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3 results on '"Ahlström, Magnus Glindvad"'

1. Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era.

Author

Martin-Iguacel, Raquel, Ahlström, Magnus Glindvad, Touma, Madeleine, Engsig, Frederik Neess, Stærke, Nina Breinholt, Stærkind, Mette, Obel, Niels, and Rasmussen, Line D.

Subjects
HIV infection complications, COMBINATION drug therapy, HIV infections, LONGITUDINAL method, POISSON distribution, PROGNOSIS, AIDS-related opportunistic infections, HIGHLY active antiretroviral therapy, DISEASE incidence, CEREBRAL toxoplasmosis, ANTI-HIV agents, DIAGNOSIS
Abstract

Background: HIV-associated incidence and prognosis of cerebral toxoplasmosis (CTX) is not well established during later years.Methods: From the Danish HIV Cohort Study, we identified 6325 HIV-infected individuals. We assessed incidence, mortality, predictive and prognostic factors of CTX during the pre-combination antiretroviral therapy (pre-cART; 1995-1996) and cART-era (1997-2014). Adjusted incidence rate ratios (aIRR), mortality rate ratios (aMRR) and 95% confidence intervals (CI) were assessed using Poisson regression analysis.Results: CTX IR was 1.17/1000 PYR (95% CI 0.93-1.47). We observed no change in CTX-risk in the first year after HIV-diagnosis, but a substantial reduction in mortality in the first 3 months after CTX diagnosis when comparing the cART-era to the pre-cART-era; {(aIRR: 0.79; 95% CI: 0.37-1.72) (aMRR: 0.15; 95% CI: 0.06-0.38)}. For individuals surviving the first year after HIV-diagnosis or the first 3 months after CTX-diagnosis, IRR and MRR had declined to minimal levels {(aIRR: 0.06; 95% CI: 0.03-0.10); (aMRR: 0.02; 95% CI: 0.01-0.05)}. Three years after CTX-diagnosis 30% of the patients still had neurological deficits.Conclusion: Although, CTX remains an important cause of morbidity and mortality in the cART-era, with high prevalence of neurological sequelae, incidence and mortality has largely declined, especially among those surviving the first year after diagnosis. [ABSTRACT FROM AUTHOR]

Published
2017
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2. Agreement between Estimated and Measured Renal Function in an Everyday Clinical Outpatient Setting of Human Immunodeficiency Virus-Infected Individuals

Author

Ahlström, Magnus Glindvad, Kjær, Andreas, Gerstoft, Jan, and Obel, Niels

Abstract

Introduction:Estimated renal function (eRF) has been widely implemented as a screening tool in handling human immunodeficiency virus (HIV)-infected individuals. Our primary objective was to investigate the agreement between measured renal function (mRF) and eRF in HIV-infected individuals in an everyday clinical setting. Methods:A single-center study at the HIV-outpatient clinic at Copenhagen University Hospital, Rigshospitalet. Study period from January 1, 2004-June 1, 2015. We included all HIV-infected individuals who had an mRF performed and compared this with eRF assessed with 9 different serum-creatinine-based equations and the eRF reported by the Department of Clinical Biochemistry. We evaluated performance characteristics of the different eRFs, with concordance correlation coefficient, total deviation index, coverage probability, relative accuracy, and Bland Altman plots. We also evaluated whether exposure to (1) rilpivirine, cobicistat, or dolutegravir (RLP/COB/DTG), (2) protease inhibitors (PIs), or (3) tenofovir disoproxil fumarate (TDF) had an impact on agreement. Furthermore, we compared inter- and intra-individual differences between mRF and eRF. Results:Ninety-eight individuals had an mRF performed during the study period. We found that the agreement between mRF and eRF was poor irrespective of the eRF equation. Exposure to RLP/COB/DTG and PIs was not associated with different agreement. Exposure to TDF was associated with statistically significant better agreement for 3 of the evaluated equations. Conclusion:Irrespective of calculation methods, the agreement between mRF and eRF is poor. Surprisingly TDF exposure was associated with a better agreement compared with TDF-unexposed individuals.

Published
2017
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