All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America: findings from the ART-CC cohort collaboration

Sophia M Rein; Fiona C Lampe; Suzanne M Ingle; Jonathan A C Sterne; Adam J W Trickey; Michael John Gill; Vasileios Papastamopoulos; Linda Wittkop; Marc van der Valk; Maria Kitchen; Jodie Guest; Derek D Satre; Gilles Wandeler; Pepa Galindo; Jessica L. Castilho; Heidi M Crane; Colette Smith

doi:10.1016/S2468-2667(23)00178-0

All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America: findings from the ART-CC cohort collaboration

Sophia M Rein^*
, Fiona C Lampe
, Suzanne M Ingle
, Jonathan A C Sterne
, Adam J W Trickey
, Michael John Gill
, Vasileios Papastamopoulos
, Linda Wittkop
, Marc van der Valk
, Maria Kitchen
, Jodie Guest
, Derek D Satre
, Gilles Wandeler
, Pepa Galindo
, Jessica L. Castilho
, Heidi M Crane
, Colette Smith

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

8 Citations (Scopus)

Abstract

Background
Understanding demographic disparities in hospitalization is critical for identification of vulnerable populations, intervention and resource planning.
Methods
Data were from the Antiretroviral Therapy Cohort Collaboration (ART-CC) on people with HIV (PLHIV) in Europe and North America (NA), followed between 2007-2020. We investigated differences in all-cause hospitalization according to gender & mode of HIV acquisition, ethnicity and combined geographic origin and ethnicity, in PLHIV on modern combination antiretroviral therapy (cART). Analyses were performed separately for European and North American cohorts. Hospitalization rates were assessed using negative binomial multi-level regression, adjusted for age, time since cART intitiaion and calender period.
Findings
Among 23,594 PLHIV in Europe and 9,612 in NA, hospitalization rates/100 person-years were 16.2 (95% confidence interval 16.0-16.4) and 13.1 (12.8-13.5). Compared to gay, bisexual and other men who have sex with men, rates were higher for heterosexual men and women, and much higher for men and women who acquired HIV through injection drug use (adjusted incidence rate ratios (aIRRs) ranging from 1.2-2.8 in Europe and 1.3-4.3 in NA). In both regions, migrant groups generally had lower hospitalization rates compared to non-migrants. In NA, indigenous and Black/African-American individuals had higher rates than white individuals (aIRRs: 1.9 and 1.1), while Asian and Hispanic PLHIV had somewhat lower rates. In Europe there was a lower rate in Asian individuals compared to white.
Interpretation
Substantial disparities exist in all-cause hospitalization between demographic groups of PLHIV in the current cART era in high-income settings, highlighting the need for targeted support.
Funding
Royal Free Charity; National Institute on Alcohol Abuse and Alcoholism (U01-AA026209).

Original language	English
Pages (from-to)	e776-e787
Journal	Lancet Public Health
Volume	8
Issue number	10
DOIs	https://doi.org/10.1016/S2468-2667(23)00178-0
Publication status	Published - 1 Oct 2023

Bibliographical note

Funding Information:
This work was funded by the Royal Free Charity for PhD research and by the US National Institute on Alcohol Abuse and Alcoholism (U01-AA026209) for the ART-CC. We thank all patients participating in the cohorts for their time and effort.

Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Rein, S. M., Lampe, F. C., Ingle, S. M., Sterne, J. A. C., Trickey, A. J. W., Gill, M. J., Papastamopoulos, V., Wittkop, L., van der Valk, M., Kitchen, M., Guest, J., Satre, D. D., Wandeler, G., Galindo, P., Castilho, J. L., Crane, H. M., & Smith, C. (2023). All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America: findings from the ART-CC cohort collaboration. Lancet Public Health, 8(10), e776-e787. https://doi.org/10.1016/S2468-2667(23)00178-0

@article{a0695723b73e4484a0222e8d4dbc5733,

title = "All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America: findings from the ART-CC cohort collaboration",

abstract = "Background Understanding demographic disparities in hospitalization is critical for identification of vulnerable populations, intervention and resource planning. Methods Data were from the Antiretroviral Therapy Cohort Collaboration (ART-CC) on people with HIV (PLHIV) in Europe and North America (NA), followed between 2007-2020. We investigated differences in all-cause hospitalization according to gender \& mode of HIV acquisition, ethnicity and combined geographic origin and ethnicity, in PLHIV on modern combination antiretroviral therapy (cART). Analyses were performed separately for European and North American cohorts. Hospitalization rates were assessed using negative binomial multi-level regression, adjusted for age, time since cART intitiaion and calender period. Findings Among 23,594 PLHIV in Europe and 9,612 in NA, hospitalization rates/100 person-years were 16.2 (95\% confidence interval 16.0-16.4) and 13.1 (12.8-13.5). Compared to gay, bisexual and other men who have sex with men, rates were higher for heterosexual men and women, and much higher for men and women who acquired HIV through injection drug use (adjusted incidence rate ratios (aIRRs) ranging from 1.2-2.8 in Europe and 1.3-4.3 in NA). In both regions, migrant groups generally had lower hospitalization rates compared to non-migrants. In NA, indigenous and Black/African-American individuals had higher rates than white individuals (aIRRs: 1.9 and 1.1), while Asian and Hispanic PLHIV had somewhat lower rates. In Europe there was a lower rate in Asian individuals compared to white. Interpretation Substantial disparities exist in all-cause hospitalization between demographic groups of PLHIV in the current cART era in high-income settings, highlighting the need for targeted support. Funding Royal Free Charity; National Institute on Alcohol Abuse and Alcoholism (U01-AA026209).",

author = "Rein, \{Sophia M\} and Lampe, \{Fiona C\} and Ingle, \{Suzanne M\} and Sterne, \{Jonathan A C\} and Trickey, \{Adam J W\} and Gill, \{Michael John\} and Vasileios Papastamopoulos and Linda Wittkop and \{van der Valk\}, Marc and Maria Kitchen and Jodie Guest and Satre, \{Derek D\} and Gilles Wandeler and Pepa Galindo and Castilho, \{Jessica L.\} and Crane, \{Heidi M\} and Colette Smith",

note = "Funding Information: This work was funded by the Royal Free Charity for PhD research and by the US National Institute on Alcohol Abuse and Alcoholism (U01-AA026209) for the ART-CC. We thank all patients participating in the cohorts for their time and effort. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license",

year = "2023",

month = oct,

day = "1",

doi = "10.1016/S2468-2667(23)00178-0",

language = "English",

volume = "8",

pages = "e776--e787",

journal = "Lancet Public Health",

issn = "2468-2667",

publisher = "Elsevier Limited",

number = "10",

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Rein, SM, Lampe, FC, Ingle, SM , Sterne, JAC , Trickey, AJW, Gill, MJ, Papastamopoulos, V, Wittkop, L, van der Valk, M, Kitchen, M, Guest, J, Satre, DD, Wandeler, G, Galindo, P, Castilho, JL, Crane, HM & Smith, C 2023, 'All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America: findings from the ART-CC cohort collaboration', Lancet Public Health, vol. 8, no. 10, pp. e776-e787. https://doi.org/10.1016/S2468-2667(23)00178-0

All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America: findings from the ART-CC cohort collaboration. / Rein, Sophia M; Lampe, Fiona C; Ingle, Suzanne M et al.
In: Lancet Public Health, Vol. 8, No. 10, 01.10.2023, p. e776-e787.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America

T2 - findings from the ART-CC cohort collaboration

AU - Rein, Sophia M

AU - Lampe, Fiona C

AU - Ingle, Suzanne M

AU - Sterne, Jonathan A C

AU - Trickey, Adam J W

AU - Gill, Michael John

AU - Papastamopoulos, Vasileios

AU - Wittkop, Linda

AU - van der Valk, Marc

AU - Kitchen, Maria

AU - Guest, Jodie

AU - Satre, Derek D

AU - Wandeler, Gilles

AU - Galindo, Pepa

AU - Castilho, Jessica L.

AU - Crane, Heidi M

AU - Smith, Colette

N1 - Funding Information: This work was funded by the Royal Free Charity for PhD research and by the US National Institute on Alcohol Abuse and Alcoholism (U01-AA026209) for the ART-CC. We thank all patients participating in the cohorts for their time and effort. Publisher Copyright: © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license

PY - 2023/10/1

Y1 - 2023/10/1

N2 - Background Understanding demographic disparities in hospitalization is critical for identification of vulnerable populations, intervention and resource planning. Methods Data were from the Antiretroviral Therapy Cohort Collaboration (ART-CC) on people with HIV (PLHIV) in Europe and North America (NA), followed between 2007-2020. We investigated differences in all-cause hospitalization according to gender & mode of HIV acquisition, ethnicity and combined geographic origin and ethnicity, in PLHIV on modern combination antiretroviral therapy (cART). Analyses were performed separately for European and North American cohorts. Hospitalization rates were assessed using negative binomial multi-level regression, adjusted for age, time since cART intitiaion and calender period. Findings Among 23,594 PLHIV in Europe and 9,612 in NA, hospitalization rates/100 person-years were 16.2 (95% confidence interval 16.0-16.4) and 13.1 (12.8-13.5). Compared to gay, bisexual and other men who have sex with men, rates were higher for heterosexual men and women, and much higher for men and women who acquired HIV through injection drug use (adjusted incidence rate ratios (aIRRs) ranging from 1.2-2.8 in Europe and 1.3-4.3 in NA). In both regions, migrant groups generally had lower hospitalization rates compared to non-migrants. In NA, indigenous and Black/African-American individuals had higher rates than white individuals (aIRRs: 1.9 and 1.1), while Asian and Hispanic PLHIV had somewhat lower rates. In Europe there was a lower rate in Asian individuals compared to white. Interpretation Substantial disparities exist in all-cause hospitalization between demographic groups of PLHIV in the current cART era in high-income settings, highlighting the need for targeted support. Funding Royal Free Charity; National Institute on Alcohol Abuse and Alcoholism (U01-AA026209).

AB - Background Understanding demographic disparities in hospitalization is critical for identification of vulnerable populations, intervention and resource planning. Methods Data were from the Antiretroviral Therapy Cohort Collaboration (ART-CC) on people with HIV (PLHIV) in Europe and North America (NA), followed between 2007-2020. We investigated differences in all-cause hospitalization according to gender & mode of HIV acquisition, ethnicity and combined geographic origin and ethnicity, in PLHIV on modern combination antiretroviral therapy (cART). Analyses were performed separately for European and North American cohorts. Hospitalization rates were assessed using negative binomial multi-level regression, adjusted for age, time since cART intitiaion and calender period. Findings Among 23,594 PLHIV in Europe and 9,612 in NA, hospitalization rates/100 person-years were 16.2 (95% confidence interval 16.0-16.4) and 13.1 (12.8-13.5). Compared to gay, bisexual and other men who have sex with men, rates were higher for heterosexual men and women, and much higher for men and women who acquired HIV through injection drug use (adjusted incidence rate ratios (aIRRs) ranging from 1.2-2.8 in Europe and 1.3-4.3 in NA). In both regions, migrant groups generally had lower hospitalization rates compared to non-migrants. In NA, indigenous and Black/African-American individuals had higher rates than white individuals (aIRRs: 1.9 and 1.1), while Asian and Hispanic PLHIV had somewhat lower rates. In Europe there was a lower rate in Asian individuals compared to white. Interpretation Substantial disparities exist in all-cause hospitalization between demographic groups of PLHIV in the current cART era in high-income settings, highlighting the need for targeted support. Funding Royal Free Charity; National Institute on Alcohol Abuse and Alcoholism (U01-AA026209).

U2 - 10.1016/S2468-2667(23)00178-0

DO - 10.1016/S2468-2667(23)00178-0

M3 - Article (Academic Journal)

C2 - 37777287

SN - 2468-2667

VL - 8

SP - e776-e787

JO - Lancet Public Health

JF - Lancet Public Health

IS - 10

ER -