{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:27:54Z","timestamp":1789547274611,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["#148522"],"award-info":[{"award-number":["#148522"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["320030_159868"],"award-info":[{"award-number":["320030_159868"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["33CS30_148522"],"award-info":[{"award-number":["33CS30_148522"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The number of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals from developed countries travelling to tropical and subtropical areas has increased as a result of the clinical and survival benefits of combination antiretroviral therapy. The aim of our study was to describe the traveler population in the SHCS and to determine the frequency of viral rebound in virologically suppressed individuals after a travel episode to the tropics compared to non\u2010travelers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Swiss <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> Cohort Study participants with at least one follow\u2010up visit between 1 January 1989 and 28 February 2015 were eligible for inclusion in the study. The primary outcome was the occurrence of viral rebound (viral load &gt; 200 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u20101 <jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content> copies\/mL) after a travel episode compared with a nontravel episode in previously suppressed individuals (\u2264 200 copies\/mL). All virologically suppressed patients contributed multiple travel or nontravel episodes to the analysis. Logistic regression was performed including factors associated with viral rebound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 16 635 patients in the study, of whom 6084 (36.5%) had ever travelled to the tropics. Travel frequency increased over time, with travellers showing better <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> parameters than nontravellers [less advanced Centers for Disease Control and Prevention (<jats:styled-content style=\"fixed-case\">CDC<\/jats:styled-content>) stage and higher <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 count nadir]. Viral rebound was seen in 477 (3.9%) of 12 265 travel episodes and in 5121 (4.5%) of 114 884 nontravel episodes [unadjusted odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 0.87; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.78\u20130.97]. Among these 477 post\u2010travel viral rebounds, 115 had a resistance test performed and 51 (44%) of these showed new resistance mutations. Compared with European and North American patients, the odds for viral rebound were significantly lower in Southeast Asian (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.67; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.51\u20130.88) and higher in sub\u2010Saharan African (<jats:styled-content style=\"fixed-case\">SSA<\/jats:styled-content>) patients (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.41; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.22\u20131.62). Travel further increased the odds of viral rebound in <jats:styled-content style=\"fixed-case\">SSA<\/jats:styled-content> patients (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.00; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.53\u20132.61).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Region of origin is the main risk factor for viral rebound rather than travel <jats:italic>per se<\/jats:italic>. Pre\u2010travel adherence counselling should focus on patients of <jats:styled-content style=\"fixed-case\">SSA<\/jats:styled-content> origin.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12491","type":"journal-article","created":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T07:26:40Z","timestamp":1488353200000},"page":"564-572","source":"Crossref","is-referenced-by-count":7,"title":["Ethnicity predicts viral rebound after travel to the tropics in HIV\u2010infected travelers to the tropics in the Swiss HIV Cohort Study"],"prefix":"10.1111","volume":"18","author":[{"given":"HM","family":"Gebreselassie","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Inselspital Bern University Hospital University of Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Kraus","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Inselspital Bern University Hospital University of Bern 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