123 results on '"Saag, M."'
Search Results
2. Association of temporomandibular joint osseous changes with anxiety, depression, and limitation of mandibular function in elderly Vietnamese
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Nguyen, MS, Reemann, P, Loorits, D, Ilves, P, Jagomagi, T, Nguyen, T, Saag, M, and Voog-Oras, U
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- 2019
3. Oxidative stress in patients with endodontic pathologies
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Vengerfeldt V, Mändar R, Saag M, Piir A, and Kullisaar T
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apical periodontitis ,irreversible pulpitis ,oxidative stress ,dental pulp cavity ,saliva ,Medicine (General) ,R5-920 - Abstract
Veiko Vengerfeldt,1 Reet Mändar,2,3 Mare Saag,1 Anneli Piir,2 Tiiu Kullisaar2 1Institute of Dental Sciences, Faculty of Medicine, University of Tartu, 2Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, 3Competence Centre on Health Technologies, Tartu, Estonia Background: Apical periodontitis (AP) is an inflammatory disease affecting periradicular tissues. It is a widespread condition but its etiopathogenetic mechanisms have not been completely elucidated and the current treatment options are not always successful.Purpose: To compare oxidative stress (OxS) levels in the saliva and the endodontium (root canal [RC] contents) in patients with different endodontic pathologies and in endodontically healthy subjects.Patients and methods: The study group of this comparison study included 22 subjects with primary chronic apical periodontitis (pCAP), 26 with posttreatment or secondary chronic apical periodontitis (sCAP), eight with acute periapical abscess, 13 with irreversible pulpitis, and 17 healthy controls. Resting saliva samples were collected before clinical treatment. Pulp samples (remnants of the pulp, tooth tissue, and/or previous root filling material) were collected under strict aseptic conditions using the Hedström file. The samples were frozen to −80°C until analysis. OxS markers (myeloperoxidase [MPO], oxidative stress index [OSI], 8-isoprostanes [8-EPI]) were detected in the saliva and the endodontium. Results: The highest MPO and 8-EPI levels were seen in pCAP and pulpitis, while the highest levels of OSI were seen in pCAP and abscess patients, as well as the saliva of sCAP patients. Controls showed the lowest OxS levels in both RC contents and saliva. Significant positive correlations between OxS markers, periapical index, and pain were revealed. Patients with pain had significantly higher OxS levels in both the endodontium (MPO median 27.9 vs 72.6 ng/mg protein, p=0.004; OSI 6.0 vs 10.4, p
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- 2017
4. Antiretroviral pill count and clinical outcomes in treatment‐naïve patients with HIV infection
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Young, J, Smith, C, Teira, R, Reiss, P, Jarrín Vera, I, Crane, H, Miro, JM, DʼArminio Monforte, A, Saag, M, Zangerle, R, Bucher, HC, Boulle, Andrew, Stephan, Christoph, Cavassini, Matthias, del Amo, Julia, Fätkenheuer, Gerd, Gill, John, Guest, Jodie, Hans‐Ulrich Haerry, David, Hogg, Robert, Justice, Amy, Shepherd, Leah, Obel, Neils, Sterling, Tim, and Williams, Matthew
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- 2018
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5. Application of an embryonated chicken egg model to assess the vector competence of Australian Culicoides midges for bluetongue viruses
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VAN DER SAAG, M. R., WARD, M. P., and KIRKLAND, P. D.
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- 2017
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6. Supplement to: Ledipasvir and sofosbuvir for HCV in patients coinfected with HIV-1.
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Naggie, S, Cooper, C, and Saag, M
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- 2015
7. Development and evaluation of real-time PCR assays for bloodmeal identification in Culicoides midges
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VAN DER SAAG, M. R., GU, X., WARD, M. P., and KIRKLAND, P. D.
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- 2016
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8. Opportunistic infections and biologic therapies in immune-mediated inflammatory diseases: consensus recommendations for infection reporting during clinical trials and postmarketing surveillance
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Winthrop, K L, Novosad, S A, Baddley, J W, Calabrese, L, Chiller, T, Polgreen, P, Bartalesi, F, Lipman, M, Mariette, X, Lortholary, O, Weinblatt, M E, Saag, M, and Smolen, J
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- 2015
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9. DEVELOPMENT OF DENTAL CURRICULUM IN COOPERATION WITH STUDENTS
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Nõmmela, R, Runnel, R, Olak, J, and Saag, M
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- 2015
10. Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study
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Harding, B. N., primary, Whitney, B. M., additional, Nance, R. M., additional, Ruderman, S. A., additional, Crane, H. M., additional, Burkholder, G., additional, Moore, R. D., additional, Mathews, W. C., additional, Eron, J. J., additional, Hunt, P. W., additional, Volberding, P., additional, Rodriguez, B., additional, Mayer, K. H., additional, Saag, M. S., additional, Kitahata, M. M., additional, Heckbert, S. R., additional, and Delaney, J. A. C., additional
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- 2020
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11. Marked variation in the susceptibility of HIV-1 to type 1 interferon inhibition during early, late and rebound infection
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Gondim, M., primary, Sherrill-Mix, S., additional, Saag, M., additional, Nussenzweig, M., additional, Silicano, J., additional, Sharp, P., additional, Borrow, P., additional, Montaner, L., additional, Bar, K., additional, and Hahn, B., additional
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- 2019
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12. Determinants of Restoration of CD4 and CD8 Cell Counts and Their Ratio in HIV-1-Positive Individuals With Sustained Virological Suppression on Antiretroviral Therapy
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Gras, L, Ryder, LP, Helleberg, M, Thiebaut, R, Crane, H, Lima, VD, Sterling, TR, Miro, J, Moreno, S, Tate, J, Saag, M, Rieger, A, Gillor, D, Montero, M, Ingle, SM, Wit, FWNM, de Wolf, F, Geskus, R, Boulle, A, Stephan, C, Miro, JM, Cavassini, M, Chene, G, Costagliola, D, Dabis, F, Monforte, AD, del Amo, J, van Sighem, A, Vehreschild, JJ, Gill, J, Guest, J, Haerry, DHU, Hogg, R, Justice, A, Shepherd, L, Obel, N, Crane, HM, Smith, C, Reiss, P, Sterling, T, Teira, R, Williams, M, Zangerle, R, Sterne, J, May, M, Ingle, S, Trickey, A, and Antiretroviral Therapy Cohort
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CD8 ratio [CD4] ,age ,CD8 cell count ,antiretroviral therapy ,CD4 cell count ,HIV - Abstract
Background: An increasing number of HIV-positive individuals now start antiretroviral therapy (ART) with high CD4 cell counts. We investigated whether this makes restoration of CD4 and CD8 cell counts and the CD4: CD8 ratio during virologically suppressive ART to median levels seen in HIV-uninfected individuals more likely and whether restoration depends on gender, age, and other individual characteristics. Methods: We determined median and quartile reference values for CD4 and CD8 cell counts and their ratio using cross-sectional data from 2309 HIV-negative individuals. We used longitudinal measurements of 60,997 HIV-positive individuals from the Antiretroviral Therapy Cohort Collaboration in linear mixed-effects models. Results: When baseline CD4 cell counts were higher, higher long-term CD4 cell counts and CD4: CD8 ratios were reached. Highest long-term CD4 cell counts were observed in middle-aged individuals. During the first 2 years, median CD8 cell counts converged toward median reference values. However, changes were small thereafter and long-term CD8 cell count levels were higher than median reference values. Median 8-year CD8 cell counts were higher when ART was started with,250 CD4 cells/mm(3). Median CD4: CD8 trajectories did not reach median reference values, even when ART was started at 500 cells/mm(3). Discussion: Starting ART with a CD4 cell count of >= 500 cells/mm3 makes reaching median reference CD4 cell counts more likely. However, median CD4: CD8 ratio trajectories remained below the median levels of HIV-negative individuals because of persisting high CD8 cell counts. To what extent these subnormal immunological responses affect specific clinical endpoints requires further investigation.
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- 2019
13. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study
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Rohner E., Butikofer L., Schmidlin K., Sengayi M., Maskew M., Giddy J., Garone D., Moore R. D., D'Souza G., Goedert J. J., Achenbach C., Gill M. J., Kitahata M. M., Patel P., Silverberg M. J., Castilho J., McGowan C., Chen Y. -M. A., Law M., Taylor N., Paparizos V., Bonnet F., Verbon A., Fatkenheuer G., Post F. A., Sabin C., Mocroft A., Le Moing V., Dronda F., Obel N., Grabar S., Spagnuolo V., Antinori A., Quiros-Roldan E., Mussini C., Miro J. M., Meyer L., Hasse B., Konopnicki D., Roca B., Barger D., Raben D., Clifford G. M., Franceschi S., Brockmeyer N., Chakraborty R., Egger M., Bohlius J., Judd A., Zangerle R., Touloumi G., Warszawski J., Dabis F., Krause M. M., Ghosn J., Leport C., Wittkop L., Reiss P., Wit F., Prins M., Bucher H., Gibb D., Del Amo J., Thorne C., Kirk O., Stephan C., Perez-Hoyos S., Hamouda O., Bartmeyer B., Chkhartishvili N., Noguera-Julian A., Monforte A. D., Prieto L., Conejo P. R., Soriano-Arandes A., Battegay M., Kouyos R., Tookey P., Casabona J., Castagna A., Konopnick D., Goetghebuer T., Sonnerborg A., Teira R., Garrido M., Haerry D., De Wit S., Costagliola D., D'Arminio-Monforte A., Chene G., Schwimmer C., Termote M., Campbell M., Frederiksen C. M., Friis-Moller N., Kjaer J., Brandt R. S., Berenguer J., Bouteloup V., Cozzi-Lepri A., Davies M. -A., Dorrucci M., Dunn D., Furrer H., Guiguet M., Lambotte O., Leroy V., Lodi S., Matheron S., Monge S., Nakagawa F., Paredes R., Phillips A., Puoti M., Schomaker M., Smit C., Sterne J., Thiebaut R., Torti C., Van Der Valk M., Tanser F., Vinikoor M., MacEte E., Wood R., Stinson K., Fatti G., Phiri S., Chimbetete C., Malisita K., Eley B., Fritz C., Hobbins M., Kamenova K., Fox M., Prozesky H., Technau K., Sawry S., Benson C. A., Bosch R. J., Kirk G. D., Boswell S., Mayer K. H., Grasso C., Hogg R. S., Harrigan P. R., Montaner J. S. G., Yip B., Zhu J., Salters K., Gabler K., Buchacz K., Brooks J. T., Gebo K. A., Carey J. T., Rodriguez B., Horberg M. A., Thorne J. E., Rabkin C., Margolick J. B., Jacobson L. P., Klein M. B., Rourke S. B., Rachlis A. R., Cupido P., Hunter-Mellado R. F., Mayor A. M., Deeks S. G., Martin J. N., Saag M. S., Mugavero M. J., Willig J., Eron J. J., Napravnik S., Crane H. M., Drozd D. R., Haas D., Rebeiro P., Turner M., Bebawy S., Rogers B., Justice A. C., Dubrow R., Fiellin D., Gange S. J., Anastos K., Althoff K. N., McKaig R. G., Freeman A. M., Lent C., Van Rompaey S. E., Morton L., McReynolds J., Lober W. B., Abraham A. G., Lau B., Zhang J., Jing J., Modur S., Wong C., Hogan B., Desir F., Liu B., You B., Cahn P., Cesar C., Fink V., Sued O., Dell'Isola E., Perez H., Valiente J., Yamamoto C., Grinsztejn B., Veloso V., Luz P., De Boni R., Wagner S. C., Friedman R., Moreira R., Pinto J., Ferreira F., Maia M., De Menezes Succi R. C., MacHado D. M., De Fatima Barbosa Gouvea A., Wolff M., Cortes C., Rodriguez M. F., Allendes G., Pape J. W., Rouzier V., Marcelin A., Perodin C., Luque M. T., Padgett D., Madero J. S., Ramirez B. C., Belaunzaran P., Vega Y. C., Gotuzzo E., Mejia F., Carriquiry G., McGowan C. C., Shepherd B. E., Sterling T., Jayathilake K., Person A. K., Rebeiro P. F., Giganti M., Duda S. N., Maruri F., Vansell H., Ly P. S., Khol V., Zhang F. J., Zhao H. X., Han N., Lee M. P., Li P. C. K., Lam W., Chan Y. T., Kumarasamy N., Saghayam S., Ezhilarasi C., Pujari S., Joshi K., Gaikwad S., Chitalikar A., Merati T. P., Wirawan D. N., Yuliana F., Yunihastuti E., Imran D., Widhani A., Tanuma J., Oka S., Nishijima T., Choi J. Y., Na S., Kim J. M., Sim B. L. H., Gani Y. M., David R., Kamarulzaman A., Syed Omar S. F., Ponnampalavanar S., Azwa I., Ditangco R., Uy E., Bantique R., Wong W. W., Ku W. W., Wu P. C., Ng O. T., Lim P. L., Lee L. S., Ohnmar P. S., Avihingsanon A., Gatechompol S., Phanuphak P., Phadungphon C., Kiertiburanakul S., Sungkanuparph S., Chumla L., Sanmeema N., Chaiwarith R., Sirisanthana T., Kotarathititum W., Praparattanapan J., Kantipong P., Kambua P., Ratanasuwan W., Sriondee R., Nguyen K. V., Bui H. V., Nguyen D. T. H., Nguyen D. T., Cuong D. D., An N. V., Luan N. T., Sohn A. H., Ross J. L., Petersen B., Cooper D. A., Law M. G., Jiamsakul A., Boettiger D. C., Ellis D., Bloch M., Agrawal S., Vincent T., Allen D., Smith D., Rankin A., Baker D., Templeton D. J., Jackson E., McCallum K., Ryder N., Sweeney G., Cooper D., Carr A., MacRae K., Hesse K., Finlayson R., Gupta S., Langton-Lockton J., Shakeshaft J., Brown K., Idle S., Arvela N., Varma R., Lu H., Couldwell D., Eswarappa S., Smith D. E., Furner V., Cabrera G., Fernando S., Cogle A., Lawrence C., Mulhall B., Boyd M., Petoumenos K., Puhr R., Huang R., Han A., Gunathilake M., Payne R., O'Sullivan M., Croydon A., Russell D., Cashman C., Roberts C., Sowden D., Taing K., Marshall P., Orth D., Youds D., Rowling D., Latch N., Warzywoda E., Dickson B., Donohue W., Moore R., Edwards S., Boyd S., Roth N. J., Lau H., Read T., Silvers J., Zeng W., Hoy J., Watson K., Bryant M., Price S., Woolley I., Giles M., Korman T., Williams J., Nolan D., Allen A., Guelfi G., Mills G., Wharry C., Raymond N., Bargh K., Templeton D., Medical Microbiology & Infectious Diseases, Global Health, Infectious diseases, APH - Aging & Later Life, AII - Infectious diseases, APH - Global Health, Graduate School, APH - Digital Health, APH - Personalized Medicine, Bohlius, Julia, Cohere In, Eurocoord, Castagna, Antonella, Rohner, E, Butikofer, L, Schmidlin, K, Sengayi, M, Maskew, M, Giddy, J, Garone, D, Moore, R, D'Souza, G, Goedert, J, Achenbach, C, Gill, M, Kitahata, M, Patel, P, Silverberg, M, Castilho, J, Mcgowan, C, Chen, Y, Law, M, Taylor, N, Paparizos, V, Bonnet, F, Verbon, A, Fatkenheuer, G, Post, F, Sabin, C, Mocroft, A, Le Moing, V, Dronda, F, Obel, N, Grabar, S, Spagnuolo, V, Antinori, A, Quiros-Roldan, E, Mussini, C, Miro, J, Meyer, L, Hasse, B, Konopnicki, D, Roca, B, Barger, D, Raben, D, Clifford, G, Franceschi, S, Brockmeyer, N, Chakraborty, R, Egger, M, Bohlius, J, Judd, A, Zangerle, R, Touloumi, G, Warszawski, J, Dabis, F, Krause, M, Ghosn, J, Leport, C, Wittkop, L, Reiss, P, Wit, F, Prins, M, Bucher, H, Gibb, D, Del Amo, J, Thorne, C, Kirk, O, Stephan, C, Perez-Hoyos, S, Hamouda, O, Bartmeyer, B, Chkhartishvili, N, Noguera-Julian, A, Monforte, A, Prieto, L, Conejo, P, Soriano-Arandes, A, Battegay, M, Kouyos, R, Tookey, P, Casabona, J, Castagna, A, Konopnick, D, Goetghebuer, T, Sonnerborg, A, Teira, R, Garrido, M, Haerry, D, De Wit, S, Costagliola, D, D'Arminio-Monforte, A, Chene, G, Schwimmer, C, Termote, M, Campbell, M, Frederiksen, C, Friis-Moller, N, Kjaer, J, Brandt, R, Berenguer, J, Bouteloup, V, Cozzi-Lepri, A, Davies, M, Dorrucci, M, Dunn, D, Furrer, H, Guiguet, M, Lambotte, O, Leroy, V, Lodi, S, Matheron, S, Monge, S, Nakagawa, F, Paredes, R, Phillips, A, Puoti, M, Schomaker, M, Smit, C, Sterne, J, Thiebaut, R, Torti, C, Van Der Valk, M, Tanser, F, Vinikoor, M, Macete, E, Wood, R, Stinson, K, Fatti, G, Phiri, S, Chimbetete, C, Malisita, K, Eley, B, Fritz, C, Hobbins, M, Kamenova, K, Fox, M, Prozesky, H, Technau, K, Sawry, S, Benson, C, Bosch, R, Kirk, G, Boswell, S, Mayer, K, Grasso, C, Hogg, R, Harrigan, P, Montaner, J, Yip, B, Zhu, J, Salters, K, Gabler, K, Buchacz, K, Brooks, J, Gebo, K, Carey, J, Rodriguez, B, Horberg, M, Thorne, J, Rabkin, C, Margolick, J, Jacobson, L, Klein, M, Rourke, S, Rachlis, A, Cupido, P, Hunter-Mellado, R, Mayor, A, Deeks, S, Martin, J, Saag, M, Mugavero, M, Willig, J, Eron, J, Napravnik, S, Crane, H, Drozd, D, Haas, D, Rebeiro, P, Turner, M, Bebawy, S, Rogers, B, Justice, A, Dubrow, R, Fiellin, D, Gange, S, Anastos, K, Althoff, K, Mckaig, R, Freeman, A, Lent, C, Van Rompaey, S, Morton, L, Mcreynolds, J, Lober, W, Abraham, A, Lau, B, Zhang, J, Jing, J, Modur, S, Wong, C, Hogan, B, Desir, F, Liu, B, You, B, Cahn, P, Cesar, C, Fink, V, Sued, O, Dell'Isola, E, Perez, H, Valiente, J, Yamamoto, C, Grinsztejn, B, Veloso, V, Luz, P, De Boni, R, Wagner, S, Friedman, R, Moreira, R, Pinto, J, Ferreira, F, Maia, M, De Menezes Succi, R, Machado, D, De Fatima Barbosa Gouvea, A, Wolff, M, Cortes, C, Rodriguez, M, Allendes, G, Pape, J, Rouzier, V, Marcelin, A, Perodin, C, Luque, M, Padgett, D, Madero, J, Ramirez, B, Belaunzaran, P, Vega, Y, Gotuzzo, E, Mejia, F, Carriquiry, G, Shepherd, B, Sterling, T, Jayathilake, K, Person, A, Giganti, M, Duda, S, Maruri, F, Vansell, H, Ly, P, Khol, V, Zhang, F, Zhao, H, Han, N, Lee, M, Li, P, Lam, W, Chan, Y, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Merati, T, Wirawan, D, Yuliana, F, Yunihastuti, E, Imran, D, Widhani, A, Tanuma, J, Oka, S, Nishijima, T, Choi, J, Na, S, Kim, J, Sim, B, Gani, Y, David, R, Kamarulzaman, A, Syed Omar, S, Ponnampalavanar, S, Azwa, I, Ditangco, R, Uy, E, Bantique, R, Wong, W, Ku, W, Wu, P, Ng, O, Lim, P, Lee, L, Ohnmar, P, Avihingsanon, A, Gatechompol, S, Phanuphak, P, Phadungphon, C, Kiertiburanakul, S, Sungkanuparph, S, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kantipong, P, Kambua, P, Ratanasuwan, W, Sriondee, R, Nguyen, K, Bui, H, Nguyen, D, Cuong, D, An, N, Luan, N, Sohn, A, Ross, J, Petersen, B, Cooper, D, Jiamsakul, A, Boettiger, D, Ellis, D, Bloch, M, Agrawal, S, Vincent, T, Allen, D, Smith, D, Rankin, A, Baker, D, Templeton, D, Jackson, E, Mccallum, K, Ryder, N, Sweeney, G, Carr, A, Macrae, K, Hesse, K, Finlayson, R, Gupta, S, Langton-Lockton, J, Shakeshaft, J, Brown, K, Idle, S, Arvela, N, Varma, R, Lu, H, Couldwell, D, Eswarappa, S, Furner, V, Cabrera, G, Fernando, S, Cogle, A, Lawrence, C, Mulhall, B, Boyd, M, Petoumenos, K, Puhr, R, Huang, R, Han, A, Gunathilake, M, Payne, R, O'Sullivan, M, Croydon, A, Russell, D, Cashman, C, Roberts, C, Sowden, D, Taing, K, Marshall, P, Orth, D, Youds, D, Rowling, D, Latch, N, Warzywoda, E, Dickson, B, Donohue, W, Edwards, S, Boyd, S, Roth, N, Lau, H, Read, T, Silvers, J, Zeng, W, Hoy, J, Watson, K, Bryant, M, Price, S, Woolley, I, Giles, M, Korman, T, Williams, J, Nolan, D, Allen, A, Guelfi, G, Mills, G, Wharry, C, Raymond, N, and Bargh, K
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Male ,viruses ,HIV Infections ,Men who have sex with men ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,Antiretroviral therapy ,Cohort study ,HIV ,Kaposi sarcoma ,Adolescent ,Adult ,Anti-Retroviral Agents ,CD4 Lymphocyte Count ,Female ,HIV-1 ,Humans ,Middle Aged ,Sarcoma, Kaposi ,Viral Load ,Young Adult ,030212 general & internal medicine ,Articles and Commentaries ,Incidence (epidemiology) ,Hazard ratio ,virus diseases ,Sarcoma ,3. Good health ,Infectious Diseases ,030220 oncology & carcinogenesis ,Cohort ,Coinfection ,Microbiology (medical) ,antiretroviral therapy ,610 Medicine & health ,Kaposi ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,360 Social problems & social services ,medicine ,cohort study ,business.industry ,medicine.disease ,Confidence interval ,business ,Demography - Abstract
Background We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. Methods We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). Results We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were
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- 2017
14. Long-term trends in CD4 cell counts, CD8 cell counts, and the CD4: CD8 ratio: ART Cohort Collaboration (ART-CC) Study
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HUGHES, R. A., MAY, M. T., TILLING, K., TAYLOR, N., WITTKOP, Linda, REISS, P., GILL, J., SCHOMMERS, P., COSTAGLIOLA, D., GUEST, J. L., LIMA, V. D., MONFORTE, A. D., SMITH, C., CAVASSINI, M., SAAG, M., STERLING, T. R., and STERNE, J. A. C.
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- 2018
15. Associations of food insecurity and psychosocial measures with diet quality in adults aging with HIV
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Muhammad, J. N., primary, Fernandez, J. R., additional, Clay, O. J., additional, Saag, M. S., additional, Overton, E. T., additional, and Willig, A. L., additional
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- 2018
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16. Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women: an application of the parametric g-formula
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Gange, S., Kassaye, S., French, A., Kempf, M.-C., Cole, S.R., Milam, J., Wingood, G., Anastos, K., Bacchetti, P., Rubtsova, A., Gange, S.J., Tien, P., Gustafson, D., Greenblatt, R., Ofotokun, I., Adimora, A., Todd, J.V., Konkle-Parker, D., Fischl, M., Edwards, J.K., Minkoff, H., Adimora, A.A., Saag, M., Mack, W.J., WIHS Investigators, Cohen, M., Golub, E., Edmonds, A., Aouizerat, B., Pence, B.W., Metsch, L., Lesko, C.R., and Young, M.
- Abstract
Purpose Among HIV-infected persons, antiretroviral therapy (ART) and depression are strongly associated with mortality. We estimated reductions in 5-year mortality in Women's Interagency HIV Study participants under plausible hypothetical increases in ART initiation and reductions in depression (CES-D score≥16). Methods We followed 885 ART-naïve Women's Interagency HIV Study participants for 5 years from their first study visit after April 1998 to death or censoring. We used the parametric extended g-formula to estimate cumulative mortality under the natural course (NC) and alternative exposure distributions. Results Baseline prevalence of depression was 52% and 62% initiated ART by 5 years. Compared with mortality under NC (13.2%), immediate ART and elimination of 36% or 67% of depressive episodes were associated with risk differences (RDs) of −5.2% (95% CI: −7.7%, −2.6%) and −5.7 (95% CI: −8.7, −2.7). Compared with immediate ART and NC for depression, additionally eliminating 67% of the depressive episodes was associated with RD = −1.6 (95% CI: −3.9, 0.8). Compared with 5-year mortality under NC for ART and elimination of 67% of depression, also initiating ART immediately was associated with RD = -2.6 (95% CI: -5.0, -0.3). Conclusions Increasing ART initiation and reducing depression were associated with moderate reductions in 5-year mortality among HIV-infected women.
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- 2017
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17. Occlusal features and need for orthodontic treatment in persons with osteogenesis imperfecta
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Nguyen, M.S., Binh, H.D., Nguyen, K.M., Maasalu, K., Kõks, S., Märtson, A., Saag, M., Jagomägi, T., Nguyen, M.S., Binh, H.D., Nguyen, K.M., Maasalu, K., Kõks, S., Märtson, A., Saag, M., and Jagomägi, T.
- Abstract
The aim of the study was to (a) analyse dental occlusion and determine the need for orthodontic treatment of persons with osteogenesis imperfecta (OI) in comparison with the healthy population and (b) investigate the associations between OI and malocclusion. A case‐control study included 26 OI persons and 400 healthy participants (control group). Occlusal features and the need for orthodontic treatment were defined according to Dental Health Component‐Index of Orthodontic Treatment Need and Dental Aesthetic Index. Results showed that Angle Class I, II, and III relationship was found in 23.1%, 3.8%, and 73.1% of OI group, and in the control group, it was 67%, 17.5%, and 15.5%, respectively. OI group had significantly higher prevalence of reverse overjet >1 mm (76.9%), missing teeth (42.3%), posterior crossbite (34.6%), and open bite >2 mm (19.2%) compared to the control group (8.5%, 2.2%, 6.2%, and 3.5%, respectively). OI group had less incisal segment crowding and more incisal segment spacing than the control group (p < 0.05). The need for orthodontic treatment of OI group according to Dental Health Component‐Index of Orthodontic Treatment Need and Dental Aesthetic Index was 88.5% and 61.5%, respectively, while in the control group, it was 24.8% and 51.8%. The malocclusion in OI persons was associated with reverse overjet > 1 mm (OR = 13.3, 95% CI = 3.9–44.7, p < .001), Angle Class III malocclusion (OR = 8.0, 95% CI = 2.0–30.8, p = .003), and missing teeth (OR = 4.7, 95% CI = 1.0–22.4, p = .049). In conclusion, there is the high probability of malocclusion in OI persons. Persons with OI require early orthodontic treatment because of significant correlation of OI disease with Angle Class III malocclusion, reverse overjet, and missing teeth.
- Published
- 2017
18. Application of an embryonated chicken egg model to assess the vector competence of AustralianCulicoidesmidges for bluetongue viruses
- Author
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VAN DER SAAG, M. R., primary, WARD, M. P., additional, and KIRKLAND, P. D., additional
- Published
- 2017
- Full Text
- View/download PDF
19. Circulating microRNAs in Sera Correlate with Soluble Biomarkers of Immune Activation but Do Not Predict Mortality in ART Treated Individuals with HIV-1 Infection: A Case Control Study
- Author
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Murray, D. D., Suzuki, K., Law, M., Trebicka, J., Neuhaus, J., Wentworth, D., Johnson, M., Vjecha, M. J., Kelleher, A. D., Emery, S., Aagaard, B., Aragon, E., Arnaiz, J., Borup, L., Clotet, B., Dragsted, U., Fau, A., Gey, D., Grarup, J., Hengge, U., Herrero, P., Jansson, P., Jensen, B., Jensen, K., Juncher, H., Lopez, P., Lundgren, J. 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M., Sowden, D., Street, A., Tee, B. K., Thomson, J., Topaz, S., Vale, R., Villella, C., Walker, A., Watson, A., Wendt, N., Williams, L., Youds, D., Aichelburg, A., Cichon, P., Gemeinhart, B., Rieger, A., Schmied, B., Touzeau-Romer, V., Vetter, N., Colebunders, R., Clumeck, N., Deroo, A., Kabeya, K., O'Doherty, E., De Wit, S., De Salles Amorim, C., Basso, C., Flint, S., Kallas, E., Levi, G., Lewi, D., Pereira, L., Da Silva, M., Souza, T., Toscano, A., Angel, J., Arsenault, M., Bast, M., Beckthold, B., Bouchard, P., Chabot, I., Clarke, R., Cohen, J., Cote, P., Ellis, M., Gagne, C., Gill, J., Houde, M., Johnston, B., Jubinville, N., Kato, C., Lamoureux, N., Latendre-Paquette, J., Lindemulder, A., Mcneil, A., Mcfarland, N., Montaner, J., Morrisseau, C., O'Neill, R., Page, G., Piche, A., Pongracz, B., Preziosi, H., Puri, L., Rachlis, A., Ralph, E., Raymond, I., Rouleau, D., Routy, J. 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M., Le Baut, V., Lefebvre, B., Leturque, N., Levy, Y., Loison, J., Maddi, G., Maignan, A., Majerholc, C., De Boever, C., Meynard, J. L., Michelet, C., Michon, C., Mole, M., Netzer, E., Pialoux, G., Poizot-Martin, I., Raffi, F., Ratajczak, M., Ravaux, I., Reynes, J., Salmon-Ceron, D., Sebire, M., Simon, A., Tegna, L., Tisne-Dessus, D., Tramoni, C., Viard, J. P., Vidal, M., Viet-Peaucelle, C., Weiss, L., Zeng, A., Zucman, D., Adam, A., Arasteh, K., Behrens, G., Bergmann, F., Bickel, M., Bittner, D., Bogner, J., Brockmeyer, N., Darrelmann, N., Deja, M., Doerler, M., Esser, S., Faetkenheuer, G., Fenske, S., Gajetzki, S., Goebel, F., Gorriahn, D., Harrer, E., Harrer, T., Hartl, H., Hartmann, M., Heesch, S., Jakob, W., Jager, H., Klinker, H., Kremer, G., Ludwig, C., Mantzsch, K., Mauss, S., Meurer, A., Niedermeier, A., Pittack, N., Plettenberg, A., Potthoff, A., Probst, M., Rittweger, M., Rockstroh, J., Ross, B., Rotty, J., Rund, E., Ruzicka, T., Schmidt, R., Schmutz, G., Schnaitmann, E., Schuster, D., Sehr, T., Spaeth, B., Staszewski, S., Stellbrink, H. J., Stephan, C., Stockey, T., Stoehr, A., Trein, A., Vaeth, T., Vogel, M., Wasmuth, J., Wengenroth, C., Winzer, R., Wolf, E., Mulcahy, F., Reidy, D., Cohen, Y., Drora, G., Eliezer, I., Godo, O., Kedem, E., Magen, E., Mamorsky, M., Pollack, S., Sthoeger, Z., Vered, H., Yust, I., Aiuti, F., Bechi, M., Bergamasco, A., Bertelli, D., Bruno, R., Butini, L., Cagliuso, M., Carosi, G., Casari, S., Chrysoula, V., Cologni, G., Conti, V., Costantini, A., Corpolongo, A., D'Offizi, G., Gaiottino, F., Di Pietro, M., Esposito, R., Filice, G., Francesco, M., Gianelli, E., Graziella, C., Magenta, L., Martellotta, F., Maserati, R., Mazzotta, F., Murdaca, G., Nardini, G., Nozza, S., Puppo, F., Pogliaghi, M., Ripamonti, D., Ronchetti, C., Rusconi, S., Rusconi, V., Sacchi, P., Silvia, N., Suter, F., Tambussi, G., Uglietti, A., Vechi, M., Vergani, B., Vichi, F., Vitiello, P., Iwamoto, A., Kikuchi, Y., Miyazaki, N., Mori, M., Nakamura, T., Odawara, T., Oka, S., Shirasaka, T., Tabata, M., Takano, M., Ueta, C., Watanabe, D., Yamamoto, Y., Erradey, I., Himmich, H., El Filali, K. M., Blok, W., Van Boxtel, R., Doevelaar, K. B. H., Van Eeden, A., Grijsen, M., Groot, M., Juttmann, J., Kuipers, M., Ligthart, S., Van Der Meulen, P., Lange, J., Langebeek, N., Reiss, P., Richter, C., Schoemaker, M., Schrijnders-Gudde, L., Septer-Bijleveld, E., Sprenger, H., Vermeulen, J., Ten Kate, R., Van De Ven, B., Bruun, J., Kvale, D., Maeland, A., Bakowska, E., Beniowski, M., Boron-Kaczmarska, A., Gasiorowski, J., Horban, A., Inglot, M., Knysz, B., Mularska, E., Parczewski, M., Pynka, M., Rymer, W., Szymczak, A., Aldir, M., Antunes, F., Baptista, C., Da Conceicao Vera, J., Doroana, M., Mansinho, K., Dos Santos, C. R. A., Valadas, E., Vaz Pinto, I., Chia, E., Foo, E., Karim, F., Lim, P. 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C., Wiedemeyer, K., Hatzakis, A., Touloumi, G., Antoniadou, A., Daikos, G. L., Dimitrakaki, A., Gargalianos-Kakolyris, P., Giannaris, M., Karafoulidou, A., Katsambas, A., Katsarou, O., Kontos, A. N., Kordossis, T., Lazanas, M. K., Panagopoulos, P., Panos, G., Paparizos, V., Papastamopoulos, V., Petrikkos, G., Sambatakou, H., Skoutelis, A., Tsogas, N., Xylomenos, G., Bergin, C. J., Mooka, B., Mamorksy, M. G., Agmon-Levin, N., Karplus, R., Maayan, S., Shahar, E., Turner, D., Abeli, C., Biglino, A., Bonora, S., De Gioanni, M., Di Perri, G., Montroni, M., Quirino, T., Raise, E., Honda, M., Ishisaka, M., Caplinskas, S., Uzdaviniene, V., Schmit, J. C., Staub, T., Mills, G. D., Blackmore, T., Masters, J. A., Morgan, J., Pithie, A., Brunn, J., Ormassen, V., La Rosa, A., Guerra, O., Espichan, M., Gutierrez, L., Mendo, F., Salazar, R., Knytz, B., Kwiatkowski, J., Castro, R. S., Horta, A., Miranda, A. C., Pinto, I. V., Vera, J., Rakhmanova, A., Vinogradova, E., Yakovlev, A., Zakharova, N., Wood, R., Orrel, C., Arnaiz, J. A., Carrillo, R., Dalmau, D., Jordano, Q., Knobel, H., Larrousse, M., Moreno, J. S., Oretaga, E., Pena, J. N., Hirschel, B., Spycher, R., Battegay, M., Bottone, S., Cavassini, M., Christen, A., Furrer, H. J., Gayet-Ageron, A., Genne, D., Hochstrasser, S., Moens, C., Muller, N., Nuesch, R., Ruxrungtham, K., Pumpradit, W., Dangthongdee, S., Kiertiburanakul, S., Klinbuayaem, V., Mootsikapun, P., Nonenoy, S., Piyavong, B., Prasithsirikul, W., Raksakulkarn, P., Gazzard, B. G., Ainsworth, J. G., Angus, B. J., Barber, T. J., Brook, M. G., Care, C. D., Chadwick, D. R., Chikohora, M., Churchill, D. R., Cornforth, D., Dockrell, D. H., Easterbrook, P. J., Fox, P. A., Gomez, P. A., Gompels, M. M., Harris, G. M., Herman, S., Jackson, A. G. A., Jebakumar, S. P. R., Kinghorn, G. R., Kuldanek, K. A., Larbalestier, N., Lumsden, M., Maher, T., Mantell, J., Muromba, L., Orkin, C. M., Peters, S., Peto, T. E. A., Portsmouth, S. D., Rajamanoharan, S., Ronan, Schwenk, A., Slinn, M. A., Stroud, C. J., Thomas, R. C., Wansbrough-Jones, M. H., Whiles, H. J., White, D. J., Williams, E., Williams, G., Youle, M., Abrams, D. I., Acosta, E. A., Adamski, A., Antoniskis, D., Aragon, D. R., Barnett, B. J., Baroni, C., Barron, M., Baxter, J. D., Beers, D., Beilke, M., Bemenderfer, Bernard, A., Besch, C. L., Bessesen, M. T., Bethel, J. T., Blue, S., Blum, J. D., Boarden, S., Bolan, R. K., Borgman, J. B., Brar, I., Braxton, B. K., Bredeek, U. F., Brennan, R., Britt, D. E., Bulgin-Coleman, D., Bullock, E., Campbell, B., Caras, S., Carroll, J., Casey, K. K., Chiang, F., Cindrich, R. B., Cohen, C., Coley, J., Condoluci, D. V., Contreras, R., Corser, J., Cozzolino, J., Crane, L. R., Daley, L., Dandridge, D., D'Antuono, V., Darcourt Rizo Patron, J. G., Dehovitz, J. A., Dejesus, E., Desjardin, J., Dietrich, C., Dolce, A., Erickson, D., Faber, L. L., Falbo, J., Farrough, M. J., Farthing, C. F., Ferrell-Gonzalez, P., Flynn, H., Frank, M., Freeman, K. F., French, N., Friedland, G., Fujita, N., Gahagan, L., Gilson, I., Goetz, M. B., Goodwin, E., Guity, C. K., Gulick, P., Gunderson, E. R., Hale, C. M., Hannah, K., Henderson, H., Hennessey, K., Henry, W. K., Higgins, T., Hodder, S. L., Horowitz, H. W., Howe-Pittman, M., Hubbard, J., Hudson, R., Hunter, H., Hutelmyer, C., Insignares, M. T., Jackson, L., Jenny, L., Johnson, D. L., Johnson, G., Johnson, J., Kaatz, J., Kaczmarski, J., Kagan, S., Kantor, C., Kempner, T., Kieckhaus, K., Kimmel, N., Klaus, B. M., Koeppe, J. R., Koirala, J., Kopka, J., Kostman, J. R., Kozal, M. J., Kumar, A., Lampiris, H., Lamprecht, C., Lattanzi, K. M., Lee, J., Leggett, J., Long, C., Loquere, A., Loveless, K., Lucasti, C. J., Luskin-Hawk, R., Macveigh, M., Makohon, L. H., Markowitz, N. P., Marks, C., Martorell, C., Mcfeaters, E., Mcgee, B., Mcintyre, D. M., Mcmanus, E., Melecio, L. G., Melton, D., Mercado, S., Merrifield, E., Mieras, J. A., Mogyoros, M., Moran, F. M., Murphy, K., Mutic, S., Nadeem, I., Nadler, J. P., Ognjan, A., O'Hearn, M., O'Keefe, K., Okhuysen, P. C., Oldfield, E., Olson, D., Orenstein, R., Ortiz, R., Parpart, F., Pastore-Lange, V., Paul, S., Pavlatos, A., Pearce, D. D., Pelz, R., Peterson, S., Pitrak, D., Powers, S. L., Pujet, H. C., Raaum, J. W., Ravishankar, J., Reeder, J., Reilly, N. A., Reyelt, C., Riddell, J., Rimland, D., Robinson, M. L., Rodriguez, A. E., Rodriguez Derouen, V., Rosmarin, C., Rossen, W. L., Rouff, J. R., Sands, M., Savini, C., Schrader, S., Schulte, M. M., Scott, R., Seedhom, H., Sension, M., Sheblehall, A., Shuter, J., Slater, L. N., Slotten, R., Smith, M., Snap, S., States, D. M., Stringer, G., Summers, K. K., Swanson, K., Sweeton, I. B., Szabo, S., Tedaldi, E. M., Telzak, E. E., Thompson, M. A., Thompson, S., Bong, C. T. H., Vaccaro, A., Vasco, L. M., Vecino, I., Verlinghieri, G. K., Visnegarwala, F., Wade, H., Weis, S. E., Weise, J. A., Weissman, S., Wilkin, M., Witter, J. H., Wojtusic, L., Wright, T. J., Yeh, V., Young, B., Zeana, C., Zeh, J., Savio, E., Vacarezza, M., and Pacheco, Antonio Guilherme
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Adult ,CD4-Positive T-Lymphocytes ,Male ,General Science & Technology ,Anti-HIV Agents ,T cell ,lcsh:Medicine ,Antiretroviral Therapy ,HIV Infections ,Biology ,Essential hypertension ,Logistic regression ,Malignancy ,Acquired immunodeficiency syndrome (AIDS) ,Clinical Research ,Antiretroviral Therapy, Highly Active ,microRNA ,medicine ,Genetics ,2.1 Biological and endogenous factors ,Humans ,Highly Active ,Aetiology ,lcsh:Science ,Genetic Association Studies ,Multidisciplinary ,lcsh:R ,Case-control study ,Middle Aged ,medicine.disease ,3. Good health ,Circulating MicroRNA ,MicroRNAs ,medicine.anatomical_structure ,Infectious Diseases ,Good Health and Well Being ,INSIGHT ESPRIT and SMART Study Groups ,Immunology ,HIV-1 ,HIV/AIDS ,lcsh:Q ,Female ,Infection ,Biomarkers ,Biotechnology ,Research Article - Abstract
Introduction The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR-145 correlated with nadir CD4+ T cell count. Discussion No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection.
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- 2015
20. Development and validation of a risk score for chronic kidney disease in HIV infection using prospective cohort data from the D:A:D study
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Mocroft, Amanda, Lundgren, Jens D., Ross, Michael, Law, Matthew, Reiss, Peter, Kirk, Ole, Smith, Colette, Wentworth, Deborah, Neuhaus, Jacqueline, Fux, Christoph A., Moranne, Olivier, Morlat, Phillipe, Johnson, Margaret A., Ryom, Lene, Lundgren, J. D., Powderly, B., Shortman, N., Moecklinghoff, C., Reilly, G., Franquet, X., Sabin, C. A., Phillips, A., Kirk, O., Reiss, P., Weber, R., Pradier, C., Law, M., d'Arminio Monforte, A., Dabis, F., El-Sadr, W. M., De Wit, S., Ryom, L., Kamara, D., Smith, C., Mocroft, A., Tverland, J., Mansfeld, M., Nielsen, J., Raben, D., Salbøl Brandt, R., Rickenbach, M., Fanti, I., Krum, E., Hillebregt, M., Geffard, S., Sundström, A., Delforge, M., Fontas, E., Torres, F., Mcmanus, H., Wright, S., Kjær, J., Sjøl, A., Meidahl, P., Helweg-Larsen, J., Schmidt Iversen, J., Ross, M., Fux, C. A., Morlat, P., Moranne, O., Kesselring, A. M., Kamara, D. A., Friis-Møller, N., Kowalska, J., Sabin, C., Bruyand, M., Bower, M., Fätkenheuer, G., Donald, A., Grulich, A., Prins, J. M., Kuijpers, T. W., Scherpbier, H. J., van der Meer, J. T. M., Wit, F. W. M. N., Godfried, M. H., van der Poll, T., Nellen, F. J. B., Geerlings, S. E., van Vugt, M., Pajkrt, D., Bos, J. C., Wiersinga, W. J., van der Valk, M., Goorhuis, A., Hovius, J. W., van Eden, J., Henderiks, A., van Hes, A. M. H., Mutschelknauss, M., Nobel, H. E., Pijnappel, F. J. J., Westerman, A. M., Jurriaans, S., Back, N. K. T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T. E., Schinkel, C. J., Thomas, X. V., van den Berge, M., Stegeman, A., Baas, S., Hage de Looff, L., Versteeg, D., Pronk, M. J. H., Ammerlaan, H. S. M., Korsten-Vorstermans, E. M. H. M., de Munnik, E. S., Jansz, A. R., Tjhie, J., Wegdam, M. C. A., Deiman, B., Scharnhorst, V., van der Plas, A., Weijsenfeld, A. M., van der Ende, M. E., de Vries-Sluijs, T. E. M. S., C. M. van Gorp, E., Schurink, C. A. M., Nouwen, J. 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L., Dimitrakaki, A., Gargalianos-Kakolyris, P., Giannaris, M., Karafoulidou, A., Katsambas, A., Katsarou, O., Kontos, A. N., Kordossis, T., Lazanas, M. K., Panagopoulos, P., Paparizos, V., Papastamopoulos, V., Petrikkos, G., Skoutelis, A., Tsogas, N., Bergin, C. J., Mooka, B., Mamorksy, M. G., Agmon-Levin, N., Karplus, R., Shahar, E., Biglino, A., De Gioanni, M., Montroni, M., Raise, E., Honda, M., Ishisaka, M., Caplinskas, S., Uzdaviniene, V., Schmit, J. C., Mills, G. D., Blackmore, T., Masters, J. A., Morgan, J., Pithie, A., Brunn, J., Ormasssen, V., La Rosa, A., Guerra, O., Espichan, M., Gutierrez, L., Mendo, F., Salazar, R., Knytz, B., Kwiatkowski, J., Castro, R. S., Horta, A., Miranda, A. C., Pinto, I. V., Vera, J., Vinogradova, E., Yakovlev, A., Wood, R., Orrel, C., Arnaiz, J. A., Carrillo, R., Dalmau, D., Jordano, Q., Knobel, H., Larrousse, M., Moreno, J. S., Oretaga, E., Pena, J. N., Spycher, R., Bottone, S., Christen, A., Franc, C., Furrer, H. J., Gayet-Ageron, A., Genné, D., Hochstrasser, S., Moens, C., Nüesch, R., Ruxrungtham, K., Pumpradit, W., Dangthongdee, S., Kiertiburanakul, S., Klinbuayaem, V., Mootsikapun, P., Nonenoy, S., Piyavong, B., Prasithsirikul, W., Raksakulkarn, P., Gazzard, B. G., Ainsworth, J. G., Angus, B. J., Barber, T. J., Brook, M. G., Care, C. D., Chadwick, D. R., Chikohora, M., Churchill, D. R., Cornforth, D., Dockrell, D. H., Easterbrook, P. J., Fox, P. A., Gomez, P. A., Gompels, M. M., Harris, G. M., Herman, S., Jackson, A. G. A., Jebakumar, S. P. R., Kinghorn, G. R., Kuldanek, K. A., Larbalestier, N., Lumsden, M., Maher, T., Mantell, J., Muromba, L., Orkin, C. M., Peters, B. S., Peto, T. E. A., Portsmouth, S. D., Rajamanoharan, S., Ronan, A., Schwenk, A., Slinn, M. A., Stroud, C. J., Thomas, R. C., Wansbrough-Jones, M. H., Whiles, H. J., White, D. J., Williams, E., Williams, I. G., Acosta, E. A., Adamski, A., Antoniskis, D., Aragon, D. R., Barnett, B. J., Baroni, C., Barron, M., Baxter, J. D., Beers, D., Beilke, M., Bemenderfer, D., Bernard, A., Besch, C. L., Bessesen, M. T., Bethel, J. T., Blue, S., Blum, J. D., Boarden, S., Bolan, R. K., Borgman, J. B., Brar, I., Braxton, B. K., Bredeek, U. F., Brennan, R., Britt, D. E., Bulgin-Coleman, D., Bullock, D. E., Campbell, B., Caras, S., Carroll, J., Casey, K. K., Chiang, F., Cindrich, R. B., Clark, C., Cohen, C., Coley, J., Condoluci, D. V., Contreras, R., Corser, J., Cozzolino, J., Daley, L., Dandridge, D., D'Antuono, V., Darcourt Rizo Patron, J. G., Dehovitz, J. A., Dejesus, E., Desjardin, J., Dietrich, C., Dolce, E., Erickson, D., Faber, L. L., Falbo, J., Farrough, M. J., Farthing, C. F., Ferrell-Gonzalez, P., Flynn, H., Frank, M., Freeman, K. F., French, N., Fujita, N., Gahagan, L., Gilson, I., Goetz, M. B., Goodwin, E., Guity, C. K., Gulick, P., Gunderson, E. R., Hale, C. M., Hannah, K., Henderson, H., Hennessey, K., Henry, W. K., Higgins, D. T., Hodder, S. L., Horowitz, H. W., Howe-Pittman, M., Hubbard, J., Hudson, R., Hunter, H., Hutelmyer, C., Insignares, M. T., Jackson, L., Jenny, L., Johnson, D. L., Johnson, G., Johnson, J., Kaatz, J., Kaczmarski, J., Kagan, S., Kantor, C., Kempner, T., Kieckhaus, K., Kimmel, N., Klaus, B. M., Koeppe, J. R., Koirala, J., Kopka, J., Kostman, J. R., Kozal, M. J., Kumar, A., Lampiris, H., Lamprecht, C., Lattanzi, K. M., Lee, J., Leggett, J., Long, C., Loquere, A., Loveless, K., Lucasti, C. J., Macveigh, M., Makohon, L. H., Markowitz, N. P., Marks, C., Martorell, C., Mcfeaters, E., Mcgee, B., Mcintyre, D. M., Mcmanus, E., Melecio, L. G., Melton, D., Mercado, S., Merrifield, E., Mieras, J. A., Mogyoros, M., Moran, F. M., Murphy, K., Mutic, S., Nadeem, I., Nadler, J. P., Ognjan, A., O'Hearn, M., O'Keefe, K., Okhuysen, P. C., Oldfield, E., Olson, D., Orenstein, R., Ortiz, R., Parpart, F., Pastore-Lange, V., Paul, S., Pavlatos, A., Pearce, D. D., Pelz, R., Peterson, S., Pitrak, D., Powers, S. L., Pujet, H. C., Raaum, J. W., Ravishankar, J., Reeder, J., Reilly, N. A., Reyelt, C., Riddell, J., Rimland, D., Robinson, M. L., Rodriguez, A. E., Rodriguez-Barradas, M. C., Rodriguez Derouen, V., Rosmarin, C., Rossen, W. L., Rouff, J. R., Sampson, J. H., Sands, M., Savini, C., Schrader, S., Schulte, M. M., Scott, R., Seedhom, H., Sension, M., Sheble-Hall, A., Shuter, J., Slater, L. N., Slotten, R., Smith, M., Snap, S., States, D. M., Stringer, G., Summers, K. K., Swanson, K., Sweeton, I. B., Szabo, S., Tedaldi, E. M., Telzak, E. E., Thompson, M. A., Thompson, S., Ting Hong Bong, C., Vaccaro, A., Vasco, L. M., Vecino, I., Verlinghieri, G. K., Visnegarwala, F., Wade, B. H., Weis, S. E., Weise, J. A., Weissman, S., Wilkin, A. M., Witter, J. H., Wojtusic, L., Wright, T. J., Yeh, V., Young, B., Zeana, C., Zeh, J., Savio, E., Vacarezza, M., University College of London [London] (UCL), University of Copenhagen = Københavns Universitet (KU), University of New South Wales [Sydney] (UNSW), University of Amsterdam [Amsterdam] (UvA), University of Minnesota [Twin Cities] (UMN), University of Minnesota System, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nice (CHU Nice), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Med Microbiol, Infect Dis & Infect Prev, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R4 - Health Inequities and Societal Participation, Interne Geneeskunde, Chemical Biology, Mocroft, A, Lundgren, J, Ross, M, Law, M, Reiss, P, Kirk, O, Smith, C, Wentworth, D, Neuhaus, J, Fux, C, Moranne, O, Morlat, P, Johnson, M, Ryom, L, Gori, A, Internal medicine, CCA - Innovative therapy, ICaR - Circulation and metabolism, Medical Microbiology and Infection Prevention, CCA - Disease profiling, CCA - Immuno-pathogenesis, Plastic, Reconstructive and Hand Surgery, Mocroft, Amanda, Lundgren, Jens D., Ross, Michael, Law, Matthew, Reiss, Peter, Kirk, Ole, Smith, Colette, Wentworth, Deborah, Neuhaus, Jacqueline, Fux, Christoph A., Moranne, Olivier, Morlat, Phillipe, Johnson, Margaret A., Ryom, Lene, D:a:d Study, Group, Castagna, Antonella, the Royal Free Hospital Clinic, Cohort, and the, Insight, Smart, and ESPRIT, Study, Clinicum, Department of Medicine, Herrada, Anthony, University of Copenhagen = Københavns Universitet (UCPH), AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Global Health, Other departments, Infectious diseases, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Center of Experimental and Molecular Medicine, Graduate School, Gastroenterology and Hepatology, Dermatology, ACS - Amsterdam Cardiovascular Sciences, Other Research, Anesthesiology, and Bartlett, John
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Male ,Adult ,Age Factors ,Anti-HIV Agents ,CD4 Lymphocyte Count ,Clinical Decision-Making ,Comorbidity ,Female ,HIV ,HIV Infections ,HIV Seropositivity ,Humans ,Incidence ,Kidney ,Middle Aged ,Prospective Studies ,Renal Insufficiency, Chronic ,Risk ,Risk Assessment ,Sex Factors ,urologic and male genital diseases ,Biochemistry ,0302 clinical medicine ,ANTIRETROVIRAL THERAPY ,Adult, Age Factors, Anti-HIV Agents, CD4 Lymphocyte Count, Clinical Decision-Making, Comorbidity, Female, HIV, HIV Infections, HIV Seropositivity, Humans, Incidence, Kidney, Male, Middle Aged, Prospective Studies, Renal Insufficiency, Chronic, Risk, Risk Assessment, Sex Factors ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Age Factor ,Chronic ,STAGE RENAL-DISEASE ,PROTEINURIA ,virus diseases ,11 Medical And Health Sciences ,General Medicine ,ASSOCIATION ,6. Clean water ,female genital diseases and pregnancy complications ,3. Good health ,HIV/AIDS ,Medicine ,Infection ,psychological phenomena and processes ,Human ,medicine.medical_specialty ,Renal function ,NEFROPATIAS ,chronic kidney disease ,risk score model ,12. Responsible consumption ,ESPRIT study group ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Clinical Research ,D:A:D study group ,Intensive care medicine ,medicine (all) ,Molecular Biology ,Royal Free Hospital Clinic Cohort ,Prevention ,Anti-HIV Agent ,medicine.disease ,Prospective Studie ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Immunology ,Kidney Disease ,PREDICTION ,POSITIVE PERSONS ,030232 urology & nephrology ,Sex Factor ,SDG 3 – Goede gezondheid en welzijn ,Medical and Health Sciences ,GLOMERULAR-FILTRATION-RATE ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,INSIGHT study group ,HIV Infection ,LIFE EXPECTANCY ,030212 general & internal medicine ,Renal Insufficiency ,Prospective cohort study ,Framingham Risk Score ,Incidence (epidemiology) ,adult ,age factors ,anti-hiv agents ,CD4 lymphocyte count ,clinical decision-making ,comorbidity ,female ,hiv ,hiv infections ,hiv seropositivity ,humans ,incidence ,kidney ,male ,middle aged ,prospective studies ,renal insufficiency, chronic ,risk ,risk assessment ,sex factors ,SMART study group ,6.1 Pharmaceuticals ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Patient Safety ,Risk assessment ,Biotechnology ,Research Article ,Settore MED/17 - MALATTIE INFETTIVE ,NO ,A:D study group [D] ,General & Internal Medicine ,Diabetes mellitus ,mental disorders ,medicine ,EXPOSURE ,business.industry ,Evaluation of treatments and therapeutic interventions ,Cell Biology ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,INDIVIDUALS ,Good Health and Well Being ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,3121 General medicine, internal medicine and other clinical medicine ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Kidney disease - Abstract
Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with ≥3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR ≤ 60 ml/min/1.73 m2. Poisson regression was used to develop a risk score, externally validated on two independent cohorts. In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7–6.7; median follow-up 6.1 y, range 0.3–9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was −2 (interquartile range –4 to 2). There was a 1:393 chance of developing CKD in the next 5 y in the low risk group (risk score < 0, 33 events), rising to 1:47 and 1:6 in the medium (risk score 0–4, 103 events) and high risk groups (risk score ≥ 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166–3,367); NNTH was 202 (95% CI 159–278) and 21 (95% CI 19–23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506–1462), 88 (95% CI 69–121), and 9 (95% CI 8–10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3–12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6–8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD., Editors’ Summary Background About 35 million people are currently infected with HIV, the virus that causes AIDS. HIV destroys CD4 lymphocytes and other immune system cells, leaving infected individuals susceptible to other infections. HIV infection can be controlled, but not cured, using combination antiretroviral therapy (cART), and, nowadays, the life expectancy of many HIV-positive individuals is similar to that of HIV-negative people. HIV-positive individuals nevertheless experience some illnesses more frequently than HIV-negative people do. For example, up to a third of HIV-positive individuals develop chronic kidney disease (CKD), which is associated with an increased risk of cardiovascular disease and death. Persons with CKD may have an impaired effect of the filtration units in the kidneys that remove waste products and excess water from the blood to make urine, thereby leading to a reduced blood filtration rate (the estimated glomerular filtration rate [eGFR]) and waste product accumulation in the blood. Symptoms of CKD, which rarely occur until the disease is advanced, include tiredness, swollen feet, and frequent urination. Advanced stages of CKD cannot be cured, but its progression can be slowed by, for example, controlling hypertension (high blood pressure) and diabetes (two CDK risk factors) and by adopting a healthy lifestyle. Why Was This Study Done? The burden of CKD may increase among HIV-positive individuals as they age, and clinicians need to know which individuals are at high risk of developing CKD when choosing cART regimens for their patients. In addition, clinicians need to be able to identify those HIV-positive individuals at greatest risk of CKD so that they can monitor them for early signs of kidney disease. Some antiretroviral drugs—for example, tenofovir and atazanavir/ritonavir (a boosted protease inhibitor)—are associated with kidney damage. Clinicians may need to weigh the benefits and risks of giving such potentially nephrotoxic drugs to individuals who already have a high CKD risk. Here, the researchers develop and validate a simple, widely applicable risk score (a risk prediction model) for CKD among HIV-positive individuals and investigate the relationship between CKD and potentially nephrotoxic antiretroviral drugs among individuals with different CKD risk score profiles. What Did the Researchers Do and Find? To develop their CKD risk score, the researchers used clinical and demographic data collected from 17,954 HIV-positive individuals enrolled in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study who had an eGFR > 60 ml/min/1.73 m2 and were not taking a potentially nephrotoxic antiretroviral at baseline. During 103,185 person-years of follow-up, 641 individuals developed CKD. Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease predicted CKD. The researchers included these nine factors in their risk score model (which is available online) and defined three risk groups: low (risk score < 0), medium (risk score 0–4), and high (risk score ≥ 5) risk of CKD development in the next five years. Specifically, there was a 1 in 393, 1 in 47, and 1 in 6 chance of developing CKD in the next five years in the low, medium, and high risk groups, respectively. Because some patients started to use potentially nephrotoxic antiretroviral drugs during follow-up, the researchers were able to use their risk score model to calculate how many patients would have to be treated with one of these drugs for an additional patient to develop CKD over five years in each risk group. This “number needed to harm” (NNTH) for patients starting treatment with tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor was 739, 88, and 9 in the low, medium, and high risk groups, respectively. Finally, the researchers validated the accuracy of their risk score in two independent HIV study groups. What Do These Findings Mean? These findings provide a simple, validated risk score for CKD and indicate that the NNTH when starting potentially nephrotoxic antiretrovirals was low among HIV-positive individuals at the highest risk of CKD (i.e., treating just nine individuals with nephrotoxic antiretroviral drugs will likely lead to an additional case of CKD in five years). Although various aspects of the study, including the lack of data on race, limit the accuracy of these findings, these findings highlight the need for monitoring, screening, and chronic disease prevention to minimize the risk of HIV-positive individuals developing diabetes, hypertension, or cardiovascular disease, or becoming coinfected with hepatitis C, all of which contribute to the CKD risk score. Moreover, the development of a tool for estimating an individual’s five-year risk of developing CKD with or without the addition of potentially nephrotoxic antiretroviral drugs will enable clinicians and patients to weigh the benefits of certain antiretroviral drugs against the risk of CKD and make informed decisions about treatment options. Additional Information Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001809. Information is available from the US National Institute of Allergy and Infectious Diseases on HIV infection and AIDS NAM/aidsmap provides basic information about HIV/AIDS, summaries of recent research findings on HIV care and treatment, and personal stories about living with AIDS/HIV Information is available from Avert, an international AIDS charity, on many aspects of HIV/AIDS, including personal stories about living with HIV/AIDS The World Health Organization provides information on all aspects of HIV/AIDS (in several languages), including its guidelines on the use of ART for treating and preventing HIV infection The UNAIDS World AIDS Day Report 2014 provides up-to-date information about the AIDS epidemic and efforts to halt it The UK National Health Service Choices website provides information for patients on chronic kidney disease, including some personal stories The US National Kidney Foundation, a not-for-profit organization, provides information about chronic kidney disease (in English and Spanish) A tool for calculating the CDK risk score developed in this study is available Additional information about the D:A:D study is available, Amanda Mocroft and colleagues develop and validate a model for determining risk of developing chronic kidney disease for individuals with HIV if treated with different antiretroviral therapies.
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- 2015
21. Associations of food insecurity and psychosocial measures with diet quality in adults aging with HIV.
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Muhammad, J. N., Fernandez, J. R., Clay, O. J., Saag, M. S., Overton, E. T., and Willig, A. L.
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ACADEMIC medical centers ,HUMAN microbiota ,DIET ,PSYCHOLOGY of HIV-positive persons ,INGESTION ,QUESTIONNAIRES ,REGRESSION analysis ,PSYCHOLOGICAL stress ,SOCIOECONOMIC factors ,BODY mass index ,CROSS-sectional method ,RETROSPECTIVE studies ,FOOD security - Abstract
People aging with HIV face social stressors which may negatively affect their overall nutrition. Here, we assess relationships between self-reported measures of depression, perceived stress, social support, and food insecurity with diet quality in older adults with HIV. A retrospective analysis of self-reported data from parent study at The University of Alabama at Birmingham 1917 HIV Clinic was performed. The study sample consisted of sixty people living with HIV (PLWH) with controlled HIV infection (<50 copies/mL), aged 50 years or older who participated in a cross-sectional microbiome study. Dietary intake was measured using the NHANES 12-month Food Frequency Questionnaire (FFQ) and three Automated Self-Administered (ASA) 24-hr diet recalls to calculate diet quality scores using the Mediterranean Diet Score (MDS); alternative Healthy Eating Index (aHEI); and the Recommended Food Score (RFS) indices. Food insecurity was measured with the Food Security Questionnaire (FSQ). Participants completed the following psychosocial scales: (1) depression - Patient Health Questionnaire-8 (PHQ8); (2) perceived stress - Perceived Stress Scale (PSS-10); (3) social support - Multidimensional Scale of Perceived Social Support (MSPSS). Linear regression models were used to investigate relationships among variables controlling for gender and income. The cohort was characterized as follows: Mean age 56 ± 4.6 years, 80% African-American, and 32% women. Mean body mass index (BMI) was 28.4 ± 7.2 with 55% reporting food insecurity. Most participants reported having post-secondary education (53%), although 77% reported annual incomes <$20,000. Food insecurity was independently associated with measures of poor dietary intake: aHEI (β = −0.08, p = .02) and MDS (β = −0.23, p < 0.01) and with low dietary intake of fibre (β = −0.27, p = .04), vitamin E (β = −0.35, p = .01), folate (β = −0.31, p = .02), magnesium (β = −0.34, p = .01) and copper (β = −0.36, p = .01). These data indicate food insecurity is associated with poor diet quality among PLWH. Clinical interventions are needed to improve food access for PLWH of low SES. [ABSTRACT FROM AUTHOR]
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- 2019
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22. Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study
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Mocroft, A., Lundgren, J. D., Ross, M., Law, M., Reiss, P., Kirk, O., Smith, C., Wentworth, D., Neuhaus, J., Fux, C. A., Moranne, O., Morlat, P., Johnson, M. A., Ryom, L., Powderly, B., Shortman, N., Moecklinghoff, C., Reilly, G., Franquet, X., Sabin, C. A., Phillips, A., Weber, R., Pradier, C., d'Arminio Monforte, A., Dabis, F., El-Sadr, W. M., De Wit, S., Kamara, D., Tverland, J., Mansfeld, M., Nielsen, J., Raben, D., Salbol Brandt, R., Rickenbach, M., Fanti, I., Krum, E., Hillebregt, M., Geffard, S., Sundstrom, A., Delforge, M., Fontas, E., Torres, F., Mcmanus, H., Wright, S., Kjaer, J., Sjol, A., Meidahl, P., Helweg-Larsen, J., Schmidt Iversen, J., Kesselring, A. M., Friis-Moller, N., Kowalska, J., Sabin, C., Bruyand, M., Kamara, D. A., Bower, M., Fatkenheuer, G., Donald, A., Grulich, A., Prins, J. M., Kuijpers, T. W., Scherpbier, H. J., van der Meer, J. T. M., Wit, F. W. M. N., Godfried, M. H., van der Poll, T., Nellen, F. J. B., Geerlings, S. E., van Vugt, M., Pajkrt, D., Bos, J. C., Wiersinga, W. J., van der Valk, M., Goorhuis, A., Hovius, J. W., van Eden, J., Henderiks, A., van Hes, A. M. H., Mutschelknauss, M., Nobel, H. E., Pijnappel, F. J. J., Westerman, A. M., Jurriaans, S., Back, N. K. T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T. E., Schinkel, C. J., Thomas, X. V., van den Berge, M., Stegeman, A., Baas, S., Hage de Looff, L., Versteeg, D., Pronk, M. J. H., Ammerlaan, H. S. M., Korsten-Vorstermans, E. M. H. M., de Munnik, E. S., Jansz, A. R., Tjhie, J., Wegdam, M. C. A., Deiman, B., Scharnhorst, V., van der Plas, A., Weijsenfeld, A. M., van der Ende, M. E., de Vries-Sluijs, T. E. M. S., C. M. van Gorp, E., Schurink, C. A. M., Nouwen, J. L., Verbon, A., Rijnders, B. J. A., Bax, H. I., Hassing, R. J., van der Feltz, M., Bassant, N., van Beek, J. E. A., Vriesde, M., van Zonneveld, L. M., de Oude-Lubbers, A., van den Berg-Cameron, H. J., Bruinsma-Broekman, F. B., de Groot, J., de Zeeuw- de Man, M., Broekhoven-Kruijne, M. J., Schutten, M., Osterhaus, A. D. M. E., Boucher, C. A. B., Driessen, G. J. A., van Rossum, A. M. C., van der Knaap, L. C., Visser, E., Branger, J., H. M. Duijf-van de Ven C., J., Schippers, E. F., van Nieuwkoop, C., Brimicombe, R. W., van IJperen, J. M., van der Hut, G., Franck, P. F. H., van Eeden, A., Brokking, W., Groot, M., Damen, M., Kwa, I. S., Groeneveld, P. H. P., Bouwhuis, J. W., van den Berg, J. F., van Hulzen, A. G. W., van der Bliek, G. L., Bor, P. C. J., Bloembergen, P., Wolfhagen, M. J. H. M., Ruijs, G. J. H. M., van Lelyveld, S. F. L., Soetekouw, R., Hulshoff, N., van der Prijt, L. M. M., Schoemaker, M., Bermon, N., van der Reijden, W. A., Jansen, R., Herpers, B. L., Veenendaal, D., Kroon, F. P., Arend, S. M., de Boer, M. G. J., Bauer, M. P., Jolink, H., Vollaard, A. M., Dorama, W., Moons, C., Claas, E. C. J., Kroes, A. C. M., den Hollander, J. G., Pogany, K., Kastelijns, M., Smit, J. 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L., Cohen, Y., Drora, G., Eliezer, I., Godo, O., Kedem, E., Magen, E., Mamorsky, M., Sthoeger, Z., Vered, H., Aiuti, F., Bechi, M., Bergamasco, A., Bertelli, D., Bruno, R., Butini, L., Cagliuso, M., Carosi, G., Casari, S., Chrysoula, V., Cologni, G., Conti, V., Corpolongo, A., D'Offizi, G., Gaiottino, F., Di Pietro, M., Filice, G., Francesco, M., Gianelli, E., Graziella, C., Magenta, L., Martellotta, F., Maserati, R., Murdaca, G., Nardini, G., Nozza, S., Puppo, F., Pogliaghi, M., Ripamonti, D., Ronchetti, C., Rusconi, V., Sacchi, P., Silvia, N., Suter, F., Tambussi, G., Uglietti, A., Vechi, M., Vergani, B., Vichi, F., Vitiello, P., Iwamoto, A., Kikuchi, Y., Miyazaki, N., Mori, M., Nakamura, T., Odawara, T., Oka, S., Shirasaka, T., Tabata, M., Takano, M., Ueta, C., Watanabe, D., Yamamoto, Y., Erradey, I., Himmich, H., Marhoum El Filali, K., Blok, W., van Boxtel, R., Brinkman H Doevelaar, K., Grijsen, M., Juttmann, J., Ligthart, S., van der Meulen, P., Lange, J., Schrijnders-Gudde, L., Septer-Bijleveld, E., Sprenger, H., Vermeulen, J., ten Kate, R., van de Ven, B., Kvale, D., Inglot, M., Rymer, W., Szymczak, A., Aldir, M., Baptista, C., da Conceicao Vera, J., Raquel A dos Santos, C., Valadas, E., Vaz Pinto, I., Chia, E., Foo, E., Karim, F., Lim, P. L., Panchalingam, A., Quek, A., Alcazar-Caballero, R., Arribas, J., Arrizabalaga, J., de Barron, X., Blanco, F., Bouza, E., Calvo, S., Carbonero, L., Carpena, I., Castro, M., Cortes, L., del Toro, M., Elias, M., Espinosa, J., Estrada, V., Fernandez-Cruz, E., Fernandez, P., Freud, H., Garcia, A., Garcia, G., Garrido, R., Gijon, P., Gonzalez- Garcia, J., Gil, I., Gonzalez, A., Lopez Grosso, P., Guzman, E., Iribarren, J., Jimenez, M., Juega, J., Lopez, J., Lozano, F., Martin-Carbonero, L., Mata, R., Menasalvas, A., Mirelles, C., de Miguel Prieto, J., Montes, M., Moreno, A., Moreno, J., Moreno, V., Munoz, R., Ocampo, A., Ortega, E., Ortiz, L., Padilla, B., Parras, A., Paster, A., Pedreira, J., Pena, J., Perea, R., Portas, B., Pulido, F., Rebollar, M., de Rivera, J., Roca, V., Rodriguez- Arrondo, F., Rubio, R., Santos, J., Sanz, J., Sebastian, G., Segovia, M., Tamargo, L., Viciana, P., von Wichmann, M., Bratt, G., Hollander, A., Olov Pehrson, P., Petz, I., Sandstrom, E., Sonnerborg, A., Gurtner, V., Ampunpong, U., Auchieng, C., Bowonwatanuwong, C., Chanchai, P., Chetchotisakd, P., Chuenyan, T., Duncombe, C., Horsakulthai, M., Kantipong, P., Laohajinda, K., Phanuphak, P., Pongsurachet, V., Pradapmook, S., Ruxruntham, K., Seekaew, S., Sonjai, A., Suwanagool, S., Techasathit, W., Ubolyam, S., Wankoon, J., Alexander, I., Dockrell, D., Easterbrook, P., Edwards, B., Evans, E., Fox, R., Gazzard, B., Gilleran, G., Hand, J., Heald, L., Higgs, C., Jebakumar, S., Jendrulek, I., Johnson, S., Kinghorn, G., Kuldanek, K., Maw, R., Mckernan, S., Mclean, L., Morris, S., O'Farrell, S., Ong, E., Peters, B., Stroud, C., Wansbrough-Jones, M., White, D., Williams, I., Wiselka, M., Yee, T., Adams, S., Allegra, D., Andrews, L., Aneja, B., Anstead, G., Artz, R., Bailowitz, J., Banks, S., Baum, J., Benator, D., Black, D., Boh, D., Bonam, T., Brito, M., Brockelman, J., Bruzzese, V., Burnside, A., Cafaro, V., Casey, K., Cason, L., Childress, G., Clark, C. L., Clifford, D., Climo, M., Couey, P., Cuervo, H., Deeks, S., Dennis, M., Diaz-Linares, M., Dickerson, D., Diez, M., Di Puppo, J., Dodson, P., Dupre, D., Elion, R., Elliott, K., El-Sadr, W., Estes, M., Fabre, J., Farrough, M., Flamm, J., Follansbee, S., Foster, C., Frank, C., Franz, J., Frechette, G., Freidland, G., Frische, J., Fuentes, L., Funk, C., Geisler, C., Genther, K., Giles, M., Goetz, M., Gonzalez, M., Graeber, C., Graziano, F., Grice, D., Hahn, B., Hamilton, C., Hassler, S., Henson, A., Hopper, S., John, M., Johnson, L., Johnson, R., Jones, R., Kahn, J., Klimas, N., Kolber, M., Koletar, S., Labriola, A., Larsen, R., Lasseter, F., Lederman, M., Ling, T., Lusch, T., Macarthur, R., Machado, C., Makohon, L., Mandelke, J., Mannheimer, S., Martinez, M., Martinez, N., Mass, M., Masur, H., Mcgregor, D., Mcintyre, D., Mckee, J., Mcmullen, D., Mettinger, M., Middleton, S., Mieras, J., Mildvan, D., Miller, P., Miller, T., Mitchell, V., Mitsuyasu, R., Moanna, A., Mogridge, C., Moran, F., Murphy, R., Nahass, R., Nixon, D., O'Brien, S., Ojeda, J., Okhuysen, P., Olson, M., Osterberger, J., Owen, W., Pablovich, S. S., Patel, S., Pierone, G., Poblete, R., Potter, A., Preston, E., Rappoport, C., Regevik, N., Reyelt, M., Riney, L., Rodriguez-Barradas, M., Rodriguez, M., Rodriguez, J., Roland, R., Rosmarin-DeStefano, C., Rossen, W., Rouff, J., Saag, M., Santiago, S., Sarria, J., Wirtz, S., Schmidt, U., Scott, C., Sheridan, A., Shin, A., Shrader, S., Slowinski, D., Smith, K., Spotkov, J., Sprague, C., States, D., Suh, C., Sullivan, J., Summers, K., Sweeton, B., Tan, V., Tanner, T., Temesgen, Z., Thomas, D., Thompson, M., Tobin, C., Toro, N., Towner, W., Upton, K., Uy, J., Valenti, S., van der Horst, C., Vita, J., Voell, J., Walker, J., Walton, T., Wason, K., Watson, V., Wellons, A., Weise, J., White, M., Whitman, T., Williams, B., Williams, N., Windham, J., Witt, M., Workowski, K., Wortmann, G., Wright, T., Zelasky, C., Zwickl, B., Finley, E., Dietz, D., Chesson, C., Vjecha, M., Schmetter, B., Grue, L., Willoughby, M., Demers, A., Dragsted, U. B., Jensen, K. B., Jansson, P. O., Jensen, B. G., Benfield, T. L., Darbyshire, J. H., Babiker, A. G., Fleck, S. L., Collaco-Moraes, Y., Wyzydrag, L., Drummond, F. M., Connor, S. A., Satchell, C. S., Gunn, S., Delfino, M. A., Merlin, K., Mcginley, C., Neaton, J. D., George, M., Grund, B., Hogan, C., Miller, C., Roediger, M. P., Thackeray, L., Campbell, C., Lahart, C., Perlman, D., Rein, M., Dersimonian, R., Brody, B. A., Daar, E. S., Dubler, N. N., Fleming, T. R., Freeman, D. J., Kahn, J. P., Kim, K. M., Medoff, G., Modlin, J. F., Moellering, R., Murray, B. E., Robb, M. L., Scharfstein, D. O., Sugarman, J., Tsiatis, A., Tuazon, C., Zoloth, L., Belloso, W. H., Losso, M. H., Benetucci, J. A., Bogdanowicz, E. P., Cahn, P. E., Casiro, A. D., Cassetti, I., Contarelli, J. M., Corral, J. A., Crinejo, A., David, D. O., Ishida, M. T., Laplume, H. E., Lasala, M. B., Lupo, S. H., Masciottra, F., Michaan, M., Ruggieri, L., Salazar, E., Allworth, A. M., Anderson, J. S. C., Armishaw, J., Barnes, K., Chiam, A., Chuah, J. C. P., Curry, M. C., Dever, R. L., Donohue, W. A., Doong, N. C., Dwyer, D. E., Dyer, J., Eu, B., Ferguson, V. W., French, M. A. H., Garsia, R. J., Hudson, J. H., Jeganathan, S., Konecny, P., Mccormack, C. L., Mcmurchie, M., Moore, R. J., Moussa, M. B., Piper, M., Read, T., Roney, J. J., Shaw, D. R., Silvers, J., Smith, D. J., Street, A. C., Vale, R. J., Wendt, N. A., Wood, H., Youds, D. W., Zillman, J., Tozeau, V., de Roo, A., Leonard, P., Lynen, L., Moutschen, M., Pereira, L. C., Souza, T. N. L., Schechter, M., Zajdenverg, R., Almeida, M. M. T. B., Araujo, F., Bahia, F., Brites, C., Caseiro, M. M., Casseb, J., Etzel, A., Falco, G. G., Filho, E. C. J., Flint, S. R., Gonzales, C. R., Madruga, J. V. R., Passos, L. N., Reuter, T., Sidi, L. C., Toscano, A. L. C., Cherban, E., Conway, B., Dufour, C., Foster, A., Haase, D., Haldane, H., Klein, M., Lessard, B., Martel, A., Martel, C., Paradis, E., Schlech, W., Schmidt, S., Thompson, B., Vezina, S., Wolff Reyes, M. J., Northland, R., Hergens, L., Loftheim, I. R., Raukas, M., Justinen, J., Landman, R., Abel, S., Abgrall, S., Amat, K., Auperin, L., Barruet, R., Benalycherif, A., Benammar, N., Bentata, M., Besnier, J. M., Blanc, M., Cabie, A., Chavannet, P., Dargere, S., de la Tribonniere, X., Debord, T., Decaux, N., Delgado, J., Frixon-Marin, V., Genet, C., Gerard, L., Gilquin, J., Jeantils, V., Kouadio, H., Leclercq, P., Lelievre, J. -D., Michon, C. P., Nau, P., Pacanowski, J., Piketty, C., Salmon, D., Schmit, J. L., Serini, M. A., Tassi, S., Touam, F., Verdon, R., Weinbreck, P., Yazdanpanah, Y., Yeni, P., Bitsch, S., Bogner, J. R., Goebel, F. D., Lehmann, C., Lennemann, T., Potthof, A., Wasmuth, J. C., Wiedemeyer, K., Hatzakis, A., Touloumi, G., Antoniadou, A., Daikos, G. L., Dimitrakaki, A., Gargalianos-Kakolyris, P., Giannaris, M., Karafoulidou, A., Katsambas, A., Katsarou, O., Kontos, A. N., Kordossis, T., Lazanas, M. K., Panagopoulos, P., Paparizos, V., Papastamopoulos, V., Petrikkos, G., Skoutelis, A., Tsogas, N., Bergin, C. J., Mooka, B., Mamorksy, M. G., Agmon-Levin, N., Karplus, R., Shahar, E., Biglino, A., De Gioanni, M., Montroni, M., Raise, E., Honda, M., Ishisaka, M., Caplinskas, S., Uzdaviniene, V., Schmit, J. C., Mills, G. D., Blackmore, T., Masters, J. A., Morgan, J., Pithie, A., Brunn, J., Ormasssen, V., La Rosa, A., Guerra, O., Espichan, M., Gutierrez, L., Mendo, F., Salazar, R., Knytz, B., Kwiatkowski, J., Castro, R. S., Horta, A., Miranda, A. C., Pinto, I. V., Vera, J., Vinogradova, E., Yakovlev, A., Wood, R., Orrel, C., Arnaiz, J. A., Carrillo, R., Dalmau, D., Jordano, Q., Knobel, H., Larrousse, M., Moreno, J. S., Oretaga, E., Pena, J. N., Spycher, R., Bottone, S., Christen, A., Franc, C., Furrer, H. J., Gayet-Ageron, A., Genne, D., Hochstrasser, S., Moens, C., Nuesch, R., Ruxrungtham, K., Pumpradit, W., Dangthongdee, S., Kiertiburanakul, S., Klinbuayaem, V., Mootsikapun, P., Nonenoy, S., Piyavong, B., Prasithsirikul, W., Raksakulkarn, P., Gazzard, B. G., Ainsworth, J. G., Angus, B. J., Barber, T. J., Brook, M. G., Care, C. D., Chadwick, D. R., Chikohora, M., Churchill, D. R., Cornforth, D., Dockrell, D. H., Easterbrook, P. J., Fox, P. A., Gomez, P. A., Gompels, M. M., Harris, G. M., Herman, S., Jackson, A. G. A., Jebakumar, S. P. R., Kinghorn, G. R., Kuldanek, K. A., Larbalestier, N., Lumsden, M., Maher, T., Mantell, J., Muromba, L., Orkin, C. M., Palfreeman, A. J., Peters, B. S., Peto, T. E. A., Portsmouth, S. D., Rajamanoharan, S., Ronan, A., Schwenk, A., Slinn, M. A., Stroud, C. J., Thomas, R. C., Wansbrough-Jones, M. H., Whiles, H. J., White, D. J., Williams, E., Williams, I. G., Acosta, E. A., Adamski, A., Antoniskis, D., Aragon, D. R., Barnett, B. J., Baroni, C., Barron, M., Baxter, J. D., Beers, D., Beilke, M., Bemenderfer, D., Bernard, A., Besch, C. L., Bessesen, M. T., Bethel, J. T., Blue, S., Blum, J. D., Boarden, S., Bolan, R. K., Borgman, J. B., Brar, I., Braxton, B. K., Bredeek, U. F., Brennan, R., Britt, D. E., Bulgin-Coleman, D., Bullock, D. E., Campbell, B., Caras, S., Carroll, J., Casey, K. K., Chiang, F., Cindrich, R. B., Clark, C., Cohen, C., Coley, J., Condoluci, D. V., Contreras, R., Corser, J., Cozzolino, J., Daley, L., Dandridge, D., D'Antuono, V., Darcourt Rizo Patron, J. G., Dehovitz, J. A., Dejesus, E., Desjardin, J., Dietrich, C., Dolce, E., Erickson, D., Faber, L. L., Falbo, J., Farrough, M. J., Farthing, C. F., Ferrell-Gonzalez, P., Flynn, H., Frank, M., Freeman, K. F., French, N., Fujita, N., Gahagan, L., Gilson, I., Goetz, M. B., Goodwin, E., Guity, C. K., Gulick, P., Gunderson, E. R., Hale, C. M., Hannah, K., Henderson, H., Hennessey, K., Henry, W. K., Higgins, D. T., Hodder, S. L., Horowitz, H. W., Howe-Pittman, M., Hubbard, J., Hudson, R., Hunter, H., Hutelmyer, C., Insignares, M. T., Jackson, L., Jenny, L., Johnson, D. L., Johnson, G., Johnson, J., Kaatz, J., Kaczmarski, J., Kagan, S., Kantor, C., Kempner, T., Kieckhaus, K., Kimmel, N., Klaus, B. M., Koeppe, J. R., Koirala, J., Kopka, J., Kostman, J. R., Kozal, M. J., Kumar, A., Lampiris, H., Lamprecht, C., Lattanzi, K. M., Lee, J., Leggett, J., Long, C., Loquere, A., Loveless, K., Lucasti, C. J., Macveigh, M., Makohon, L. H., Markowitz, N. P., Marks, C., Martorell, C., Mcfeaters, E., Mcgee, B., Mcintyre, D. M., Mcmanus, E., Melecio, L. G., Melton, D., Mercado, S., Merrifield, E., Mieras, J. A., Mogyoros, M., Moran, F. M., Murphy, K., Mutic, S., Nadeem, I., Nadler, J. P., Ognjan, A., O'Hearn, M., O'Keefe, K., Okhuysen, P. C., Oldfield, E., Olson, D., Orenstein, R., Ortiz, R., Parpart, F., Pastore-Lange, V., Paul, S., Pavlatos, A., Pearce, D. D., Pelz, R., Peterson, S., Pitrak, D., Powers, S. L., Pujet, H. C., Raaum, J. W., Ravishankar, J., Reeder, J., Reilly, N. A., Reyelt, C., Riddell, J., Rimland, D., Robinson, M. L., Rodriguez, A. E., Rodriguez-Barradas, M. C., Rodriguez Derouen, V., Rosmarin, C., Rossen, W. L., Rouff, J. R., Sampson, J. H., Sands, M., Savini, C., Schrader, S., Schulte, M. M., Scott, R., Seedhom, H., Sension, M., Sheble-Hall, A., Shuter, J., Slater, L. N., Slotten, R., Smith, M., Snap, S., States, D. M., Stringer, G., Summers, K. K., Swanson, K., Sweeton, I. B., Szabo, S., Telzak, E. E., Thompson, M. A., Thompson, S., Ting Hong Bong, C., Vaccaro, A., Vasco, L. M., Vecino, I., Verlinghieri, G. K., Visnegarwala, F., Wade, B. H., Weis, S. E., Weise, J. A., Weissman, S., Wilkin, A. M., Witter, J. H., Wojtusic, L., Wright, T. J., Yeh, V., Young, B., Zeana, C., Zeh, J., Savio, E., Vacarezza, M., and Cauda R. (ORCID:0000-0002-1498-4229)
- Abstract
Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with ≥3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR ≤ 60 ml/min/1.73 m2. Poisson regression was used to develop a risk score, externally validated on two independent cohorts. In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7–6.7; median follow-up 6.1 y, range 0.3–9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was −2 (interquartile range –4 to 2). There was a 1:393 chance of developing CKD in the next 5 y in the low risk group (risk score < 0, 33 events), rising to 1:47 and 1:6 in the medium (risk score 0–4, 103 events) and high risk groups (risk score ≥ 5, 505 events)
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- 2015
23. Antiretroviral pill count and clinical outcomes in treatment‐naïve patients with HIV infection.
- Author
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the Antiretroviral Therapy Cohort Collaboration (ART‐CC), Young, J., Bucher, H. C., Zangerle, R., Smith, C., Teira, R., Reiss, P., Jarrín Vera, I., Crane, H., Miro, J. M., D'Arminio Monforte, A., and Saag, M.
- Subjects
AIDS ,CONFIDENCE intervals ,HIV infections ,EVALUATION of medical care ,MORTALITY ,TIME ,ANTIRETROVIRAL agents ,CAUSAL models ,PROPORTIONAL hazards models ,DISEASE progression ,STATISTICAL models ,KAPLAN-Meier estimator ,CONFOUNDING variables - Abstract
Objectives: Treatment guidelines recommend single‐tablet regimens for patients with HIV infection starting antiretroviral therapy. These regimens might be as effective and cost less if taken as separate drugs. We assessed whether the one pill once a day combination of efavirenz, emtricitabine and tenofovir reduces the risk of disease progression compared with multiple‐pill formulations of the same regimen. Methods: We selected treatment‐naïve patients starting one‐, two‐ or three‐pill formulations of this regimen in data from the Antiretroviral Therapy Cohort Collaboration. These patients were followed until an AIDS event or death or until they modified their regimen. We analysed these data using Cox regression models, then used our models to predict the potential consequences of exposing a future population to either a one‐pill regimen or a three‐pill regimen. Results: Among 11 739 treatment‐naïve patients starting the regimen, there were 386 AIDS events and 87 deaths. Follow‐up often ended when patients switched to the same regimen with fewer pills. After the first month, two pills rather than one was associated with an increase in the risk of AIDS or death [hazard ratio (HR) 1.39; 95% confidence interval (CI) 1.01‐1.91], but three pills rather than two did not appreciably add to that increase (HR 1.19; 95% CI 0.84‐1.68). We estimate that 77 patients would need to be exposed to a one‐pill regimen rather than a three‐pill regimen for 1 year to avoid one additional AIDS event or death. Conclusions: This particular single‐tablet regimen is associated with a modest decrease in the risk of AIDS or death relative to multiple‐pill formulations. [ABSTRACT FROM AUTHOR]
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- 2018
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24. Mortality of treated HIV-1 positive individuals according to viral subtype in Europe and Canada
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May, MT, Gill, MJ, Wittkop, L, Klein, M, Sabin, C, Harrigan, PR, Dunn, D, Vehreschild, JJ, Rubio, R, Mocroft, A, Cavassini, M, Reiss, P, Monforte, AD, Zangerle, R, Ingle, SM, Hill, T, Jose, S, Sterne, JAC, Boulle, A, Stephan, C, Miro, JM, Chene, G-V, Costagliola, D, Dabis, F, Del Amo, J, Van Sighem, A, Vehreschild, J, Gill, J, Guest, J, Haerry, DH-U, Hogg, R, Justice, A, Obel, N, Crane, H, Smith, C, Saag, M, Sterling, T, Teira, R, Williams, M, Sterne, J, May, M, Ingle, S, Trickey, A, Ainsworth, J, Anderson, J, Babiker, A, Chadwick, D, Delpech, V, Fisher, M, Gazzard, B, Gilson, R, Hay, P, Gompels, M, Johnson, M, Kegg, S, Leen, C, Mackie, N, Nelson, M, Orkin, C, Palfreeman, A, Phillips, A, Pillay, D, Post, F, Sachikonye, M, Schwenk, A, Walsh, J, Thornton, A, Huntington, S, Glabay, A, Garrett, N, Lynch, J, Hand, J, De Souza, C, Perry, N, Tilbury, S, Youssef, E, Churchill, D, Waxman, M, Asboe, D, Mandalia, S, Munshi, S, Awosika, D, Korat, H, Taylor, C, Gleisner, Z, Ibrahim, F, Campbell, L, Baillie, K, Cope, E, Gibney, M, Gibson, J, Brima, N, Williams, I, Miller, S, Wood, C, Youle, M, Lampe, F, Chaloner, C, Winston, A, Weber, J, Ramzan, F, Carder, M, Wilson, A, Morris, S, Allan, S, Moore, A, Fox, L, Bojanowski, J, Lewszuk, A, Main, P, Mitchell, D, Hunter, D, Dhillon, M, Martin, F, Douglas, S, Russell-Sharp, S, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, and Global Health
- Subjects
Male ,0301 basic medicine ,IMPACT ,DIVERSITY ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Cohort Studies ,0302 clinical medicine ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,Cooperative Behavior ,Viral failure ,Hazard ratio ,viral failure ,11 Medical And Health Sciences ,Middle Aged ,Prognosis ,Antiretroviral therapy ,3. Good health ,Europe ,Infectious Diseases ,Anti-Retroviral Agents ,INFECTIONS ,Cohort ,Female ,Life Sciences & Biomedicine ,NAIVE PATIENTS ,Cohort study ,Adult ,Canada ,medicine.medical_specialty ,Genotype ,Epidemiology and Social ,antiretroviral therapy ,Immunology ,17 Psychology And Cognitive Sciences ,03 medical and health sciences ,Acquired immunodeficiency syndrome (AIDS) ,Virology ,Internal medicine ,Humans ,TYPE-1 SUBTYPES ,Mortality ,COMBINATION ANTIRETROVIRAL THERAPY ,HIV-1 subtype ,Science & Technology ,business.industry ,DISEASE PROGRESSION ,06 Biological Sciences ,medicine.disease ,Survival Analysis ,mortality ,IMMUNOLOGICAL RESPONSE ,030112 virology ,Confidence interval ,Regimen ,HIV-1 ,prognosis ,T-CELL DECLINE ,business ,RESISTANCE - Abstract
Objectives: To estimate prognosis by viral subtype in HIV-1-infected individuals from start of antiretroviral therapy (ART) and after viral failure.Design: Collaborative analysis of data from eight European and three Canadian cohorts. Methods: Adults (N>20 000) who started triple ART between 1996 and 2012 and had data on viral subtype were followed for mortality. We estimated crude and adjusted (for age, sex, regimen, CD4+ cell count, and AIDS at baseline, period of starting ART, stratified by cohort, region of origin and risk group) mortality hazard ratios (MHR) by subtype. We estimated MHR subsequent to viral failure defined as two HIV-RNA measurements greater than 500 copies/ml after achieving viral suppression.Results: The most prevalent subtypes were B (15 419; 74%), C (2091; 10%), CRF02AG (1057; 5%), A (873; 4%), CRF01AE (506; 2.4%), G (359; 1.7%), and D (232; 1.1%). Subtypes were strongly patterned by region of origin and risk group. During 104 649 person-years of observation, 1172/20 784 patients died. Compared with subtype B, mortality was higher for subtype A, but similar for all other subtypes. MHR for A versus B were 1.13 (95% confidence interval 0.85,1.50) when stratified by cohort, increased to 1.78 (1.27,2.51) on stratification by region and risk, and attenuated to 1.59 (1.14,2.23) on adjustment for covariates. MHR for A versus B was 2.65 (1.64,4.28) and 0.95 (0.57,1.57) for patients who started ART with CD4+ cell count below, or more than, 100 cells/ml, respectively. There was no difference in mortality between subtypes A, B and C after viral failure.Conclusion: Patients with subtype A had worse prognosis, an observation which may be confounded by socio-demographic factors.
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- 2015
25. P1353 : A single tablet regimen of ledipasvir/sofosbuvir for 12 weeks in HCV genotype 1 or 4 infected patients with HIV-1 co-infection : The phase 3 ION-4 study
- Author
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Cooper, C., primary, Naggie, S., additional, Saag, M., additional, Yang, J., additional, Stamm, L., additional, Pang, P., additional, McHutchison, J., additional, Dieterich, D., additional, and Sulkowski, M., additional
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- 2015
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26. P0887 : C-edge co-infected: phase 3 study of grazoprevir/elbasvir in patients with HCV/HIV
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Rockstroh, J.K., primary, Nelson, M., additional, Katlama, C., additional, Lalezari, J., additional, Mallolas, J., additional, Bloch, M., additional, Matthews, G., additional, Saag, M., additional, Zamor, P., additional, Orkin, C., additional, Gress, J., additional, Klopfer, S., additional, Platt, H., additional, Robertson, M., additional, and Sulkowski, M., additional
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- 2015
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27. Genetic susceptibility to temporomandibular joint involvement in juvenile idiopathic arthritis.
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Niibo, P., Nikopensius, T., Jagomägi, T., Voog, Ü., Haller, T., Tõnisson, N., Metspalu, A., Saag, M., and Pruunsild, C.
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JUVENILE idiopathic arthritis , *TEMPOROMANDIBULAR joint , *MASTICATORY muscles , *MASTICATION disorders , *RHEUMATOID arthritis , *TEMPOROMANDIBULAR disorders - Abstract
Background Objective Methods Results Conclusion Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition of childhood. Temporomandibular joint (TMJ) is among the most commonly affected joints in JIA patients. When JIA involves the TMJ, it may affect condylar growth in the joint; therefore, JIA patients are at risk of unfavourable long‐term outcomes from associated joint damage. If undetected, TMJ involvement can lead to various functional disabilities such as reduced mandibular mobility and disorders of the mastication muscles. Limitations in sagittal and vertical mandibular growth can result in micrognathia and anterior open bite with aesthetic and functional restrictions.Genetic factors may play a role in determining which individuals are more prone to develop TMJ disorders or in predicting the severity of the disease process. Therefore, we applied a GWAS approach to identify loci associated with TMJ involvement in a sample of Estonian patients with JIA. Our aim was to address the potential role of genetic susceptibility factors in TMJ‐JIA, a condition not previously studied in this context.The case group consisted of 55 JIA patients with TMJ involvement and 208 patients without TMJ involvement comprised the control group. The entire cohort was genotyped using the Illumina HumanOmniExpress BeadChip arrays. Imputation was performed using a nationwide reference panel obtained of 2240 individuals whose data were obtained from the Estonian Biobank.We identified six loci as being associated with the risk of TMJ‐JIA in Estonian JIA patients. The strongest associations were identified at CD6 rs3019551 (P = 3.80 × 10−6), SLC26A8/MAPK14 rs9470191 (P = 6.15 × 10−6), NLRP3 rs2056795 (P = 8.91 × 10−6) and MAP2K4 rs7225328 (P = 1.64 × 10−5).This study provides first insights into the risk‐associated loci between JIA and its manifestation in the TMJ. The reported loci are involved in molecular pathways of immunological relevance and likely represent genomic regions that render the TMJ susceptible to involvement by JIA in Estonian patients. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013:a collaborative analysis of cohort studies
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M. John Gill, Adam Trickey, Marta Montero, Leah Shepherd, Ard van Sighem, Sophie Grabar, Sophie Patterson, Timothy R. Sterling, Michael S. Saag, Charles Cazanave, Robert Zangerle, Christoph Boesecke, Niels Obel, Heidi M. Crane, Jonathan A C Sterne, Vicky Hernando, Jorg-Janne Vehreschild, Matthias Cavassini, Margaret T May, Amy C. Justice, Suzanne M Ingle, Fiona C Lampe, Antonella d'Arminio Monforte, Antiretroviral Therapy Cohort Collaboration, Trickey, A., May, M.T., Vehreschild, J.J., Obel, N., Gill, M.J., Crane, H.M., Boesecke, C., Patterson, S., Grabar, S., Cazanave, C., Cavassini, M., Shepherd, L., Monforte, A.D., van Sighem, A., Saag, M., Lampe, F., Hernando, V., Montero, M., Zangerle, R., Justice, A.C., Sterling, T., Ingle, S.M., and Sterne, JAC
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0301 basic medicine ,Epidemiology ,business.industry ,Immunology ,Hazard ratio ,Human immunodeficiency virus (HIV) ,medicine.disease_cause ,medicine.disease ,Comorbidity ,3. Good health ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Infectious Diseases ,Acquired immunodeficiency syndrome (AIDS) ,Virology ,Health care ,medicine ,Life expectancy ,030212 general & internal medicine ,business ,Viral load ,Demography ,Cohort study - Abstract
BackgroundHealth care for people living with HIV has improved substantially in the past two decades. Robust estimates of how these improvements have affected prognosis and life expectancy are of utmost importance to patients, clinicians, and health-care planners. We examined changes in 3 year survival and life expectancy of patients starting combination antiretroviral therapy (ART) between 1996 and 2013.MethodsWe analysed data from 18 European and North American HIV-1 cohorts. Patients (aged ≥16 years) were eligible for this analysis if they had started ART with three or more drugs between 1996 and 2010 and had at least 3 years of potential follow-up. We estimated adjusted (for age, sex, AIDS, risk group, CD4 cell count, and HIV-1 RNA at start of ART) all-cause and cause-specific mortality hazard ratios (HRs) for the first year after ART initiation and the second and third years after ART initiation in four calendar periods (1996–99, 2000–03 [comparator], 2004–07, 2008–10). We estimated life expectancy by calendar period of initiation of ART.Findings88 504 patients were included in our analyses, of whom 2106 died during the first year of ART and 2302 died during the second or third year of ART. Patients starting ART in 2008–10 had lower all-cause mortality in the first year after ART initiation than did patients starting ART in 2000–03 (adjusted HR 0·71, 95% CI 0·61–0·83). All-cause mortality in the second and third years after initiation of ART was also lower in patients who started ART in 2008–10 than in those who started in 2000–03 (0·57, 0·49–0·67); this decrease was not fully explained by viral load and CD4 cell count at 1 year. Rates of non-AIDS deaths were lower in patients who started ART in 2008–10 (vs 2000–03) in the first year (0·48, 0·34–0·67) and second and third years (0·29, 0·21–0·40) after initiation of ART. Between 1996 and 2010, life expectancy in 20-year-old patients starting ART increased by about 9 years in women and 10 years in men.InterpretationEven in the late ART era, survival during the first 3 years of ART continues to improve, which probably reflects transition to less toxic antiretroviral drugs, improved adherence, prophylactic measures, and management of comorbidity. Prognostic models and life expectancy estimates should be updated to account for these improvements.FundingUK Medical Research Council, UK Department for International Development, EU EDCTP2 programme.
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- 2017
29. CD4:CD8 Ratio and CD8 Count as Prognostic Markers for Mortality in Human Immunodeficiency Virus\textendashInfected Patients on Antiretroviral Therapy: The Antiretroviral Therapy Cohort Collaboration (ART-CC)
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Trickey, Adam, May, Margaret T, Schommers, Philipp, Tate, Jan, Ingle, Suzanne M, Guest, Jodie L, Gill, M John, Zangerle, Robert, Saag, Mike, Reiss, Peter, Monforte, Antonella, Johnson, Margaret, Lima, Viviane D, Sterling, Tim R, Cavassini, Matthias, Wittkop, Linda, Costagliola, Dominique, Sterne, Jonathan a C, Boulle, Andrew, Stephan, Christoph, Miró, José M, Chêne, Geneviève, Dabis, François, Monforte, Antonella d'Arminio, Amo, Julia, van Sighem, Ard, Vehreschild, Jorg Janne, Gill, John, Guest, Jodie, Haerry, David Hans-Ulrich, Hogg, Robert, Justice, Amy, Shepherd, Leah, Obel, Niels, Crane, Heidi M, Smith, Colette, Saag, Michael, Sterling, Tim, Teira, Ramon, Williams, Matthew, Sterne, Jonathan, May, Margaret, Ingle, Suzanne, University of Bristol [Bristol], University Hospital of Cologne [Cologne], Yale University [New Haven], Atlanta Veterans Affairs Medical Center [Decatur, GA, États-Unis], University of Calgary, Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), University of Alabama at Birmingham [ Birmingham] (UAB), University of Amsterdam [Amsterdam] (UvA), Amsterdam Institute for Global Health & Development [Amsterdam, The Netherlands], Università degli Studi di Milano = University of Milan (UNIMI), Royal Free London NHS Foundation Trust, University of British Columbia (UBC), Vanderbilt University School of Medicine [Nashville], Lausanne University Hospital, Université de Lausanne = University of Lausanne (UNIL), Epidémiologie et Biostatistique, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), School of Public Health and Family Medicine, University of Cape Town, Universitätsklinikum Frankfurt, CHU Bordeaux [Bordeaux], Team MORPH3EUS (INSERM U1219 - UB - ISPED), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU de Bordeaux Pellegrin [Bordeaux], VA Connecticut Healthcare System, Rigshospitalet [Copenhagen], Copenhagen University Hospital, University of Alabama [Tuscaloosa] (UA), AII - Infectious diseases, APH - Aging & Later Life, Global Health, AII - Amsterdam institute for Infection and Immunity, Antiretroviral Therapy Cohort Collaboration (ART-CC), Boulle, A., Stephan, C., Miro, J.M., Cavassini, M., Chêne, G., Costagliola, D., Dabis, F., Monforte, A.D., Del Amo, J., Van Sighem, A., Vehreschild, J.J., Gill, J., Guest, J., Haerry, D.H., Hogg, R., Justice, A., Shepherd, L., Obel, N., Crane, H.M., Smith, C., Reiss, P., Saag, M., Sterling, T., Teira, R., Williams, M., Zangerle, R., Sterne, J., May, M., Ingle, S., and Trickey, A.
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0301 basic medicine ,CD4-Positive T-Lymphocytes ,Male ,CD4:CD8 ratio ,[SDV]Life Sciences [q-bio] ,CD4-CD8 Ratio ,HIV Infections ,CD8-Positive T-Lymphocytes ,North America/epidemiology ,CD8 ratio ,CD8 count ,HIV ,antiretroviral therapy ,mortality [CD4] ,0302 clinical medicine ,Cause of Death ,030212 general & internal medicine ,Young adult ,Articles and Commentaries ,Cause of death ,Hazard ratio ,Middle Aged ,Viral Load ,Prognosis ,3. Good health ,Europe ,Infectious Diseases ,Cohort ,Female ,Viral load ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,Adolescent ,Anti-HIV Agents ,HIV Infections/drug therapy ,Article ,Europe/epidemiology ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,Humans ,Lymphocyte Count ,Aged ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,030112 virology ,mortality ,Confidence interval ,Anti-HIV Agents/therapeutic use ,North America ,business ,Biomarkers ,Biomarkers/blood - Abstract
Summary Associations of CD4:CD8 ratio or CD8 count with all-cause and cause-specific mortality were too small for them to be useful as independent prognostic markers in addition to CD4 count in virally suppressed patients on antiretroviral therapy with high CD4 count., Background We investigated whether CD4:CD8 ratio and CD8 count were prognostic for all-cause, AIDS, and non-AIDS mortality in virologically suppressed patients with high CD4 count. Methods We used data from 13 European and North American cohorts of human immunodeficiency virus–infected, antiretroviral therapy (ART)–naive adults who started ART during 1996–2010, who were followed from the date they had CD4 count ≥350 cells/μL and were virologically suppressed (baseline). We used stratified Cox models to estimate unadjusted and adjusted (for sex, people who inject drugs, ART initiation year, and baseline age, CD4 count, AIDS, duration of ART) all-cause and cause-specific mortality hazard ratios for tertiles of CD4:CD8 ratio (0–0.40, 0.41–0.64 [reference], >0.64) and CD8 count (0–760, 761–1138 [reference], >1138 cells/μL) and examined the shape of associations using cubic splines. Results During 276526 person-years, 1834 of 49865 patients died (249 AIDS-related; 1076 non-AIDS-defining; 509 unknown/unclassifiable deaths). There was little evidence that CD4:CD8 ratio was prognostic for all-cause mortality after adjustment for other factors: the adjusted hazard ratio (aHR) for lower vs middle tertile was 1.11 (95% confidence interval [CI], 1.00–1.25). The association of CD8 count with all-cause mortality was U-shaped: aHR for higher vs middle tertile was 1.13 (95% CI, 1.01–1.26). AIDS-related mortality declined with increasing CD4:CD8 ratio and decreasing CD8 count. There was little evidence that CD4:CD8 ratio or CD8 count was prognostic for non-AIDS mortality. Conclusions In this large cohort collaboration, the magnitude of adjusted associations of CD4:CD8 ratio or CD8 count with mortality was too small for them to be useful as independent prognostic markers in virally suppressed patients on ART.
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- 2017
30. Mortality according to CD4 count at start of combination antiretroviral therapy among HIV positive patients followed for up to 15 years after start of treatment: collaborative cohort study
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May, Margaret T, Vehreschild, Jorg-Janne, Trickey, Adam, Obel, Niels, Reiss, Peter, Bonnet, Fabrice, Mary-Krause, Murielle, Samji, Hasina, Cavassini, Matthias, Gill, Michael John, Shepherd, Leah C, Crane, Heidi M, d'Arminio Monforte, Antonella, Burkholder, Greer A, Johnson, Margaret M, Sobrino-Vegas, Paz, Domingo, Pere, Zangerle, Robert, Justice, Amy C, Sterling, Timothy R, Miró, José M, Sterne, Jonathan A C, Antiretroviral Therapy Cohort Collaboration (ART-CC), University of Bristol [Bristol], Universität zu Köln = University of Cologne, University of Copenhagen = Københavns Universitet (UCPH), University of Amsterdam [Amsterdam] (UvA), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, CHU Bordeaux [Bordeaux], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Université de Lausanne = University of Lausanne (UNIL), University of Calgary, UCL Medical School, University of Washington [Seattle], 'San Paolo' Hospital, University of Alabama [Tuscaloosa] (UA), Royal Free London NHS Foundation Trust, Instituto Salud Carlos III, Universitat Autònoma de Barcelona (UAB), Universität Innsbruck [Innsbruck], Yale University [New Haven], VA Connecticut Healthcare System, Vanderbilt University [Nashville], Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Medical Research Council (Reino Unido), Department for International Development (Reino Unido), National Institute for Health Research (Reino Unido), Agence Nationale de Recherches sur le sida et les hépatites virales (Francia), Institut National de la Santé et de la Recherche Médicale (Francia), Ministère de la Santé (Francia), Ministero della Salute (Italia), Ministerio de Sanidad (España), Swiss National Science Foundation, Ministerio de Ciencia e Innovación (España), Red de Investigación Cooperativa en Investigación en Sida (España), Stichting HIV Monitoring (Netherlands), Unión Europea, National Institutes of Health (Estados Unidos), NIH - National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Estados Unidos), United States Department of Veterans Affairs, Michael Smith Foundation for Health Research, Canadian Institutes of Health Research, Veterans Health Administration, Unión Europea. Comisión Europea. 7 Programa Marco, Government of Alberta (Canadá), Government of Columnia (Estados Unidos), Government of the United Kingdom, Abbott, Gilead Sciences (Spain), Tibotec-Upjohn, ViiV Healthcare, GlaxoSmithKline, Pfizer, Bristol-Myers Squibb, Roche, Boehringer Ingelheim Fonds, Merck, Sharp & Dohme, HAL UPMC, Gestionnaire, Antiretroviral Therapy Cohort Collaboration (ART-CC), Boulle, A., Stephan, C., Miro, JM., Cavassini, M., Chêne, G., Costagliola, D., Dabis, F., Monforte£££Antonella D'Arminio£££ AD., Del Amo, J., Van Sighem, A., Fätkenheuer, G., Gill, J., Guest, J., Haerry, DH., Hogg, R., Justice, A., Shepherd, L., Obel, N., Crane, H., Smith, C., Reiss, P., Saag, M., Sterling, T., Teira, R., Williams, M., Zangerle, R., Sterne, J., May, M., Ingle, S., Trickey, A., Universität zu Köln, University of Copenhagen = Københavns Universitet (KU), Université de Lausanne (UNIL), AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Global Health, and Universitat de Barcelona
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0301 basic medicine ,Male ,Integrase inhibitor ,HIV Infections ,Kaplan-Meier Estimate ,Cohort Studies ,0302 clinical medicine ,Cohort collaboration ,030212 general & internal medicine ,Lymphocytes ,[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,education.field_of_study ,Reverse-transcriptase inhibitor ,Relative survival ,Mortality rate ,Antiretrovirals ,Middle Aged ,3. Good health ,Antiretroviral therapy ,Infectious Diseases ,Anti-Retroviral Agents ,Cohort ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,HIV/AIDS ,Female ,medicine.drug ,Cohort study ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,Adolescent ,Population ,antiretroviral therapy ,CD4 count ,Limfòcits ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,VIH (Virus) ,Humans ,Mortality ,education ,Survival analysis ,business.industry ,HIV (Viruses) ,cohort collaboration ,HIV ,mortality ,Antiretroviral agents ,Surgery ,CD4 Lymphocyte Count ,030104 developmental biology ,Morbiditat ,Morbidity ,business - Abstract
The strong association of CD4 count at start of combination therapy with subsequent survival in HIV-infected patients diminished during the first 5 years of treatment. After 5 years, lower baseline CD4 counts were not associated with higher mortality., Background. CD4 count at start of combination antiretroviral therapy (ART) is strongly associated with short-term survival, but its association with longer-term survival is less well characterized. Methods. We estimated mortality rates (MRs) by time since start of ART (
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- 2016
31. Association of Alcohol Use with COVID-19 Infection and Hospitalization Among People Living with HIV in the United States, 2020.
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Xia C, Chander G, Hutton HE, McCaul ME, Delaney JA, Mayer KH, Jacobson JM, Puryear S, Crane HM, Shapiro AE, Cachay ER, Lau B, Napravnik S, Saag M, and Lesko CR
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- Humans, Male, Female, Middle Aged, United States epidemiology, Adult, Risk Factors, Alcoholism epidemiology, Prevalence, COVID-19 epidemiology, COVID-19 psychology, Hospitalization statistics & numerical data, HIV Infections epidemiology, HIV Infections psychology, Alcohol Drinking epidemiology, SARS-CoV-2
- Abstract
Alcohol use was associated with elevated COVID-19 risk in the general population. People with HIV (PWH) have high prevalences of alcohol use. To evaluate the effect of alcohol use on COVID-19 risks among PWH, we estimated the risk of COVID-19 diagnosis and COVID-19-related hospitalization among PWH in routine care at 8 HIV primary care centers that contributed data to the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort according to their alcohol use just prior to the COVID-19 pandemic. The CNICS data repository includes demographic characteristics, clinical diagnoses, and laboratory test results from electronic medical records and other sources. Alcohol use, substance use, and mental health symptoms were self-reported on tablet-based standardized surveys. Alcohol use was categorized according to standard, sex-specific Alcohol Use Disorder Identification Test-Consumption instrument cut-offs. We followed 5,496 PWH (79% male, 48% Black race, median age = 53 years) from March 1, 2020 to December 31, 2020. Relative to PWH with no baseline alcohol use, the adjusted hazard ratio (aHR) of COVID-19 diagnosis was 1.09 (95% confidence interval [CI]: 0.78, 1.51) for lower-risk drinking and 1.19 (95%CI: 0.81, 1.73) for unhealthy drinking. The aHR of COVID-19-related hospitalization was 0.82 (95%CI: 0.33, 1.99) for lower-risk drinking and 1.25 (95%CI: 0.50, 3.09) for unhealthy drinking. Results were not modified by recent cocaine or non-prescribed opioid use, depressive symptoms, or diagnoses of alcohol use disorder. The study suggested a slightly increased, but not statistically significant risk of COVID-19 diagnosis and hospitalization associated with unhealthy alcohol use., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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32. Alcohol and drug use severity are independently associated with antiretroviral adherence in the current treatment era.
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Ma J, Luu B, Ruderman SA, Whitney BM, Merrill JO, Mixson LS, Nance RM, Drumright LN, Hahn AW, Fredericksen RJ, Chander G, Lau B, McCaul ME, Safren S, O'Cleirigh C, Cropsey K, Mayer KH, Mathews WC, Moore RD, Napravnik S, Christopoulos K, Willig A, Jacobson JM, Webel A, Burkholder G, Mugavero MJ, Saag MS, Kitahata MM, Crane HM, and Delaney JAC
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- Adult, Male, Humans, Anti-Retroviral Agents therapeutic use, Ethanol therapeutic use, Medication Adherence, HIV Infections drug therapy, HIV Infections complications, Substance-Related Disorders complications, Illicit Drugs, Methamphetamine therapeutic use
- Abstract
Substance use in people with HIV (PWH) negatively impacts antiretroviral therapy (ART) adherence. However, less is known about this in the current treatment era and the impact of specific substances or severity of substance use. We examined the associations of alcohol, marijuana, and illicit drug use (methamphetamine/crystal, cocaine/crack, illicit opioids/heroin) and their severity of use with adherence using multivariable linear regression in adult PWH in care between 2016 and 2020 at 8 sites across the US. PWH completed assessments of alcohol use severity (AUDIT-C), drug use severity (modified ASSIST), and ART adherence (visual analogue scale). Among 9400 PWH, 16% reported current hazardous alcohol use, 31% current marijuana use, and 15% current use of ≥1 illicit drugs. In multivariable analysis, current methamphetamine/crystal use, particularly common among men who had sex with men, was associated with 10.1% lower mean ART adherence ( p < 0.001) and 2.6% lower adherence per 5-point higher severity of use (ASSIST score) ( p < 0.001). Current and more severe use of alcohol, marijuana, and other illicit drugs were also associated with lower adherence in a dose-dependent manner. In the current HIV treatment era, individualized substance use treatment, especially for methamphetamine/crystal, and ART adherence should be prioritized.
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- 2024
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33. Dental Students' and Dental School Graduates' Practical Skills: An International Survey of Perceptions of National Dental Associations in Europe.
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Wolf TG, Dianišková S, Cavallé E, Aliyeva R, Cagetti MG, Campus G, Deschner J, Forna N, Ilhan D, Mazevet M, Lella A, Melo P, Perlea P, Rovera A, Sculean A, Sharkov N, Slutsky A, Torres AR, and Saag M
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- Humans, Cross-Sectional Studies, Europe, Emotions, Schools, Dental, Students, Dental
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Purpose: Dental students learn knowledge and practical skills to provide oral health care to the population. Practical skills must be maintained or continuously developed throughout a professional career. This cross-sectional survey aimed to evaluate the perception of practical skills of dental students and dental-school graduates by national dental associations (NDAs) in international comparison in the European Regional Organization of the FDI World Dental Federation (ERO-FDI) zone., Materials and Methods: A questionnaire of 14 items collected information on pre-/postgraduate areas., Results: A total of 25 countries participated (response rate: 69.4%), with 80.0% having minimum requirements for practical skills acquisition and 64.0% starting practical training in the 3rd year of study. In countries where clinical practical work on patients begins in the 2nd year of study, practical skills of graduates are perceived as average, starting in the 3rd year of study as mainly good, starting in the 4th as varying widely from poor to very good. In total, 76.0% of respondents feel that improvements are needed before entering dental practice. Improvements could be reached by treating more patients in dental school (32.0%), increasing the quantity of clinical training (20.0%), or having more clinical instructors (12.0%). In 56.0% of the countries, it is possible to open one's own dental practice immediately after graduation, and in 16.0%, prior vocational training is mandatory., Conclusions: All participating countries in the ERO-FDI zone reported practical training in dental school, most starting in the 3rd year of study. The perception of practical skills of dental students and dental-school graduates among NDAs is very heterogeneous. Reasons for the perceived deficiencies should be further explored.
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- 2024
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34. African American/Black race, apolipoprotein L1 , and serum creatinine among persons with HIV.
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Shelton BA, Sawinski D, Peter I, Maclennan PA, Pelletier NF, Nadkarni G, Julian B, Saag M, Fatima H, Crane H, Lee W, Moore RD, Christopoulos K, Jacobson JM, Eron JJ, Kumar V, and Locke JE
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- Humans, Black or African American genetics, Cross-Sectional Studies, Risk Factors, Apolipoprotein L1 genetics, Creatinine blood, HIV Infections drug therapy
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Objective: Accurate estimation of kidney function is critical among persons with HIV (PWH) to avoid under-dosing of antiretroviral therapies and ensure timely referral for kidney transplantation. Existing estimation equations for kidney function include race, the appropriateness of which has been debated. Given advancements in understanding of race and the necessity of accuracy in kidney function estimation, this study aimed to examine whether race, or genetic factors, improved prediction of serum creatinine among PWH., Design: This cross-sectional study utilized data from the Center for AIDS Research Network of Integrated Clinical Systems cohort (2008-2018). The outcome was baseline serum creatinine., Methods: Ordinary least squares regression was used to examine whether inclusion of race or genetic factors [ apolipoprotein-L1 ( APOL1 ) variants and genetic African ancestry] improved serum creatinine prediction. A reduction in root mean squared error (RMSE) greater than 2% was a clinically relevant improvement in predictive ability., Results: There were 4183 PWH included. Among PWH whose serum creatinine was less than 1.7 mg/dl, race was significantly associated with serum creatinine ( β = 0.06, SE = 0.01, P < 0.001) but did not improve predictive ability. African ancestry and APOL1 variants similarly failed to improve predictive ability. Whereas, when serum creatinine was at least 1.7 mg/dl, inclusion of race reduced the RMSE by 2.1%, indicating improvement in predictive ability. APOL1 variants further improved predictive ability by reducing the RMSE by 2.9%., Conclusion: These data suggest that, among PWH, inclusion of race or genetic factors may only be warranted at higher serum creatinine levels. Work eliminating existing healthcare disparities while preserving the utility of estimating equations is needed., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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35. Use of nonstigmatizing language is associated with improved outcomes in hospitalized people who inject drugs.
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Carpenter JE, Catalanotti J, Notis M, Brokus C, Moran TP, Akselrod H, Burkholder G, Eaton EF, Kuo I, Mai W, McGonigle K, Steck A, Del Rio C, Saag M, Kottilil S, Masur H, Kattakuzhy S, and Rosenthal ES
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- Adult, Female, Humans, Male, Middle Aged, Follow-Up Studies, Hospitalization, Retrospective Studies, Treatment Outcome, Language, Opioid-Related Disorders therapy
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Background: Stigma surrounding opioid use disorder (OUD) is a barrier to treatment. The use of stigmatizing language may be evidence of negative views toward patients., Objective: We aimed to identify associations between language and clinical outcomes in patients admitted for infectious complications of OUD., Designs: We performed a retrospective medical record review., Settings and Participants: Four U.S. academic health systems. Participants were patients with OUD admitted for infectious complications of injection opioid use from January 1, 2018, to December 31, 2018, identified through international classification of diseases, 10th revision codes consistent with OUD and acute bacterial/fungal infection., Main Outcome and Measures: Discharge summaries were reviewed for language, specifically: abuse, addiction, dependence, misuse, use disorder, intravenous drug use, and others. Binary outcomes including medication for OUD, planned discharge, naloxone provision, and an OUD treatment plan were evaluated using logistic regressions and admission duration was evaluated using Gamma regression., Results: A total of 1285 records were reviewed and 328 met inclusion criteria. Of those, 191 (58%) were male, with a median age of 38 years. The most common term was "abuse" (219, 67%), whereas "use disorder" was recorded in 75 (23%) records. Having "use disorder" in the discharge summary was associated with increased odds of having a documented plan for ongoing OUD treatment (adjusted odds ratio [AOR]: 4.11, 95% confidence interval [CI]: 1.89-8.93) and having a documented plan for addiction-specific follow-up care (AOR: 2.31, 95% CI: 1.30-4.09)., Conclusions: Stigmatizing language was common in this study of patients hospitalized for infectious complications of OUD. Best-practice language was uncommon, but when used was associated with increased odds of addiction treatment and specialty care referrals., (© 2023 Society of Hospital Medicine.)
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- 2023
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36. HIV post-treatment controllers have distinct immunological and virological features.
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Etemad B, Sun X, Li Y, Melberg M, Moisi D, Gottlieb R, Ahmed H, Aga E, Bosch RJ, Acosta EP, Yuki Y, Martin MP, Carrington M, Gandhi RT, Jacobson JM, Volberding P, Connick E, Mitsuyasu R, Frank I, Saag M, Eron JJ, Skiest D, Margolis DM, Havlir D, Schooley RT, Lederman MM, Yu XG, and Li JZ
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- Humans, Killer Cells, Natural, Lymphocyte Activation, RNA, Viremia, CD8-Positive T-Lymphocytes, HIV Infections drug therapy, HIV Infections immunology
- Abstract
HIV post-treatment controllers (PTCs) are rare individuals who maintain low levels of viremia after stopping antiretroviral therapy (ART). Understanding the mechanisms of HIV post-treatment control will inform development of strategies aiming at achieving HIV functional cure. In this study, we evaluated 22 PTCs from 8 AIDS Clinical Trials Group (ACTG) analytical treatment interruption (ATI) studies who maintained viral loads ≤400 copies/mL for ≥24 wk. There were no significant differences in demographics or frequency of protective and susceptible human leukocyte antigen (HLA) alleles between PTCs and post-treatment noncontrollers (NCs, n = 37). Unlike NCs, PTCs demonstrated a stable HIV reservoir measured by cell-associated RNA (CA-RNA) and intact proviral DNA assay (IPDA) during analytical treatment interruption (ATI). Immunologically, PTCs demonstrated significantly lower CD4
+ and CD8+ T cell activation, lower CD4+ T cell exhaustion, and more robust Gag-specific CD4+ T cell responses and natural killer (NK) cell responses. Sparse partial least squares discriminant analysis (sPLS-DA) identified a set of features enriched in PTCs, including a higher CD4+ T cell% and CD4+ /CD8+ ratio, more functional NK cells, and a lower CD4+ T cell exhaustion level. These results provide insights into the key viral reservoir features and immunological profiles for HIV PTCs and have implications for future studies evaluating interventions to achieve an HIV functional cure.- Published
- 2023
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37. Alcohol consumption upon direct-acting antiviral therapy for hepatitis C among persons with human immunodeficiency virus in the United States.
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Chen PH, Yenokyan K, Fojo AT, Hutton HE, Lesko CR, McCaul ME, Yang C, Cachay ER, Crane HM, Jacobson JM, Kim HN, Kitahata MM, Mayer KH, Moore RD, Napravnik S, Saag M, Lau B, and Chander G
- Subjects
- Male, Female, Humans, United States epidemiology, Hepacivirus, Antiviral Agents therapeutic use, HIV, Cohort Studies, Alcohol Drinking epidemiology, Hepatitis C, Chronic drug therapy, Alcoholism complications, Alcoholism drug therapy, Alcoholism epidemiology, HIV Infections complications, HIV Infections drug therapy, HIV Infections epidemiology, Hepatitis C complications, Hepatitis C drug therapy, Hepatitis C epidemiology, Coinfection
- Abstract
Background: Direct-acting antivirals (DAA) are highly effective against hepatitis C virus (HCV) infection among persons with human immunodeficiency virus (PWH). However, alcohol use post-DAA treatment poses a continued threat to the liver. Whether the focus on liver health alone during HCV treatment can impact alcohol consumption is unclear. Therefore, we examined the change in alcohol use among HCV-coinfected PWH who received DAA therapy by non-addiction medical providers., Methods: In our longitudinal clinical cohort study, we identified HCV-coinfected PWH who received interferon-free DAA therapy between January 2014 and June 2019 in the Centers for AIDS Research Network of Integrated Clinical Systems. The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was the alcohol screening instrument. We used mixed-effects logistic regression models to estimate the longitudinal change in alcohol use upon DAA therapy., Results: Among 738 HCV-coinfected PWH, 339 (46 %) reported any alcohol use at the end of HCV treatment, including 113 (15 %) with high-risk use (i.e., AUDIT-C ≥3 for women, ≥4 for men). Concurrently, 280 (38 %) PWH noted active drug use, and 357 (48 %) were currently smoking. We observed no changes in the odds of any alcohol or high-risk alcohol use over time with DAA therapy. Findings were similar in the PWH subgroup with a history of alcohol use before DAA treatment., Conclusions: For PWH with HCV, alcohol use did not change following interferon-free DAA treatment by non-addiction medical providers. Thus, clinicians should consider integrating targeted alcohol use interventions into HCV care to motivate reduced alcohol consumption and safeguard future liver health., Competing Interests: Conflict of interest disclosures Po-Hung Chen reports serving as a Medical Safety Officer for the Non-Alcoholic Steatohepatitis Clinical Research Network, a Steering Committee member for the Alcohol-associated Liver Disease Special Interest Group of the American Association for the Study of Liver Diseases (AASLD), and a Practice Guidelines Committee member of AASLD. Edward R. Cachay reports receiving Gilead Sciences Unrestricted Research Grant, Merck Sharp & Dohme Unrestricted Research Grant, and consulting for Thera Technologies. H. Nina Kim reports receiving a grant from Gilead Sciences., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2022
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38. Tobacco smoking and binge alcohol use are associated with incident venous thromboembolism in an HIV cohort.
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Luu B, Ruderman S, Nance R, Delaney JAC, Ma J, Hahn A, Heckbert SR, Budoff MJ, Crothers K, Mathews WC, Christopolous K, Hunt PW, Eron J, Moore R, Keruly J, Lober WB, Burkholder GA, Willig A, Chander G, McCaul ME, Cropsey K, O'Cleirigh C, Peter I, Feinstein M, Tsui JI, Lindstroem S, Saag M, Kitahata MM, Crane HM, Drumright LN, and Whitney BM
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- Ethanol, Humans, Proportional Hazards Models, Prospective Studies, Risk Factors, Tobacco Smoking, Binge Drinking complications, Binge Drinking epidemiology, HIV Infections complications, Venous Thromboembolism epidemiology, Venous Thromboembolism etiology
- Abstract
Background: People with HIV (PWH) are at increased risk of cardiovascular comorbidities and substance use is a potential predisposing factor. We evaluated associations of tobacco smoking and alcohol use with venous thromboembolism (VTE) in PWH., Methods: We assessed incident, centrally adjudicated VTE among 12 957 PWH within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort between January 2009 and December 2018. Using separate Cox proportional hazards models, we evaluated associations of time-updated alcohol and cigarette use with VTE, adjusting for demographic and clinical characteristics. Smoking was evaluated as pack-years and never, former, or current use with current cigarettes per day. Alcohol use was parameterized using categorical and continuous alcohol use score, frequency of use, and binge frequency., Results: During a median of 3.6 years of follow-up, 213 PWH developed a VTE. One-third of PWH reported binge drinking and 40% reported currently smoking. In adjusted analyses, risk of VTE was increased among both current (HR: 1.44, 95% CI: 1.02-2.03) and former (HR: 1.44, 95% CI: 0.99-2.07) smokers compared to PWH who never smoked. Additionally, total pack-years among ever-smokers (HR: 1.10 per 5 pack-years; 95% CI: 1.03-1.18) was associated with incident VTE in a dose-dependent manner. Frequency of binge drinking was associated with incident VTE (HR: 1.30 per 7 days/month, 95% CI: 1.11-1.52); however, alcohol use frequency was not. Severity of alcohol use was not significantly associated with VTE., Conclusions: Current smoking and pack-year smoking history were dose-dependently associated with incident VTE among PWH in CNICS. Binge drinking was also associated with VTE. Interventions for smoking and binge drinking may decrease VTE risk among PWH., (© 2022 British HIV Association.)
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- 2022
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39. Associations between female birth sex and risk of chronic kidney disease development among people with HIV in the USA: A longitudinal, multicentre, cohort study.
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Shelton BA, Sawinski D, MacLennan PA, Lee W, Wyatt C, Nadkarni G, Fatima H, Mehta S, Crane HM, Porrett P, Julian B, Moore RD, Christopoulos K, Jacobson JM, Muller E, Eron JJ, Saag M, Peter I, and Locke JE
- Abstract
Background: Women represent a meaningful proportion of new HIV diagnoses, with Black women comprising 58% of new diagnoses among women. As HIV infection also increases risk of chronic kidney disease (CKD), understanding CKD risk among women with HIV (WWH), particularly Black women, is critical., Methods: In this longitudinal cohort study of people with HIV (PWH) enrolled in CFAR Network of Integrated Clinical Systems (CNICS), a multicentre study comprised of eight academic medical centres across the United States from Jan 01, 1996 and Nov 01, 2019, adult PWH were excluded if they had ≤2 serum creatinine measurements, developed CKD prior to enrollment, or identified as intersex or transgendered, leaving a final cohort of 33,998 PWH. The outcome was CKD development, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1·73 m
2 calculated using the CKD-EPI equation, for ≥90 days with no intervening higher values., Findings: Adjusting for demographic and clinical characteristics, WWH were 61% more likely to develop CKD than men (adjusted hazard ratio [aHR]: 1·61, 95% CI: 1·46-1·78, p<0·001). This difference persisted after further adjustment for APOL1 risk variants (aHR female sex: 1·92, 95% CI: 1·63-2·26, p<0·001) and substance abuse (aHR female sex: 1·70, 95% CI: 1·54-1·87, p<0·001)., Interpretation: WWH experienced increased risk of CKD. Given disparities in care among patients with end-stage kidney disease, efforts to engage WWH in nephrology care to improve chronic disease management are critical., Funding: US National Institutes of Health., Competing Interests: JEL reports grands and funding from Hansa, United Therapeutics, honoraria from Sanofi, and non-monetary support from the FDA and Davita, and reports support from the NIH for the present study. KC reports an investigator-initiated grant from Gilead Sciences and serves as a medical advisory board member for Gilead Sciences. GN reports R01-DK127139, R01-HL155915, R56-DK126930, and funding from Renalytix. GN also receives consulting fees from Renalytx (as well as royalties), Variant Bio, Qiming Capital, Cambridge Healthcare, Daiichi Sankyo (as well as honoraria). GN also has patent with Renalytx and participates in advisory boards for Renalytix and Pensieve Health. Finally, GN has stock/stock options in Renaltyx, Pensieve Health, Vierici Dx, Nexus I Connect, and Data2Wisdom LLC. SM reports honoraria from CareDx and serves on their advisory board, and reports NIH grants/contracts for use of CCR5 in HIV-positive transplant recipients and the prospective HOPE In-Action trial. DS has entered into a consulting agreement with IMS Consulting and Expert Services, has been elected as Councilor at Large to the American Society of Transplantation Board of Directors, and reports funding from the NIH for the present study. HC reports funding from the NIH (for the present study), AHRQ, Viiv, and serves on the Office of AIDS Advisory Council for the NIH. MS serves on the advisory or DSMB board for I-SPY, an NIH-funded study, and in a leadership role for IAS-USA. JJE reports financial support for the present study from the NIH; grants (outside the present study) from ViiV Healthcare, Gilead Science and Janssen; and consulting fees (outside the present study) from Merck, ViiV Healthcare, Gilead Sciences, and Jansssen. BJ and BAS report funding from the NIH. RM and IP report financial support from the NIH for the present study. All other authors declare no competing interests., (© 2022 The Author(s).)- Published
- 2022
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40. Racial and ethnic disparities in coronavirus disease 2019 disease incidence independent of comorbidities, among people with HIV in the United States.
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Bender Ignacio RA, Shapiro AE, Nance RM, Whitney BM, Delaney JAC, Bamford L, Wooten D, Karris MY, Mathews WC, Kim HN, Keruly J, Burkholder G, Napravnik S, Mayer KH, Jacobson J, Saag M, Moore RD, Eron JJ, Willig AL, Christopoulos KA, Martin J, Hunt PW, Crane HM, Kitahata MM, and Cachay ER
- Subjects
- Adult, COVID-19 Testing, Ethnicity, Female, Humans, Incidence, Middle Aged, United States epidemiology, COVID-19 epidemiology, HIV Infections drug therapy
- Abstract
Objectives: To define the incidence of clinically detected coronavirus disease 2019 (COVID-19) in people with HIV (PWH) in the United States and evaluate how racial and ethnic disparities, comorbidities, and HIV-related factors contribute to risk of COVID-19., Design: Observational study within the CFAR Network of Integrated Clinical Systems cohort in seven cities during 2020., Methods: We calculated cumulative incidence rates of COVID-19 diagnosis among PWH in routine care by key characteristics including race/ethnicity, current and lowest CD4+ cell count, and geographic area. We evaluated risk factors for COVID-19 among PWH using relative risk regression models adjusted with disease risk scores., Results: Among 16 056 PWH in care, of whom 44.5% were black, 12.5% were Hispanic, with a median age of 52 years (IQR 40-59), 18% had a current CD4+ cell count less than 350 cells/μl, including 7% less than 200; 95.5% were on antiretroviral therapy (ART), and 85.6% were virologically suppressed. Overall in 2020, 649 PWH were diagnosed with COVID-19 for a rate of 4.94 cases per 100 person-years. The cumulative incidence of COVID-19 was 2.4-fold and 1.7-fold higher in Hispanic and black PWH respectively, than non-Hispanic white PWH. In adjusted analyses, factors associated with COVID-19 included female sex, Hispanic or black identity, lowest historical CD4+ cell count less than 350 cells/μl (proxy for CD4+ nadir), current low CD4+ : CD8+ ratio, diabetes, and obesity., Conclusion: Our results suggest that the presence of structural racial inequities above and beyond medical comorbidities increased the risk of COVID-19 among PWH. PWH with immune exhaustion as evidenced by lowest historical CD4+ cell count or current low CD4+ : CD8+ ratio had greater risk of COVID-19., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2022
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41. Wonder of wonders, miracle of miracles: the unprecedented speed of COVID-19 science.
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Saag M
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- Humans, COVID-19
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- 2022
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42. Racial and ethnic disparities in COVID-19 disease incidence independent of comorbidities, among people with HIV in the US.
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Bender Ignacio RA, Shapiro AE, Nance RM, Whitney BM, Delaney J, Bamford L, Wooten D, Karris M, Mathews WC, Kim HN, Van Rompaey SE, Keruly JC, Burkholder G, Napravnik S, Mayer KH, Jacobson J, Saag MS, Moore RD, Eron JJ, Willig AL, Christopoulos KA, Martin J, Hunt PW, Crane HM, Kitahata MM, and Cachay E
- Abstract
Objectives: To define the incidence of clinically-detected COVID-19 in people with HIV (PWH) in the US and evaluate how racial and ethnic disparities, comorbidities, and HIV-related factors contribute to risk of COVID-19., Design: Observational study within the CFAR Network of Integrated Clinical Systems cohort in 7 cities during 2020., Methods: We calculated cumulative incidence rates of COVID-19 diagnosis among PWH in routine care by key characteristics including race/ethnicity, current and lowest CD4 count, and geographic area. We evaluated risk factors for COVID-19 among PWH using relative risk regression models adjusted with disease risk scores., Results: Among 16,056 PWH in care, of whom 44.5% were Black, 12.5% were Hispanic, with a median age of 52 years (IQR 40-59), 18% had a current CD4 count < 350, including 7% < 200; 95.5% were on antiretroviral therapy, and 85.6% were virologically suppressed. Overall in 2020, 649 PWH were diagnosed with COVID-19 for a rate of 4.94 cases per 100 person-years. The cumulative incidence of COVID-19 was 2.4-fold and 1.7-fold higher in Hispanic and Black PWH respectively, than non-Hispanic White PWH. In adjusted analyses, factors associated with COVID-19 included female sex, Hispanic or Black identity, lowest historical CD4 count <350 (proxy for CD4 nadir), current low CD4/CD8 ratio, diabetes, and obesity., Conclusions: Our results suggest that the presence of structural racial inequities above and beyond medical comorbidities increased the risk of COVID-19 among PWHPWH with immune exhaustion as evidenced by lowest historical CD4 or current low CD4:CD8 ratio had greater risk of COVID-19.
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- 2021
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43. Association analysis of juvenile idiopathic arthritis genetic susceptibility factors in Estonian patients.
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Nikopensius T, Niibo P, Haller T, Jagomägi T, Voog-Oras Ü, Tõnisson N, Metspalu A, Saag M, and Pruunsild C
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- Case-Control Studies, Estonia, Genome-Wide Association Study, Humans, Polymorphism, Single Nucleotide, Arthritis, Juvenile genetics, Genetic Predisposition to Disease
- Abstract
Background: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition of childhood. Genetic association studies have revealed several JIA susceptibility loci with the strongest effect size observed in the human leukocyte antigen (HLA) region. Genome-wide association studies have augmented the number of JIA-associated loci, particularly for non-HLA genes. The aim of this study was to identify new associations at non-HLA loci predisposing to the risk of JIA development in Estonian patients., Methods: We performed genome-wide association analyses in an entire JIA case-control sample (All-JIA) and in a case-control sample for oligoarticular JIA, the most prevalent JIA subtype. The entire cohort was genotyped using the Illumina HumanOmniExpress BeadChip arrays. After imputation, 16,583,468 variants were analyzed in 263 cases and 6956 controls., Results: We demonstrated nominal evidence of association for 12 novel non-HLA loci not previously implicated in JIA predisposition. We replicated known JIA associations in CLEC16A and VCTN1 regions in the oligoarticular JIA sample. The strongest associations in the All-JIA analysis were identified at PRKG1 (P = 2,54 × 10
-6 ), LTBP1 (P = 9,45 × 10-6 ), and ELMO1 (P = 1,05 × 10-5 ). In the oligoarticular JIA analysis, the strongest associations were identified at NFIA (P = 5,05 × 10-6 ), LTBP1 (P = 9,95 × 10-6 ), MX1 (P = 1,65 × 10-5 ), and CD200R1 (P = 2,59 × 10-5 )., Conclusion: This study increases the number of known JIA risk loci and provides additional evidence for the existence of overlapping genetic risk loci between JIA and other autoimmune diseases, particularly rheumatoid arthritis. The reported loci are involved in molecular pathways of immunological relevance and likely represent genomic regions that confer susceptibility to JIA in Estonian patients. Key Points • Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease with heterogeneous presentation and genetic predisposition. • Present genome-wide association study for Estonian JIA patients is first of its kind in Northern and Northeastern Europe. • The results of the present study increase the knowledge about JIA risk loci replicating some previously described associations, so adding weight to their relevance and describing novel loci. • The study provides additional evidence for the existence of overlapping genetic risk loci between JIA and other autoimmune diseases, particularly rheumatoid arthritis., (© 2021. The Author(s).)- Published
- 2021
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44. Switching to Bictegravir/Emtricitabine/Tenofovir Alafenamide in Black Americans With HIV-1: A Randomized Phase 3b, Multicenter, Open-Label Study.
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Hagins D, Kumar P, Saag M, Wurapa AK, Brar I, Berger D, Osiyemi O, Hileman CO, Ramgopal MN, McDonald C, Blair C, Andreatta K, Collins SE, Brainard DM, and Martin H
- Subjects
- Adenine therapeutic use, Adolescent, Adult, Black or African American, Aged, Drug Combinations, Female, HIV Infections ethnology, HIV Seropositivity, HIV-1 genetics, HIV-1 isolation & purification, Heterocyclic Compounds, 4 or More Rings therapeutic use, Humans, Male, Middle Aged, RNA therapeutic use, Tenofovir therapeutic use, United States epidemiology, Viral Load drug effects, Alanine therapeutic use, Amides therapeutic use, Anti-HIV Agents therapeutic use, Emtricitabine therapeutic use, HIV Infections drug therapy, HIV-1 drug effects, Heterocyclic Compounds, 3-Ring therapeutic use, Piperazines therapeutic use, Pyridones therapeutic use, Tenofovir analogs & derivatives
- Abstract
Background: With the highest rates of HIV/AIDS in the United States, Black Americans are still underrepresented in HIV medical research., Setting: BRAAVE (NCT03631732) is a randomized, phase 3b, multicenter, open-label US study., Methods: Adults identifying as Black or African American and virologically suppressed on 2 nucleoside reverse transcriptase inhibitors (NRTIs) plus third agent were randomized (2:1) to switch to open-label bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) once daily or stay on baseline regimen (SBR) for 24 weeks, after which SBR had delayed switch to B/F/TAF. Resistance to non-NRTIs, protease inhibitors, and/or NRTIs was permitted; integrase strand transfer inhibitor resistance was exclusionary. Primary endpoint was proportion of participants with HIV-1 RNA ≥50 copies/mL at week 24 (snapshot algorithm; noninferiority margin of 6%)., Results: Of 558 screened, 495 were randomized/treated (B/F/TAF n = 330; SBR n = 165). Overall, 32% were ciswomen, 2% transwomen, and 10% had an M184V/I mutation. At week 24, 0.6% on B/F/TAF vs 1.8% on SBR had HIV-1 RNA ≥50 copies/mL (difference -1.2%; 95% confidence interval -4.8% to 0.9%), demonstrating noninferiority of B/F/TAF vs SBR. Proportions with HIV-1 RNA <50 copies/mL at week 24 were 96% B/F/TAF and 95% SBR and remained high at week 48. No participant had treatment-emergent resistance to study drug. Treatments were well tolerated. Study drug-related adverse events, mostly grade 1, occurred in 10% of participants on B/F/TAF through week 48 and led to discontinuation in 9 participants through week 48., Conclusions: For Black Americans with HIV, switching to B/F/TAF was noninferior to continuing a variety of regimens, including those with pre-existing NRTI mutations., Competing Interests: P.K. reports grants from Gilead Sciences, Inc. (Gilead), GlaxoSmithKline (GSK), Merck, and Theratechnologies, has received personal fees for participating in advisory boards for GSK, Merck, and Theratechnologies, and is a shareholder of stock from Gilead, GSK, Johnson & Johnson, Merck, and Pfizer. M.S. has received research grants and support awarded to his institution from Gilead, Merck, and ViiV Healthcare. A.K.W. has received research grants from Gilead, Janssen, Pfizer, and GSK and has served on advisory boards for Gilead and Janssen. I.B. has received speakers' bureau honoraria from Gilead, ViiV, and Janssen. C.O.H. has received grant support from the National Institutes of Health (K23HL116209) and has served as consultant to Gilead Sciences. M.N.R. has served on the speakers' bureau for Gilead, Janssen, AbbVie, and Allergan and has consulted for Gilead, ViiV, and Merck. C.M. reports receiving research grants from Gilead, Janssen, Merck, and ViiV and speaker's bureau income from Gilead and Merck. C.B., K.A., S.E.C., D.M.B., and H.M. are employees of Gilead and shareholders of Gilead stock. The remaining authors have no conflicts of interest to disclose., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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45. Mortality Among Persons Entering HIV Care Compared With the General U.S. Population : An Observational Study.
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Edwards JK, Cole SR, Breger TL, Rudolph JE, Filiatreau LM, Buchacz K, Humes E, Rebeiro PF, D'Souza G, Gill MJ, Silverberg MJ, Mathews WC, Horberg MA, Thorne J, Hall HI, Justice A, Marconi VC, Lima VD, Bosch RJ, Sterling TR, Althoff KN, Moore RD, Saag M, and Eron JJ
- Subjects
- Adult, Cause of Death, Cohort Studies, Female, Humans, Male, Middle Aged, Population Surveillance, Risk Factors, United States epidemiology, HIV Infections mortality
- Abstract
Background: Understanding advances in the care and treatment of adults with HIV as well as remaining gaps requires comparing differences in mortality between persons entering care for HIV and the general population., Objective: To assess the extent to which mortality among persons entering HIV care in the United States is elevated over mortality among matched persons in the general U.S. population and trends in this difference over time., Design: Observational cohort study., Setting: Thirteen sites from the U.S. North American AIDS Cohort Collaboration on Research and Design., Participants: 82 766 adults entering HIV clinical care between 1999 and 2017 and a subset of the U.S. population matched on calendar time, age, sex, race/ethnicity, and county using U.S. mortality and population data compiled by the National Center for Health Statistics., Measurements: Five-year all-cause mortality, estimated using the Kaplan-Meier estimator of the survival function., Results: Overall 5-year mortality among persons entering HIV care was 10.6%, and mortality among the matched U.S. population was 2.9%, for a difference of 7.7 (95% CI, 7.4 to 7.9) percentage points. This difference decreased over time, from 11.1 percentage points among those entering care between 1999 and 2004 to 2.7 percentage points among those entering care between 2011 and 2017., Limitation: Matching on available covariates may have failed to account for differences in mortality that were due to sociodemographic factors rather than consequences of HIV infection and other modifiable factors., Conclusion: Mortality among persons entering HIV care decreased dramatically between 1999 and 2017, although those entering care remained at modestly higher risk for death in the years after starting care than comparable persons in the general U.S. population., Primary Funding Source: National Institutes of Health.
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- 2021
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46. Special section: COVID-19 among people living with HIV.
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Saag M
- Subjects
- Betacoronavirus, COVID-19, Coronavirus Infections epidemiology, HIV Infections epidemiology, HIV Infections virology, Humans, Pneumonia, Viral epidemiology, SARS-CoV-2, Coronavirus Infections complications, Coronavirus Infections prevention & control, HIV Infections complications, Pandemics prevention & control, Pneumonia, Viral complications, Pneumonia, Viral prevention & control
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- 2020
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47. Estimating a Set of Mortality Risk Functions with Multiple Contributing Causes of Death.
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Breger TL, Edwards JK, Cole SR, Saag M, Rebeiro PF, Moore RD, and Eron JJ
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- Adult, Female, Homosexuality, Male statistics & numerical data, Humans, Male, Middle Aged, Risk Factors, United States epidemiology, Cause of Death, HIV Infections drug therapy, HIV Infections mortality
- Abstract
Background: There are few methodologic examples of how multiple causes of death may be summarized in cause-specific mortality analyses to address limitations of attributing death to a single underlying cause. We propose a cause-of-death weighting approach to estimate the set of risk functions of specific causes of mortality using both underlying and contributing cause-of-death information., Methods: We constructed weights according to a user-specified function. Using data from four southern US human immunodeficiency virus (HIV) clinics, we constructed a cause of death-weighted Aalen-Johansen estimator of the cumulative incidence function to estimate risks of five specific causes of mortality in the full sample and by injection drug use history., Results: Among 7740 HIV-positive patients initiating antiretroviral therapy between 1999 and 2014, the 8-year risk of all-cause mortality was 17.5% [95% confidence interval (CI) = 16.5, 18.4]. The cause of death-weighted risk of HIV-related mortality was 6.7% (95% CI = 6.0, 7.3) and accounted for 39% (95% CI = 35, 42) of total mortality risk. This compared with 10.2% (95% CI = 9.2, 11.2) using only the underlying cause, in which case HIV-related deaths accounted for nearly 60% of total mortality risk. The proportion attributable to cardiovascular disease among those whose HIV risk factor was injection drug use was twice as high using cause-of-death weights compared with only the underlying cause (8%; 95% CI = 5, 11 vs 4%; 95% CI = 1, 6)., Conclusion: Using cause of death-weighted estimators to incorporate multiple causes of death may yield different conclusions regarding the importance of certain causes of mortality. See video abstract: http://links.lww.com/EDE/B706.
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- 2020
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48. Eligibility for hepatitis B antiviral therapy among adults in the general population in Zambia.
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Vinikoor MJ, Sinkala E, Kanunga A, Muchimba M, Zanolini A, Saag M, Pry J, Nsokolo B, Chisenga T, and Kelly P
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- Adult, DNA, Viral blood, Female, HIV Infections drug therapy, Hepatitis B Surface Antigens blood, Hepatitis B e Antigens blood, Hepatitis B, Chronic blood, Hepatitis B, Chronic epidemiology, Humans, Male, Patient Selection, Surveys and Questionnaires, Zambia epidemiology, Antiviral Agents therapeutic use, Hepatitis B, Chronic diagnosis, Hepatitis B, Chronic drug therapy
- Abstract
Introduction: We evaluated antiviral therapy (AVT) eligibility in a population-based sample of adults with chronic hepatitis B virus (HBV) infection in Zambia., Materials and Methods: Using a household survey, adults (18+ years) were tested for hepatitis B surface antigen (HBsAg). Sociodemographic correlates of HBsAg-positivity were identified with multivariable regression. HBsAg-positive individuals were referred to a central hospital for physical examination, elastography, and phlebotomy for HBV DNA, hepatitis B e antigen, serum transaminases, platelet count, and HIV-1/2 antibody. We determined the proportion of HBV monoinfected adults eligible for antiviral therapy (AVT) based on European Association for the Study of the Liver (EASL) 2017 guidelines. We also evaluated the performance of two alternative criteria developed for use in sub-Saharan Africa, the World Health Organization (WHO) and Treat-B guidelines., Results: Across 12 urban and 4 rural communities, 4,961 adults (62.9% female) were tested and 182 (3.7%) were HBsAg-positive, 80% of whom attended hospital follow-up. HBsAg-positivity was higher among men (adjusted odds ratio [AOR], 1.37; 95% confidence interval [CI], 0.99-1.87) and with decreasing income (AOR, 0.89 per household asset; 95% CI, 0.81-0.98). Trends toward higher HBsAg-positivity were also seen at ages 30-39 years (AOR, 2.11; 95% CI, 0.96-4.63) and among pregnant women (AOR, 1.74; 95% CI, 0.93-3.25). Among HBV monoinfected individuals (i.e., HIV-negative) evaluated for AVT, median age was 31 years, 24.6% were HBeAg-positive, and 27.9% had HBV DNA >2,000 IU/ml. AVT-eligibility was 17.0% by EASL, 10.2% by WHO, and 31.1% by Treat-B. Men had increased odds of eligibility. WHO (area under the receiver operating curve [AUROC], 0.68) and Treat-B criteria (AUROC, 0.76) had modest accuracy. Fourteen percent of HBsAg-positive individuals were HIV coinfection, and most coinfected individuals were taking tenofovir-containing antiretroviral therapy (ART)., Conclusion: Approximately 1 in 6 HBV monoinfected adults in the general population in Zambia may be AVT-eligible. Men should be a major focus of hepatitis B diagnosis and treatment. Further development and evaluation of HBV treatment criteria for resource-limited settings is needed. In settings with overlapping HIV and HBV epidemics, scale-up of ART has contributed towards hepatitis B elimination., Competing Interests: MJV received research support from Gilead Sciences (IN-US-174-3939) and the Fogarty International Center at US National Institutes of Health (K01TW009998). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding from Gilead Sciences does not alter our adherence to PLOS ONE policies on sharing data and materials.
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- 2020
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49. Case 36-2019: A 34-Year-Old Man with Dyspnea, Odynophagia, and Abdominal Pain.
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Saag M, Mendoza DP, Sherman MS, Cote GM, and Shih AR
- Subjects
- AIDS-Related Opportunistic Infections, Abdominal Pain etiology, Adult, Biopsy, CD4 Lymphocyte Count, Deglutition Disorders etiology, Diagnosis, Differential, Dyspnea etiology, Endoscopy, Gastrointestinal, Gastrointestinal Neoplasms etiology, HIV Infections complications, Humans, Male, Sarcoma, Kaposi etiology, Skin pathology, Duodenum pathology, Gastrointestinal Neoplasms diagnosis, Sarcoma, Kaposi diagnosis, Stomach pathology
- Published
- 2019
- Full Text
- View/download PDF
50. Emulating a trial of joint dynamic strategies: An application to monitoring and treatment of HIV-positive individuals.
- Author
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Caniglia EC, Robins JM, Cain LE, Sabin C, Logan R, Abgrall S, Mugavero MJ, Hernández-Díaz S, Meyer L, Seng R, Drozd DR, Seage Iii GR, Bonnet F, Le Marec F, Moore RD, Reiss P, van Sighem A, Mathews WC, Jarrín I, Alejos B, Deeks SG, Muga R, Boswell SL, Ferrer E, Eron JJ, Gill J, Pacheco A, Grinsztejn B, Napravnik S, Jose S, Phillips A, Justice A, Tate J, Bucher HC, Egger M, Furrer H, Miro JM, Casabona J, Porter K, Touloumi G, Crane H, Costagliola D, Saag M, and Hernán MA
- Subjects
- Adult, CD4 Lymphocyte Count, Decision Making, Female, HIV Infections mortality, Humans, Male, Middle Aged, RNA, Viral analysis, Research Design, Survival Analysis, Viral Load, Anti-HIV Agents administration & dosage, Drug Monitoring statistics & numerical data, HIV Infections drug therapy
- Abstract
Decisions about when to start or switch a therapy often depend on the frequency with which individuals are monitored or tested. For example, the optimal time to switch antiretroviral therapy depends on the frequency with which HIV-positive individuals have HIV RNA measured. This paper describes an approach to use observational data for the comparison of joint monitoring and treatment strategies and applies the method to a clinically relevant question in HIV research: when can monitoring frequency be decreased and when should individuals switch from a first-line treatment regimen to a new regimen? We outline the target trial that would compare the dynamic strategies of interest and then describe how to emulate it using data from HIV-positive individuals included in the HIV-CAUSAL Collaboration and the Centers for AIDS Research Network of Integrated Clinical Systems. When, as in our example, few individuals follow the dynamic strategies of interest over long periods of follow-up, we describe how to leverage an additional assumption: no direct effect of monitoring on the outcome of interest. We compare our results with and without the "no direct effect" assumption. We found little differences on survival and AIDS-free survival between strategies where monitoring frequency was decreased at a CD4 threshold of 350 cells/μl compared with 500 cells/μl and where treatment was switched at an HIV-RNA threshold of 1000 copies/ml compared with 200 copies/ml. The "no direct effect" assumption resulted in efficiency improvements for the risk difference estimates ranging from an 7- to 53-fold increase in the effective sample size., (© 2019 John Wiley & Sons, Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
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