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Ozhmegova EN, Kuznetsova AI, Lebedev AV, Antonova AA, Kim KV, Munchak YM, Tumanov AS, Kazennova EV. Efficacy of first-line ART regimens based on tenofovir in HIV-infected patients with pre-existing A62V mutation in reverse transcriptase. Vopr Virusol 2024; 69:231-240. [PMID: 38996372 DOI: 10.36233/0507-4088-232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION The amino acid substitution A62V in reverse transcriptase was identified as a mutation correlated with virologic failure in patients on first-line therapy including tenofovir (TDF) and tenofovir alafenamide (TAF). A62V is a typically polymorphic mutation in HIV-1 sub-subtype A6, which is the most widespread virus variant in Russia. MATERIALS AND METHODS The European EuResist (EIDB) database was queried to form two equivalent groups of patients: group 1 ‒ patients with A62V at baseline treated with TDF or TAF on the first-line therapy, group 2 ‒ patients without A62V at baseline treated with TDF or TAF on the first-line therapy. Each group included 23 patients. RESULTS There was no statistical difference between the two groups in virologic efficacy in 4, 12, and 24 weeks after the start of antiretroviral therapy (ART) and in the frequency of virologic failures. CONCLUSION This study has some limitations, and the exact role of A62V in the efficacy of the first-line ART based on tenofovir deserves further investigation.
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Affiliation(s)
- E N Ozhmegova
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
| | - A I Kuznetsova
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
| | - A V Lebedev
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
| | - A A Antonova
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
| | - K V Kim
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
| | - Y M Munchak
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
| | - A S Tumanov
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
| | - E V Kazennova
- National Research Center for Epidemiology and Microbiology named after the Honorary Academician N.F. Gamaleya of the Russian Ministry of Health
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Weibull Wärnberg A, Brännström J, Elvstam O, Gisslén M, Månsson F, Sönnerborg A, van de Klundert MA. The molecular epidemiology of HIV-1 in Sweden 1996 to 2022, and the influence of migration from Ukraine. Euro Surveill 2023; 28:2300224. [PMID: 38037731 PMCID: PMC10690863 DOI: 10.2807/1560-7917.es.2023.28.48.2300224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/04/2023] [Indexed: 12/02/2023] Open
Abstract
BackgroundThe global distribution of HIV-1 subtypes is evolving, which is reflected in the Swedish HIV cohort. The subtype HIV-1A6, which may be prone to developing resistance to cabotegravir, is the most common subtype in Ukraine.AimWe aimed to examine trends in HIV-1 subtype distribution in Sweden, with a special focus on HIV-1A6, and to describe the virology, demography and treatment of Ukrainian people living with HIV (PLWH) who migrated to Sweden in 2022.MethodsData about PLWH in Sweden are included in a national database (InfCareHIV). We used the online tool COMET to establish HIV-1 subtypes and the Stanford database to define drug resistance mutations. We investigated the relation between virological characteristics and demographic data.ResultsThe early epidemic was predominated by HIV-1 subtype B infections in people born in Sweden. After 1990, the majority of new PLWH in Sweden were PLWH migrating to Sweden, resulting in an increasingly diverse epidemic. In 2022, HIV-1A6 had become the sixth most common subtype in Sweden and 98 of the 431 new PLWH that were registered in Sweden came from Ukraine. We detected HIV RNA in plasma of 32 Ukrainian patients (34%), of whom 17 were previously undiagnosed, 10 had interrupted therapy and five were previously diagnosed but not treated. We found HIV-1A6 in 23 of 24 sequenced patients.ConclusionThe molecular HIV epidemiology in Sweden continues to diversify and PLWH unaware of their HIV status and predominance of HIV-1A6 should be considered when arranging care directed at PLWH from Ukraine.
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Affiliation(s)
- Anna Weibull Wärnberg
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Johanna Brännström
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Södersjukhuset, Stockholm, Sweden
| | - Olof Elvstam
- Department of Translational Medicine, Clinical Infection Medicine, Lund University, Malmö
- Department of Infectious Diseases, Växjö Central Hospital, Växjö, Sweden
| | - Magnus Gisslén
- Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Månsson
- Department of Translational Medicine, Clinical Infection Medicine, Lund University, Malmö
| | - Anders Sönnerborg
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Maarten Aa van de Klundert
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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Rossetti B, Incardona F, Di Teodoro G, Mommo C, Saladini F, Kaiser R, Sönnerborg A, Lengauer T, Zazzi M. Cohort Profile: A European Multidisciplinary Network for the Fight against HIV Drug Resistance (EuResist Network). Trop Med Infect Dis 2023; 8:tropicalmed8050243. [PMID: 37235291 DOI: 10.3390/tropicalmed8050243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
The EuResist cohort was established in 2006 with the purpose of developing a clinical decision-support tool predicting the most effective antiretroviral therapy (ART) for persons living with HIV (PLWH), based on their clinical and virological data. Further to continuous extensive data collection from several European countries, the EuResist cohort later widened its activity to the more general area of antiretroviral treatment resistance with a focus on virus evolution. The EuResist cohort has retrospectively enrolled PLWH, both treatment-naïve and treatment-experienced, under clinical follow-up from 1998, in nine national cohorts across Europe and beyond, and this article is an overview of its achievement. A clinically oriented treatment-response prediction system was released and made available online in 2008. Clinical and virological data have been collected from more than one hundred thousand PLWH, allowing for a number of studies on the response to treatment, selection and spread of resistance-associated mutations and the circulation of viral subtypes. Drawing from its interdisciplinary vocation, EuResist will continue to investigate clinical response to antiretroviral treatment against HIV and monitor the development and circulation of HIV drug resistance in clinical settings, along with the development of novel drugs and the introduction of new treatment strategies. The support of artificial intelligence in these activities is essential.
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Affiliation(s)
- Barbara Rossetti
- Infectious Diseases Department, Infectious Diseases Unit, USL SUDEST Toscana, Misericordia Hospital, 58100 Grosseto, Italy
| | | | - Giulia Di Teodoro
- EuResist Network, 00152 Rome, Italy
- Department of Computer Control and Management Engineering Antonio Ruberti, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Francesco Saladini
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Rolf Kaiser
- Institute of Virology, University and University Hospital Cologne, University of Cologne, 50923 Cologne, Germany
| | - Anders Sönnerborg
- Department of Medicine Huddinge, Karolinska Institutet, Division of Infectious Diseases, 17177 Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institutet, Division of Clinical Microbiology, 17177 Stockholm, Sweden
| | - Thomas Lengauer
- Institute of Virology, University and University Hospital Cologne, University of Cologne, 50923 Cologne, Germany
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
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Kirichenko A, Kireev D, Lapovok I, Shlykova A, Lopatukhin A, Pokrovskaya A, Bobkova M, Antonova A, Kuznetsova A, Ozhmegova E, Shtrek S, Sannikov A, Zaytseva N, Peksheva O, Piterskiy M, Semenov A, Turbina G, Filoniuk N, Shemshura A, Kulagin V, Kolpakov D, Suladze A, Kotova V, Balakhontseva L, Pokrovsky V, Akimkin V. HIV-1 Drug Resistance among Treatment-Naïve Patients in Russia: Analysis of the National Database, 2006-2022. Viruses 2023; 15:v15040991. [PMID: 37112971 PMCID: PMC10141655 DOI: 10.3390/v15040991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
In Russia, antiretroviral therapy (ART) coverage has significantly increased, which, in the absence of routine genotyping testing, could lead to an increase in HIV drug resistance (DR). The aim of this study was to investigate the patterns and temporal trends in HIV DR as well as the prevalence of genetic variants in treatment-naïve patients from 2006 to 2022, using data from the Russian database (4481 protease and reverse transcriptase and 844 integrase gene sequences). HIV genetic variants, and DR and DR mutations (DRMs) were determined using the Stanford Database. The analysis showed high viral diversity, with the predominance of A6 (78.4%), which was the most common in all transmission risk groups. The overall prevalence of surveillance DRMs (SDRMs) was 5.4%, and it reached 10.0% in 2022. Most patients harbored NNRTI SDRMs (3.3%). The prevalence of SDRMs was highest in the Ural (7.9%). Male gender and the CRF63_02A6 variant were association factors with SDRMs. The overall prevalence of DR was 12.7% and increased over time, primarily due to NNRTIs. Because baseline HIV genotyping is unavailable in Russia, it is necessary to conduct surveillance of HIV DR due to the increased ART coverage and DR prevalence. Centralized collection and unified analysis of all received genotypes in the national database can help in understanding the patterns and trends in DR to improve treatment protocols and increase the effectiveness of ART. Moreover, using the national database can help identify regions or transmission risk groups with a high prevalence of HIV DR for epidemiological measures to prevent the spread of HIV DR in the country.
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Affiliation(s)
- Alina Kirichenko
- Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Dmitry Kireev
- Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Ilya Lapovok
- Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | | | | | - Anastasia Pokrovskaya
- Central Research Institute of Epidemiology, 111123 Moscow, Russia
- Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Marina Bobkova
- Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Anastasiia Antonova
- Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Anna Kuznetsova
- Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Ekaterina Ozhmegova
- Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Sergey Shtrek
- Omsk Research Institute of Natural Focal Infections, 644080 Omsk, Russia
- Department of Microbiology, Virology and Immunology, Omsk State Medical University, 644099 Omsk, Russia
| | - Aleksej Sannikov
- Omsk Research Institute of Natural Focal Infections, 644080 Omsk, Russia
- Department of Microbiology, Virology and Immunology, Omsk State Medical University, 644099 Omsk, Russia
| | - Natalia Zaytseva
- Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 603022 Nizhny Novgorod, Russia
| | - Olga Peksheva
- Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 603022 Nizhny Novgorod, Russia
| | - Michael Piterskiy
- Federal Scientific Research Institute of Viral Infections «Virome» Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Ekaterinburg, Russia
| | - Aleksandr Semenov
- Federal Scientific Research Institute of Viral Infections «Virome» Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Ekaterinburg, Russia
| | - Galina Turbina
- Lipetsk Regional Center for Prevention and Control of AIDS and Infectious Diseases, 398043 Lipetsk, Russia
| | - Natalia Filoniuk
- Lipetsk Regional Center for Prevention and Control of AIDS and Infectious Diseases, 398043 Lipetsk, Russia
| | - Andrey Shemshura
- Clinical Center of HIV/AIDS Treatment and Prevention of the Ministry of Health of Krasnodar Region, 350000 Krasnodar, Russia
- Department of Infectious Diseases and Epidemiology, The Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University of the Ministry of Health of the Russian Federation, 350063 Krasnodar, Russia
| | - Valeriy Kulagin
- Clinical Center of HIV/AIDS Treatment and Prevention of the Ministry of Health of Krasnodar Region, 350000 Krasnodar, Russia
- Department of Infectious Diseases and Epidemiology, The Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University of the Ministry of Health of the Russian Federation, 350063 Krasnodar, Russia
| | - Dmitry Kolpakov
- Rostov Research Institute of Microbiology and Parasitology, 344000 Rostov-on-Don, Russia
| | - Aleksandr Suladze
- Rostov Research Institute of Microbiology and Parasitology, 344000 Rostov-on-Don, Russia
| | - Valeriya Kotova
- Khabarovsk Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 680610 Khabarovsk, Russia
| | - Lyudmila Balakhontseva
- Khabarovsk Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 680610 Khabarovsk, Russia
| | - Vadim Pokrovsky
- Central Research Institute of Epidemiology, 111123 Moscow, Russia
| | - Vasiliy Akimkin
- Central Research Institute of Epidemiology, 111123 Moscow, Russia
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Sayan M, Sultanoglu N, Sanlidag T. Dynamics of Rilpivirine Resistance-Associated Mutation: E138 in Reverse Transcriptase among Antiretroviral-Naive HIV-1-Infected Individuals in Turkey. AIDS Res Hum Retroviruses 2023; 39:84-90. [PMID: 36301912 DOI: 10.1089/aid.2022.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Rilpivirine, one of the non-nucleoside reverse transcriptase inhibitors class anti-HIV agents, is used as an alternative drug to treat HIV-1-positive individuals according to current antiretroviral therapy (ART) guidelines. Mutation in the position E138 in HIV-1 reverse transcriptase (RT) leads to resistance to rilpivirine, alone reducing its susceptibility two to threefolds. The main aim of this study was to determine the dynamics of E138 mutation in the RT domain of the HIV-1 pol gene; in 6398 newly diagnosed and treatment-naive individuals in Turkey from 2013 to 2021. Rilpivirine-associated mutations were found among 424 (6.6%) out of 6398. Individuals with the E138 mutation had significantly higher HIV-1 RNA load than individuals without the E138 mutation (p = .044). The E138 mutation was mainly observed in the B subtype (40%) of HIV-1 compared to the non-B subtypes (26.9%) and the circulating recombinant forms (33.1%) (p < .001). Most E138 mutations were E138A (80%), followed by E138G (16.5%). This study uncovered the dynamics of rilpivirine-associated mutations over a long period and a large patient population. Before administering ART regimens consisting of rilpivirine, resistance monitoring is highly recommended for effective patient management in the treatment-of naive HIV-1-infected individuals.
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Affiliation(s)
- Murat Sayan
- Clinical Laboratory, PCR Unit, Kocaeli University, Kocaeli, Turkey.,DESAM Research Institute, Near East University, Nicosia, North Cyprus.,Operational Research Center in Healthcare, Near East University, Nicosia, North Cyprus
| | - Nazife Sultanoglu
- DESAM Research Institute, Near East University, Nicosia, North Cyprus.,Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, North Cyprus
| | - Tamer Sanlidag
- DESAM Research Institute, Near East University, Nicosia, North Cyprus
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van de Klundert MAA, Antonova A, Di Teodoro G, Ceña Diez R, Chkhartishvili N, Heger E, Kuznetsova A, Lebedev A, Narayanan A, Ozhmegova E, Pronin A, Shemshura A, Tumanov A, Pfeifer N, Kaiser R, Saladini F, Zazzi M, Incardona F, Bobkova M, Sönnerborg A. Molecular Epidemiology of HIV-1 in Eastern Europe and Russia. Viruses 2022; 14:v14102099. [PMID: 36298654 PMCID: PMC9609922 DOI: 10.3390/v14102099] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 12/04/2022] Open
Abstract
The HIV epidemic in Eastern Europe and Russia is large and not well-controlled. To describe the more recent molecular epidemiology of HIV-1, transmitted drug resistance, and the relationship between the epidemics in this region, we sequenced the protease and reverse transcriptase genes of HIV-1 from 812 people living with HIV from Ukraine (n = 191), Georgia (n = 201), and Russia (n = 420) before the initiation of antiretroviral therapy. In 190 Ukrainian patients, the integrase gene sequence was also determined. The most reported route of transmission was heterosexual contact, followed by intravenous drug use, and men having sex with men (MSM). Several pre-existing drug resistance mutations were found against non-nucleoside reverse transcriptase inhibitors (RTIs) (n = 103), protease inhibitors (n = 11), and nucleoside analogue RTIs (n = 12), mostly polymorphic mutations or revertants. In the integrase gene, four strains with accessory integrase strand transfer inhibitor mutations were identified. Sub-subtype A6 caused most of the infections (713/812; 87.8%) in all three countries, including in MSM. In contrast to earlier studies, no clear clusters related to the route of transmission were identified, indicating that, within the region, the exchange of viruses among the different risk groups may occur more often than earlier reported.
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Affiliation(s)
| | - Anastasiia Antonova
- T-Lymphotropic Viruses Laboratory, Gamaleya Centre of Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Giulia Di Teodoro
- EuResist Network, 00152 Rome, Italy
- Department of Computer Control and Management Engineering Antonio Ruberti, Sapienza University of Rome, 00185 Rome, Italy
| | - Rafael Ceña Diez
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, 14152 Stockholm, Sweden
| | - Nikoloz Chkhartishvili
- Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC), 0160 Tbilisi, Georgia
| | - Eva Heger
- Institute of Virology, University of Cologne, 50935 Cologne, Germany
| | - Anna Kuznetsova
- T-Lymphotropic Viruses Laboratory, Gamaleya Centre of Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Aleksey Lebedev
- T-Lymphotropic Viruses Laboratory, Gamaleya Centre of Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Aswathy Narayanan
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, 14152 Stockholm, Sweden
| | - Ekaterina Ozhmegova
- T-Lymphotropic Viruses Laboratory, Gamaleya Centre of Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Alexander Pronin
- Moscow Regional Center for Control and Prevention of AIDS and Infectious Diseases, 123098 Moscow, Russia
| | - Andrey Shemshura
- Clinical Center of HIV/AIDS of the Ministry of Health of Krasnodar Region, 350015 Krasnodar, Russia
| | - Alexandr Tumanov
- T-Lymphotropic Viruses Laboratory, Gamaleya Centre of Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Nico Pfeifer
- Methods in Medical Informatics, Department of Computer Science, University of Tübingen, 72076 Tübingen, Germany
| | - Rolf Kaiser
- Institute of Virology, University of Cologne, 50935 Cologne, Germany
| | - Francesco Saladini
- Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
| | | | - Marina Bobkova
- T-Lymphotropic Viruses Laboratory, Gamaleya Centre of Epidemiology and Microbiology, 123098 Moscow, Russia
- Correspondence: (M.B.); (A.S.)
| | - Anders Sönnerborg
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, 14152 Stockholm, Sweden
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
- Correspondence: (M.B.); (A.S.)
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