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Hofstra LM, Sauvageot N, Albert J, Alexiev I, Garcia F, Struck D, Van de Vijver DAMC, Åsjö B, Beshkov D, Coughlan S, Descamps D, Griskevicius A, Hamouda O, Horban A, Van Kasteren M, Kolupajeva T, Kostrikis LG, Liitsola K, Linka M, Mor O, Nielsen C, Otelea D, Paraskevis D, Paredes R, Poljak M, Puchhammer-Stöckl E, Sönnerborg A, Staneková D, Stanojevic M, Van Laethem K, Zazzi M, Zidovec Lepej S, Boucher CAB, Schmit JC, Wensing AMJ, Puchhammer-Stockl E, Sarcletti M, Schmied B, Geit M, Balluch G, Vandamme AM, Vercauteren J, Derdelinckx I, Sasse A, Bogaert M, Ceunen H, De Roo A, De Wit S, Echahidi F, Fransen K, Goffard JC, Goubau P, Goudeseune E, Yombi JC, Lacor P, Liesnard C, Moutschen M, Pierard D, Rens R, Schrooten Y, Vaira D, Vandekerckhove LPR, Van den Heuvel A, Van Der Gucht B, Van Ranst M, Van Wijngaerden E, Vandercam B, Vekemans M, Verhofstede C, Clumeck N, Van Laethem K, Beshkov D, Alexiev I, Lepej SZ, Begovac J, Kostrikis L, Demetriades I, Kousiappa I, Demetriou V, Hezka J, Linka M, Maly M, Machala L, Nielsen C, Jørgensen LB, Gerstoft J, Mathiesen L, Pedersen C, Nielsen H, Laursen A, Kvinesdal B, Liitsola K, Ristola M, Suni J, Sutinen J, Descamps D, Assoumou L, Castor G, Grude M, Flandre P, Storto A, Hamouda O, Kücherer C, Berg T, Braun P, Poggensee G, Däumer M, Eberle J, Heiken H, Kaiser R, Knechten H, Korn K, Müller H, Neifer S, Schmidt B, Walter H, Gunsenheimer-Bartmeyer B, Harrer T, Paraskevis D, Hatzakis A, Zavitsanou A, Vassilakis A, Lazanas M, Chini M, Lioni A, Sakka V, Kourkounti S, Paparizos V, Antoniadou A, Papadopoulos A, Poulakou G, Katsarolis I, Protopapas K, Chryssos G, Drimis S, Gargalianos P, Xylomenos G, Lourida G, Psichogiou M, Daikos GL, Sipsas NV, Kontos A, Gamaletsou MN, Koratzanis G, Sambatakou H, Mariolis H, Skoutelis A, Papastamopoulos V, Georgiou O, Panagopoulos P, Maltezos E, Coughlan S, De Gascun C, Byrne C, Duffy M, Bergin C, Reidy D, Farrell G, Lambert J, O'Connor E, Rochford A, Low J, Coakely P, O'Dea S, Hall W, Mor O, Levi I, Chemtob D, Grossman Z, Zazzi M, de Luca A, Balotta C, Riva C, Mussini C, Caramma I, Capetti A, Colombo MC, Rossi C, Prati F, Tramuto F, Vitale F, Ciccozzi M, Angarano G, Rezza G, Kolupajeva T, Vasins O, Griskevicius A, Lipnickiene V, Schmit JC, Struck D, Sauvageot N, Hemmer R, Arendt V, Michaux C, Staub T, Sequin-Devaux C, Wensing AMJ, Boucher CAB, van de Vijver DAMC, van Kessel A, van Bentum PHM, Brinkman K, Connell BJ, van der Ende ME, Hoepelman IM, van Kasteren M, Kuipers M, Langebeek N, Richter C, Santegoets RMWJ, Schrijnders-Gudde L, Schuurman R, van de Ven BJM, Åsjö B, Kran AMB, Ormaasen V, Aavitsland P, Horban A, Stanczak JJ, Stanczak GP, Firlag-Burkacka E, Wiercinska-Drapalo A, Jablonowska E, Maolepsza E, Leszczyszyn-Pynka M, Szata W, Camacho R, Palma C, Borges F, Paixão T, Duque V, Araújo F, Otelea D, Paraschiv S, Tudor AM, Cernat R, Chiriac C, Dumitrescu F, Prisecariu LJ, Stanojevic M, Jevtovic D, Salemovic D, Stanekova D, Habekova M, Chabadová Z, Drobkova T, Bukovinova P, Shunnar A, Truska P, Poljak M, Lunar M, Babic D, Tomazic J, Vidmar L, Vovko T, Karner P, Garcia F, Paredes R, Monge S, Moreno S, Del Amo J, Asensi V, Sirvent JL, de Mendoza C, Delgado R, Gutiérrez F, Berenguer J, Garcia-Bujalance S, Stella N, de Los Santos I, Blanco JR, Dalmau D, Rivero M, Segura F, Elías MJP, Alvarez M, Chueca N, Rodríguez-Martín C, Vidal C, Palomares JC, Viciana I, Viciana P, Cordoba J, Aguilera A, Domingo P, Galindo MJ, Miralles C, Del Pozo MA, Ribera E, Iribarren JA, Ruiz L, de la Torre J, Vidal F, Clotet B, Albert J, Heidarian A, Aperia-Peipke K, Axelsson M, Mild M, Karlsson A, Sönnerborg A, Thalme A, Navér L, Bratt G, Karlsson A, Blaxhult A, Gisslén M, Svennerholm B, Bergbrant I, Björkman P, Säll C, Mellgren Å, Lindholm A, Kuylenstierna N, Montelius R, Azimi F, Johansson B, Carlsson M, Johansson E, Ljungberg B, Ekvall H, Strand A, Mäkitalo S, Öberg S, Holmblad P, Höfer M, Holmberg H, Josefson P, Ryding U. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe. Clin Infect Dis 2015; 62:655-663. [PMID: 26620652 PMCID: PMC4741360 DOI: 10.1093/cid/civ963] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/06/2015] [Indexed: 11/13/2022] Open
Abstract
Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors. Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)–infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%–9.5%) in 2008–2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.
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Affiliation(s)
- L Marije Hofstra
- Luxembourg Institute of Health, Luxembourg.,Department of Virology, University Medical Center Utrecht, The Netherlands
| | | | - Jan Albert
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
| | - Ivailo Alexiev
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Federico Garcia
- Complejo Hospitalario Universitario de Granada, Instituto de Investigación IBS Granada; on behalf of Cohorte de Adultos de la Red de Investigación en SIDA, Spain
| | | | | | | | - Danail Beshkov
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Diane Descamps
- AP-HP Groupe hospitalier Bichat-Claude Bernard, IAME INSERM UMR 1137, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | | | | | | | | | | | | | - Kirsi Liitsola
- Department of Infectious Diseases, National Institute for Health and Welfare, Helsinki, Finland
| | - Marek Linka
- National Reference Laboratory for HIV/AIDS, National Institute of Public Health, Prague, Czech Republic
| | - Orna Mor
- National HIV Reference Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Dan Otelea
- National Institute for Infectious Diseases "Prof. dr. Matei Bals", Bucharest, Romania
| | | | | | - Mario Poljak
- Faculty of Medicine, Slovenian HIV/AIDS Reference Centre, University of Ljubljana, Slovenia
| | | | - Anders Sönnerborg
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
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Dabrowska M, Mikula T, Wiercinska-Drapalo A. HCV co-infection may promote the subclinical left ventricular dysfunction development in HIV-infected subjects. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Dabrowska MM, Nazzal K, Wiercinska-Drapalo A. Hepatitis A and hepatitis A virus/HIV coinfection in men who have sex with men, Warsaw, Poland, September 2008 to September 2009. Euro Surveill 2011; 16:19950. [PMID: 21903035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
We describe the epidemiology and characteristics of hepatitis A among men who have sex with men (MSM)who had been hospitalised due to the infection in Warsaw, Poland, from September 2008 to September 2009. A total of 50 men were analysed; their median age was 28 years (range: 17–43). None had travelled to hepatitis A-endemic regions during the six months before hospitalisation nor had they been vaccinated against hepatitis A. Of the 50 men, 40 had been tested before hospitalisation or on admission for the presence of anti-HIV antibodies: six were coinfected with HIV.The six HIV-positive MSM were significantly older than those who were HIV negative – median age: 37 years(range: 26–43) versus 28 years (range: 17–43); p=0.02.No difference in disease severity or the duration of hospitalisation was observed, however, between the two groups. Our study underlines the need to screen MSM for hepatitis A and to vaccinate them against hepatitis A. Given the ages of the MSM in our study,we recommend that this be carried out in Poland when the MSM are aged 20–35 years. This should apply not only to MSM with multiple casual partners but also to those in monogamous relationships.
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Affiliation(s)
- M M Dabrowska
- Department of Hepatology and Acquired Immunodeficiences, Warsaw Medical University, Warsaw, Poland.
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Dabrowska MM, Nazzal K, Wiercinska-Drapalo A. Hepatitis A and hepatitis A virus/HIV coinfection in men who have sex with men, Warsaw, Poland, September 2008 to September 2009. Euro Surveill 2011. [DOI: 10.2807/ese.16.34.19950-en] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- M M Dabrowska
- Department of Hepatology and Acquired Immunodeficiences, Warsaw Medical University, Warsaw, Poland
| | - K Nazzal
- Hospital for Infectious Diseases, Warsaw, Poland
| | - A Wiercinska-Drapalo
- Department of Hepatology and Acquired Immunodeficiences, Warsaw Medical University, Warsaw, Poland
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Phillips AN, Ledergerber B, Bogner JR, Lacombe K, Wiercinska-Drapalo A, Reiss P, Kirk O, Lundgren JD, Mocroft A. O212 Rate of change in CD4 counts in patients with stable HIV viremia. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-o17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Stanczak GP, Przybylska-Stengiel KJ, Firlag-Burkacka E, Wiercinska-Drapalo A, Horban A, Stanczak JJ. Continuous decline in prevalence of drug resistance mutations among naïve and cART experienced HIV-positive patients in Poland over time. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wiercinska-Drapalo A, Jaroszewicz J, Tarasow E, Siergiejczyk L, Prokopowicz D. The possible association between serum cholesterol concentration and decreased bone mineral density as well as intravertebral marrow fat in HIV-1 infected patients. Infection 2007; 35:46-8. [PMID: 17297592 DOI: 10.1007/s15010-007-5033-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2005] [Accepted: 11/13/2006] [Indexed: 10/23/2022]
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Podlasin RB, Wiercinska-Drapalo A, Olczak A, Beniowski M, Smiatacz T, Malolepsza E, Juszczyk J, Leszczyszyn-Pynka M, Mach T, Mian M, Knysz B, Horban A. Opportunistic infections and other AIDS-defining illnesses in Poland in 2000-2002. Infection 2006; 34:196-200. [PMID: 16896577 DOI: 10.1007/s15010-006-5030-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2005] [Accepted: 03/08/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND The introduction of highly active antiretroviral therapy (HAART) led to a decreased incidence of the most severe opportunistic infections (OIs) in HIV-infected patients. In Poland, HAART became widely used in 1998. MATERIALS AND METHODS This study was based on data from medical records data collected in the years 2000-2002 from medical centers for HIV-infected patients in Poland. The aim of the study was to determine the incidence of opportunistic infections (OIs) and other AIDS defining illnesses (ADIs). The chi(2) test was used to determine any significant trends. RESULTS The incidence of ADIs was 6.8, 6.5 and 4.8/100 persons/year in 2000-2002, respectively. The most common diagnosed OIs were: fungal infections, tuberculosis, recurrent pneumonia, PCP and toxoplasmosis. In patients receiving HAART (HAART+) the incidence of ADIs was significantly lower than in non-ARV-treated as well as in all HIV+ (p < 0.02, p < 0.001, p < 0.001, respectively). A significant decrease in the incidence of ADIs in HAART+ patients between 2000 and 2002 (p < 0.0001) was observed. From 25% to 30% of ADIs among HAART+ patients were diagnosed within the first 3 months of antiretroviral therapy. In HAART+ patients the most common ADIs were fungal infections and tuberculosis. The diagnosis of ADIs resulted in the recognition of HIV status in 8.7-8.9% of patients. CONCLUSIONS Five years after the introduction of HAART the incidence of ADIs had declined. Fungal infections and tuberculosis were the most common OIs in HIV+ patients in Poland.
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Affiliation(s)
- R B Podlasin
- Hospital of Infectious Diseases, Wolska 37, 01-201, Warsaw, Poland.
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Mocroft A, Rockstroh J, Soriano V, Ledergerber B, Kirk O, Vinogradova E, Reiss P, Katlama C, Phillips AN, Lundgren JD, Losso M, Duran A, Vetter N, Karpov I, Vassilenko A, Clumeck N, De Wit S, Poll B, Machala L, Rozsypal H, Sedlacek D, Nielsen J, Lundgren J, Benfield T, Kirk O, Gerstoft J, Katzenstein T, Hansen ABE, Skinhøj P, Pedersen C, Zilmer K, Katlama C, Viard JP, Girard PM, Marc TS, Vanhems P, Pradier C, Dabis F, Dietrich M, Manegold C, Van Lunzen J, Stellbrink HJ, Staszewski S, Bickel M, Goebel FD, Fätkenheuer G, Rockstroh J, Schmidt R, Kosmidis J, Gargalianos P, Sambatakou H, Perdios J, Panos G, Banhegyi D, Mulcahy F, Yust I, Turner D, Burke M, Pollack S, Hassoun G, Sthoeger Z, Maayan S, Vella S, Chiesi A, Arici C, Pristerá R, Mazzotta F, Gabbuti A, Esposito R, Bedini A, Chirianni A, Montesarchio E, Vullo V, Santopadre P, Narciso P, Antinori A, Franci P, Zaccarelli M, Lazzarin A, Finazzi R, Monforte AD, Viksna L, Chaplinskas S, Hemmer R, Staub T, Reiss P, Bruun J, Maeland A, Ormaasen V, Knysz B, Gasiorowski J, Horban A, Prokopowicz D, Wiercinska-Drapalo A, Boron-Kaczmarska A, Pynka M, Beniowski M, Mularska E, Trocha H, Antunes F, Valadas E, Mansinho K, Matez F, Duiculescu D, Streinu-Cercel A, Vinogradova E, Rakhmanova A, Jevtovic D, Mokrás M, Staneková D, González-Lahoz J, Sánchez-Conde M, García-Benayas T, Martin-Carbonero L, Soriano V, Clotet B, Jou A, Conejero J, Tural C, Gatell JM, Miró JM, Blaxhult A, Karlsson A, Pehrson P, Ledergerber B, Weber R, Francioli P, Telenti A, Hirschel B, Soravia-Dunand V, Furrer H, Chentsova N, Barton S, Johnson AM, Mercey D, Phillips A, Johnson MA, Mocroft A, Murphy M, Weber J, Scullard G, Fisher M, Brettle R, Loveday C, Clotet B, Antunes F, Blaxhult A, Clumeck N, Gatell J, Horban A, Johnson A, Katlama C, Ledergerber B, Loveday C, Phillips A, Reiss P, Vella S, Lundgren J, Gjørup I, Kirk O, Friis-Moeller N, Mocroft A, Cozzi-Lepri A, Bannister W, Mollerup D, Podlevkareva D, Olsen CH, Kjær J. Are Specific Antiretrovirals associated with an Increased Risk of Discontinuation due to Toxicities or Patient/Physician Choice in patients with Hepatitis C Virus Coinfection? Antivir Ther 2005. [DOI: 10.1177/135965350501000704] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Liver damage associated with hepatitis C (HCV) may influence the likelihood of experiencing discontinuation due to toxicities or patient/physician choice (TOXPC) in patients taking combination antiretroviral therapy (cART). Little information to address this concern is available from clinical trials as patients with HCV are often excluded. Aims To compare incidence rates of discontinuation due to TOXPC associated with specific antiretrovial drugs in patients with or without HCV. Patients/methods A total of 4929 patients from EuroSIDA under follow-up from January 1999 on a specific nucleoside pair (zidovudine/lamivudine, didanosine/stavudine, stavudine/lamivudine, or other) with a third drug (abacavir, nelfinavir, indinavir, nevirapine, efavirenz, lopinavir/ ritonavir or other boosted-protease inhibitor (PI)-containing regimen) and with known HCV serostatus were studied for the incidence of discontinuation of any nucleoside pair or third drug due to TOXPC. Incidence rate ratios were derived from Poisson regression models. Results In total 1358 patients had HCV (27.5%). During 12 799 person-years of follow-up there were 2141 discontinuations due to TOXPC for nucleoside pairs and 2501 for third drugs. The incidence of discontinuation due to TOXPC was consistently higher in patients with HCV after stratification by nucleoside pair or third drug. After adjustment for CD4+ count, gender, exposure group, time on HAART, region and treatment regimen, there were few differences in the rate of discontinuation due to TOXPC in those with HCV compared with those without for any nucleoside pairs or third drugs. Similar results were seen when concentrating on discontinuation due to toxicities alone. Conclusions Although patients with HCV generally had higher rates of discontinuation due to TOXPC compared with patients without HCV, there was little evidence to suggest that this was associated with any specific nucleoside pair or third drug used as part of cART. Our results do not suggest that any specific component of cART is more poorly tolerated in patients with HCV or that the presence of HCV should influence the choice between antiretrovirals used as part of a cART regimen.
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Affiliation(s)
- Amanda Mocroft
- Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
| | | | | | | | - Ole Kirk
- Copenhagen HIV Program, Hvidovre Hospital, Copenhagen, Denmark
| | | | - Peter Reiss
- Academisch Medisch Centrum bij de Universiteit van Amsterdam, Amsterdam, the Netherlands
| | | | - Andrew N Phillips
- Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
| | - Jens D Lundgren
- Copenhagen HIV Program, Hvidovre Hospital, Copenhagen, Denmark
| | - M Losso
- Hospital JM Ramos Mejia, Buenos Aires
| | - A Duran
- Hospital JM Ramos Mejia, Buenos Aires
| | - N Vetter
- Pulmologisches Zentrum der Stadt Wien, Vienna
| | - I Karpov
- Belarus State Medical University, Minsk
| | | | - N Clumeck
- Saint-Pierre Hospital, Brussels; R Colebunders, Institute of Tropical Medicine, Antwerp
| | - S De Wit
- Saint-Pierre Hospital, Brussels; R Colebunders, Institute of Tropical Medicine, Antwerp
| | - B Poll
- Saint-Pierre Hospital, Brussels; R Colebunders, Institute of Tropical Medicine, Antwerp
| | | | | | | | | | | | | | - O Kirk
- Hvidovre Hospital, Copenhagen
| | | | | | | | | | | | - K Zilmer
- West-Tallinn Central Hospital, Tallinn
| | - C Katlama
- Hôpital de la Pitié-Salpétière, Paris
| | - J-P Viard
- Hôpital Necker-Enfants Malades, Paris
| | | | | | | | | | | | - M Dietrich
- Bernhard-Nocht-Institut for Tropical Medicine, Hamburg
| | - C Manegold
- Bernhard-Nocht-Institut for Tropical Medicine, Hamburg
| | | | | | | | - M Bickel
- JW Goethe University Hospital, Frankfurt
| | | | | | | | | | | | | | | | | | - G Panos
- A Filandras and E Karabatsaki, 1st IKA Hospital, Athens
| | | | | | - I Yust
- Ichilov Hospital, Tel Aviv
| | | | | | | | | | | | - S Maayan
- Hadassah University Hospital, Jerusalem
| | - S Vella
- Istituto Superiore di Sanita, Rome
| | - A Chiesi
- Istituto Superiore di Sanita, Rome
| | | | | | | | - A Gabbuti
- Ospedale S. Maria Annunziata, Florence
| | | | | | | | | | - V Vullo
- Università di Roma La Sapienza, Rome
| | | | | | | | | | | | | | | | | | - L Viksna
- Infectology Centre of Latvia, Riga
| | | | | | - T Staub
- Centre Hospitalier, Luxembourg
| | - P Reiss
- Academisch Medisch Centrum bij de Universiteit van Amsterdam, Amsterdam
| | | | | | | | | | | | - A Horban
- Centrum Diagnostyki i Terapii AIDS, Warsaw
| | | | | | | | | | | | - E Mularska
- Osrodek Diagnostyki i Terapii AIDS, Chorzow
| | | | | | | | | | - F Matez
- Hospital Curry Cabral, Lisbon
| | - D Duiculescu
- Spitalul de Boli Infectioase si Tropicale: Dr. Victor Babes, Bucarest
| | | | | | | | - D Jevtovic
- The Institute for Infectious and Tropical Diseases, Belgrade
| | | | | | | | | | | | | | | | - B Clotet
- Hospital Germans Trias i Pujol, Badalona
| | - A Jou
- Hospital Germans Trias i Pujol, Badalona
| | - J Conejero
- Hospital Germans Trias i Pujol, Badalona
| | - C Tural
- Hospital Germans Trias i Pujol, Badalona
| | - JM Gatell
- Hospital Clinic i Provincial, Barcelona
| | - JM Miró
- Hospital Clinic i Provincial, Barcelona
| | | | - A Karlsson
- Karolinska University Hospital, Stockholm
| | - P Pehrson
- Karolinska University Hospital, Huddinge
| | | | | | - P Francioli
- Centre Hospitalier Universitaire Vaudois, Lausanne
| | - A Telenti
- Centre Hospitalier Universitaire Vaudois, Lausanne
| | - B Hirschel
- Hospital Cantonal Universitaire de Geneve, Geneve
| | | | | | | | - S Barton
- St. Stephen's Clinic, Chelsea and Westminster Hospital, London
| | - AM Johnson
- Royal Free and University College London Medical School, London (University College Campus)
| | - D Mercey
- Royal Free and University College London Medical School, London (University College Campus)
| | - A Phillips
- Royal Free and University College Medical School, London (Royal Free Campus)
| | - MA Johnson
- Royal Free and University College Medical School, London (Royal Free Campus)
| | - A Mocroft
- Royal Free and University College Medical School, London (Royal Free Campus)
| | - M Murphy
- Medical College of Saint Bartholomew's Hospital, London
| | - J Weber
- Imperial College School of Medicine at St. Mary's, London
| | - G Scullard
- Imperial College School of Medicine at St. Mary's, London
| | - M Fisher
- Royal Sussex County Hospital, Brighton
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Wiercinska-Drapalo A, Jaroszewicz J, Tarasow E, Flisiak R, Prokopowicz D. Transforming growth factor beta1 and prostaglandin E2 concentrations are associated with bone formation markers in ulcerative colitis patients. Prostaglandins Other Lipid Mediat 2005; 78:160-8. [PMID: 16303613 DOI: 10.1016/j.prostaglandins.2005.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Revised: 05/25/2005] [Accepted: 06/23/2005] [Indexed: 01/05/2023]
Abstract
Osteoporosis is a significant complication of a multifactoral etiology associated with inflammatory bowel disease. The aim of study was to evaluate the relationships between bone mineral density as well as bone turnover markers and inflammatory activity modulators (i.e., PGE2 and TGFbeta1) in ulcerative colitis (UC). Twenty-one active ulcerative colitis subjects and 14 healthy individuals were included into the study. We observed no significant differences in serum concentrations of osteoprotegerin and osteocalcin, as well as bone mineral density between UC patients and healthy individuals. Plasma concentrations of PGE2, TGFbeta1 and TNF-alpha were significantly higher in UC patients than in controls. Serum osteocalcin demonstrated a positive correlation with both serum PGE2 and plasma TGFbeta1. Moreover there was significant correlation between osteoprotegerin and TGFbeta1 as well as serum TNF-alpha concentrations. In conclusion a positive association between PGE2 and TGFbeta1 and bone formation markers-osteoprotegerin and osteocalcin, as well as a comparable BMD in UC patients and healthy individuals was shown. Our results may indicate that increase of PGE2 as well as TGFbeta1 concentrations may play a protective role against bone loss in ulcerative colitis patients.
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Affiliation(s)
- A Wiercinska-Drapalo
- Department of Infectious Diseases, Medical University of Bialystok, Zurawia 14 Str., 15-540 Bialystok, Poland.
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11
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Cabrera C, Cozzi-Lepri A, Phillips AN, Loveday C, Kirk O, Ait-Khaled M, Reiss P, Kjær J, Ledergerber B, Lundgren JD, Clotet B, Ruiz L, Losso M, Duran A, Vetter N, Clumeck N, Hermans P, Sommereijns B, Colebunders R, Machala L, Rozsypal H, Nielsen J, Lundgren J, Benfield T, Kirk O, Gerstoft J, Katzenstein T, Røge B, Skinhøj P, Pedersen C, Zilmer K, Katlama C, De Sa M, Viard JP, Saint-Marc T, Vanhems P, Pradier C, Dietrich M, Manegold C, van Lunzen J, Stellbrink HJ, Miller V, Staszewski S, Goebel FD, Salzberger B, Rockstroh J, Kosmidis J, Gargalianos P, Sambatakou H, Perdios J, Panos G, Karydis I, Filandras A, Banhegyi D, Mulcahy F, Yust I, Burke M, Pollack S, Ben-Ishai Z, Bentwich Z, Maayan S, Vella S, Chiesi A, Arici C, Pristerá R, Mazzotta F, Gabbuti A, Esposito R, Bedini A, Chirianni A, Montesarchio E, Vullo V, Santopadre P, Narciso P, Antinori A, Franci P, Zaccarelli M, Lazzarin A, Finazzi R, D'Arminio Monforte A, Viksna L, Chaplinskas S, Hemmer R, Staub T, Reiss P, Bruun J, Maeland A, Ormaasen V, Knysz B, Gasiorowski J, Horban A, Prokopowicz D, Wiercinska-Drapalo A, Boron-Kaczmarska A, Pynka M, Beniowski M, Trocha H, Antunes F, Mansinho K, Proenca R, Duiculescu D, Streinu-Cercel A, Mikras M, González-Lahoz J, Diaz B, García-Benayas T, Martin-Carbonero L, Soriano V, Clotet B, Jou A, Conejero J, Tural C, Gatell JM, Miró JM, Blaxhult A, Karlsson A, Pehrson P, Ledergerber B, Weber R, Francioli P, Telenti A, Hirschel B, Soravia-Dunand V, Furrer H, Chentsova N, Barton S, Johnson AM, Mercey D, Phillips A, Loveday C, Johnson MA, Mocroft A, Pinching A, Parkin J, Weber J, Scullard G, Fisher M, Brettle R. Baseline Resistance and Virological Outcome in Patients with Virological Failure who Start a Regimen Containing Abacavir: Eurosida Study. Antivir Ther 2004. [DOI: 10.1177/135965350400900509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives To investigate the ability of several HIV-1 drug-resistance interpretation systems, as well as the number of pre-specified combinations of abacavir-related mutations, to predict virological response to abacavir-containing regimens in antiretroviral therapy-experienced, abacavir-naive patients starting an abacavir-containing regimen in the EuroSIDA cohort. Patients and methods A total of 100 HIV-infected patients with viral load (VL) >500 copies/ml who had a plasma sample available at the time of starting abacavir (baseline) were included. Resistance to abacavir was interpreted by using eight different commonly used systems that consisted of rules-based algorithms or tables of mutations. Correlation between baseline abacavir-resistance mutations and month 6 virological response was performed on this population using a multivariable linear regression model accounting for censored data. Results The baseline VL was 4.36 log10 RNA copies/ml [interquartile range (IQR): 3.65–4.99 log10 RNA copies/ml] and the median CD4 cell count was 210 cells/μl (IQR: 67–305 cells/μl). Our patients were pre-exposed to a median of seven antiretrovirals (2–12) before starting abacavir therapy. The median (range) number of abacavir mutations (according to the International AIDS Society-USA) detected at baseline was 3.5 (0–8). Overall, the Kaplan–Meier estimate of the median month 6 VL decline was 0.86 log10 RNA copies/ml [95% confidence intervals (95% CI): 0.45–1.24]. The VL in those patients ( n=31) who intensified treatment by adding only abacavir decreased by a median 0.20 log10 RNA copies/ml (95% CI: -0.18; +0.94). The proportion of patients who harboured viruses fully resistant to abacavir among the eight genotypic resistance interpretation algorithms ranged from 12% [Agence Nationale de Recherches sur le SIDA (ANRS)] to 79% [Stanford HIV RT and PR Sequence Database (HIVdb)]. Some interpretation systems showed statistically significant associations between the predicted resistance status and the virological response while others showed no consistent association. The number of active drugs in the regimen was associated with greater virological suppression (additional month 6 VL reduction per additional sensitive drug=0.51, 95% CI: 0.15–0.88, P=0.006); baseline VL was also weakly associated (additional month 6 VL reduction per log10 higher=0.30, 95% CI: -0.02; +0.62, P=0.06). In contrast, the number of drugs previously received was associated with diminished viral reduction (additional month 6 VL reduction per additional drug=-0.14, 95% CI: -0.28; 0.00, P=0.05). Conclusions Our results revealed a high degree of variability among several genotypic resistance interpretation algorithms currently in use for abacavir. Therefore, the interpretation of genotypic resistance for predicting response to regimens containing abacavir remains a major challenge.
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Affiliation(s)
| | - Cecilia Cabrera
- IrsiCaixa Foundation & Lluita contra la SIDA Foundation, Badalona, Spain
| | | | | | - Clive Loveday
- International Clinical Virology Centre (ICVC), Buckinghamshire, UK
| | - Ole Kirk
- EuroSIDA Coordinating Centre, Hvidovre University Hospital, Hvidovre, Denmark
| | | | - Peter Reiss
- Academisch Medisch Centrum bij de Universiteit van Amsterdam, Amsterdam, the Netherlands
| | - Jesper Kjær
- EuroSIDA Coordinating Centre, Hvidovre University Hospital, Hvidovre, Denmark
| | | | - Jens D Lundgren
- EuroSIDA Coordinating Centre, Hvidovre University Hospital, Hvidovre, Denmark
| | - Bonaventura Clotet
- IrsiCaixa Foundation & Lluita contra la SIDA Foundation, Badalona, Spain
| | - Lidia Ruiz
- IrsiCaixa Foundation & Lluita contra la SIDA Foundation, Badalona, Spain
| | - M Losso
- Hospital JM Ramos Mejia, Buenos Aires. Argentina
| | - A Duran
- Hospital JM Ramos Mejia, Buenos Aires. Argentina
| | - N Vetter
- Pulmologisches Zentrum der Stadt Wien, Vienna. Austria
| | - N Clumeck
- Saint-Pierre Hospital, Brussels; Belgium
| | - P Hermans
- Saint-Pierre Hospital, Brussels; Belgium
| | | | | | - L Machala
- Faculty Hospital Bulovka, Prague. Czech Republic
| | - H Rozsypal
- Faculty Hospital Bulovka, Prague. Czech Republic
| | - J Nielsen
- Hvidovre Hospital, Copenhagen; Denmark
| | | | | | - O Kirk
- Hvidovre Hospital, Copenhagen; Denmark
| | | | | | - B Røge
- Rigshospitalet, Copenhagen
| | | | | | - K Zilmer
- Tallinn Merimetsa Hospital, Tallinn. Estonia
| | - C Katlama
- Hôpital de la Pitié-Salpêtière, Paris; France
| | - M De Sa
- Hôpital de la Pitié-Salpêtière, Paris; France
| | - J-P Viard
- Hôpital Necker-Enfants Malades, Paris
| | | | | | | | - M Dietrich
- Bernhard-Nocht-Institut for Tropical Medicine, Hamburg; Germany
| | - C Manegold
- Bernhard-Nocht-Institut for Tropical Medicine, Hamburg; Germany
| | | | | | - V Miller
- JW Goethe University Hospital, Frankfurt
| | | | | | | | | | | | | | | | - J Perdios
- Athens General Hospital, Athens; Greece
| | | | | | | | | | - F Mulcahy
- St James's Hospital, Dublin. Ireland
| | - I Yust
- Ichilov Hospital, Tel Aviv; Israel
| | - M Burke
- Ichilov Hospital, Tel Aviv; Israel
| | | | | | | | - S Maayan
- Hadassah University Hospital, Jerusalem
| | - S Vella
- Istituto Superiore di Sanita, Rome; Italy
| | - A Chiesi
- Istituto Superiore di Sanita, Rome; Italy
| | | | | | | | - A Gabbuti
- Ospedale S Maria Annunziata, Florence
| | | | | | | | | | - V Vullo
- Università di Roma La Sapienza, Rome
| | | | | | | | | | | | | | | | | | - L Viksna
- Infectology Centre of Latvia, Riga. Latvia
| | | | - R Hemmer
- Centre Hospitalier, Luxembourg. Luxembourg
| | - T Staub
- Centre Hospitalier, Luxembourg. Luxembourg
| | - P Reiss
- Academisch Medisch Centrum bij de Universiteit van Amsterdam, Amsterdam. Netherlands
| | - J Bruun
- Ullevål Hospital, Oslo. Norway
| | | | | | - B Knysz
- Medical University, Wroclaw; Poland
| | | | - A Horban
- Centrum Diagnostyki i Terapii AIDS, Warsaw
| | | | | | | | | | | | | | - F Antunes
- Hospital Santa Maria, Lisbon; Portugal
| | | | | | - D Duiculescu
- Spitalul de Boli Infectioase si Tropicale Dr Victor Babes, Bucharest; Romania
| | | | - M Mikras
- Derrer Hospital, Bratislava. Slovakia
| | | | - B Diaz
- Hospital Carlos III, Madrid; Spain
| | | | | | | | - B Clotet
- Hospital Germans Trias i Pujol, Barcelona
| | - A Jou
- Hospital Germans Trias i Pujol, Barcelona
| | - J Conejero
- Hospital Germans Trias i Pujol, Barcelona
| | - C Tural
- Hospital Germans Trias i Pujol, Barcelona
| | - JM Gatell
- Hospital Clinic i Provincial, Barcelona
| | - JM Miró
- Hospital Clinic i Provincial, Barcelona
| | | | | | | | | | | | - P Francioli
- Centre Hospitalier Universitaire Vaudois, Lausanne; Switzerland
| | - A Telenti
- Centre Hospitalier Universitaire Vaudois, Lausanne; Switzerland
| | - B Hirschel
- Hospital Cantonal Universitaire de Geneve, Geneve
| | | | | | | | - S Barton
- St Stephen's Clinic, Chelsea and Westminster Hospital, London; United Kingdom
| | - AM Johnson
- Royal Free and University College London Medical School, London University College Campus
| | - D Mercey
- Royal Free and University College London Medical School, London University College Campus
| | - A Phillips
- Royal Free and University College Medical School, London Royal Free Campus
| | - C Loveday
- Royal Free and University College Medical School, London Royal Free Campus
| | - MA Johnson
- Royal Free and University College Medical School, London Royal Free Campus
| | - A Mocroft
- Royal Free and University College Medical School, London Royal Free Campus
| | - A Pinching
- Medical College of Saint Bartholomew's Hospital, London
| | - J Parkin
- Medical College of Saint Bartholomew's Hospital, London
| | - J Weber
- Imperial College School of Medicine at St Mary's, London
| | - G Scullard
- Imperial College School of Medicine at St Mary's, London
| | - M Fisher
- Royal Sussex County Hospital, Brighton
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12
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van Leth F, Conway B, Laplumé H, Martin D, Fisher M, Jelaska A, Wit FW, Lange JMA, Laplumé H, Lasala MB, Losso MH, Bogdanowicz E, Lattes R, Krolewiecki A, Zala C, Orcese C, Terlizzi S, Duran A, Ebensrteijn J, Bloch M, Russell O, Russell DB, Roth NR, Eu B, Austin D, Gowers A, Quan D, Demonty J, Peleman R, Vandercam B, Vogelaers D, van der Gucht B, van Wanzeele F, Moutschen MM, Badaro R, Grinsztejn B, Schechter M, Uip D, Netto EN, Coelho SS, Badaró F, Pilotto JH, Schubach A, Barros ML, Leite OHM, Kiffer CRV, Wunsch CT, Nunes D, Catalani A, de Cassia Alves LR, Dossin TJ, D'Alló de Oliveira MT, Martini S, Conway B, de Wet JJ, Montaner JSG, Murphy C, Woodfall B, Sestak P, Phillips P, Montessori V, Harris M, Tesiorowski A, Willoughby B, Voigt R, Farley J, Reynolds R, Devlaming S, Livrozet JM, Rozenbaum W, Sereni D, Valantin MA, Lascoux C, Milpied B, Brunet C, Billaud E, Huart A, Reliquet V, Charonnat MF, Sicot M, Esnault JL, Slama L, Staszewski S, Bickel M, Lazanas MK, Stavrianeas N, Mangafas N, Zagoreos I, Kourkounti S, Paparizos V, Botsi C, Clarke S, Brannigan E, Boyle N, Chiriani A, Leoncini F, Montella F, Francesco L, Ambu S, Farese A, Gargiulo M, Di Sora F, Lavria F, Folgori F, Beniowski M, Boron Kaczmarska A, Halota W, Prokopowicz D, Bander DB, Leszuzyszyn-Pynka MLP, Wnuk AW, Bakowska E, Pulik P, Flisiak R, Wiercinska-Drapalo A, Mularska E, Witor A, Antunes F, Sarmento RSE, Doroana M, Horta AA, Vasconcelos O, Andrews SM, Huisamen CB, Johnson D, Martin O, Bekker LG, Maartens G, Wilson D, Visagie CJ, David NJ, Rattley M, Nettleship E, Martin DJ, Keyser V, Moraites TM, Moorhouse MA, Pitt JA, Orrell CJ, Bester C, Parboosing R, Moodley P, Gathiram V, Woolf D, Bernasconi E, Magenta L, Cardiello P, Kroon E, Ungsedhapand C, Fisher M, Wilkins EGL, Stockwell E, Day J, Daintith RS, Perry N, Timaeus C, Intosh-Roffet JM, Powell A, Youle M, Tyrer M, Madge S, Drinkwater A, Cuthbertson Z, Carroll A, Becker S, Katner H, Rimland D, Saag MS, Thompson M, Witt M, Aguilar MM, LaVoy A, Illeman M, Guerrero M, Gatell J, Belsey E, Hirschel B, Potarca A, Cronenberg M, Kreekel L, Meester R, Khodabaks J, Botma HJ, Esrhir N, Farida I, Feenstra M, Jansen K, Klotz A, Mulder M, Ruiter G, Bass CB, Pluymers E, de Vlegelaer E, Leeneman (VCL) R, Carlier H, van Steenberge E, Hall D. Quality of Life in Patients Treated with First-Line Antiretroviral Therapy Containing Nevirapine And/Or Efavirenz. Antivir Ther 2004. [DOI: 10.1177/135965350400900512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To assess whether differences in safety profiles between nevirapine (NVP) and efavirenz (EFV), as observed in the 2NN study, translated into differences in ‘health related quality of life’ (HRQoL). Design A sub-study of the 2NN study, with antiretro-viral-naive patients randomly allocated to NVP (once or twice daily), EFV or NVP+EFV, in addition to stavudine and lamivudine. Methods Comparing differences in changes of HRQoL over 48 weeks as measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire, using analysis of variance. Results The 2NN study enrolled 1216 patients. No validated questionnaires were available for 244 patients, and 55 patients had no HRQoL data at all, leaving 917 patients eligible for this sub-study. A total of 471 (51%) had HRQoL measurements both at baseline and week 48. The majority (69%) of patients without HRQoL measurements did, however, complete the study. The change in the physical health score (PHS) was 3.9 for NVP, 3.4 for EFV and 2.4 for NVP+EFV ( P=0.712). For the mental health score (MHS) these values were 6.1, 7.0 and 3.9, respectively ( P=0.098). A baseline plasma HIV-1 RNA concentration (pVL) ≥100 000 copies/ml and a decline in pVL (per log10) were independently associated with an increase of PHS. An increase of MHS was only associated with pVL decline. Patients experiencing an adverse event during follow-up had a comparable change in PHS but a significantly smaller change in MHS, compared with those without an adverse event. Conclusions First-line ART containing NVP and/or EFV leads to an improvement in HRQoL. The gain in HRQoL was similar for NVP and EFV, but slightly lower for the combination of these drugs.
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Affiliation(s)
| | - Frank van Leth
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Brian Conway
- University of British Columbia, Vancouver, BC, Canada
| | - Hector Laplumé
- Hospital Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Des Martin
- Toga Laboratories, Edenvale, South Africa
| | - Martin Fisher
- Brighton and Sussex University Hospitals, Brighton, UK
| | - Ante Jelaska
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Conn., USA
| | - Ferdinand W Wit
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joep MA Lange
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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13
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Mocroft A, Phillips AN, Friis-Møller N, Colebunders R, Johnson AM, Hirschel B, Saint-Marc T, Staub T, Clotet B, Lundgren JD, Ledergerber B, Antunes F, Blaxhult A, Clumeck N, Gatell JM, Horban A, Johnson AM, Katlama C, Loveday C, Phillips A, Reiss P, Vella S, Vetter N, Clumeck N, Hermans P, Sommereijns B, Colebunders R, Machala L, Rozsypal H, Nielsen J, Lundgren J, Benfield T, Kirk O, Gerstoft J, Katzenstein T, Røge B, Skinhøj P, Pedersen C, Katlama C, Rivière C, Viard JP, Saint-Marc T, Vanhems P, Pradier C, Dietrich M, Manegold C, van Lunzen J, Miller V, Staszewski S, Goebel FD, Salzberger B, Rockstroh J, Kosmidis J, Gargalianos P, Sambatakou H, Perdios J, Panos G, Karydis I, Filandras A, Banhegyi D, Mulcahy F, Yust I, Turner D, Pollack S, Ben-Ishai Z, Bentwich Z, Maayan S, Vella S, Chiesi A, Arici C, Pristerá R, Mazzotta F, Gabbuti A, Esposito R, Bedini A, Chirianni A, Montesarchio E, Vullo V, Santopadre P, Narciso P, Antinori A, Franci P, Zaccarelli M, Lazzarin A, Finazzi R, Monforte AD, Hemmer R, Staub T, Reiss P, Bruun J, Maeland A, Ormaasen V, Knysz B, Gasiorowski J, Horban A, Prokopowicz D, Wiercinska-Drapalo A, Boron-Kaczmarska A, Pynka M, Beniowski M, Trocha H, Antunes F, Mansinho K, Proenca R, González-Lahoz J, Diaz B, García-Benayas T, Martin-Carbonero L, Soriano V, Clotet B, Jou A, Conejero J, Tural C, Gatell JM, Miró JM, Blaxhult A, Heidemann B, Pehrson P, Ledergerber B, Weber R, Francioli P, Telenti A, Hirschel B, Soravia-Dunand V, Barton S, Johnson AM, Mercey D, Phillips A, Loveday C, Johnson MA, Mocroft A, Pinching A, Parkin J, Weber J, Scullard G, Fisher M, Brettle R, Lundgren J, Gjørup I, Kirk O, Friis-Moeller N, Mocroft A, Cozzi-Lepri A, Mollerup D, Nielsen M, Hansen A, Kristensen D, Aabolt S, Cimposeu P, Hansen L, Kjær J. Response to Antiretroviral Therapy among Patients Exposed to Three Classes of Antiretrovirals: Results from the Eurosida Study. Antivir Ther 2002. [DOI: 10.1177/135965350200700103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is an increasing proportion of HIV-positive patients exposed to all licensed classes of antiretrovirals, and the response to salvage regimens may be poor. Among over 8500 patients in EuroSIDA, the proportion of treated patients exposed to nucleosides, protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitor (NNRTI) increased from 0% in 1996 to 47% in 2001. Four-hundred-and-thirteen patients, who had failed virologically two highly active antiretroviral therapy (HAART) regimens and experienced all three main drug classes, started a salvage regimen of at least three drugs, in which at least one new PI or NNRTI was included. Median viral load was 4.7 log copies/ml [Interquartile range (IQR) 4.2–5.2], CD4 lymphocyte count 150/mm3 (IQR 60–274/mm3) and follow-up 14 months. Of these patients, 283 (69%) subsequently experienced at least a 1 log decline in viral load and 202 (49%) achieved a viral load <500 copies/ml. Conversely, the CD4 count halved from the baseline value in 88 (21%), and 45 (11%) experienced a new AIDS-defining disease. In multivariable analyses, a 1 log viral load reduction was related to baseline viral load [relative hazard (RH) 1.27 per 1 log higher; P=0.008], a previous viral load of less than 500 copies/ml (RH 1.69; P=0.002), more recent initiation of the regimen (RH 1.36 per year more recent; P=0.02), number of new drugs in the regimen (RH 1.20 per drug; P=0.02), time since start of antiretroviral therapy (RH 0.94 per extra year; P=0.035) and time spent on HAART with viral load >1000 copies/ml (RH 0.96 per extra month; P=0.0001). Analysis of factors associated with CD4 count decline and new AIDS disease also indicated improved outcomes in more recent times and a tendency for a better response in those starting more new drugs, but no relationship with the total number of drugs. Outcomes in people starting salvage regimens appear to depend on the number of new drugs started but not on the total number of drugs being used.
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Affiliation(s)
- A Mocroft
- Royal Free Centre for HIV Medicine, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
| | - AN Phillips
- Royal Free Centre for HIV Medicine, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
| | - N Friis-Møller
- EuroSIDA Coordinating Centre, Hvidovre Hospital, Hvidovre, Denmark
| | | | - AM Johnson
- Royal Free Centre for HIV Medicine, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
| | - B Hirschel
- Hospital Cantonal Universitaire de Geneve, Geneva, Switzerland
| | | | - T Staub
- Centre Hospitalier, Luxembourg
| | - B Clotet
- Hospital Germans Trias I Pujol, Barcelona, Spain
| | - JD Lundgren
- EuroSIDA Coordinating Centre, Hvidovre Hospital, Hvidovre, Denmark
| | | | | | | | | | | | | | | | | | | | | | | | | | - N Vetter
- Pulmologisches Zentrum der Stadt Wien, Vienna
| | | | | | | | | | | | | | | | | | | | - O Kirk
- Hvidovre Hospital, Copenhagen
| | | | | | - B Røge
- Rigshospitalet, Copenhagen
| | | | | | - C Katlama
- Hôpital de la Pitié-Salpétière, Paris
| | - C Rivière
- Hôpital de la Pitié-Salpétière, Paris
| | - J-P Viard
- Hôpital Necker-Enfants Malades, Paris
| | | | | | | | - M Dietrich
- Bernhard-Nocht-Institut for Tropical Medicine, Hamburg
| | - C Manegold
- Bernhard-Nocht-Institut for Tropical Medicine, Hamburg
| | | | - V Miller
- JW Goethe University Hospital, Frankfurt
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - I Yust
- Ichilov Hospital, Tel Aviv
| | | | | | | | | | - S Maayan
- Hadassah University Hospital, Jerusalem
| | - S Vella
- Istituto Superiore di Sanita, Rome
| | - A Chiesi
- Istituto Superiore di Sanita, Rome
| | | | | | | | - A Gabbuti
- Ospedale S. Maria Annunziata, Florence
| | | | | | | | | | - V Vullo
- Università di Roma La Sapienza, Rome
| | | | | | | | | | | | | | | | | | | | - T Staub
- Centre Hospitalier, Luxembourg
| | - P Reiss
- Academisch Medisch Centrum bij de Universiteit van Amsterdam, Amsterdam
| | | | | | | | | | | | - A Horban
- Centrum Diagnostyki i Terapii AIDS, Warsaw
| | | | | | | | - M Pynka
- Medical University, Szczecin
| | | | | | | | | | | | | | - B Diaz
- Hospital Carlos III, Madrid
| | | | | | | | - B Clotet
- Hospital Germans Trias i Pujol, Badalona
| | - A Jou
- Hospital Germans Trias i Pujol, Badalona
| | - J Conejero
- Hospital Germans Trias i Pujol, Badalona
| | - C Tural
- Hospital Germans Trias i Pujol, Badalona
| | - JM Gatell
- Hospital Clinic i Provincial, Barcelona
| | - JM Miró
- Hospital Clinic i Provincial, Barcelona
| | | | | | | | | | | | - P Francioli
- Centre Hospitalier Universitaire Vaudois, Lausanne
| | - A Telenti
- Centre Hospitalier Universitaire Vaudois, Lausanne
| | - B Hirschel
- Hospital Cantonal Universitaire de Geneve, Geneve
| | | | - S Barton
- St Stephen's Clinic, Chelsea and Westminster Hospital, London
| | - AM Johnson
- Royal Free and University College London Medical School, London (University College Campus)
| | - D Mercey
- Royal Free and University College London Medical School, London (University College Campus)
| | - A Phillips
- Royal Free and University College Medical School, London (Royal Free Campus)
| | - C Loveday
- Royal Free and University College Medical School, London (Royal Free Campus)
| | - MA Johnson
- Royal Free and University College Medical School, London (Royal Free Campus)
| | - A Mocroft
- Royal Free and University College Medical School, London (Royal Free Campus)
| | - A Pinching
- Medical College of St Bartholomew's Hospital, London
| | - J Parkin
- Medical College of St Bartholomew's Hospital, London
| | - J Weber
- Imperial College School of Medicine at St Mary's, London
| | - G Scullard
- Imperial College School of Medicine at St Mary's, London
| | - M Fisher
- Royal Sussex County Hospital, Brighton
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Wiercinska-Drapalo A, Flisiak R, Prokopowicz D. Mucosal and plasma prostaglandin E2 in ulcerative colitis. Hepatogastroenterology 1999; 46:2338-42. [PMID: 10521993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND/AIMS Despite extensive studies, the role of prostaglandins in the course of inflammatory bowel diseases and their possible usefulness as predictive indicators of inflammation, remain largely speculative. The aim of this study was to determine whether mucosal and plasma concentrations of prostaglandin E2 (PGE2) are affected by the clinical course and degree of colonic injury in patients with ulcerative colitis. METHODOLOGY PGE2 concentration was measured with an enzyme immunoassay (EIA) in biopsies of rectal mucosa and in the plasma of 38 patients with ulcerative colitis and 12 controls. Patients were divided into groups according to mild or severe clinical course of the disease, and with respect to scored endoscopical picture. RESULTS Ulcerative colitis resulted in an increase of mucosal and plasma concentrations of PGE2, that was significantly elevated in patients with a severe clinical course of the disease. These concentrations increased depending on degree of mucosal injury. A significant, positive correlation with endoscopical score regarding plasma and mucosal PGE2 concentration, as well as between them, was found. CONCLUSIONS Plasma and mucosal PGE2 rise simultaneously with degree of colonic injury. Because of a good correlation with mucosal injury and PGE2 content, measurement of plasma PGE2 could be considered as a possible surrogate marker of bowel inflammation.
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