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Turner CP, Gutierrez S, Liu C, Miller L, Chou J, Finucane B, Carnes A, Kim J, Shing E, Haddad T, Phillips A. Strategies to defeat ketamine-induced neonatal brain injury. Neuroscience 2012; 210:384-92. [PMID: 22406413 DOI: 10.1016/j.neuroscience.2012.02.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 02/03/2012] [Accepted: 02/07/2012] [Indexed: 11/19/2022]
Abstract
Studies using animal models have shown that general anesthetics such as ketamine trigger widespread and robust apoptosis in the infant rodent brain. Recent clinical evidence suggests that the use of general anesthetics on young children (at ages equivalent to those used in rodent studies) can promote learning deficits as they mature. Thus, there is a growing need to develop strategies to prevent this injury. In this study, we describe a number of independent approaches to address therapeutic intervention. Postnatal day 7 (P7) rats were injected with vehicle (sterile PBS) or the NMDAR antagonist ketamine (20 mg/kg). After 8 h, we prepared brains for immunohistochemical detection of the pro-apoptotic enzyme activated caspase-3 (AC3). Focusing on the somatosensory cortex, AC3-positive cells were then counted in a non-biased stereological manner. We found AC3 levels were markedly increased in ketamine-treated animals. In one study, microarray analysis of the somatosensory cortex from ketamine-treated P7 pups revealed that expression of activity dependent neuroprotective protein (ADNP) was enhanced. Thus, we injected P7 animals with the ADNP peptide fragment NAPVSIPQ (NAP) 15 min before ketamine administration and found we could dose-dependently reverse the injury. In separate studies, pretreatment of P6 animals with 20 mg/kg vitamin D(3) or a nontoxic dose of ketamine (5 mg/kg) also prevented ketamine-induced apoptosis at P7. In contrast, pretreatment of P7 animals with aspirin (30 mg/kg) 15 min before ketamine administration actually increased AC3 counts in some regions. These data show that a number of unique approaches can be taken to address anesthesia-induced neurotoxicity in the infant brain, thus providing MDs with a variety of alternative strategies that enhance therapeutic flexibility.
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Burr J, Bredin S, Phillips A, Foulds H, Cote A, Charlesworth S, Ivey A, Drury T, Fougere R, Warburton D. Systemic Arterial Compliance Following Ultra-Marathon. Int J Sports Med 2012; 33:224-9. [DOI: 10.1055/s-0031-1297956] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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103
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Worm SW, Kamara DA, Reiss P, Fontas E, De Wit S, El-Sadr W, D′Arminio Monforte A, Law M, Phillips A, Ryom L, Dabis F, Weber R, Sabin C, Lundgren JD. Evaluation of HIV Protease Inhibitor Use and the Risk of Sudden Death or Nonhemorrhagic Stroke. J Infect Dis 2012; 205:535-9. [DOI: 10.1093/infdis/jir788] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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104
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Fawcett A, Phillips A. Clinical snapshot: A corn in a whippet. COMPENDIUM (YARDLEY, PA) 2012; 34:E3. [PMID: 23713159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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105
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Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54:136-60. [PMID: 22197856 DOI: 10.1097/mpg.0b013e31821a23d0] [Citation(s) in RCA: 1704] [Impact Index Per Article: 142.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen (HLA)-DQ2 and HLA-DQ8; and CD-specific antibody tests have improved. METHODS A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process. Two groups of patients were defined with different diagnostic approaches to diagnose CD: children with symptoms suggestive of CD (group 1) and asymptomatic children at increased risk for CD (group 2). The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CD-specific antibody testing. RESULTS In group 1, the diagnosis of CD is based on symptoms, positive serology, and histology that is consistent with CD. If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high (>10 times the upper limit of normal), then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests. In group 2, the diagnosis of CD is based on positive serology and histology. HLA-DQ2 and HLA-DQ8 testing is valuable because CD is unlikely if both haplotypes are negative. CONCLUSIONS The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families. The performance of these guidelines in clinical practice should be evaluated prospectively.
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Phillips A. Book review. WOMENS STUDIES INTERNATIONAL FORUM 2012. [DOI: 10.1016/j.wsif.2011.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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107
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Beatty JA, Tasker S, Jarrett O, Lam A, Gibson S, Noe-Nordberg A, Phillips A, Fawcett A, Barrs VR. Markers of Feline Leukaemia Virus Infection or Exposure in Cats from a Region of Low Seroprevalence. J Feline Med Surg 2011; 13:927-33. [PMID: 21880527 DOI: 10.1016/j.jfms.2011.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 07/11/2011] [Accepted: 07/16/2011] [Indexed: 11/18/2022]
Abstract
Molecular techniques have demonstrated that cats may harbour feline leukaemia virus (FeLV) provirus in the absence of antigenaemia. Using quantitative real-time polymerase chain reaction (qPCR), p27 enzyme-linked immunosorbent assay (ELISA), anti-feline oncornavirus-associated cell-membrane-antigen (FOCMA) antibody testing and virus isolation (VI) we investigated three groups of cats. Among cats with cytopenias or lymphoma, 2/75 were transiently positive for provirus and anti-FOCMA antibodies were the only evidence of exposure in another. In 169 young, healthy cats, all tests were negative. In contrast, 3/4 cats from a closed household where FeLV was confirmed by isolation, had evidence of infection. Our results support a role for factors other than FeLV in the pathogenesis of cytopenias and lymphoma. There was no evidence of exposure in young cats. In regions of low prevalence, where the positive predictive value of antigen testing is low, qPCR may assist with diagnosis.
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Phillips A, Burr J, Cote A, Foulds H, Charlesworth S, Bredin S, Warburton D. Comparing the Finapres and Caretaker Systems for Measuring Pulse Transit Time Before and After Exercise. Int J Sports Med 2011; 33:130-6. [DOI: 10.1055/s-0031-1291185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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109
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Behera MK, Sharma A, Dutta S, Sharma S, Julka PK, Rath GK, Kil WJ, Ko C, Kaushal A, Warran K, Ning H, Camphausen K, Smart D, Vern-Gross TZ, McMullen KP, Case LD, Bourland JD, Ellis TL, Lawrence JA, Tatter SB, Shaw EG, Urbanic JJ, Chan MD, Jensen RL, Shrieve DC, Mohindra P, Robins HI, Tome WA, Howard SP, Chen C, Damek D, Gaspar LE, Ney D, Waziri A, Lillehei K, Kavanagh BD, Wang CC, Floyd S, Chang CH, Warnke P, Chio CC, Kasper E, Mahadevan A, Wong E, Jeyapalan S, Chen C, Mahajan A, Grosshans D, McAleer MF, Brown PD, Chintagumpala M, Vats T, Puduvalli V, Yock T, Schulder M, Herschmann Y, Ghaly M, Knisely J, Ghaly M, Kapur A, Schulder M, Knisely J, Goetz P, Lwu S, Ebinu J, Arayee M, Monsalves E, Laperriere N, Menard C, Bernstein M, Zadeh G, Loganathan AG, Chan MD, Alphonse N, Peiffer AM, Johnson A, McMullen KP, Urbanic JJ, Saconn PA, Bourland JD, Munley MT, Shaw EG, Tatter SB, Ellis TL, Lwu S, Goetz P, Aryaee M, Monsalves E, Laperriere N, Menard C, Bernstein M, Zadeh G, Mahajan A, Lowe C, McAleer MF, Grosshans D, DeGroot J, Mark G, Vats T, Brown PD, Ruda R, Trevisan E, Magliola U, Bertero L, Bosa C, Ricardi U, Soffietti R, Rajappa P, Margetis K, Wernicke AG, Sherr DL, Lavi E, Fine RL, Schwartz T, Pannullo SC, Laack N, Blanchard M, Buckner J, Glass J, Andrews DW, Werner-Wasik M, Evans J, Lawrence YR, Shi W, Strauss I, Corn BW, Matceyevsky D, Alani S, Gez E, Shtraus N, Kanner AA, Spasic M, Choy W, Nagasawa D, Yang I, Noel M, Woolf E, Smith R, Castillo-Rojas P, Sorenson S, Smith K, Scheck AC, Han SJ, Oh MC, Sughrue ME, Rutkowski MJ, Aranda D, Barani IJ, Parsa AT, Redmond KJ, Horska A, Ishaq O, Ford E, McNutt T, Batra S, Kleinberg L, Wharam M, Mahone M, Terezakis S, Ryu S, Rock J, Movsas B, Mikkelsen T, Rosenblum M, Sabsevitz D, Bovi JA, Leo P, LaViolette P, Rand S, Mueller W, Phillips A, Venkatramani R, Olch A, Grimm J, Davidson T, Brown R, Dhall G, Finlay J, Wong K. RADIATION THERAPY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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110
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Waters L, Fisher M, Anderson J, Wood C, Delpech V, Hill T, Walsh J, Orkin C, Bansi L, Gompels M, Phillips A, Johnson M, Gilson R, Easterbrook P, Leen C, Porter K, Gazzard B, Sabin C. Authors' response to Drs Scourfield, Jackson and Nelson. HIV Med 2011. [DOI: 10.1111/j.1468-1293.2011.00932.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Prudden H, Foss A, Mitchell K, Pickles M, Phillips A, Ramesh BM, Washington R, Alary M, Lowndes C, Vickerman P. P1-S4.18 Using mathematical modelling to investigate the role of the hidden "population of men who have sex with men (MSM) on the HIV epidemic in Southern India". Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mitchell K, Foss A, Prudden H, Williams J, Johnson H, Pickles M, Phillips A, Ramesh B, Washington R, Vickerman P. P1-S4.24 Balancing the "supply and demand" of sex acts: implications for modelling the HIV epidemic among men who have sex with men in Southern India. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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113
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Higgins J, Hodges N, Olliff C, Katz T, Phillips A. The Use of Electrical Conductivity to Assess the Potential Activity of Cryoprotectives. J Pharm Pharmacol 2011. [DOI: 10.1111/j.2042-7158.1985.tb14193.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Higgins J, Hodges N, Olliff C, Phillips A. The Evaluation of Betaine as a Liposome Cryoprotective. J Pharm Pharmacol 2011. [DOI: 10.1111/j.2042-7158.1985.tb14127.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Van Hateren A, James E, Bailey A, Phillips A, Dalchau N, Elliott T. The cell biology of major histocompatibility complex class I assembly: towards a molecular understanding. ACTA ACUST UNITED AC 2011; 76:259-75. [PMID: 21050182 DOI: 10.1111/j.1399-0039.2010.01550.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Major histocompatibility complex class I (MHC I) proteins protect the host from intracellular pathogens and cellular abnormalities through the binding of peptide fragments derived primarily from intracellular proteins. These peptide-MHC complexes are displayed at the cell surface for inspection by cytotoxic T lymphocytes. Here we reveal how MHC I molecules achieve this feat in the face of numerous levels of quality control. Among these is the chaperone tapasin, which governs peptide selection in the endoplasmic reticulum as part of the peptide-loading complex, and we propose key amino acid interactions central to the peptide selection mechanism. We discuss how the aminopeptidase ERAAP fine-tunes the peptide repertoire available to assembling MHC I molecules, before focusing on the journey of MHC I molecules through the secretory pathway, where calreticulin provides additional regulation of MHC I expression. Lastly we discuss how these processes culminate to influence immune responses.
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Antinori A, Coenen T, Costagiola D, Dedes N, Ellefson M, Gatell J, Girardi E, Johnson M, Kirk O, Lundgren J, Mocroft A, D'Arminio Monforte A, Phillips A, Raben D, Rockstroh JK, Sabin C, Sönnerborg A, De Wolf F. Late presentation of HIV infection: a consensus definition. HIV Med 2011; 12:61-4. [PMID: 20561080 DOI: 10.1111/j.1468-1293.2010.00857.x] [Citation(s) in RCA: 329] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Across Europe, almost a third of individuals infected with HIV do not enter health care until late in the course of their infection. Surveillance to identify the extent to which late presentation occurs remains inadequate across Europe and is further complicated by the lack of a common clinical definition of late presentation. The objective of this article is to present a consensus definition of late presentation of HIV infection. METHODS Over the past year, two initiatives have moved towards a harmonized definition. In spring 2009, they joined efforts to identify a common definition of what is meant by a 'late-presenting' patient. RESULTS Two definitions were agreed upon, as follows. Late presentation: persons presenting for care with a CD4 count below 350 cells/μL or presenting with an AIDS-defining event, regardless of the CD4 cell count. Presentation with advanced HIV disease: persons presenting for care with a CD4 count below 200 cells/μL or presenting with an AIDS-defining event, regardless of the CD4 cell count. CONCLUSION The European Late Presenter Consensus working group believe it would be beneficial if all national health agencies, institutions, and researchers were able to implement this definition (either on its own or alongside their own preferred definition) when reporting surveillance or research data relating to late presentation of HIV infection.
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Waters L, Fisher M, Anderson J, Wood C, Delpech V, Hill T, Walsh J, Orkin C, Bansi L, Gompels M, Phillips A, Johnson M, Gilson R, Easterbrook P, Leen C, Porter K, Gazzard B, Sabin C. Responses to highly active antiretroviral therapy and clinical events in patients with a low CD4 cell count: late presenters vs. late starters. HIV Med 2010; 12:289-98. [PMID: 21054749 DOI: 10.1111/j.1468-1293.2010.00881.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We investigated whether adverse responses to highly active antiretroviral therapy (HAART) associated with late HIV presentation are secondary to low CD4 cell count per se or other confounding factors. METHODS A longitudinal analysis of the UK Collaborative HIV Cohort (CHIC) Study of individuals starting HAART in 1998-2007 was carried out, comparing late presenters (presenting/starting HAART at a CD4 count <200 cells/μL) with late starters (presenting at a CD4 count>350 cells/μL; starting HAART at a CD4 count<200 cells/μL), using 'ideal starters' (presenting at a CD4 count>350 cells/μL; starting HAART at a CD4 count of 200-350 cells/μL) as a comparator. Virological, immunological and clinical (new AIDS event/death) outcomes at 48 and 96 weeks were analysed, with the analysis being limited to those remaining on HAART for>3 months. RESULTS A total of 4978 of 9095 individuals starting first-line HAART with HIV RNA>500 HIV-1 RNA copies/mL were included in the analysis: 2741 late presenters, 947 late starters and 1290 ideal starters. Late presenters were more commonly female, heterosexual and Black African. Most started nonnucleoside reverse transcriptase inhibitors (NNRTIs); 48-week virological suppression was similar in late presenters and starters (and marginally lower than in ideal starters); by week 96 differences were reduced and nonsignificant. The median CD4 cell count increase in late presenters was significantly lower than that in late starters (weeks 48 and 96). During year 1, new clinical events were more frequent for late presenters [odds ratio (OR) 2.04; 95% confidence interval (CI) 1.19-3.51; P=0.01]; by year 2, event rates were similar in all groups. CONCLUSION Amongst patients who initiate, and remain on, HAART, late presentation is associated with lower rates of virological suppression, blunted CD4 cell count increases and more clinical events compared with late starters in year 1, but similar clinical and immunological outcomes by year 2 to those of both late and ideal starters. Differences between late presenters and late starters suggest that factors other than CD4 cell count alone may be driving adverse treatment outcomes in late-presenting individuals.
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Gorman G, Turnbull DM, Horvath R, Whittaker R, Phillips A, Cadogan M, Elson JL, McColl E, Apabhai S, MaFarland R. POG06 Development and validation of a quality of life scale for mitochondrial disease (Mito-QoL). Journal of Neurology, Neurosurgery and Psychiatry 2010. [DOI: 10.1136/jnnp.2010.226340.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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119
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Alba R, Phillips A, Mackie S, Gillikin N, Maxwell C, Brune P, Ridley W, Fitzpatrick J, Levine M, Harris S. Improvements to the International Life Sciences Institute Crop Composition Database. J Food Compost Anal 2010. [DOI: 10.1016/j.jfca.2010.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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120
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Fawcett A, Phillips A, Billson M. Ocular hemangiosarcoma in a husky. COMPENDIUM (YARDLEY, PA) 2010; 32:E8. [PMID: 23705189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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121
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Lazarus JV, Jürgens R, Weait M, Phillips A, Hows J, Gatell J, Coenen T, Sönnerborg A, Raben D, Lundgren JD. Overcoming obstacles to late presentation for HIV infection in Europe. HIV Med 2010; 12:246-9. [DOI: 10.1111/j.1468-1293.2010.00872.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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122
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Turner J, Bansi L, Gilson R, Gazzard B, Walsh J, Pillay D, Orkin C, Phillips A, Easterbrook P, Johnson M, Porter K, Schwenk A, Hill T, Leen C, Anderson J, Fisher M, Sabin C. The prevalence of hepatitis C virus (HCV) infection in HIV-positive individuals in the UK - trends in HCV testing and the impact of HCV on HIV treatment outcomes. J Viral Hepat 2010; 17:569-77. [PMID: 19840365 DOI: 10.1111/j.1365-2893.2009.01215.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We examined the prevalence of hepatitis C virus (HCV) infection among HIV-positive individuals in the UK, trends in HCV testing and the impact of HCV on HIV treatment outcomes. Trends over time in HCV prevalence were calculated using each patient's most recent HCV status at the end of each calendar year. Logistic regression was used to identify factors associated with having a HCV antibody test, and Cox regression was used to determine whether HCV status was associated with the time to experiencing an immunological response to highly active antiretroviral treatment (HAART), time to virological response and viral rebound. Of the 31,765 HIV-positive individuals seen for care between January 1996 and September 2007, 20,365 (64.1%) individuals were tested for HCV, and 1807 (8.9%) had detectable HCV antibody. The proportion of patients in follow-up ever tested for HCV increased over time, from 782/8505 (9.2%) in 1996 to 14,280/17,872 (79.9%) in 2007. Nine thousand six hundred and sixty-nine individuals started HAART for the first time in or after January 2000, of whom, 396 (4.1%) were HCV positive. Presence of HCV infection did not affect initial virological response, virological rebound or immunological response. The cumulative prevalence of HCV in the UK CHIC Study is 8.9%. Despite UK guidelines, over 20% of HIV-positive individuals have not had their HCV status determined by 2007. HCV infection had no impact on HIV virological outcomes or immunological response to HIV treatment. The long-term impact on morbidity and mortality remain to be determined.
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Elson J, Cadogan M, Apabhai S, Phillips A, McFarland R, Whittaker R, Horvath R, McColl E, Turnbull D, Gorman G. P71 Development and validation of a mitochondrial disease-specific quality of life scale (Mito-QOL). Neuromuscul Disord 2010. [DOI: 10.1016/s0960-8966(10)70086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bansi L, Sabin C, Delpech V, Hill T, Fisher M, Walsh J, Chadborn T, Easterbrook P, Gilson R, Johnson M, Porter K, Anderson J, Gompels M, Leen C, Ainsworth J, Orkin C, Nelson M, Rice B, Phillips A. Trends over calendar time in antiretroviral treatment success and failure in HIV clinic populations. HIV Med 2010; 11:432-8. [PMID: 20146736 DOI: 10.1111/j.1468-1293.2009.00809.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Effective antiretroviral therapy (ART) has transformed the care of people with HIV, but it is important to monitor time trends in indicators of treatment success and antic future changes. METHODS We assessed time trends from 2000 to 2007 in several indicators of treatment success in the UK Collaborative HIV Cohort (CHIC) Study, and using national HIV data from the Health Protection Agency (HPA) we developed a model to project future trends. RESULTS The proportion of patients on ART with a viral load <50 HIV-1 RNA copies/mL increased from 62% in 2000 to 84% in 2007, and the proportion of all patients with a CD4 count <200 cells/microL decreased from 21% to 10%. During this period, the number of patients who experienced extensive triple class failure (ETCF) rose from 147 (0.9%) to 1771 (3.9%). The number who experienced such ETCF and had a current viral load >50 copies/mL rose fromz 118 (0.7%) to 857 (1.9%). Projections to 2012 suggest sustained high levels of success, with a continued increase in the number of patients who have failed multiple drugs but a relatively stable number of such patients experiencing viral loads >50 copies/mL. Numbers of deaths are projected to remain low. CONCLUSIONS There have been continued improvements in key indicators of success in patients with HIV from 2000 to 2007. Although the number of patients who have ETCF is projected to rise in the future, the number of such patients with viral loads >50 copies/mL is not projected to increase up to 2012. New drugs may be needed in future to sustain these positive trends.
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Windsor J, Loveday B, Petrov M, Connor S, Rossaak J, Mittal A, Phillips A. Classification of Invasive Procedures for Treating the Local Complications of Acute Pancreatitis. J Surg Res 2010. [DOI: 10.1016/j.jss.2009.11.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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