1
|
van Welzen BJ, Van Lelyveld SFL, Ter Beest G, Gisolf JH, Geerlings SE, Prins JM, Van Twillert G, Van Nieuwkoop C, Van der Valk M, Burger D, Wensing AMJ. Virological failure after switch to long-acting cabotegravir and rilpivirine injectable therapy: an in-depth analysis. Clin Infect Dis 2024:ciae016. [PMID: 38207125 DOI: 10.1093/cid/ciae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Long-acting (LA) injectable therapy with cabotegravir (CAB) and rilpivirine (RPV) is currently used as maintenance treatment for HIV-1, and has a low risk for virological failure (VF). Although the risk is low, the circumstances and impact of VF in the real-world setting merits further evaluation. METHODS We performed an in-depth clinical, virological and pharmacokinetic analysis on the reasons behind, and the impact of VF during LA CAB/RPV therapy in five cases from the Netherlands. Genotypic resistance testing was performed after the occurrence of VF and drug plasma (trough) concentrations were measured after VF was established and on any other samples to assess on-treatment drug levels. CAB and RPV drug levels that were below the first quartile of the population cut-off ( RESULTS Five cases who were eligible for LA CAB/RPV experienced VF despite a low predicted risk at baseline. Genotypic resistance testing revealed extensive selection of non-nucleoside reverse transcriptase inhibitor associated mutations in all, and integrase strand transfer inhibitor mutations in four cases. All cases displayed low drug levels of either CAB, RPV or both during the treatment course, likely contributing to the occurrence of VF. In three cases, we were able to identify the potential mechanisms behind these low drug levels. CONCLUSIONS This is the first in-depth multiple case analysis of VF on LA CAB/RPV therapy in a real-world setting. Our observations stress the need to be aware for (evolving) risk factors and the yield of a comprehensive clinical, virological and pharmacokinetic approach in case of failure.
Collapse
Affiliation(s)
- Berend J van Welzen
- Department of Infectious Diseases. University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Gerjanne Ter Beest
- Department of Internal Medicine. Rijnstate hospital, Arnhem. The Netherlands
| | - Jet H Gisolf
- Department of Internal Medicine. Rijnstate hospital, Arnhem. The Netherlands
| | - Suzanne E Geerlings
- Department of Internal Medicine, Infectious Diseases. Amsterdam UMC Location University of Amsterdam, and Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
| | - Jan M Prins
- Department of Internal Medicine, Infectious Diseases. Amsterdam UMC Location University of Amsterdam, and Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
| | - Gitte Van Twillert
- Department of Internal Medicine. Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Cees Van Nieuwkoop
- Department of Internal Medicine, Haga Teaching Hospital, The Hague, The Netherlands
| | - Marc Van der Valk
- Department of Internal Medicine, Infectious Diseases. Amsterdam UMC Location University of Amsterdam, and Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, The Netherlands
- Stichting hiv Monitoring, Amsterdam, The Netherlands
| | - David Burger
- Department of Pharmacy, Radboud UMC Institute of Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annemarie M J Wensing
- Translational Virology, Department of Medical Microbiology. University Medical Center Utrecht, Utrecht, The Netherlands
- Ezintsha, Department of Health, University of Witwatersrand. Johannesburg, South Africa
| |
Collapse
|
2
|
Moody K, Nieuwkerk PT, Bedert M, Nellen JF, Weijsenfeld A, Sigaloff KCE, Laan L, Bruins C, van Oers H, Haverman L, Geerlings SE, Van der Valk M. Optimising HIV care using information obtained from PROMs: protocol for an observational study. BMJ Open 2023; 13:e073758. [PMID: 38011973 PMCID: PMC10685965 DOI: 10.1136/bmjopen-2023-073758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Successful antiviral therapy has transformed HIV infection into a chronic condition, where optimising quality of life (QoL) has become essential for successful lifelong treatment. Patient-reported outcome measures (PROMs) can signal potential physical and mental health problems related to QoL. This study aims to determine whether PROMs in routine clinical care improve quality of care as experienced by people with HIV (PWH). METHODS AND ANALYSIS We report the protocol of a multicentre longitudinal cohort studying PWH at Amsterdam University Medical Centres in the Netherlands. PROMs are offered annually to patients via the patient portal of the electronic health record. Domains include anxiety, depression, fatigue, sleep disturbances, social isolation, physical functioning, stigma, post-traumatic stress disorder, adherence, drug and alcohol use and screening questions for sexual health and issues related to finances, housing and migration status. Our intervention comprises (1) patients' completion of PROMs, (2) discussion of PROMs scores during annual consultations and (3) documentation of follow-up actions in an individualised care plan, if indicated. The primary endpoint will be patient-experienced quality of care, measured by the Patient Assessment of Chronic Illness Care, Short Form (PACIC-S). Patients will provide measurements at baseline, year 1 and year 2. We will explore change over time in PACIC-S and PROMs scores and examine the sociodemographical and HIV-specific characteristics of subgroups of patients who participated in all or only part of the intervention to ascertain whether benefit has been achieved from our intervention in all subgroups. ETHICS AND DISSEMINATION Patients provide consent for the analysis of data collected as part of routine clinical care to the AIDS Therapy Evaluation in the Netherlands study (ATHENA) cohort through mechanisms described in Boender et al. Additional ethical approval for the analysis of these data is not required under the ATHENA cohort protocol. The results will be presented at national and international academic meetings and submitted to peer-reviewed journals for publication.
Collapse
Affiliation(s)
- Kevin Moody
- Infectious Diseases and Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Pythia T Nieuwkerk
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Medical Psychology and Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maarten Bedert
- Infectious Diseases and Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeannine F Nellen
- Infectious Diseases and Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Kim C E Sigaloff
- Infectious Diseases and Amsterdam Institute for Infection and Immunology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Laura Laan
- Infectious Diseases, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Claire Bruins
- Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hedy van Oers
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Child and Adolescent Psychiatry and Psychological Care, Emma Children's Hospital, Amsterdam Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Child and Adolescent Psychiatry and Psychological Care, Emma Children's Hospital, Amsterdam Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Suzanne E Geerlings
- Infectious Diseases and Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marc Van der Valk
- Infectious Diseases and Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, The Netherlands
| |
Collapse
|
3
|
Verburgh ML, Wit FW, Boyd A, Reiss P, Van der Valk M. No evidence of rapid reversibility of tenofovir alafenamide and/or integrase strand transfer inhibitor-associated weight gain. AIDS 2023; 37:1843-1850. [PMID: 37433218 PMCID: PMC10481918 DOI: 10.1097/qad.0000000000003654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE We aimed to determine the reversibility of at least 7% weight gain within 12 months following tenofovir alafenamide (TAF) and/or integrase strand transfer inhibitor (INSTI) discontinuation in people with HIV (PWH) from the Dutch ATHENA cohort. DESIGN AND METHODS PWH with at least 7% weight gain within 24 months after first switch to TAF and/or INSTI whilst being virally suppressed were selected, excluding those with comorbidities/co-medication known to be associated with weight gain. PWH who discontinued only TAF, only INSTI or TAF+INSTI, with available follow-up weight, were included. Mean weight change in the 24 months prior to and 12 months after discontinuation was modelled using mixed-effects linear regression. Factors associated with yearly weight change were assessed using linear regression. RESULTS In 115 PWH, discontinuing only TAF ( n = 39), only INSTI ( n = 53) or TAF+INSTI ( n = 23), the adjusted mean modelled weight change in the 24 months prior to discontinuation was +4.50 kg [95% confidence interval (CI) 3.04-6.10], +4.80 kg (95% CI 2.43-7.03) and +4.13 kg (95% CI 1.50-7.13), respectively, and -1.89 kg (95% CI -3.40 to -0.37), -1.93 kg (95% CI -3.92 to +0.07) and -2.55 kg (95% CI -5.80 to +0.02) in the 12 months postdiscontinuation. A greater number of years since HIV diagnosis was associated with greater reversibility of weight gain. No associations were found between weight change postdiscontinuation and changes in NRTI backbone or anchor agent at moment of discontinuation. CONCLUSION There was no evidence of rapid reversibility of at least 7% TAF-associated and/or INSTI-associated weight gain after discontinuation of these agents. Studies of larger and more diverse populations of PWH are required to more fully understand the degree to which weight gain is reversible when discontinuing TAF and/or INSTI.
Collapse
Affiliation(s)
- Myrthe L. Verburgh
- Department of Infectious Diseases, Amsterdam UMC location University of Amsterdam
- Division Infectious Diseases, Amsterdam Institute for Infection and Immunity
- Division Global Health, Amsterdam Public Health
- Amsterdam Institute for Global Health and Development
| | - Ferdinand W.N.M. Wit
- Department of Infectious Diseases, Amsterdam UMC location University of Amsterdam
- Division Infectious Diseases, Amsterdam Institute for Infection and Immunity
- HIV Monitoring Foundation
| | - Anders Boyd
- HIV Monitoring Foundation
- Department of Infectious Diseases, Public Health Service of Amsterdam
| | - Peter Reiss
- Department of Infectious Diseases, Amsterdam UMC location University of Amsterdam
- Division Infectious Diseases, Amsterdam Institute for Infection and Immunity
- Division Global Health, Amsterdam Public Health
- Amsterdam Institute for Global Health and Development
- Global Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Marc Van der Valk
- Department of Infectious Diseases, Amsterdam UMC location University of Amsterdam
- Division Infectious Diseases, Amsterdam Institute for Infection and Immunity
- HIV Monitoring Foundation
| |
Collapse
|
4
|
Ruiz-Burga E, Tariq S, Touloumi G, Gill J, Nicholls EJ, Sabin C, Mussini C, Meyer L, Volny Anne A, Carlander C, Grabar S, Jarrin I, Van der Valk M, Wittkop L, Spire B, Pantazis N, Burns FM, Porter K. CASCADE protocol: exploring current viral and host characteristics, measuring clinical and patient-reported outcomes, and understanding the lived experiences and needs of individuals with recently acquired HIV infection through a multicentre mixed-methods observational study in Europe and Canada. BMJ Open 2023; 13:e070837. [PMID: 37169505 DOI: 10.1136/bmjopen-2022-070837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Despite the availability of pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART), 21 793 people were newly diagnosed with HIV in Europe in 2019. The Concerted action on seroconversion to AIDS and death in Europe study aims to understand current drivers of the HIV epidemic; factors associated with access to, and uptake of prevention methods and ART initiation; and the experiences, needs and outcomes of people with recently acquired HIV. METHODS AND ANALYSIS This longitudinal observational study is recruiting participants aged ≥16 years with documented laboratory evidence of HIV seroconversion from clinics in Canada and six European countries. We will analyse data from medical records, self-administered questionnaires, semistructured interviews and participatory photography. We will assess temporal trends in transmitted drug resistance and viral subtype and examine outcomes following early ART initiation. We will investigate patient-reported outcomes, well-being, and experiences of, knowledge of, and attitudes to HIV preventions, including PrEP. We will analyse qualitative data thematically and triangulate quantitative and qualitative findings. As patient public involvement is central to this work, we have convened a community advisory board (CAB) comprising people living with HIV. ETHICS AND DISSEMINATION All respective research ethics committees have approval for data to contribute to international collaborations. Written informed consent is required to take part. A dissemination strategy will be developed in collaboration with CAB and the scientific committee. It will include peer-reviewed publications, conference presentations and accessible summaries of findings on the study's website, social media and via community organisations.
Collapse
Affiliation(s)
- Elisa Ruiz-Burga
- Institute for Global Health, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
- Central and Northwest London NHS Foundation Trust, Mortimer Market Centre, London, UK
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - John Gill
- Southern Alberta HIV Clinic, Calgary, Alberta, Canada
| | | | - Caroline Sabin
- Institute for Global Health, University College London, London, UK
| | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, University of Modena and Reggio Emilia, Modena, Italy
| | - Laurence Meyer
- INSERM CESP U1018, APHP Hôpital de Bicêtre, Le Kremlin-Bicêtre, Paris-Saclay University, Gif-sur-Yvette, France
| | | | - Christina Carlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Sophie Grabar
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, AP-HP, Hôpital St Antoine, Paris, France
| | - Inma Jarrin
- National Centre of Epidemiology, Carlos III Health Institute, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Infecciosas, Madrid, Spain
| | - Marc Van der Valk
- Department of Infectious Diseases, Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, Netherlands
| | - Linda Wittkop
- INSERM, BPH, U1219, CIC-EC 1401, Universite Bordeaux, Bordeaux, France
- INRIA SISTM Team, Talence, France
| | - Bruno Spire
- Inserm, IRD, SESSTIM, ISSPAM, Aix-Marseille Université, Marseille, France
| | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Fiona M Burns
- Institute for Global Health, University College London, London, UK
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| |
Collapse
|
5
|
Matthews GV, Bhagani S, Van der Valk M, Rockstroh J, Feld JJ, Rauch A, Thurnheer C, Bruneau J, Kim A, Hellard M, Shaw D, Gane E, Nelson M, Ingiliz P, Applegate TL, Grebely J, Marks P, Martinello M, Petoumenos K, Dore GJ. Sofosbuvir/velpatasvir for 12 vs. 6 weeks for the treatment of recently acquired hepatitis C infection. J Hepatol 2021; 75:829-839. [PMID: 34023350 PMCID: PMC9831671 DOI: 10.1016/j.jhep.2021.04.056] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Shortened duration therapy for acute and recent HCV infection has been shown to be highly effective in several small non-randomised studies with direct-acting antiviral regimens; however, large randomised studies are lacking. METHODS REACT was an NIH-funded multicentre international, open-label, randomised, phase IV non-inferiority trial examining the efficacy of short course (6-week) vs. standard course (12-week) therapy with sofosbuvir-velpatasvir for recent HCV infection (estimated duration of infection ≤12 months). Randomisation occurred at week 6. The primary endpoint was sustained virological response 12 weeks after treatment end (SVR12) in the intention-to treat (ITT) population. A total of 250 participants were due to be enrolled, but on advice of the data safety and monitoring board the study was halted early. RESULTS The primary analysis population consisted of 188 randomised participants at termination of study enrolment; short arm (n = 93), standard arm (n = 95). Ninety-seven percent were male and 69% HIV positive. ITT SVR12 was 76/93, 81.7% (95% CI 72.4-89.0) in the short arm and 86/95, 90.5% (95% CI 82.7-95.6) in the standard arm. The difference between the arms was -8.8 (95% CI -18.6 to 1.0). In modified ITT analysis, wherein non-virological reasons for failure were excluded (death, reinfection, loss to follow-up), SVR12 was 76/85, 89.4% (95% CI 80.8-95.0) in the short arm and 86/88, 97.7% in the standard arm (95% CI 92.0-99.7; difference -8.3%, p = 0.025). CONCLUSIONS In this randomised study in recent HCV infection, a 6-week course of sofosbuvir-velpatasvir did not meet the criteria for non-inferiority to standard 12-week therapy. LAY SUMMARY In this randomised trial, 188 people with recently acquired hepatitis C infection were randomly assigned to treatment using either a short 6-week course (93 people) or standard 12-week course (95 people) of the hepatitis C treatment sofosbuvir/velpatasvir. There were 9 cases of relapse after treatment with the short course and 2 following the standard course. A shortened course of 6-week therapy for hepatitis C infection appeared to be less effective than a standard 12-week course in people with recently acquired hepatitis C infection. CLINICALTRIALS. GOV IDENTIFIER NCT02625909.
Collapse
Affiliation(s)
- Gail V Matthews
- Kirby Institute, UNSW Sydney, Australia; St Vincent's Hospital, Sydney, Australia.
| | | | - Marc Van der Valk
- Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Department of Infectious Diseases, Amsterdam Infection & Immunity Institute, Amsterdam, the Netherlands
| | | | - Jordan J Feld
- Toronto Centre for Liver Diseases, Toronto General Hospital, Toronto, Canada
| | - Andri Rauch
- Department of Infectious Diseases, Inselspital, Bern, Switzerland
| | | | - Julie Bruneau
- Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Arthur Kim
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, United States
| | - Margaret Hellard
- The Alfred Hospital, Melbourne, Australia; The Burnet Institute, Melbourne, Australia
| | - David Shaw
- Royal Adelaide Hospital, Adelaide, Australia
| | - Ed Gane
- Auckland City Hospital, Auckland, New Zealand
| | - Mark Nelson
- Chelsea & Westminster Hospital, London, United Kingdom
| | - Patrick Ingiliz
- Zentrum für Infektiologie Berlin-Prenzlauer Berg, Berlin, Germany
| | | | | | | | | | | | - Gregory J Dore
- Kirby Institute, UNSW Sydney, Australia; St Vincent's Hospital, Sydney, Australia
| |
Collapse
|
6
|
Rockstroh JK, Ingiliz P, Petersen J, Peck-Radosavljevic M, Welzel TM, Van der Valk M, Zhao Y, Jimenez-Exposito MJ, Zeuzem S. Daclatasvir plus sofosbuvir, with or without ribavirin, in real-world patients with HIV-HCV coinfection and advanced liver disease. Antivir Ther 2016; 22:225-236. [PMID: 27845298 DOI: 10.3851/imp3108] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND HIV-HCV-coinfected patients respond just as well to modern direct-acting antiviral HCV therapy as HCV-monoinfected patients. However, clinical data for all-oral HCV treatments are sparse in HIV-HCV-coinfected patients with an advanced stage of liver cirrhosis. METHODS A subanalysis of efficacy and safety for a daclatasvir (DCV) and sofosbuvir (SOF) regimen, with or without ribavirin (RBV), was undertaken in HIV-HCV-coinfected patients with advanced liver disease and no other treatment options enrolled into a European DCV compassionate use programme. RESULTS Fifty five HIV-HCV (mostly genotypes 1, 3, 4) coinfected patients were treated with DCV+SOF with (n=16) or without RBV (n=39), mostly for 24 weeks. Patients were predominantly (95%) cirrhotic (50% were Child-Pugh class B or C) and were receiving a wide range of antiretrovirals; 40% were injection drug users and 25% were receiving oral opioid substitution. Sustained virological response at post-treatment week 12 (SVR12) by modified intention-to-treat analysis (n=52) was 92% overall (95% CI 81.5, 97.9), and was similar with (94% [95% CI 69.8, 99.8]) or without RBV (92% [95% CI 77.5, 98.2]). Only one patient relapsed (Child-Pugh class B). The overall SVR12 rate after excluding non-virological failures (n=49) was 98% (95% CI 89.1, 99.9). Four patients discontinued treatment for adverse events and one died during treatment (not treatment-related). No patient lost opioid maintenance or required a change of antiretrovirals due to drug-drug interactions. CONCLUSIONS DCV+SOF, with or without RBV, showed high SVR12 rates and was well tolerated in this real-world cohort of HIV-HCV-coinfected patients with very advanced liver disease. ClinicalTrials.gov ID NCT02097966 (Study AI444-237).
Collapse
Affiliation(s)
| | | | - Jörg Petersen
- IFI-Medizin GmbH and the Asklepios Klinik St Georg, Hamburg, Germany
| | - Markus Peck-Radosavljevic
- Medical University of Vienna, Vienna, Austria.,Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria
| | - Tania M Welzel
- Universitätsklinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany
| | - Marc Van der Valk
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Yue Zhao
- Bristol-Myers Squibb, Global Biostatistics, Hopewell, NJ, USA
| | | | - Stefan Zeuzem
- Universitätsklinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany
| |
Collapse
|