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Martin C, Bottieau E, Delforge M, Dauby N. Do people living with HIV travel safely? Assessment of travel patterns and advice-seeking behaviour in a cohort of people living with HIV in Belgium. HIV Med 2023. [PMID: 36883615 DOI: 10.1111/hiv.13470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/07/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVES Pre-travel counselling has demonstrated its efficacy in decreasing travel-related health complications. The current profile of people living with HIV (PLWH) in Europe [increasing age, visiting friends and relatives (VFR)] makes pre-travel counselling crucial. We aimed to survey the self-reported travel patterns and advice-seeking behaviour among PLWH followed up at the HIV Reference Centre (HRC) of Saint-Pierre Hospital, Brussels. METHODS A survey was conducted in all PLWH presenting at the HRC from February to June 2021. The survey covered demographic elements, travel and pre-travel consultation habits over the last 10 years, or since the diagnosis of HIV if it was made less than 10 years earlier. RESULTS The survey was completed by 1024 PLWH (35% women, median age 49 years, the majority being virologically controlled). A substantial number of PLWH were involved in VFR travel in low-resource countries and 65% sought pre-travel advice before travelling: if not, it was because they did not know it was necessary (91%). CONCLUSION Travel is common among PLWH. Raising awareness of the importance of pre-travel counselling should be a routine part of every healthcare encounter and especially during regular contact with HIV physicians.
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Affiliation(s)
- Charlotte Martin
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marc Delforge
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Dauby
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.,Institute for Medical Immunology, Université Libre de Bruxelles, Brussels, Belgium.,Environmental Health Research Centre, Public Health School, Université Libre de Bruxelles, Brussels, Belgium
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2
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Perez-Molina JA, Crespillo-Andújar C, Moreno S, Serrano-Villar S, López-Vélez R. Travelling with HIV in the XXI century: Case report and narrative review. Travel Med Infect Dis 2020; 38:101921. [PMID: 33220457 DOI: 10.1016/j.tmaid.2020.101921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/26/2022]
Abstract
The number of migrants and travellers has grown in recent decades. This phenomenon is also true of people living with HIV, given their much-improved life expectancy and quality of life. A significant number of travellers with HIV are migrants returning to their home countries to visit friends and relatives (VFRs). This population constitutes a high-risk group because they travel for longer and often to rural and remote areas and have closer contact with the local population. In this review we discuss the sociodemographic characteristics of travellers with HIV, the differences between conventional travellers and VFRs, and the risks of HIV acquisition and transmission during travel. We also present the most relevant travel-associated illnesses and highlight the particularities of pre-travel advice given to this population, including immunosuppression, responses to vaccines, high incidence of comorbidities, drug interactions, legal and language barriers. The need to integrate these factors based on far less evidence than that available for the general population makes pre-travel advice for travellers with HIV genuinely challenging.
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Affiliation(s)
- Jose A Perez-Molina
- National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar, Km 9.1, 28034, Madrid, Spain.
| | - Clara Crespillo-Andújar
- National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar, Km 9.1, 28034, Madrid, Spain
| | - Santiago Moreno
- HIV Unit, Infectious Diseases Department, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar, Km 9.1, 28034, Madrid, Spain
| | - Sergio Serrano-Villar
- HIV Unit, Infectious Diseases Department, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar, Km 9.1, 28034, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar, Km 9.1, 28034, Madrid, Spain
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3
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Kankou JM, Bouchaud O, Lele N, Guiguet M, Spire B, Carrieri MP, Abgrall S. Factors Associated with Virological Rebound in HIV-Positive Sub-Saharan Migrants Living in France After Traveling Back to Their Native Country: ANRS-VIHVO 2006-2009 Study. J Immigr Minor Health 2020; 21:1342-1348. [PMID: 30796681 DOI: 10.1007/s10903-019-00864-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In France, around 25% of the estimated number of people living with HIV are migrants, of whom three quarters are from sub-Saharan Africa (SSA). Our objective was to determine factors associated with virological rebound (VR) at the occasion of a transient stay to the country of origin. HIV-positive migrants from SSA participating to the ANRS-VIHVO adherence study between 2006 and 2009, on effective ART with controlled pre-travel HIV-1 plasma viral load (VL), were included. Outcome was VR, defined as VL ≥ 50 copies/ml at the post-travel visit during the week following the return to France. Among 237 persons (61.6% female, median age 41 years (IQR, 35-47), median time on ART 4.2 years (IQR, 2.2-7.1), 27 (11.4%) experienced VR. The main purpose of the travel was to visit family and median time spent abroad was 5.3 weeks (IQR, 4.1-8.8). The travel was extended longer than anticipated by at least 1 week in 42 individuals (17.7%). In multivariable logistic model, risk factors for VR were male sex [adjusted OR (aOR) 5.1; 95% CI 1.6-16.2)], no employment in France (aOR 2.0; 1.2-3.5), self-reported non-adherence during the trip (aOR 14.9; 4.9-45.9) and PI-containing regimen (aOR 4.6; 1.2-17.6). In another analysis not including self-reported adherence, traveling during Ramadan while respecting the fast (aOR 3.3; 1.2-9.6) and extension of the stay (aOR 3.0; 1.1-7.8) were associated with VR. Virological rebound was partly explained by structural barriers to adherence such as extension of the travel and inadequate management of Ramadan fasting. Individuals' journeys should be carefully planned with health care providers.
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Affiliation(s)
- Jean-Médard Kankou
- APHP, service de maladies infectieuses et tropicales, Hôpital Avicenne, Bobigny, France.,Laboratoire Parcours Santé Systémique, (PSS, EA 4129), Université Claude Bernard Lyon 1, Lyon, France
| | - Olivier Bouchaud
- APHP, service de maladies infectieuses et tropicales, Hôpital Avicenne, Bobigny, France.,Université Paris 13, Bobigny, France
| | - Nathalie Lele
- APHP, service de maladies infectieuses et tropicales, Hôpital Avicenne, Bobigny, France
| | - Marguerite Guiguet
- Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Université Pierre et Marie Curie, Sorbonne Universités, 75013, Paris, France
| | - Bruno Spire
- INSERM U912 (SE4S), Marseille, France.,Université Aix Marseille, IRD, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provences Alpes Côte d'Azur, Marseille, France
| | - Maria Patrizia Carrieri
- INSERM U912 (SE4S), Marseille, France.,Université Aix Marseille, IRD, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provences Alpes Côte d'Azur, Marseille, France
| | - Sophie Abgrall
- AP-HP, Service de Médecine interne/Immunologie clinique, Hôpital Antoine Béclère, 157 rue de la Porte de Trivaux, 92140, Clamart, France. .,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Le Kremlin-Bicêtre, France. .,CESP INSERM U1018, Le Kremlin-Bicêtre, France.
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4
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Pistone T, Ouattara E, Gabillard D, Lele N, Duvignaud A, Cordel H, Malvy D, Bouchaud O, Abgrall S. Travel-related health events and their risk factors in HIV-infected sub-Saharan migrants living in France and visiting their native country: The ANRS VIHVO cohort study. Travel Med Infect Dis 2019; 29:40-47. [PMID: 30951905 DOI: 10.1016/j.tmaid.2019.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 02/20/2019] [Accepted: 03/28/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Literature on health events in HIV-infected travellers is scarce, particularly in sub-Saharan African (SSA) migrants. METHODS We investigated health events in HIV-infected SSA migrants living in France during and after travel to their native country. All had a pre-travel plasma viral load (pVL) below 200 copies/mL and were on stable combined antiretroviral therapy (cART). Logistic regression models were used to assess the risk factors for at least one adverse health event or febrile event. RESULTS Among 264 HIV migrants, pre-travel median CD4 count was 439/mm3 and 27 migrants (6%) experienced a low-level viremia between 50 and 200 copies/mL. One hundred (38%) experienced at least one event (13 experienced two events). The most common events were gastrointestinal, including diarrhoea (n = 29, 26%), respiratory events (n = 20, 18%), and malaria (n = 17, 15%; 1 death). In multivariable analysis, a pre-travel low-level viremia and a lack of pre-travel medical advice significantly increased the risk for any event (OR 4.31, 95% CI, 1.41-13.1; and OR 3.62, 95% CI, 1.38-9.47; respectively). A lack of pre-travel advice significantly increased the risk for febrile event. CONCLUSIONS Early and tailored counselling on pre-travel medical advice regarding diarrhoea and vector-borne diseases prophylactic measures in HIV-infected SSA migrants should be emphasised before travel to Africa.
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Affiliation(s)
- Thierry Pistone
- CHU Bordeaux, Department for Infectious and Tropical Diseases, 33000, Bordeaux, France; Inserm U1219, Infectious Diseases in Lower Income Countries (IDLIC), Université de Bordeaux, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.
| | - Eric Ouattara
- CHU Bordeaux, Department for Infectious and Tropical Diseases, 33000, Bordeaux, France; Inserm U1219, Infectious Diseases in Lower Income Countries (IDLIC), Université de Bordeaux, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.
| | - Delphine Gabillard
- Inserm U1219, Infectious Diseases in Lower Income Countries (IDLIC), Université de Bordeaux, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.
| | - Nathalie Lele
- AP-HP, Hôpital Avicenne, Service des Maladies Infectieuses et Tropicales, 93000, Bobigny, France; Université Paris 13, Bobigny, France.
| | - Alexandre Duvignaud
- CHU Bordeaux, Department for Infectious and Tropical Diseases, 33000, Bordeaux, France; Inserm U1219, Infectious Diseases in Lower Income Countries (IDLIC), Université de Bordeaux, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.
| | - Hugues Cordel
- AP-HP, Hôpital Avicenne, Service des Maladies Infectieuses et Tropicales, 93000, Bobigny, France; Université Paris 13, Bobigny, France.
| | - Denis Malvy
- CHU Bordeaux, Department for Infectious and Tropical Diseases, 33000, Bordeaux, France; Inserm U1219, Infectious Diseases in Lower Income Countries (IDLIC), Université de Bordeaux, 146 rue Léo-Saignat, 33076, Bordeaux cedex, France.
| | - Olivier Bouchaud
- AP-HP, Hôpital Avicenne, Service des Maladies Infectieuses et Tropicales, 93000, Bobigny, France; Université Paris 13, Bobigny, France.
| | - Sophie Abgrall
- AP-HP, Hôpital Antoine Béclère, Clamart, France; Inserm U1018, Centre de recherche en Epidémiologie et Santé des Populations (CESP), Le Kremlin-Bicêtre Cedex, Université Paris Sud University, Paris Saclay University, France.
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Norman FF, López-Polín A, Salvador F, Treviño B, Calabuig E, Torrús D, Soriano-Arandes A, Ruíz-Giardín JM, Monge-Maillo B, Pérez-Molina JA, Perez-Ayala A, García M, Rodríguez A, Martínez-Serrano M, Zubero M, López-Vélez R. Imported malaria in Spain (2009-2016): results from the +REDIVI Collaborative Network. Malar J 2017; 16:407. [PMID: 29017499 PMCID: PMC5635489 DOI: 10.1186/s12936-017-2057-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/06/2017] [Indexed: 11/15/2022] Open
Abstract
Background Imported malaria is a frequent diagnosis in travellers and migrants. The objective of this study was to describe the epidemiological and clinical characteristics of patients diagnosed with imported malaria within a Spanish collaborative network registering imported diseases (+REDIVI). In addition, the possible association between malaria and type of case, gender, age or area of exposure was explored. Methods Cases of imported malaria were identified among all cases registered in the +REDIVI database during the period October 2009–October 2016. Demographic, epidemiological and clinical characteristics were analysed. Results In total, 11,816 cases of imported infectious diseases were registered in +REDIVI’s database between October 2009 and October 2016. Immigrants seen for the first time after migration accounted for 60.2% of cases, 21.0% of patients were travellers, and 18.8% were travellers/immigrants visiting friends and relatives (VFRs). There were 850 cases of malaria (850/11,816, 7.2%). Malaria was significantly more frequent in men than in women (56.8% vs 43.2%) and in VFR-immigrants (52.6%) as compared to travellers (21.3%), immigrants (20.7%) and VFR-travellers (5.4%) (p < 0.001). Although this data was not available for most patients with malaria, only a minority (29/217, 13.4%) mentioned correct anti-malarial prophylaxis. Sub-Saharan Africa was found to be the most common region of acquisition of malaria. Most common reason for consultation after travel was a febrile syndrome although an important proportion of immigrants were asymptomatic and presented only for health screening (27.3%). Around 5% of travellers presented with severe malaria. The most prevalent species of Plasmodium diagnosed was Plasmodium falciparum (81.5%). Malaria due to Plasmodium ovale/Plasmodium vivax was frequent among travellers (17%) and nearly 5% of all malaria cases in immigrants were caused by Plasmodium malariae. Conclusions Malaria was among the five most frequent diagnoses registered in +REDIVI’s database. Some significant differences were found in the distribution of malaria according to gender, type of case, species. Among all malaria cases, the most frequent diagnosis was P. falciparum infection in VFR-immigrant men.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain.
| | - Ana López-Polín
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
| | - Fernando Salvador
- Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Begoña Treviño
- Unitat Medicina Tropical i Salut Internacional Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
| | - Eva Calabuig
- La Fe de Valencia University Hospital, Valencia, Spain
| | | | - Antonio Soriano-Arandes
- Unitat Medicina Tropical i Salut Internacional Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
| | | | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
| | - Jose-Antonio Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
| | | | | | | | | | | | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Ctra Colmenar, Km 9,100, 28034, Madrid, Spain
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6
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Pérez-Molina JA, López-Polín A, Treviño B, Molina I, Goikoetxea J, Díaz-Menéndez M, Torrús D, Calabuig E, Benito A, López-Vélez R. 6-year review of +Redivi: a prospective registry of imported infectious diseases in Spain. J Travel Med 2017; 24:3954784. [PMID: 28931128 DOI: 10.1093/jtm/tax035] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2017] [Indexed: 11/14/2022]
Abstract
BACKGROUND Understanding and detecting imported diseases is a priority in the prevention and management of prevalent and emergent infectious diseases acquired abroad. The +Redivi network measures the burden of imported infections in Spain and is essential for closing the gap in travel medicine. METHODS Demographic characteristics, travel information, syndromes and confirmed travel-related diagnoses were registered in a standardised online database. RESULTS A total of 10 767 cases of imported infectious diseases were registered between October 2009 and December 2015. Of these, 60.8% of cases were immigrants seen for the first time after arrival, 20.6% were travellers, and 18.4% were individuals visiting friends and relatives (VFR [immigrants and travellers]). The median time between arrival and medical consultation was 5.5 years for immigrants, 2.0 weeks for travellers, 3.1 weeks for VFR-travellers and 11.4 for VFR-immigrants. The most prevalent diagnoses were Chagas disease in immigrants and nonspecific acute diarrhoea in travellers. Malaria by P. falciparum was one of the most prevalent diagnoses among VFR. More than half the travellers saw a physician before travelling, although one-third of those for whom antimalarial medication was indicated did not take their medication correctly. As for VFR, only 10.4% of VFR-immigrants and 32.5% of VFR-travellers sought pre-travel advice. Only 23 and 21%, respectively, of those for whom antimalarial prophylaxis was indicated took the medication properly. CONCLUSIONS +Redivi provides a clear picture of the prevalence of imported infectious diseases among travellers and immigrants in Spain. The data collected could be used to improve everyday health care provided to travellers and immigrants after travel, to guide pre-travel consultations and to monitor the potential occurrence of tropical or exotic infectious diseases.
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Affiliation(s)
- José A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, IRYCIS, Carretera de Colmenar Km 9, 1. 28034 Madrid, Spain
| | - Ana López-Polín
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, IRYCIS, Carretera de Colmenar Km 9, 1. 28034 Madrid, Spain
| | - Begoña Treviño
- Unitat Medicina Tropical i Salut Internacional Vall d'Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001 Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Passeig Vall d'Hebron 119 - 129, 08035 Barcelona, Spain
| | - Josune Goikoetxea
- Hospital Universitario de Cruces, Plaza de Cruces s/n 48903, Barakaldo, Bizkaia, Spain
| | - Marta Díaz-Menéndez
- National Referral Unit for Tropical Diseases, Hospital Universitario La Paz-Carlos III, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Diego Torrús
- Alicante University Hospital, Calle Pintor Baeza 11, 03010 Alicante, Spain
| | - Eva Calabuig
- Infectious Diseases Unit, La Fe University Hospital, Av de Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Agustín Benito
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III-Madrid, RICET, Calle Sinesio Delgado, n° 10. 28046 Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, IRYCIS, Carretera de Colmenar Km 9, 1. 28034 Madrid, Spain
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