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3 results on '"Mark Oette"'

1. Resistenz in der antiretroviralen Therapie der HIV-Infektion*.

Author

Mark Oette and Dieter Häussinger

Abstract

Zusammenfassung. Trotz der beeindruckenden Erfolge der hochaktiven antiretroviralen Therapie gelingt eine dauerhafte Unterbindung der Virusreplikation bei einem großen Anteil von HIV-Infizierten nicht. Die wichtigste Ursache hierfür ist die Resistenzentwicklung, d. h. die Fähigkeit eines mutierten Virus, bei höheren Konzentrationen einer antiretroviralen Substanz zu replizieren als das Wildtypvirus. In vorbehandelten HIV-Populationen treten Resistenzen zu fast 50% auf, bei therapienaiven Patienten zu 10?14%. Zur Diagnostik dienen der genotypische Resistenztest, der das pol-Gen sequenziert, und der phänotypische Resistenztest, der die Suszeptibilität von Virusstämmen gegenüber Medikamenten in vitro misst. Eine besondere Schwierigkeit besteht in der Interpretation komplexer Resistenzmuster; hierfür stehen entwickelte Datenbanken zur Verfügung. Eine Reihe von klinischen Studien unterstrich den Wert der Resistenztestung bei virologischem Versagen. Es wurde gezeigt, dass die Anwendung eines Resistenztests bei Therapieversagen die Wahrscheinlichkeit einer erfolgreichen Folgebehandlung signifikant im Vergleich zur damaligen Standardbehandlung erhöht. Aus diesem Grund wurde der Resistenztest von deutschen und internationalen Expertengremien in dieser klinischen Situation empfohlen. [ABSTRACT FROM AUTHOR]

Published
2003

2. Transient Elastography for the Detection of Liver Damage in Patients with HIV

Author

Abdurrahman Sagir, Dirk Graf, Birgit Glaubach, Kurtulus Sahin, Andreas Erhardt, Mark Oette, and Dieter Häussinger

Subjects
Microbiology (medical), Pathology, medicine.medical_specialty, Transient elastography, business.industry, Liver fibrosis, Hepatotoxicity, Human immunodeficiency virus (HIV), Highly active antiretroviral therapy (HAART), HIV, Chronic liver disease, medicine.disease, medicine.disease_cause, Antiretroviral therapy, Gastroenterology, Infectious Diseases, Liver, Internal medicine, medicine, In patient, Liver damage, FibroScan®, business, Original Research
Abstract

Introduction Highly active antiretroviral therapy (HAART) is effective and well tolerated, but hepatotoxicity is relatively common. Different non-invasive methods are available for detecting liver fibrosis in patients with chronic liver disease. Methods Patients who were HIV positive and who had given their informed consent were included in this cross-sectional study. Transient elastography [FibroScan® (FS); Echosens], serum hyaluronic acid (HA), Hepascore (HS), Fibrosis-4 (FIB-4), and aspartate aminotransferase to platelet ratio index (APRI) were used to detect liver fibrosis in the patients. The agreement between FS and the other methods was evaluated. To observe the hepatotoxicity of HAART, patients with chronic viral hepatitis B or C were excluded by detection of hepatitis B surface antigens and hepatitis C virus antibodies. Patients with chronic alcohol intake were excluded by measuring carbohydrate-deficient transferrin (CDT). FS correlation with the duration of therapy with protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) was evaluated. Results Overall, 203 patients were included in the study. The agreement between the different tests ranged from 64% to 77%: FS vs. HA, 72%; FS vs. APRI, 74%; FS vs. HS, 77%; and FS vs. FIB-4, 64%. After excluding patients with chronic hepatitis B or C and elevated CDT, 153 patients remained for studying the hepatotoxicity of HAART. A significant correlation of FS with the duration of medication intake was observed for PIs (P = 0.026; r = 0.18). NRTI and NNRTI therapy duration did not correlate with FS. Conclusions The agreement between FS and other tests ranged from 64% to 77%. A significant correlation was found between liver stiffness and the duration of therapy with PIs, which underlines the known hepatotoxicity of this substance group. Funding Heinz-Ansmann Foundation. Electronic supplementary material The online version of this article (doi:10.1007/s40121-015-0073-y) contains supplementary material, which is available to authorized users.

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3. Cerebral malaria in spite of peripheral parasite clearance in a patient treated with atovaquone/proguanil.

Author

Stefanie Koch, Klaus Göbels, Joachim Richter, Mark Oette, and Dieter Häussinger

Subjects
MALARIA, BRAIN diseases, FEVER
Abstract

Abstract??Cerebral malaria, the most frequent complication of falciparum malaria, is usually predicted by an increased count of asexual parasites in peripheral blood. We report a case of a female returnee from Ghana who developed cerebral malaria in spite of parasite clearance in peripheral blood after therapy with atovaquone/proguanil. [ABSTRACT FROM AUTHOR]

Published
2007
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