BACKGROUND Compared with the general population, international migrants arriving in Europe face severe socioeconomic challenges that result in higher HIV prevalence and limited access to health care, potentially leading to negative outcomes. In this systematic review and meta-analysis, we aimed to investigate the incidence of HIV-related outcomes among international migrants arriving in Europe compared with the incidence among the general population. METHODS We did a systematic review and meta-analysis to identify studies investigating HIV-related outcomes in migrants and the general population living with HIV in Europe. Six authors (EDV, VP, VS, SDG, MC, and RN) independently searched PubMed, Scopus, and Web of Science from database inception until July 22, 2023 (with an update on March 3, 2024), then screened titles and abstracts of all potentially eligible articles. Studies were included if they were observational studies; investigated clinical, virological, or immunological outcomes in migrants living with HIV; were conducted in Europe; had at least one control group of non-migrants living in a European country; and were in English. Titles and abstracts were screened for eligibility followed by a full-text assessment by two authors (EDV, VP, VS, SDG, MC, or RN). Data were extracted from articles using a structured Redcap form. Primary outcomes of our systematic review were (1) mortality, (2) AIDS-defining condition, (3) combined outcome of AIDS or death, (4) treatment discontinuation, (5) rate of loss to follow-up, (6) virological failure, and (7) immunological failure. Data were reported as relative risks (RRs) or odds ratios with their 95% CIs. The study is registered with PROSPERO, CRD42024501191. FINDINGS Of the 1316 articles identified (1297 in the initial search and 19 in the updated search), 19 were included in our systematic review, consisting of 104 676 participants who were followed up for a mean of 79·3 months. The meta-analysis, adjusted for potential confounders, showed that migrants present similar mortality risk (RR 0·88, 95% CI 0·75-1·04), but higher risk for AIDS-defining conditions (1·23, 1·14-1·34), treatment discontinuation (2·39, 1·49-3·29), loss to follow-up (2·53, 1·41-4·53), virological failure (1·80, 1·25-2·60), and immunological failure (3·70, 2·17-12·50) compared with the general population. In subanalyses for WHO regions, people originally from the African region had higher risk for HIV-related adverse outcomes. INTERPRETATION Compared with the non-migrant population, migrants living in Europe with HIV face higher risks for progression to AIDS, loss to follow-up, treatment discontinuation, and virological and immunological failure. Interventions aimed to improve HIV care among migrants living in Europe are urgently needed. FUNDING None.

中文翻译：

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与一般人群相比，居住在欧洲的移民的 HIV 相关结果：系统评价和荟萃分析。


背景 与普通人群相比，抵达欧洲的国际移民面临着严重的社会经济挑战，导致 HIV 患病率更高，获得医疗保健的机会有限，可能导致负面结果。在本系统评价和荟萃分析中，我们旨在调查抵达欧洲的国际移民与普通人群发病率相比，HIV 相关结果的发生率。方法 我们进行了系统评价和荟萃分析，以确定调查欧洲移民和普通 HIV 感染人群 HIV 相关结局的研究。六位作者（EDV、VP、VS、SDG、MC 和 RN）独立检索了从数据库建库到 2023 年 7 月 22 日（更新于 2024 年 3 月 3 日）的 PubMed、Scopus 和 Web of Science，然后筛选了所有可能符合条件的文章的标题和摘要。如果研究是观察性研究，则纳入这些研究;调查了 HIV 感染者移民的临床、病毒学或免疫学结果;在欧洲进行;至少有一个非移民对照组居住在欧洲国家;并且是英语。筛选标题和摘要的合格性，然后由两位作者（EDV、VP、VS、SDG、MC 或 RN）进行全文评估。使用结构化的 Redcap 表单从文章中提取数据。我们系统评价的主要结局是 （1） 死亡率，（2） 艾滋病定义性疾病，（3） 艾滋病或死亡的综合结局，（4） 治疗中断，（5） 失访率，（6） 病毒学失败，以及 （7） 免疫学失败。数据以相对风险 （RRs） 或比值比报告，其 CIs 为 95%。该研究已在 CRD42024501191 PROSPERO 注册。 结果 在确定的 1316 篇文章中（初始检索中 1297 篇，更新检索中 19 篇），19 篇被纳入我们的系统评价，包括 104 676 名参与者，平均随访 79·3 个月。根据潜在混杂因素进行调整的荟萃分析显示，移民的死亡风险相似 （RR 0·88， 95% CI 0·75-1·04），但艾滋病定义性疾病 （1·23， 1·14-1·34）、治疗中断 （2·39， 1·49-3·29）、失访风险 （2·53， 1·41-4·53）、病毒学失败 （1·80， 1·25-2·60） 和免疫学失败 （3·70， 2·17-12·50）与一般人群相比。在 WHO 区域的子分析中，最初来自非洲区域的人发生 HIV 相关不良结局的风险更高。解释 与非移民人群相比，居住在欧洲的 HIV 感染移民面临更高的 AIDS 进展、失访、治疗中断以及病毒学和免疫学失败的风险。迫切需要旨在改善居住在欧洲的移民的 HIV 护理的干预措施。资金 无。