital Antoine Béclère, Clamart, Pr Philippe Labrune; Hôpital Jean Verdier, Bondy, Dr Eric Lachassine; Hôpital Trousseau, Paris, Dr Catherine Dollfus; Hôpital Robert Debré, Paris, Dr Martine Levine; Hôpital Bicêtre, Le Kremlin Bicëtre, Dr Corinne Fourcade; Centre Hospitalier Intercommunal, Montreuil, Dr Brigitte Heller‐Roussin; Centre Hospitalier Pellegrin, Bordeaux, Dr Camille Runel‐Belliard; CHU Paule de Viguier, Toulouse, Dr Joëlle Tricoire; CHU Hôpital de l'Archet II, Nice, Dr Fabrice Monpoux; Groupe Hospitalier de la Timone, Marseille; CHU Hôpital Jean Minjoz, Besancon, Dr Catherine Chirouze; CHU Nantes Hotel Dieu, Nantes, Dr Véronique Reliquet; CHU Caen, Caen, Pr Jacques Brouard; Institut d'Hématologie et Oncologie Pédiatrique, Lyon, Dr Kamila Kebaili; CHU Angers, Angers, Dr Pascale Fialaire; CHR Arnaud de Villeneuve, Montpellier, Dr Muriel Lalande; CHR Jeanne de Flandres, Lille, Dr Françoise Mazingue; Hôpital Civil, Strasbourg, Dr Maria Luisa Partisani.
Greece: Greek cohort: Vana Spoulou.
Italy: Italian Register for HIV infection in Children. Coordinators: Maurizio de Martino, Luisa Galli (Florence), Pier Angelo Tovo, Clara Gabiano (Turin). Participants: Ines Carloni (Ancona), Domenico Larovere (Bari), Francesco Baldi, Angela Miniaci, Andrea Pession (Bologna) Raffaele Badolato (Brescia), Grazia Pantò (Catania), Elisa Anastasio (Catanzaro), Carlotta Montagnani, Elisabetta Venturini, Leila Bianchi (Florence), Alessandra Allodi, Antonio Di Biagio, Sara Grignolo (Genua), Vania Giacomet, Paola Marchisio, Giuseppe Banderali, Claudia Tagliabue (Milan), Monica Cellini (Modena), Eugenia Bruzzese, Pasquale Di Costanzo, Andrea Lo Vecchio (Naples), Carlo Giaquinto, Daniele Donà, Osvalda Rampon, (Padua), Amelia Romano (Palermo), Icilio Dodi, Susanna Esposito (Parma), Valentina Zuccaro, Domenico Zanaboni (Pavia), Rita Consolini (Pisa), Stefania Bernardi, Orazio Genovese (Rome), Letizia Cristiano (Taranto), Antonio Mazza (Trento), Silvia Garazzino, Federica Mignone, Erika Silvestro (Turin), Vincenzo Portelli (Trapani).
The Netherlands: The ATHENA cohort is managed by Stichting HIV Monitoring and supported by a grant from the Dutch Ministry of Health, Welfare and Sport through the Centre for Infectious Disease Control of the National Institute for Public Health and the Environment.
Clinical centres (paediatric care)
Emma Kinderziekenhuis (Amsterdam UMC, AMC site): HIV‐treating physicians: M. van der Kuip, DPajkrt H.J. Scherpbier. HIV nurse consultants: C. de Boer, A.M. Weijsenfeld. HIV clinical virologists/chemists: S. Jurriaans, N.K.T. Back, H.L. Zaaijer, B. Berkhout, M.T.E. Cornelissen, C.J. Schinkel, K.C. Wolthers. Erasmus MC–Sophia, Rotterdam: HIV‐treating physicians: P.L.A. Fraaij, A.M.C. van Rossum, C.L. Vermont. HIV nurse consultants: L.C. van der Knaap, EVisser. HIV clinical virologists/chemists: C.A.B. Boucher, M.P.G. Koopmans, J.J.A. van Kampen. Radboudumc, Nijmegen: HIV‐treating physicians: S.S.V. Henriet, M. K. van Aerde. HIV nurse consultants: RStrik‐Albers. HIV clinical virologists/chemists: JRahamat‐Langendoen, F.F. Stelma. HIV clinical pharmacology consultant: DBurger. Universitair Medisch Centrum Groningen/Beatrix Kinderziekenhuis, Groningen: HIV‐treating physicians: E.H. Schölvinck, A.R. Verhage. HIV nurse consultants: Hde Groot‐de Jonge. HIV clinical virologists/chemists: H.G.M. Niesters, C.C. van Leer‐Buter, MKnoester. Wilhelmina Kinderziekenhuis, UMC Utrecht, Utrecht: HIV‐treating physicians: L.J. Bont, S.P.M. Geelen, Y.G.T. Loeffen, T.F.W. Wolfs. HIV nurse consultants: N. Nauta. HIV clinical virologists/chemists: RSchuurman, L.M. Hofstra, A.M.J. Wensing.
Coordinating centre
Director: PReiss. Deputy director: SZaheri. Data analysis: A.C. Boyd, D.O. Bezemer, A.I. van Sighem, C. Smit, F.W.M.N. Wit. Data management and quality control: M.M.J. Hillebregt, T.J. Woudstra. Data monitoring: DBergsma, L. van de Sande, TRutkens, S. van der Vliet, K.J Lelivelt, A Scheijgrond. Data collection: Lde Groot, M. van den Akker, Y. Bakker, A. EI Berkaoui, M. Bezemer, N. Brétin, E. Djoechro, M. Groters, E. Kruijne, K.J. Lelivelt, C. Lodewijk, E. Lucas, L. Munjishvili, F. Paling, B. Peeck, C. Ree, R. Regtop, Y. Ruijs, M. Schoorl, P. Schnörr, E. Tuijn, L. Veenenberg, K.M. Visser, E.C. Witte. Patient registration: YRuijs.
Poland: Polish paediatric cohort: Head of the team: Prof Magdalena Marczyńska, MD, PhD. Members of the team: Jolanta Popielska, MD, PhD; Maria Pokorska‐Śpiewak, MD, PhD; Agnieszka Ołdakowska, MD, PhD; Konrad Zawadka, MD, PhD; Urszula Coupland, MD, PhD. Administration assistant: Małgorzata Doroba. Affiliation: Medical University of Warsaw, Poland, Department of Children's Infectious Diseases; Hospital of Infectious Diseases in Warsaw, Poland.
Portugal: Centro Hospitalar Universitário do Porto: Laura Marques, Carla Teixeira, Alexandre Fernandes.
Portugal: Hospital de Santa Maria/CHULN: Filipa Prata.
Spain: CoRISPE‐cat, Catalonia: CoRISPE‐cat receives financial support from the Instituto de Salud Carlos III through the Red Temática de Investigación Cooperativa en Sida (grant numbers RED RIS RD06/0006/0035 yRD06/0006/0021). Members: Hospital Universitari Vall d'Hebron, Barcelona (Pere Soler‐Palacín, Maria Antoinette Frick and Santiago Pérez‐Hoyos (statistician)), Hospital Universitari del Mar, Barcelona (Antonio Mur, Núria López), Hospital Universitari Germans Trias i Pujol, Badalona (María Méndez), Hospital Universitari JosepTrueta, Girona (Lluís Mayol), Hospital Universitari Arnau de Vilanova, Lleida (Teresa Vallmanya), Hospital Universitari Joan XXIII, Tarragona (Olga Calavia), Consorci Sanitari del Maresme, Mataró (Lourdes García), Hospital General de Granollers (Maite Coll), Corporació Sanitària Parc Taulí, Sabadell (Valentí Pineda), Hospital Universitari Sant Joan, Reus (Neus Rius), Fundació Althaia, Manresa (Núria Rovira), Hospital Son Espases, Mallorca (Joaquín Dueñas) and Hospital Sant Joan de Déu, Esplugues (Clàudia Fortuny, Antoni Noguera‐Julian).
Spain: CoRISPE‐S and Madrid cohort: María José Mellado, Luis Escosa, Milagros García Hortelano, Talía Sainz (Hospital Universitario La Paz, Madrid); María Isabel González‐Tomé, Pablo Rojo, Daniel Blázquez, Luis Prieto‐Tato, Cristina Epalza (Hospital Universitario Doce de Octubre, Madrid); José Tomás Ramos (Hospital Clínico San Carlos, Madrid); Sara Guillén (Hospital Universitario de Getafe, Madrid); María Luisa Navarro, Jesús Saavedra, Mar Santos, Begoña Santiago, Santiago Jimenez de Ory, Itzíar Carrasco, Mª Angeles Muñoz‐Fernández (Hospital Universitario Gregorio Marañón, Madrid); Miguel Ángel Roa (Hospital Universitario de Móstoles, Madrid); María Penín (Hospital Universitario Príncipe de Asturias de Alcalá de Henares, Madrid); Jorge Martínez (Hospital Infantil Universitario Niño Jesús, Madrid); Katie Badillo (Hospital Universitario de Torrejón, Madrid); Eider Oñate (Hospital Universitario Donostia, Guipúzcoa); Itziar Pocheville (Hospital Universitario Cruces, Vizcaya); Elisa Garrote (Hospital Universitario Basurto, Vizcaya); Elena Colino (Hospital Insular Materno Infantil, Gran Canaria); Jorge Gómez Sirvent (Hospital Universitario Virgen de la Candelaria, Tenerife); Mónica Garzón, Vicente Román (Hospital General, Lanzarote); Raquel Angulo (Hospital de Poniente de El Ejido, Almería); Olaf Neth, Lola Falcón (Hospital Universitario Virgen del Rocío, Sevilla); Pedro Terol (Hospital Universitario Virgen de la Macarena, Sevilla); Juan Luis Santos (Hospital Universitario Virgen de las Nieves, Granada); David Moreno (Hospital Regional Universitario Carlos Haya, Málaga); Francisco Lendínez (Complejo Hospitalario Torrecárdenas, Almería); Estrella Peromingo (Hospital Universitario Puerta del Mar, Cádiz); José Uberos (Hospital Clínico San Cecilio, Granada); Beatriz Ruiz (Hospital Universitario Reina Sofía de Córdoba); Ana Grande (Complejo Hospitalario Universitario Infanta Cristina, Badajoz); Francisco José Romero (Complejo Hospitalario, Cáceres); Carlos Pérez (Hospital de Cabueñes, Asturias); Miguel Lillo (Complejo Hospitalario Universitario, Albacete); Begoña Losada (Hospital Virgen de la Salud, Toledo); Mercedes Herranz (Hospital Virgen del Camino, Navarra); Matilde Bustillo (Hospital Universitario Miguel Servet, Zaragoza); Pilar Collado (Hospital Clínico Universitario Lozano Blesa, Zaragoza); José Antonio Couceiro (Complejo Hospitalario Universitario, Pontevedra); Leticia Vila (Complejo Hospitalario Universitario, La Coruña); Consuelo Calviño (Hospital Universitario Lucus Augusti, Lugo); Ana Isabel Piqueras, Manuel Oltra (Hospital Universitario La Fe, Valencia); César Gavilán (Hospital Universitario de San Juan de Alicante, Alicante); Elena Montesinos (Hospital General Universitario, Valencia); Marta Dapena (Hospital General, Castellón); Cristina Álvarez, Beatriz Jiménez (Hospital Universitario Marqués de Valdecilla, Cantabria); Ana Gloria Andrés (Complejo Hospitalario, León); Víctor Marugán, Carlos Ochoa (Complejo Hospitalario, Zamora); Santiago Alfayate, Ana Isabel Menasalvas (Hospital Universitario Virgen de la Arrixaca, Murcia); Yolanda Ruiz del Prado (Complejo Hospitalario San Millán‐San Pedro, la Rioja) and Paediatric HIV‐BioBank integrated in the Spanish AIDS Research Network and collaborating Centers. Financial support for CoRISpeS and Madrid Cohort was provided by the Instituto de Salud Carlos III through the Red Tematica de Investigacion Cooperativa en Sida (RED‐RIS) project as part of the Plan R+D+I and cofinanced by ISCIII‐ Subdireccion General de Evaluación and Fondo Europeo de Desarrollo Regional (FEDER).
Sweden: Karolinska University Hospital, Stockholm, The Swedish InfCareHIV cohort (Lars NavérNavér, Sandra Soeria‐Atmadja, Erik Belfrage, Vendela Hagås).
Switzerland: Members of the Swiss HIV Cohort Study (SHCS) and the Swiss Mother and Child HIV Cohort (MoCHiV) Study: Aebi‐Popp K, Anagnostopoulos A, Battegay M, Baumann M, Bernasconi E, Böni J, Braun DL, Bucher HC, Calmy A, Cavassini M, Ciuffi A, Crisinel PA, Duppenthaler A, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Francini K, Furrer H, Fux CA, Günthard HF (President of the SHCS), Haerry D (deputy of "Positive Council"), Hasse B, Hirsch HH, Hoffmann M, Hösli I, Huber M, Kahlert CR (Chairman of the Mother & Child Substudy), Kaiser L, Keiser O, Klimkait T, Kottanattu L, Kouyos RD, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Marzolini C, Metzner KJ, Müller N, Nicca D, Paioni P, Pantaleo G, Perreau M, Polli Ch, Rauch A (Chairman of the Scientific Board), Rudin C, Scherrer AU (Head of Data Centre), Schmid P, Speck R, Stöckle M (Chairman of the Clinical and Laboratory Committee), Sultan‐Beyer L, Tarr P, Thanh Lecompte M, Trkola A, Vernazza P, Wagner N, Wandeler G, Weber R, Yerly S. Funding: This study has been financed within the framework of the Swiss HIV Cohort Study, supported by the Swiss National Science Foundation (grant #177499).
UK & Ireland: Collaborative HIV Paediatric Study (CHIPS): CHIPS is funded by the NHS (London Specialised Commissioning Group) and has received additional support from Abbott, Boehringer Ingelheim, Bristol‐Myers Squibb, GlaxoSmithKline, Gilead Sciences, Janssen and Roche. The MRC Clinical Trials Unit at UCL is supported by the Medical Research Council (https://www.mrc.ac.uk) programme number MC_UU_12023/26.
CHIPS Steering Committee: Hermione Lyall (chair), Alasdair Bamford, Karina Butler, Katja Doerholt, Conor Doherty, Caroline Foster, Ian Harrison, Julia Kenny, Nigel Klein, Gillian Letting, Paddy McMaster, Fungai Murau, Edith Nsangi, Katia Prime, Andrew Riordan, Fiona Shackley, Delane Shingadia, Sharon Storey, Gareth Tudor‐Williams, Anna Turkova, Steve Welch. MRC Clinical Trials Unit: Intira Jeannie Collins, Claire Cook, Siobhan Crichton, Donna Dobson, Keith Fairbrother, Diana M. Gibb, Ali Judd, Marthe Le Prevost, Nadine Van Looy. Integrated Screening Outcome Surveillance Service (ISOSS), UCL: Helen Peters, Kate Francis, Claire Thorne.
Hospitals participating in CHIPS in 2019/20: University Hospitals Birmingham NHS Foundation Trust, Birmingham: L Thrasyvoulou, S Welch; Brighton and Sussex University Hospitals NHS Trust: K Fidler; University Hospitals Bristol NHS Foundation Trust, Bristol: J Bernatoniene, F Manyika; Calderdale and Huddersfield NHS Foundation Trust, Halifax: G Sharpe; Derby Teaching Hospitals NHS Foundation Trust: B Subramaniam; Glasgow Royal Hospital for Children, Glasgow: R Hague, V Price; Great Ormond Street Hospital for Children NHS Foundation Trust, London: J Flynn, A Cardoso, M Abou – Rayyah, N Klein, A Bamford, D Shingadia; Oxford University Hospitals NHS Foundation Trust, Oxford: S Yeadon, S Segal; King's College Hospital NHS Foundation Trust, London: S Hawkins; Leeds Teaching Hospitals NHS Trust, Leeds: M Dowie; University Hospitals of Leicester NHS Trust, Leicester: S Bandi, E Percival; Luton and Dunstable Hospital NHS Foundation Trust, Luton: M Eisenhut; K Duncan; Milton Keynes General University Hospital NHS Foundation Trust, Milton Keynes: L Anguvaa, L Wren, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle: T Flood, A Pickering; The Pennine Acute Hospitals NHS Trust, Manchester: P McMaster, C Murphy; North Middlesex University Hospital NHS Trust, London: J Daniels, Y Lees; Northampton General Hospital NHS Trust, Northampton: F Thompson; London North West Healthcare NHS Trust, Middlesex; A Williams, B Williams, S Pope; Barts Health NHS trust, London Dr S Libeschutz; Nottingham University Hospitals NHS Trust, Nottingham: L Cliffe, S Southall; Portsmouth Hospitals NHS Trust, Portsmouth: A Freeman; Raigmore Hospital, Inverness: H Freeman; Royal Belfast Hospital for Sick Children, Belfast: S Christie; Royal Berkshire NHS Foundation Trust, Reading: A Gordon; Royal Children's Hospital, Aberdeen: D Rosie Hague, L Clarke; Royal Edinburgh Hospital for Sick Children, Edinburgh: L Jones L Brown; Royal Free NHS Foundation Trust, London: M Greenberg; Alder Hey Children's NHS Foundation Trust, Liverpool: C Benson, A Riordan; Sheffield Children's NHS Foundation Trust, Sheffield: L Ibberson, F Shackley; University Hospital Southampton NHS Foundation Trust, Southampton: S Patel, J Hancock; St George's University Hospitals NHS Foundation Trust, London: K Doerholt, K Prime, M Sharland, S Storey; Imperial College Healthcare NHS Trust, London: EGH Lyall, C Foster, P Seery, G Tudor‐Williams, N Kirkhope, S Raghunanan; Guy's and St Thomas' NHS Foundation Trust, London: Dr Julia Kenny, A Callaghan; University Hospitals of North Midlands NHS Trust, Stoke On Trent: A Bridgwood P McMaster; University Hospital of Wales, Cardiff: J Evans, E Blake; NHS Frimley Health Foundation Trust, Slough: A Yannoulias.
Chappell E, Kohns Vasconcelos M, Goodall RL, et al. Children living with HIV in Europe: do migrants have worse treatment outcomes? HIV Med. 2022;23:186–196. 10.1111/hiv.13177
Funding information
Funding was received from the European Union Seventh Framework Programme for research, technological development, and demonstration under EuroCoord grant agreement number 260694. The MRC Clinical Trials Unit at UCL is supported by the Medical Research Council (programme number MC_UU_12023/26). AN‐J was supported by “Subvencions per a la Intensificació de Facultatius Especialistes” (Departament de Salut de la Generalitat de Catalunya, Programa PERIS 2016‐2020) (SLT008/18/00193). The EPPICC network has received funding from the European Union's Horizon 2020 research and innovation programme for the REACH project under grant agreement no. 825579.
Contributor Information
Elizabeth Chappell, Email: e.chappell@ucl.ac.uk.
The European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC):
Ruth Goodall, Laura Rodrigues, Charlotte Duff, Ruth Goodall, Daniel Gomezpena, Charlotte Jackson, Rebecca Lundin, Laura Mangiarini, Edith Milanzi, Alessandra Nardone, Marc Hainaut, Evelyne Van der Kelen, Marc Delforge, Jerome Le Chenadec, Elisa Ramos, Olivia Dialla, Thierry Wack, Corine Laurent, Lamya Ait si Selmi, Isabelle Leymarie, Fazia Ait Benali, Maud Brossard, Leila Boufassa, Corinne Floch‐Tudal, Ghislaine Firtion, Isabelle Hau, Anne Chace, Pascal Bolot, Stéphane Blanche, Michèle Granier, Philippe Labrune, Eric Lachassine, Catherine Dollfus, Martine Levine, Corinne Fourcade, Brigitte Heller‐Roussin, Camille Runel‐Belliard, Joëlle Tricoire, Fabrice Monpoux, Catherine Chirouze, Véronique Reliquet, Jacques Brouard, Kamila Kebaili, Pascale Fialaire, Arnaud de Villeneuve, Muriel Lalande, Jeanne de Flandres, Françoise Mazingue, Maria Luisa Partisani, Maurizio de Martino, Pier Angelo Tovo, Clara Gabiano, Ines Carloni, Domenico Larovere, Francesco Baldi, Angela Miniaci, Andrea Pession, Raffaele Badolato, Grazia Pantò, Elisa Anastasio, Carlotta Montagnani, Leila Bianchi, Alessandra Allodi, Antonio Di Biagio, Sara Grignolo, Vania Giacomet, Paola Marchisio, Giuseppe Banderali, Claudia Tagliabue, Monica Cellini, Eugenia Bruzzese, Pasquale Di Costanzo, Andrea Lo Vecchio, Daniele Donà, Osvalda Rampon, Amelia Romano, Icilio Dodi, Susanna Esposito, Valentina Zuccaro, Domenico Zanaboni, Rita Consolini, Stefania Bernardi, Orazio Genovese, Letizia Cristiano, Antonio Mazza, Silvia Garazzino, Federica Mignone, Erika Silvestro, Vincenzo Portelli, Emma Kinderziekenhuis, M. van der Kuip, D Pajkrt, H.J. Scherpbier, C. de Boer, A.M. Weijsenfeld, S. Jurriaans, N.K.T. Back, H.L. Zaaijer, B. Berkhout, M.T.E. Cornelissen, C.J. Schinkel, K.C. Wolthers, P.L.A. Fraaij, A.M.C. van Rossum, C.L. Vermont, L.C. van der Knaap, E Visser, C.A.B. Boucher, M.P.G. Koopmans, J.J.A. van Kampen, S.S.V. Henriet, M. K. van Aerde, R Strik‐Albers, J Rahamat‐Langendoen, F.F. Stelma, D Burger, E.H. Schölvinck, H de Groot‐de Jonge, H.G.M. Niesters, C.C. van Leer‐Buter, M Knoester, L.J. Bont, S.P.M. Geelen, Y.G.T. Loeffen, T.F.W. Wolfs, N. Nauta, R Schuurman, L.M. Hofstra, A.M.J. Wensing, P Reiss, S Zaheri, A.C. Boyd, D.O. Bezemer, A.I. van Sighem, C. Smit, F.W.M.N. Wit, M.M.J. Hillebregt, T.J. Woudstra, D Bergsma, L. van de Sande, T Rutkens, S. van der Vliet, K.J Lelivelt, A Scheijgrond, L de Groot, M. van den Akker, Y. Bakker, A. EI Berkaoui, M. Bezemer, N. Brétin, E. Djoechro, M. Groters, E. Kruijne, K.J. Lelivelt, C. Lodewijk, E. Lucas, L. Munjishvili, F. Paling, B. Peeck, C. Ree, R. Regtop, Y. Ruijs, M. Schoorl, P. Schnörr, E. Tuijn, L. Veenenberg, K.M. Visser, E.C. Witte, Y Ruijs, Jolanta Popielska, Maria Pokorska‐Śpiewak, Agnieszka Ołdakowska, Konrad Zawadka, Urszula Coupland, Małgorzata Doroba, Carla Teixeira, Alexandre Fernandes, Pere Soler‐Palacín, Maria Antoinette Frick, Santiago Pérez‐Hoyos, Antonio Mur, Núria López, María Méndez, Lluís Mayol, Teresa Vallmanya, Olga Calavia, Lourdes García, Maite Coll, Valentí Pineda, Neus Rius, Núria Rovira, Joaquín Dueñas, Clàudia Fortuny, María José Mellado, Luis Escosa, Milagros García Hortelano, Talía Sainz, María Isabel González‐Tomé, Pablo Rojo, Daniel Blázquez, Luis Prieto‐Tato, Cristina Epalza, José Tomás Ramos, Sara Guillén, María Luisa Navarro, Jesús Saavedra, Mar Santos, Begoña Santiago, Santiago Jimenez de Ory, Itzíar Carrasco, Mª Angeles Muñoz‐Fernández, Miguel Ángel Roa, María Penín, Jorge Martínez, Katie Badillo, Eider Oñate, Itziar Pocheville, Elisa Garrote, Elena Colino, Jorge Gómez Sirvent, Mónica Garzón, Vicente Román, Raquel Angulo, Olaf Neth, Lola Falcón, Pedro Terol, Juan Luis Santos, David Moreno, Francisco Lendínez, Estrella Peromingo, José Uberos, Beatriz Ruiz, Ana Grande, Francisco José Romero, Carlos Pérez, Miguel Lillo, Begoña Losada, Mercedes Herranz, Matilde Bustillo, Pilar Collado, José Antonio Couceiro, Leticia Vila, Consuelo Calviño, Ana Isabel Piqueras, Manuel Oltra, César Gavilán, Elena Montesinos, Marta Dapena, Cristina Álvarez, Beatriz Jiménez, Ana Gloria Andrés, Víctor Marugán, Carlos Ochoa, Santiago Alfayate, Ana Isabel Menasalvas, Yolanda Ruiz del Prado, Lars NavérNavér, Sandra Soeria‐Atmadja, Erik Belfrage, Vendela Hagås, K Aebi‐Popp, A Anagnostopoulos, M Battegay, M Baumann, E Bernasconi, J Böni, DL Braun, HC Bucher, A Calmy, M Cavassini, A Ciuffi, PA Crisinel, A Duppenthaler, G Dollenmaier, M Egger, L Elzi, J Fehr, J Fellay, K Francini, H Furrer, CA Fux, HF Günthard, D Haerry, B Hasse, HH Hirsch, M Hoffmann, I Hösli, M Huber, L Kaiser, O Keiser, T Klimkait, L Kottanattu, RD Kouyos, H Kovari, B Ledergerber, G Martinetti, B Martinez de Tejada, C Marzolini, KJ Metzner, N Müller, D Nicca, P Paioni, G Pantaleo, M Perreau, Ch Polli, A Rauch, C Rudin, AU Scherrer, P Schmid, R Speck, M Stöckle, L Sultan‐Beyer, P Tarr, M Thanh Lecompte, A Trkola, P Vernazza, N Wagner, G Wandeler, R Weber, S Yerly, Hermione Lyall, Karina Butler, Katja Doerholt, Conor Doherty, Caroline Foster, Ian Harrison, Julia Kenny, Nigel Klein, Gillian Letting, Paddy McMaster, Fungai Murau, Edith Nsangi, Katia Prime, Andrew Riordan, Fiona Shackley, Delane Shingadia, Sharon Storey, Gareth Tudor‐Williams, Anna Turkova, Steve Welch, Claire Cook, Donna Dobson, Keith Fairbrother, Diana M. Gibb, Marthe Le Prevost, Nadine Van Looy, Helen Peters, Kate Francis, L Thrasyvoulou, S Welch, K Fidler, J Bernatoniene, F Manyika, G Sharpe, B Subramaniam, R Hague, V Price, J Flynn, A Cardoso, M Abou – Rayyah, N Klein, A Bamford, D Shingadia, S Yeadon, S Segal, S Hawkins, M Dowie, S Bandi, E Percival, M Eisenhut, K Duncan, L Anguvaa, L Wren, T Flood, A Pickering, P McMaster, C Murphy, J Daniels, Y Lees, F Thompson, A Williams, B Williams, S Pope, S Libeschutz, L Cliffe, S Southall, A Freeman, H Freeman, S Christie, A Gordon, D Rosie Hague, L Clarke, L Jones, L Brown, M Greenberg, C Benson, A Riordan, L Ibberson, F Shackley, S Patel, J Hancock, K Doerholt, K Prime, M Sharland, S Storey, EGH Lyall, C Foster, P Seery, G Tudor‐Williams, N Kirkhope, S Raghunanan, Julia Kenny, A Callaghan, A Bridgwood, P McMaster, J Evans, E Blake, and A Yannoulias
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Figure S1 Kaplan–Meier plot of AIDS‐free survival after ART initiation, by migrant status
Table S1 First AIDS event after ART initiation, by migrant status
Table S2 Causes of death, by migrant status
Table S3 Effect of migrant status on non‐suppressed viral load, severe immunosuppression and first AIDS event/death at 1 year after ART initiation, restricted to only migrants born in sub‐Saharan Africa.