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1. High treatment uptake in human immunodeficiency virus/ hepatitis C virus-coinfected patients after unrestricted access to direct-acting antivirals in the Netherlands

Author

Boerekamps, A. (Anne), Newsum, A.M. (Astrid M.), Smit, C. (Colette), Arends, J.E. (Joop), Richter, C. (Clemens), Reiss, P. (Peter), Rijnders, B.J.A. (Bart), Brinkman, K. (Kees), Valk, M. (Marc) van der, Geerlings, S.E. (Suzanne), Godfried, M.H., Goorhuis, A. (Abraham), Hovius, J.W.R. (Joppe), Meer, J.T.M. (J. T M) van der, Kuijpers, T.W. (Taco W.), Nellen, F.J.B. (F. J B), Van Der Poll, D.T. (D. T.), Prins, J.M. (Jan), Van Vugt, H.J.M. (H. J.M.), Wiersinga, W.J. (W. J.), Wit, F.W.N.M. (Ferdinand), Van Duinen, M. (M.), Van Eden, J., Van Hes, A.M.H., Mutschelknauss, M., Nobel, H.E., Pijnappel, F.J.J., Weijsenfeld, A.M., Jurriaans, S. (Suzanne), Back, N. (Nicole), Zaaijer, H.L. (Hans), Berkhout, B. (Ben), Cornelissen, M. (Marion), Schinkel, C.J., Wolthers, K.C. (Katja), Van Den Berge, M., Stegeman, A., Baas, S., Hage De Looff, L. (L.), Wintermans, B. (B.), Veenemans, J. (J.), Pronk, M.J.H. (Marjolijn), Ammerlaan, H.S.M. (Heidi), De Munnik, E.S., Jansz, A.R. (A. R.), Tjhie, J. (J.), Wegdam, M.C.A., Deiman, B. (B.), Scharnhorst, V., Eeden, A. (Arne) van, Brokking, W. (W.), Groot, M.M. (Marieke), Elsenburg, L.J.M. (L. J.M.), Damen, M. (M.), Kwa, I.S., Kasteren, M.E.E. (Marjo) van, Brouwer, A.E., Van Erve, R. (R.), De Kruijf-Van De Wiel, B.A.F.M. (B. A.F.M.), Keelan-Pfaf, S. (S.), Van Der Ven, B. (B.), Van Der Ven, B., Buiting, A.G.M. (Anton), Kabel, P.J. (P. J.), Versteeg, D., Ende, M.E. (Marchina) van der, Bax, H.I. (Hannelore), Gorp, E.C.M. (Eric) van, Nouwen, J.L. (Jan), Schurink, C.A.M. (Carolina), Verbon, A. (Annelies), Vriessluijs, T.E.M.S. (Theodora) de, De Jong-Peltenburg, N.C. (N. C.), Bassant, N., Van Beek, J.E.A., Vriesde, M., van Zonneveld, L. (Laura), Van Den Berg-Cameron, H.J., Groot, J.C. (Jan Cees) de, De Zeeuw-De Man, M., Boucher, C.A.B. (Charles), Koopmans D.V.M., M.P.G. (Marion), Kampen, J.J.A. (Jeroen) van, Pas, S.D. (Suzan), Branger, J., Rijkeboer-Mes, A. (A.), Duijf-Van De Ven, C.J.H.M., Schippers, E.F. (E. F.), Nieuwkoop, C. (Cees) van, Van IJperen, J.M. (J. M.), Geilings, J. (J.), Van Der Hut, G., Burgel, N.D. (Nathalie ) van, Leyten, E.M.S. (Eliane), Gelinck, L.B.S. (Luc), Van Hartingsveld, A.Y. (A. Y.), Meerkerk, C., Wildenbeest, G.S., Heikens, E. (E.), Groeneveld, P.H.P. (P. H.P.), Bouwhuis, J.W. (Jolande), Lammers, A.J.J. (A. J.J.), Kraan, S. (S.), Van Hulzen, A.G.W., Van Der Bliek, G.L. (G. L.), Bor, P.C.J., Bloembergen, P. (Peter), Wolfhagen, M.J.H.M., Ruijs, G. (G.), Kroon, F.P. (F. P.), Boer, M.G.J. (Mark) de, Scheper, H. (H.), Jolink, A. (Albert), Vollaard, A. (Albert), Dorama, W. (Willemien), Van Holten, N. (N.), Claas, E.C.J. (Eric), Wessels, E. (E.), Hollander, J.G. (Jan) den, Pogány, K. (Katalin), Roukens, A. (A.), Kastelijns, M. (M.), Smit, J.V., Smit, E., Struik-Kalkman, D. (D.), Tearno, C. (C.), Van Niekerk, T., Pontesilli, O. (Oscar), Lowe, S.H. (S. H.), Oude Lashof, A. (A.), Posthouwer, D. (Dirk), Ackens, R.P. (R. P.), Burgers, K. (K.), Schippers, J., Weijenberg-Maes, B. (B.), Loo, I. (Inge) van, Havenith, T., Mulder, J.W. (J. W.), Vrouenraets, B.C. (Bart), Lauw, F.N. (F. N.), van Broekhuizen, M. (Marjolein), Vlasblom, D.J., Smits, P.H.M. (Paul), Weijer, S. (S.), El Moussaoui, R., Bosma, A.S. (A. S.), Vonderen, M.G.A. van, Van Houte, D.P.F., Kampschreur, L.M., Dijkstra, K. (K.), Faber, S., Weel, J. (J.), Kootstra, J.G. (Jille), Delsing, C.E. (C. E.), Van Der Burg-Van De Plas, M. (M.), Heins, H., Lucas, E. (E.), Kortmann, B., Van Twillert, G. (G.), Renckens, R. (Rosemarijn), Ruiter-Pronk, D. (D.), Van Truijen-Oud, F.A., Cohen Stuart, J.W.T. (James), IJzerman, E.P.F. (Ed), Jansen, R.J. (Roel), Rozemeijer, W. (Wouter), Van Der Reijden, W.A. (W. A.), Berk, G.E.L. (Guido) van den, Blok, W.L. (Willem), Frissen, P.H.J., Lettinga, K.D. (Kamilla), Schouten, W.E.M.I. (Ineke), Veenstra, J. (Jan), Brouwer, C.J., Geerders, G.F., Hoeksema, K., Kleene, M.J., Van Der Meché, I.B., Spelbrink, M. (M.), Toonen, A.J.M., Wijnands, S. (S.), Kwa, S.L.S. (Stefan), Regez, R.M. (Rosa), Crevel, R. (Reinout) van, Keuter, M. (Monique), Ven, A.D. (Andre´) van, Ter Hofstede, H.J.M. (H. J.M.), Dofferhoff, A.S.M. (Anton), Hoogerwerf, J. (J.), Grintjes-Huisman, K.J.T., De Haan, M. (M.), Marneef, M. (M.), Hairwassers, A. (A.), Rahamat-Langendoen, J. (J.), Stelma, F.F. (Foekje), Burger, D.M. (David), Gisolf, E.H. (Elisabeth), Hassing, R.J. (Robert), Claassen, M.A.A. (Mark), Ter Beest, G. (G.), Van Bentum, P.H.M., Langebeek, N. (Nienke), Tiemessen, R. (R.), Swanink, C. (Caroline), Lelyveld, S.F.L. van, Soetekouw, R. (Robert), Van Der Prijt, L.M.M., Van Der Swaluw, J. (J.), Bermon, N. (N.), Jansen, R. (R.), Herpers, B.L. (B. L.), Veenendaal, D. (Dick), Verhagen, D.W.M. (Dominique), Van Wijk, M. (M.), Bierman, W.F.W. (Wouter), Bakker, M. (M.), Kleinnijenhuis, J. (J.), Kloeze, E. (E.), Stienstra, Y. (Y.), Wilting, K.R., Wouthuyzen-Bakker, M. (Marjan), Boonstra, P.A. (André), Van Der Meulen, P.A., De Weerd, D.A., Niesters, H.G.M. (Bert), Van Leer-Buter, C. (Coretta), Knoester, M. (M.), Hoepelman, I.M. (Ilja Mohandas), Barth, R.E. (R. E.), Bruns, A.H.W. (A. H.W.), Ellerbroek, P.M. (P.), Mudrikova, T. (Tania Tania), Oosterheert, J.J. (Jan Jelrik), Schadd, E.M. (E. M.), Wassenberg, M.W.M., Van Zoelen, M.A.D. (M. A.D.), Aarsman, K. (K.), Van Elst-Laurijssen, D.H.M. (D. H.M.), De Kroon, I. (I.), Van Rooijen, C.S.A.M. (C. S.A.M.), Van Berkel, M. (M.), Schuurman, R. (Rob), Verduyn-Lunel, F., Wensing, A. (Amj), Peters, E.J.G., Van Agtmael, M.A. (M. A.), Bomers, M., Heitmuller, M. (M.), Laan, L.M., Ang, C.W. (Wim), Houdt, R. van, Pettersson, A. (Annika), Vandenbroucke-Grauls, C.M.J.E. (Christina), Bezemer, D.O. (Daniela), Sighem, A.I. (Ard) van, Smit, C. (Cees), Wit, F. (Ferdinand), Boender, T.S. (T. S.), Zaheri, S. (S.), Hillebregt, M.M.J. (Mariska), De Jong, A., Bergsma, D., Grivell, S., Jansen, A. (A.), Raethke, M., Meijering, R., Rutkens, T. (T.), De Groot, L. (L.), Van Den Akker, M. (M.), Bakker, Y., Bezemer, M. (M.), Claessen, E., El Berkaoui, A. (A.), Geerlinks, J. (J.), Koops, J. (J.), Kruijne, E., Lodewijk, C., Van Der Meer, R. (R.), Munjishvili, L., Paling, F. (F.), Peeck, B., Ree, C., Regtop, R., Ruijs, Y., Schoorl, M. (Marianne), Timmerman, A. (A.), Tuijn, E., Veenenberg, L., Van Der Vliet, S. (S.), Wisse, A. (A.), De Witte, E.C. (E. C.), Woudstra, T., Tuk, B. (B.), Boerekamps, A. (Anne), Newsum, A.M. (Astrid M.), Smit, C. (Colette), Arends, J.E. (Joop), Richter, C. (Clemens), Reiss, P. (Peter), Rijnders, B.J.A. (Bart), Brinkman, K. (Kees), Valk, M. (Marc) van der, Geerlings, S.E. (Suzanne), Godfried, M.H., Goorhuis, A. (Abraham), Hovius, J.W.R. (Joppe), Meer, J.T.M. (J. T M) van der, Kuijpers, T.W. (Taco W.), Nellen, F.J.B. (F. J B), Van Der Poll, D.T. (D. T.), Prins, J.M. (Jan), Van Vugt, H.J.M. (H. J.M.), Wiersinga, W.J. (W. J.), Wit, F.W.N.M. (Ferdinand), Van Duinen, M. (M.), Van Eden, J., Van Hes, A.M.H., Mutschelknauss, M., Nobel, H.E., Pijnappel, F.J.J., Weijsenfeld, A.M., Jurriaans, S. (Suzanne), Back, N. (Nicole), Zaaijer, H.L. (Hans), Berkhout, B. (Ben), Cornelissen, M. (Marion), Schinkel, C.J., Wolthers, K.C. (Katja), Van Den Berge, M., Stegeman, A., Baas, S., Hage De Looff, L. (L.), Wintermans, B. (B.), Veenemans, J. (J.), Pronk, M.J.H. (Marjolijn), Ammerlaan, H.S.M. (Heidi), De Munnik, E.S., Jansz, A.R. (A. R.), Tjhie, J. (J.), Wegdam, M.C.A., Deiman, B. (B.), Scharnhorst, V., Eeden, A. (Arne) van, Brokking, W. (W.), Groot, M.M. (Marieke), Elsenburg, L.J.M. (L. J.M.), Damen, M. (M.), Kwa, I.S., Kasteren, M.E.E. (Marjo) van, Brouwer, A.E., Van Erve, R. (R.), De Kruijf-Van De Wiel, B.A.F.M. (B. A.F.M.), Keelan-Pfaf, S. (S.), Van Der Ven, B. (B.), Van Der Ven, B., Buiting, A.G.M. (Anton), Kabel, P.J. (P. J.), Versteeg, D., Ende, M.E. (Marchina) van der, Bax, H.I. (Hannelore), Gorp, E.C.M. (Eric) van, Nouwen, J.L. (Jan), Schurink, C.A.M. (Carolina), Verbon, A. (Annelies), Vriessluijs, T.E.M.S. (Theodora) de, De Jong-Peltenburg, N.C. (N. C.), Bassant, N., Van Beek, J.E.A., Vriesde, M., van Zonneveld, L. (Laura), Van Den Berg-Cameron, H.J., Groot, J.C. (Jan Cees) de, De Zeeuw-De Man, M., Boucher, C.A.B. (Charles), Koopmans D.V.M., M.P.G. (Marion), Kampen, J.J.A. (Jeroen) van, Pas, S.D. (Suzan), Branger, J., Rijkeboer-Mes, A. (A.), Duijf-Van De Ven, C.J.H.M., Schippers, E.F. (E. F.), Nieuwkoop, C. (Cees) van, Van IJperen, J.M. (J. M.), Geilings, J. (J.), Van Der Hut, G., Burgel, N.D. (Nathalie ) van, Leyten, E.M.S. (Eliane), Gelinck, L.B.S. (Luc), Van Hartingsveld, A.Y. (A. Y.), Meerkerk, C., Wildenbeest, G.S., Heikens, E. (E.), Groeneveld, P.H.P. (P. H.P.), Bouwhuis, J.W. (Jolande), Lammers, A.J.J. (A. J.J.), Kraan, S. (S.), Van Hulzen, A.G.W., Van Der Bliek, G.L. (G. L.), Bor, P.C.J., Bloembergen, P. (Peter), Wolfhagen, M.J.H.M., Ruijs, G. (G.), Kroon, F.P. (F. P.), Boer, M.G.J. (Mark) de, Scheper, H. (H.), Jolink, A. (Albert), Vollaard, A. (Albert), Dorama, W. (Willemien), Van Holten, N. (N.), Claas, E.C.J. (Eric), Wessels, E. (E.), Hollander, J.G. (Jan) den, Pogány, K. (Katalin), Roukens, A. (A.), Kastelijns, M. (M.), Smit, J.V., Smit, E., Struik-Kalkman, D. (D.), Tearno, C. (C.), Van Niekerk, T., Pontesilli, O. (Oscar), Lowe, S.H. (S. H.), Oude Lashof, A. (A.), Posthouwer, D. (Dirk), Ackens, R.P. (R. P.), Burgers, K. (K.), Schippers, J., Weijenberg-Maes, B. (B.), Loo, I. (Inge) van, Havenith, T., Mulder, J.W. (J. W.), Vrouenraets, B.C. (Bart), Lauw, F.N. (F. N.), van Broekhuizen, M. (Marjolein), Vlasblom, D.J., Smits, P.H.M. (Paul), Weijer, S. (S.), El Moussaoui, R., Bosma, A.S. (A. S.), Vonderen, M.G.A. van, Van Houte, D.P.F., Kampschreur, L.M., Dijkstra, K. (K.), Faber, S., Weel, J. (J.), Kootstra, J.G. (Jille), Delsing, C.E. (C. E.), Van Der Burg-Van De Plas, M. (M.), Heins, H., Lucas, E. (E.), Kortmann, B., Van Twillert, G. (G.), Renckens, R. (Rosemarijn), Ruiter-Pronk, D. (D.), Van Truijen-Oud, F.A., Cohen Stuart, J.W.T. (James), IJzerman, E.P.F. (Ed), Jansen, R.J. (Roel), Rozemeijer, W. (Wouter), Van Der Reijden, W.A. (W. A.), Berk, G.E.L. (Guido) van den, Blok, W.L. (Willem), Frissen, P.H.J., Lettinga, K.D. (Kamilla), Schouten, W.E.M.I. (Ineke), Veenstra, J. (Jan), Brouwer, C.J., Geerders, G.F., Hoeksema, K., Kleene, M.J., Van Der Meché, I.B., Spelbrink, M. (M.), Toonen, A.J.M., Wijnands, S. (S.), Kwa, S.L.S. (Stefan), Regez, R.M. (Rosa), Crevel, R. (Reinout) van, Keuter, M. (Monique), Ven, A.D. (Andre´) van, Ter Hofstede, H.J.M. (H. J.M.), Dofferhoff, A.S.M. (Anton), Hoogerwerf, J. (J.), Grintjes-Huisman, K.J.T., De Haan, M. (M.), Marneef, M. (M.), Hairwassers, A. (A.), Rahamat-Langendoen, J. (J.), Stelma, F.F. (Foekje), Burger, D.M. (David), Gisolf, E.H. (Elisabeth), Hassing, R.J. (Robert), Claassen, M.A.A. (Mark), Ter Beest, G. (G.), Van Bentum, P.H.M., Langebeek, N. (Nienke), Tiemessen, R. (R.), Swanink, C. (Caroline), Lelyveld, S.F.L. van, Soetekouw, R. (Robert), Van Der Prijt, L.M.M., Van Der Swaluw, J. (J.), Bermon, N. (N.), Jansen, R. (R.), Herpers, B.L. (B. L.), Veenendaal, D. (Dick), Verhagen, D.W.M. (Dominique), Van Wijk, M. (M.), Bierman, W.F.W. (Wouter), Bakker, M. (M.), Kleinnijenhuis, J. (J.), Kloeze, E. (E.), Stienstra, Y. (Y.), Wilting, K.R., Wouthuyzen-Bakker, M. (Marjan), Boonstra, P.A. (André), Van Der Meulen, P.A., De Weerd, D.A., Niesters, H.G.M. (Bert), Van Leer-Buter, C. (Coretta), Knoester, M. (M.), Hoepelman, I.M. (Ilja Mohandas), Barth, R.E. (R. E.), Bruns, A.H.W. (A. H.W.), Ellerbroek, P.M. (P.), Mudrikova, T. (Tania Tania), Oosterheert, J.J. (Jan Jelrik), Schadd, E.M. (E. M.), Wassenberg, M.W.M., Van Zoelen, M.A.D. (M. A.D.), Aarsman, K. (K.), Van Elst-Laurijssen, D.H.M. (D. H.M.), De Kroon, I. (I.), Van Rooijen, C.S.A.M. (C. S.A.M.), Van Berkel, M. (M.), Schuurman, R. (Rob), Verduyn-Lunel, F., Wensing, A. (Amj), Peters, E.J.G., Van Agtmael, M.A. (M. A.), Bomers, M., Heitmuller, M. (M.), Laan, L.M., Ang, C.W. (Wim), Houdt, R. van, Pettersson, A. (Annika), Vandenbroucke-Grauls, C.M.J.E. (Christina), Bezemer, D.O. (Daniela), Sighem, A.I. (Ard) van, Smit, C. (Cees), Wit, F. (Ferdinand), Boender, T.S. (T. S.), Zaheri, S. (S.), Hillebregt, M.M.J. (Mariska), De Jong, A., Bergsma, D., Grivell, S., Jansen, A. (A.), Raethke, M., Meijering, R., Rutkens, T. (T.), De Groot, L. (L.), Van Den Akker, M. (M.), Bakker, Y., Bezemer, M. (M.), Claessen, E., El Berkaoui, A. (A.), Geerlinks, J. (J.), Koops, J. (J.), Kruijne, E., Lodewijk, C., Van Der Meer, R. (R.), Munjishvili, L., Paling, F. (F.), Peeck, B., Ree, C., Regtop, R., Ruijs, Y., Schoorl, M. (Marianne), Timmerman, A. (A.), Tuijn, E., Veenenberg, L., Van Der Vliet, S. (S.), Wisse, A. (A.), De Witte, E.C. (E. C.), Woudstra, T., and Tuk, B. (B.)

Abstract

Background The Netherlands has provided unrestricted access to direct-acting antivirals (DAAs) since November 2015. We analyzed the nationwide hepatitis C virus (HCV) treatment uptake among patients coinfected with human immunodeficiency virus (HIV) and HCV. Methods Data were obtained from the ATHENA HIV observational cohort in which >98% of HIV-infected patients ever registered since 1998 are included. Patients were included if they ever had 1 positive HCV RNA result, did not have spontaneous clearance, and were known to still be in care. Treatment uptake and outcome were assessed. When patients were treated more than once, data were included from only the most recent treatment episode. Data were updated until February 2017. In addition, each treatment center was queried in April 2017 for a data update on DAA treatment and achieved sustained virological response. Results Of 23574 HIV-infected patients ever linked to care, 1471 HCV-coinfected patients (69% men who have sex with men, 15% persons who [formerly] injected drugs, and 15% with another HIV transmission route) fulfilled the inclusion criteria. Of these, 87% (1284 of 1471) had ever initiated HCV treatment between 2000 and 2017, 76% (1124 of 1471) had their HCV infection cured; DAA treatment results were pending in 6% (92 of 1471). Among men who have sex with men, 83% (844 of 1022) had their HCV infection cured, and DAA treatment results were pending in 6% (66 of 1022). Overall, 187 patients had never initiated treatment, DAAs had failed in 14, and a pegylated interferon-alfa–based regimen had failed in 54. Conclusions Fifteen months after unrestricted DAA availability the majority of HIV/HCV-coinfected patients in the Netherlands have their HCV infection cured (76%) or are awaiting DAA treatment results (6%). This rapid treatment scale-up may contribute to future HCV elimination among these patients.

Published
2018
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2. Missed opportunities to offer HIV tests to high-risk groups during general practitioners' STI-related consultations: an observational study

Author

Joore, I.K., Reukers, D.F.M., Donker, G.A., Sighem, A.I. van, Coul, E.L. Op de, Prins, J.M., Geerlings, S.E., Barth, R.E., Bergen, J.E. van, Broek, I.V. van den, Joore, I.K., Reukers, D.F.M., Donker, G.A., Sighem, A.I. van, Coul, E.L. Op de, Prins, J.M., Geerlings, S.E., Barth, R.E., Bergen, J.E. van, and Broek, I.V. van den

Abstract

Contains fulltext : 170977.pdf (publisher's version ) (Open Access), OBJECTIVES: Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV infections in the Netherlands. DESIGN: Observational study. SETTING: (1) Dutch primary care network of 42-45 sentinel practices where report forms during sexually transmitted infection (STI)-related consultations were routinely collected, 2008-2013. (2) Dutch observational cohort with medical data of HIV-positive patients in HIV care, 2008-2013. OUTCOME MEASURES: The proportion of STI-related consultations in patients from high-risk groups tested for HIV, with additional information requested from GPs on HIV testing preconsultation or postconsultation for whom HIV testing was indicated, but not performed. Next, information was collected on the profile of HIV-positive patients entering specialised HIV care following diagnosis by GPs. RESULTS: Initially, an HIV test was reported (360/907) in 40% of STI-related consultations in high-risk groups. Additionally, in 26% of consultations an HIV test had been performed in previous or follow-up consultations or at different STI-care facilities. The main reasons for not testing were perceived insignificant risk; 'too' recent risk according to GPs or the reluctance of patients. The initiative of the patient was a strong determinant for HIV testing. GPs diagnosed about one third of all newly found cases of HIV. Compared with STI clinics, HIV-positive patients diagnosed in general practice were more likely to be older, female, heterosexual male or sub-Saharan African. CONCLUSIONS: In one-third of the STI-related consultations of persons from high-risk groups, no HIV test was performed in primary care, which is lower than previously reported. Risk-based testing has intrinsic limitations and implementation of new additional strategies i

Published
2016

3. Missed opportunities to offer HIV tests to high-risk groups during general practitioners' STI-related consultations: an observational study

Author

Joore, I.K., Reukers, D.F.M., Donker, G.A., Sighem, A.I. van, Coul, E.L. Op de, Prins, J.M., Geerlings, S.E., Barth, R.E., Bergen, J.E. van, Broek, I.V. van den, Joore, I.K., Reukers, D.F.M., Donker, G.A., Sighem, A.I. van, Coul, E.L. Op de, Prins, J.M., Geerlings, S.E., Barth, R.E., Bergen, J.E. van, and Broek, I.V. van den

Abstract

Contains fulltext : 170977.pdf (publisher's version ) (Open Access), OBJECTIVES: Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV infections in the Netherlands. DESIGN: Observational study. SETTING: (1) Dutch primary care network of 42-45 sentinel practices where report forms during sexually transmitted infection (STI)-related consultations were routinely collected, 2008-2013. (2) Dutch observational cohort with medical data of HIV-positive patients in HIV care, 2008-2013. OUTCOME MEASURES: The proportion of STI-related consultations in patients from high-risk groups tested for HIV, with additional information requested from GPs on HIV testing preconsultation or postconsultation for whom HIV testing was indicated, but not performed. Next, information was collected on the profile of HIV-positive patients entering specialised HIV care following diagnosis by GPs. RESULTS: Initially, an HIV test was reported (360/907) in 40% of STI-related consultations in high-risk groups. Additionally, in 26% of consultations an HIV test had been performed in previous or follow-up consultations or at different STI-care facilities. The main reasons for not testing were perceived insignificant risk; 'too' recent risk according to GPs or the reluctance of patients. The initiative of the patient was a strong determinant for HIV testing. GPs diagnosed about one third of all newly found cases of HIV. Compared with STI clinics, HIV-positive patients diagnosed in general practice were more likely to be older, female, heterosexual male or sub-Saharan African. CONCLUSIONS: In one-third of the STI-related consultations of persons from high-risk groups, no HIV test was performed in primary care, which is lower than previously reported. Risk-based testing has intrinsic limitations and implementation of new additional strategies i

Published
2016

4. Missed opportunities to offer HIV tests to high-risk groups during general practitioners' STI-related consultations: an observational study

Author

Joore, I.K., Reukers, D.F.M., Donker, G.A., Sighem, A.I. van, Coul, E.L. Op de, Prins, J.M., Geerlings, S.E., Barth, R.E., Bergen, J.E. van, Broek, I.V. van den, Joore, I.K., Reukers, D.F.M., Donker, G.A., Sighem, A.I. van, Coul, E.L. Op de, Prins, J.M., Geerlings, S.E., Barth, R.E., Bergen, J.E. van, and Broek, I.V. van den

Abstract

Contains fulltext : 170977.pdf (publisher's version ) (Open Access), OBJECTIVES: Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV infections in the Netherlands. DESIGN: Observational study. SETTING: (1) Dutch primary care network of 42-45 sentinel practices where report forms during sexually transmitted infection (STI)-related consultations were routinely collected, 2008-2013. (2) Dutch observational cohort with medical data of HIV-positive patients in HIV care, 2008-2013. OUTCOME MEASURES: The proportion of STI-related consultations in patients from high-risk groups tested for HIV, with additional information requested from GPs on HIV testing preconsultation or postconsultation for whom HIV testing was indicated, but not performed. Next, information was collected on the profile of HIV-positive patients entering specialised HIV care following diagnosis by GPs. RESULTS: Initially, an HIV test was reported (360/907) in 40% of STI-related consultations in high-risk groups. Additionally, in 26% of consultations an HIV test had been performed in previous or follow-up consultations or at different STI-care facilities. The main reasons for not testing were perceived insignificant risk; 'too' recent risk according to GPs or the reluctance of patients. The initiative of the patient was a strong determinant for HIV testing. GPs diagnosed about one third of all newly found cases of HIV. Compared with STI clinics, HIV-positive patients diagnosed in general practice were more likely to be older, female, heterosexual male or sub-Saharan African. CONCLUSIONS: In one-third of the STI-related consultations of persons from high-risk groups, no HIV test was performed in primary care, which is lower than previously reported. Risk-based testing has intrinsic limitations and implementation of new additional strategies i

Published
2016

7. Diminished Impact of Ethnicity as a Risk Factor for Chronic Kidney Disease in the Current HIV Treatment Era

Author

Schoffelen, A.F., Smit, C., Lelyveld, S.F. van, Vogt, L., Bauer, M.P., Reiss, P., Hoepelman, A.I., Barth, R.E., Burger, D.M., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Hofstede, H.J.M. ter, Dofferhoff, A.S.M., Crevel, R. van, Albers, M.A., Bosch, M.E.W., Grintjes-Huisman, K.J.T., Zomer, B.J., Stelma, F.F., et al., Schoffelen, A.F., Smit, C., Lelyveld, S.F. van, Vogt, L., Bauer, M.P., Reiss, P., Hoepelman, A.I., Barth, R.E., Burger, D.M., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Hofstede, H.J.M. ter, Dofferhoff, A.S.M., Crevel, R. van, Albers, M.A., Bosch, M.E.W., Grintjes-Huisman, K.J.T., Zomer, B.J., Stelma, F.F., and et al.

Abstract

Contains fulltext : 155028.pdf (publisher's version ) (Closed access), BACKGROUND: Chronic kidney disease (CKD) is an important comorbidity during human immunodeficiency virus (HIV) infection. Historically, HIV-associated nephropathy has been the predominant cause of CKD and has primarily been observed in people of African ancestry. This study aims to investigate the role of ethnicity in relation to CKD risk in recent years. METHODS: Analyses were performed including 16 836 patients from the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort. Baseline was defined as the first available creatinine level measurement after 1 January 2007; CKD was defined as a glomerular filtration rate of <60 mL/min/1.73 m(2). The associations between ethnicity and both prevalent CKD at baseline and incident CKD during follow-up were analyzed. RESULTS: The prevalence of baseline CKD was 2.7% (460 of 16 836 patients). Birth in a sub-Saharan African country (hereafter, "SSA origin") was significantly associated with baseline CKD (adjusted odds ratio 1.49; 95% confidence interval [CI], 1.04-2.13). During follow-up (median duration, 4.7 years; interquartile range, 2.4-5.2), the rate of incident CKD was 6.0 events per 1000 person-years. The risk of newly developing CKD was similar between patients of SSA origin and those born in Western Europe, Australia, or New Zealand (adjusted hazard ratio, 1.00; 95% CI, .63-1.59). CONCLUSIONS: Among HIV-infected patients in the Netherlands, being of SSA origin was associated with a higher baseline CKD prevalence but had no impact on newly developing CKD over time. This suggests a shift in the etiology of CKD from HIV-associated nephropathy toward other etiologies.

Published
2015

8. Diminished Impact of Ethnicity as a Risk Factor for Chronic Kidney Disease in the Current HIV Treatment Era

Author

Schoffelen, A.F., Smit, C., Lelyveld, S.F. van, Vogt, L., Bauer, M.P., Reiss, P., Hoepelman, A.I., Barth, R.E., Burger, D.M., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Hofstede, H.J.M. ter, Dofferhoff, A.S.M., Crevel, R. van, Albers, M.A., Bosch, M.E.W., Grintjes-Huisman, K.J.T., Zomer, B.J., Stelma, F.F., et al., Schoffelen, A.F., Smit, C., Lelyveld, S.F. van, Vogt, L., Bauer, M.P., Reiss, P., Hoepelman, A.I., Barth, R.E., Burger, D.M., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Hofstede, H.J.M. ter, Dofferhoff, A.S.M., Crevel, R. van, Albers, M.A., Bosch, M.E.W., Grintjes-Huisman, K.J.T., Zomer, B.J., Stelma, F.F., and et al.

Abstract

Contains fulltext : 155028.pdf (publisher's version ) (Closed access), BACKGROUND: Chronic kidney disease (CKD) is an important comorbidity during human immunodeficiency virus (HIV) infection. Historically, HIV-associated nephropathy has been the predominant cause of CKD and has primarily been observed in people of African ancestry. This study aims to investigate the role of ethnicity in relation to CKD risk in recent years. METHODS: Analyses were performed including 16 836 patients from the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort. Baseline was defined as the first available creatinine level measurement after 1 January 2007; CKD was defined as a glomerular filtration rate of <60 mL/min/1.73 m(2). The associations between ethnicity and both prevalent CKD at baseline and incident CKD during follow-up were analyzed. RESULTS: The prevalence of baseline CKD was 2.7% (460 of 16 836 patients). Birth in a sub-Saharan African country (hereafter, "SSA origin") was significantly associated with baseline CKD (adjusted odds ratio 1.49; 95% confidence interval [CI], 1.04-2.13). During follow-up (median duration, 4.7 years; interquartile range, 2.4-5.2), the rate of incident CKD was 6.0 events per 1000 person-years. The risk of newly developing CKD was similar between patients of SSA origin and those born in Western Europe, Australia, or New Zealand (adjusted hazard ratio, 1.00; 95% CI, .63-1.59). CONCLUSIONS: Among HIV-infected patients in the Netherlands, being of SSA origin was associated with a higher baseline CKD prevalence but had no impact on newly developing CKD over time. This suggests a shift in the etiology of CKD from HIV-associated nephropathy toward other etiologies.

Published
2015

10. Diminished Impact of Ethnicity as a Risk Factor for Chronic Kidney Disease in the Current HIV Treatment Era

Author

Schoffelen, A.F., Smit, C., Lelyveld, S.F. van, Vogt, L., Bauer, M.P., Reiss, P., Hoepelman, A.I., Barth, R.E., Burger, D.M., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Hofstede, H.J.M. ter, Dofferhoff, A.S.M., Crevel, R. van, Albers, M.A., Bosch, M.E.W., Grintjes-Huisman, K.J.T., Zomer, B.J., Stelma, F.F., et al., Schoffelen, A.F., Smit, C., Lelyveld, S.F. van, Vogt, L., Bauer, M.P., Reiss, P., Hoepelman, A.I., Barth, R.E., Burger, D.M., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Hofstede, H.J.M. ter, Dofferhoff, A.S.M., Crevel, R. van, Albers, M.A., Bosch, M.E.W., Grintjes-Huisman, K.J.T., Zomer, B.J., Stelma, F.F., and et al.

Abstract

Contains fulltext : 155028.pdf (publisher's version ) (Closed access), BACKGROUND: Chronic kidney disease (CKD) is an important comorbidity during human immunodeficiency virus (HIV) infection. Historically, HIV-associated nephropathy has been the predominant cause of CKD and has primarily been observed in people of African ancestry. This study aims to investigate the role of ethnicity in relation to CKD risk in recent years. METHODS: Analyses were performed including 16 836 patients from the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort. Baseline was defined as the first available creatinine level measurement after 1 January 2007; CKD was defined as a glomerular filtration rate of <60 mL/min/1.73 m(2). The associations between ethnicity and both prevalent CKD at baseline and incident CKD during follow-up were analyzed. RESULTS: The prevalence of baseline CKD was 2.7% (460 of 16 836 patients). Birth in a sub-Saharan African country (hereafter, "SSA origin") was significantly associated with baseline CKD (adjusted odds ratio 1.49; 95% confidence interval [CI], 1.04-2.13). During follow-up (median duration, 4.7 years; interquartile range, 2.4-5.2), the rate of incident CKD was 6.0 events per 1000 person-years. The risk of newly developing CKD was similar between patients of SSA origin and those born in Western Europe, Australia, or New Zealand (adjusted hazard ratio, 1.00; 95% CI, .63-1.59). CONCLUSIONS: Among HIV-infected patients in the Netherlands, being of SSA origin was associated with a higher baseline CKD prevalence but had no impact on newly developing CKD over time. This suggests a shift in the etiology of CKD from HIV-associated nephropathy toward other etiologies.

Published
2015

12. Lower incidence of Pneumocystis jirovecii pneumonia among Africans in the Netherlands host or environmental factors?

Author

Schoffelen, A.F., Lelyveld, S.F. van, Barth, R.E., Gras, L., Wolf, F. de, Netea, M.G., Hoepelman, A.I., Koopmans, P.P., Keuter, M., Ven, A.J.A.M. van der, Warris, A., Crevel, R. van, et al., Schoffelen, A.F., Lelyveld, S.F. van, Barth, R.E., Gras, L., Wolf, F. de, Netea, M.G., Hoepelman, A.I., Koopmans, P.P., Keuter, M., Ven, A.J.A.M. van der, Warris, A., Crevel, R. van, and et al.

Abstract

Contains fulltext : 128541.pdf (publisher's version ) (Closed access), BACKGROUND AND OBJECTIVE: HIV-associated Pneumocystis jirovecii pneumonia (PJP) remains one of the commonest opportunistic infections in Western countries. Although it has been suggested that racial differences in PJP incidence exist, early studies report conflicting results. This study aimed to investigate differences in PJP incidence in a developed country among patients originating from sub-Saharan Africa compared with other regions of origin. DESIGN AND METHODS: A retrospective observational cohort study was performed among 13,844 HIV-infected patients from the Dutch ATHENA cohort. The main outcome measure was occurrence of PJP. RESULTS: A total number of 1055 PJP infections were diagnosed. Patients originating from sub-Saharan Africa had a significantly lower risk of having PJP at the time of HIV diagnosis after adjustment of confounders compared with patients from Western origin [Western Europe, Australia and New Zealand; adjusted odds ratio (aOR) 0.21 (95% confidence interval (CI) 0.15-0.29)]. Other factors associated with higher PJP risk were increasing age [aOR 1.01 per year (95% CI 1.00-1.02)], a low CD4 count at HIV diagnosis [CD4 <50 versus >350 cells/mul aOR 123.3 (95% CI 77.8-195.5)] and a high plasma HIV-RNA (>100,000 copies/ml) at HIV diagnosis [aOR 1.41 (95% CI 1.19-1.66)]. Moreover, a clearly lower risk for PJP acquisition later during follow-up was observed among sub-Saharan Africans versus Western patients [adjusted hazard ratio 0.60 (95% CI 0.39-0.90)]. CONCLUSION: Among HIV-infected patients living in the Netherlands, PJP occurrence is substantially lower in patients originating from sub-Saharan Africa, as compared to Western patients. Differences in genetic susceptibility may partially explain the lower PJP incidence in these patients.

Published
2013

13. Lower incidence of Pneumocystis jirovecii pneumonia among Africans in the Netherlands host or environmental factors?

Author

Schoffelen, A.F., Lelyveld, S.F. van, Barth, R.E., Gras, L., Wolf, F. de, Netea, M.G., Hoepelman, A.I., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Warris, A., Crevel, R. van, et al., Schoffelen, A.F., Lelyveld, S.F. van, Barth, R.E., Gras, L., Wolf, F. de, Netea, M.G., Hoepelman, A.I., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Warris, A., Crevel, R. van, and et al.

Abstract

Contains fulltext : 128541.pdf (publisher's version ) (Closed access), BACKGROUND AND OBJECTIVE: HIV-associated Pneumocystis jirovecii pneumonia (PJP) remains one of the commonest opportunistic infections in Western countries. Although it has been suggested that racial differences in PJP incidence exist, early studies report conflicting results. This study aimed to investigate differences in PJP incidence in a developed country among patients originating from sub-Saharan Africa compared with other regions of origin. DESIGN AND METHODS: A retrospective observational cohort study was performed among 13,844 HIV-infected patients from the Dutch ATHENA cohort. The main outcome measure was occurrence of PJP. RESULTS: A total number of 1055 PJP infections were diagnosed. Patients originating from sub-Saharan Africa had a significantly lower risk of having PJP at the time of HIV diagnosis after adjustment of confounders compared with patients from Western origin [Western Europe, Australia and New Zealand; adjusted odds ratio (aOR) 0.21 (95% confidence interval (CI) 0.15-0.29)]. Other factors associated with higher PJP risk were increasing age [aOR 1.01 per year (95% CI 1.00-1.02)], a low CD4 count at HIV diagnosis [CD4 <50 versus >350 cells/mul aOR 123.3 (95% CI 77.8-195.5)] and a high plasma HIV-RNA (>100,000 copies/ml) at HIV diagnosis [aOR 1.41 (95% CI 1.19-1.66)]. Moreover, a clearly lower risk for PJP acquisition later during follow-up was observed among sub-Saharan Africans versus Western patients [adjusted hazard ratio 0.60 (95% CI 0.39-0.90)]. CONCLUSION: Among HIV-infected patients living in the Netherlands, PJP occurrence is substantially lower in patients originating from sub-Saharan Africa, as compared to Western patients. Differences in genetic susceptibility may partially explain the lower PJP incidence in these patients.

Published
2013

14. Lower incidence of Pneumocystis jirovecii pneumonia among Africans in the Netherlands host or environmental factors?

Author

Schoffelen, A.F., Lelyveld, S.F. van, Barth, R.E., Gras, L., Wolf, F. de, Netea, M.G., Hoepelman, A.I., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Warris, A., Crevel, R. van, et al., Schoffelen, A.F., Lelyveld, S.F. van, Barth, R.E., Gras, L., Wolf, F. de, Netea, M.G., Hoepelman, A.I., Koopmans †, P.P., Keuter, M., Ven, A.J.A.M. van der, Warris, A., Crevel, R. van, and et al.

Abstract

Contains fulltext : 128541.pdf (publisher's version ) (Closed access), BACKGROUND AND OBJECTIVE: HIV-associated Pneumocystis jirovecii pneumonia (PJP) remains one of the commonest opportunistic infections in Western countries. Although it has been suggested that racial differences in PJP incidence exist, early studies report conflicting results. This study aimed to investigate differences in PJP incidence in a developed country among patients originating from sub-Saharan Africa compared with other regions of origin. DESIGN AND METHODS: A retrospective observational cohort study was performed among 13,844 HIV-infected patients from the Dutch ATHENA cohort. The main outcome measure was occurrence of PJP. RESULTS: A total number of 1055 PJP infections were diagnosed. Patients originating from sub-Saharan Africa had a significantly lower risk of having PJP at the time of HIV diagnosis after adjustment of confounders compared with patients from Western origin [Western Europe, Australia and New Zealand; adjusted odds ratio (aOR) 0.21 (95% confidence interval (CI) 0.15-0.29)]. Other factors associated with higher PJP risk were increasing age [aOR 1.01 per year (95% CI 1.00-1.02)], a low CD4 count at HIV diagnosis [CD4 <50 versus >350 cells/mul aOR 123.3 (95% CI 77.8-195.5)] and a high plasma HIV-RNA (>100,000 copies/ml) at HIV diagnosis [aOR 1.41 (95% CI 1.19-1.66)]. Moreover, a clearly lower risk for PJP acquisition later during follow-up was observed among sub-Saharan Africans versus Western patients [adjusted hazard ratio 0.60 (95% CI 0.39-0.90)]. CONCLUSION: Among HIV-infected patients living in the Netherlands, PJP occurrence is substantially lower in patients originating from sub-Saharan Africa, as compared to Western patients. Differences in genetic susceptibility may partially explain the lower PJP incidence in these patients.

Published
2013

18. Treating HIV in rural South Africa “Successes and Challenges'

Author

Infection & Immunity, MS Infectieziekten, Hoepelman, Andy, Tempelman, HA, Wensing, Annemarie, van der Meer, J.T.M., Barth, R.E., Infection & Immunity, MS Infectieziekten, Hoepelman, Andy, Tempelman, HA, Wensing, Annemarie, van der Meer, J.T.M., and Barth, R.E.

Published
2010

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