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1. External validation of the PAGE-B score for HCC risk prediction in people living with HIV/HBV coinfection

Author

Bernard Surial, Adrià Ramírez Mena, Marie Roumet, Andreas Limacher, Colette Smit, Olivier Leleux, Amanda Mocroft, Marc van der Valk, Fabrice Bonnet, Lars Peters, Jürgen K. Rockstroh, Huldrych F. Günthard, Annalisa Berzigotti, Andri Rauch, Gilles Wandeler, I. Abela, K. Aebi-Popp, A. Anagnostopoulos, M. Battegay, E. Bernasconi, D.L. Braun, H.C. Bucher, A. Calmy, M. Cavassini, A. Ciuffi, G. Dollenmaier, M. Egger, L. Elzi, J. Fehr, J. Fellay, H. Furrer, C.A. Fux, H.F. Günthard, A. Hachfeld, D. Haerry, B. Hasse, H.H. Hirsch, M. Hoffmann, I. Hösli, M. Huber, D. Jackson-Perry, C.R. Kahlert, L. Kaiser, O. Keiser, T. Klimkait, R.D. Kouyos, H. Kovari, K. Kusejko, N. Labhardt, K. Leuzinger, Martinez de Tejada B, C. Marzolini, K.J. Metzner, N. Müller, J. Nemeth, D. Nicca, J. Notter, P. Paioni, G. Pantaleo, M. Perreau, A. Rauch, L. Salazar-Vizcaya, P. Schmid, R. Speck, M. Stöckle, P. Tarr, A. Trkola, G. Wandeler, M. Weisser, S. Yerly, M. van der Valk, S.E. Geerlings, A. Goorhuis, V.C. Harris, J.W. Hovius, B. Lempkes, F.J.B. Nellen, T. van der Poll, J.M. Prins, V. Spoorenberg, M. van Vugt, W.J. Wiersinga, F.W.M.N. Wit, C. Bruins, J. van Eden, I.J. Hylkema-van den Bout, A.M.H. van Hes, F.J.J. Pijnappel, S.Y. Smalhout, A.M. Weijsenfeld, N.K.T. Back, B. Berkhout, M.T.E. Cornelissen, R. van Houdt, M. Jonges, S. Jurriaans, C.J. Schinkel, K.C. Wolthers, H.L. Zaaijer, E.J.G. Peters, M.A. van Agtmael, R.S. Autar, M. Bomers, K.C.E. Sigaloff, M. Heitmuller, L.M. Laan, M. van den Berge, A. Stegeman, S. Baas, L. Hage de Looff, A. van Arkel, J. Stohr, B. Wintermans, M.J.H. Pronk, H.S.M. Ammerlaan, E.S. de Munnik, B. Deiman, A.R. Jansz, V. Scharnhorst, J. Tjhie, M.C.A. Wegdam, A. van Eeden, E. Hoornenborg, J. Nellen, W. Alers, L.J.M. Elsenburg, H. Nobel, M.E.E. van Kasteren, M.A.H. Berrevoets, A.E. Brouwer, B.A.F.M. de Kruijf-van de Wiel, A. Adams, M. Pawels-van Rijkevoorsel, A.G.M. Buiting, J.L. Murck, C. Rokx, A.A. Anas, H.I. Bax, E.C.M. van Gorp, M. de Mendonça Melo, E. van Nood, J.L. Nouwen, B.J.A. Rijnders, C.A.M. Schurink, L. Slobbe, T.E.M.S. de Vries-Sluijs, N. Bassant, J.E.A. van Beek, M. Vriesde, L.M. van Zonneveld, J. de Groot, J.J.A. van Kampen, M.P.G. Koopmans, J.C. Rahamat-Langendoen, J. Branger, R.A. Douma, A.S. Cents-Bosma, C.J.H.M. Duijf-van de Ven, E.F. Schippers, C. van Nieuwkoop, J. Geilings, S. van Winden, G. van der Hut, N.D. van Burgel, E.M.S. Leyten, L.B.S. Gelinck, F. Mollema, G.S. Wildenbeest, T. Nguyen, P.H.P. Groeneveld, J.W. Bouwhuis, A.J.J. Lammers, A.G.W. van Hulzen, S. Kraan, M.S.M. Kruiper, G.L. van der Bliek, P.C.J. Bor, S.B. Debast, G.H.J. Wagenvoort, A.H.E. Roukens, M.G.J. de Boer, H. Jolink, M.M.C. Lambregts, H. Scheper, W. Dorama, N. van Holten, E.C.J. Claas, E. Wessels, J.G. den Hollander, R. El Moussaoui, K. Pogany, C.J. Brouwer, D. Heida-Peters, E. Mulder, J.V. Smit, D. Struik-Kalkman, T. van Niekerk, O. Pontesilli, C. van Tienen, S.H. Lowe, A.M.L. Oude Lashof, D. Posthouwer, M.E. van Wolfswinkel, R.P. Ackens, K. Burgers, M. Elasri, J. Schippers, T.R.A. Havenith, M. van Loo, M.G.A. van Vonderen, L.M. Kampschreur, M.C. van Broekhuizen, null S, null Faber, A. Al Moujahid, G.J. Kootstra, C.E. Delsing, M. van der Burg-van de Plas, L. Scheiberlich, W. Kortmann, G. van Twillert, R. Renckens, J. Wagenaar, D. Ruiter-Pronk, F.A. van Truijen-Oud, J.W.T. Cohen Stuart, M. Hoogewerf, W. Rozemeijer, J.C. Sinnige, K. Brinkman, G.E.L. van den Berk, K.D. Lettinga, M. de Regt, W.E.M. Schouten, J.E. Stalenhoef, J. Veenstra, S.M.E. Vrouenraets, H. Blaauw, G.F. Geerders, M.J. Kleene, M. Knapen, M. Kok, I.B. van der Meché, A.J.M. Toonen, S. Wijnands, E. Wttewaal, D. Kwa, T.J.W. van de Laar, R. van Crevel, K. van Aerde, A.S.M. Dofferhoff, S.S.V. Henriet, H.J.M. ter Hofstede, J. Hoogerwerf, O. Richel, M. Albers, K.J.T. Grintjes-Huisman, M. de Haan, M. Marneef, M. McCall, D. Burger, E.H. Gisolf, M. Claassen, R.J. Hassing, G. ter Beest, P.H.M. van Bentum, M. Gelling, Y. Neijland, C.M.A. Swanink, M. Klein Velderman, S.F.L. van Lelyveld, R. Soetekouw, L.M.M. van der Prijt, J. van der Swaluw, J.S. Kalpoe, A. Wagemakers, A. Vahidnia, F.N. Lauw, D.W.M. Verhagen, M. van Wijk, W.F.W. Bierman, M. Bakker, R.A. van Bentum, M.A. van den Boomgaard, J. Kleinnijenhuis, E. Kloeze, A. Middel, D.F. Postma, H.M. Schenk, Y. Stienstra, M. Wouthuyzen-Bakker, A. Boonstra, H. de Jonge, M.M.M. Maerman, D.A. de Weerd, K.J. van Eije, M. Knoester, C.C. van Leer-Buter, H.G.M. Niesters, null T.Mudrikova, R.E. Barth, A.H.W. Bruns, P.M. Ellerbroek, M.P.M. Hensgens, J.J. Oosterheert, E.M. Schadd, A. Verbon, B.J. van Welzen, H. Berends, B.M.G. Griffioen-van Santen, I. de Kroon, F.M. Verduyn Lunel, A.M.J. Wensing, S. Zaheri, A.C. Boyd, D.O. Bezemer, A.I. van Sighem, C. Smit, M.M.J. Hillebregt, T.J. Woudstra, T. Rutkens, D. Bergsma, N.M. Brétin, K.J. Lelivelt, L. van de Sande, K.M. Visser.S.T. van der Vliet, F. Paling, L.G.M. de Groot-Berndsen, M. van den Akker, R. Alexander, Y. Bakker, A. El Berkaoui, M. Bezemer-Goedhart, E.A. Djoechro, M. Groters, L.E. Koster, C.R.E. Lodewijk, E.G.A. Lucas, L. Munjishvili, B.M. Peeck, C.M.J. Ree, R. Regtop, A.F. van Rijk, Y.M.C. Ruijs-Tiggelman, P.P. Schnörr, M.J.C. Schoorl, E.M. Tuijn, D.P. Veenenberg, E.C.M. Witte, I. Karpov, M. Losso, J. Lundgren, J. Rockstroh, I. Aho, L.D. Rasmussen, P. Novak, C. Pradier, N. Chkhartishvili, R. Matulionyte, C. Oprea, J.D. Kowalska, J. Begovac, J.M. Miró, G. Guaraldi, R. Paredes, L. Peters, J.F. Larsen, B. Neesgaard, N. Jaschinski, O. Fursa, D. Raben, D. Kristensen, A.H. Fischer, S.K. Jensen, T.W. Elsing, M. Gardizi, A. Mocroft, A. Phillips, J. Reekie, A. Cozzi-Lepri, A. Pelchen-Matthews, A. Roen, E.S. Tusch, W. Bannister, P. Bellecave, P. Blanco, F. Bonnet, S. Bouchet, D. Breilh, C. Cazanave, S. Desjardin, V. Gaborieau, A. Gimbert, M. Hessamfar, L. Lacaze-Buzy, D. Lacoste, M.E. Lafon, E. Lazaro, O. Leleux, F. Le Marec, G. Le Moal, D. Malvy, L. Marchand, P. Mercié, D. Neau, I. Pellegrin, A. Perrier, V. Petrov-Sanchez, M.O. Vareil, L. Wittkop, N. Bernard, D. Bronnimann H. Chaussade, D. Dondia, P. Duffau, I. Faure, P. Morlat, E. Mériglier, F. Paccalin, E. Riebero, C. Rivoisy, M.A. Vandenhende, L. Barthod, F.A. Dauchy, A. Desclaux, M. Ducours, H. Dutronc, A. Duvignaud, J. Leitao, M. Lescure, D. Nguyen, T. Pistone, M. Puges, G. Wirth, C. Courtault, F. Camou, C. Greib, J.L. Pellegrin, E. Rivière, J.F. Viallard, Y. Imbert, M. Thierry-Mieg, P. Rispal, O. Caubet, H. Ferrand, S. Tchamgoué, S. Farbos, H. Wille, K. Andre, L. Caunegre, Y. Gerard, F. Osorio-Perez, I. Chossat, G. Iles, M. Labasse-Depis, F. Lacassin, A. Barret, B. Castan, J. Koffi, N. Rouanes, A. Saunier, J.B. Zabbe, G. Dumondin, G. Beraud, M. Catroux, M. Garcia, V. Giraud, J.P. Martellosio, F. Roblot, T. Pasdeloup, A. Riché, M. Grosset, S. Males, C. Ngo Bell, C. Carpentier, Virology P. Bellecave, C. Tumiotto, G. Miremeont-Salamé, D. Arma, G. Arnou, M.J. Blaizeau, P. Camps, M. Decoin, S. Delveaux, F. Diarra, L. Gabrea, S. Lawson-Ayayi, E. Lenaud, D. Plainchamps, A. Pougetoux, B. Uwamaliya, K. Zara, V. Conte, M. Gapillout, Internal medicine, VU University medical center, Medical Microbiology and Infection Prevention, AII - Infectious diseases, CCA - Cancer biology and immunology, AII - Inflammatory diseases, AMS - Rehabilitation & Development, APH - Quality of Care, Pulmonary medicine, ACS - Pulmonary hypertension & thrombosis, Ethics, Law & Medical humanities, APH - Methodology, Midwifery Science, Amsterdam Reproduction & Development (AR&D), Infectious diseases, APH - Digital Health, APH - Personalized Medicine, APH - Aging & Later Life, APH - Global Health, Global Health, APH - Health Behaviors & Chronic Diseases, Center of Experimental and Molecular Medicine, General Internal Medicine, AII - Cancer immunology, Landsteiner Laboratory, Cardiology, ACS - Heart failure & arrhythmias, Obstetrics and Gynaecology, ARD - Amsterdam Reproduction and Development, Microbes in Health and Disease (MHD), 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), Global Health in the Global South (GHiGS), Institut de Recherche pour le Développement (IRD)- Bordeaux population health (BPH), and 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)

Subjects
Hepatitis B virus, model validation, Hepatology, liver neoplasms, risk prediction models, liver cirrhosis, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], risk assessment, 610 Medicine & health, hepatocellular carcinoma, HIV infection, tenofovir, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 610 Medizin und Gesundheit
Abstract

Background & Aims: HBV coinfection is common among people living with HIV (PLWH) and is the most important cause of hepatocellular carcinoma (HCC). While risk prediction tools for HCC have been validated in patients with HBV monoinfection, they have not been evaluated in PLWH. Thus, we performed an external validation of PAGE-B in people with HIV/HBV coinfection.Methods: We included data on PLWH from four European cohorts who were positive for HBsAg and did not have HCC before starting tenofovir. We estimated the predictive performance of PAGE-B for HCC occurrence over 15 years in patients receiving tenofovir-containing antiretroviral therapy. Model discrimination was assessed after multiple imputation using Cox regression with the prognostic index as a covariate, and by calculating Harrell's c-index. Calibration was assessed by comparing our cumulative incidence with the PAGE-B derivation study using Kaplan-Meier curves.Results: In total, 2,963 individuals with HIV/HBV coinfection on tenofovir-containing antiretroviral therapy were included. PAGE-B was Conclusions: For individuals with HIV/HBV coinfection, PAGE-B is a valid tool to determine the need for HCC screening. Impact and implications: Chronic HBV infection is the most important cause of hepatocellular carcinoma (HCC) among people living with HIV. Valid risk prediction may enable better targeting of HCC screening efforts to high-risk individuals. We aimed to validate PAGE-B, a risk prediction tool that is based on age, sex, and platelets, in 2,963 individuals with HIV/HBV coinfection who received tenofovir-containing antiretroviral therapy. In the present study, PAGE-B showed good discrimination, adequate calibration, and a cut-off of

Published
2023
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2. HCV micro-elimination in individuals with HIV in the Netherlands 4 years after universal access to direct-acting antivirals

Author

Colette Smit, Anders Boyd, Bart J A Rijnders, Thijs J W van de Laar, Eliane M Leyten, Wouter F Bierman, Kees Brinkman, Mark A A Claassen, Jan den Hollander, Anne Boerekamps, Astrid M Newsum, Janke Schinkel, Maria Prins, Joop E Arends, Eline L M Op de Coul, Marc van der Valk, Peter Reiss, M. van der Valk, S.E. Geerlings, A. Goorhuis, J.W. Hovius, B. Lempkes, F.J.B. Nellen, T. van der Poll, J.M. Prins, M. van Vugt, W.J. Wiersinga, F.W.M.N. Wit, M. van Duinen, J. van Eden, A. Hazenberg, A.M.H. van Hes, F.J.J. Pijnappel, S.Y. Smalhout, A.M. Weijsenfeld, S. Jurriaans, N.K.T. Back, H.L. Zaaijer, B. Berkhout, M.T.E. Cornelissen, C.J. Schinkel, K.C. Wolthers, E.J.G. Peters, M.A. van Agtmael, R.S. Autar, M. Bomers, K.C.E. Sigaloff, M. Heitmuller, L.M. Laan, C.W. Ang, R. van Houdt, M. Jonges, M. van den Berge, A. Stegeman, S. Baas, L. Hage de Looff, A. Buiting, A. Reuwer, J. Veenemans, B. Wintermans, M.J.H. Pronk, H.S.M. Ammerlaan, D.N.J. van den Bersselaar, E.S. de Munnik, B. Deiman, A.R. Jansz, V. Scharnhorst, J. Tjhie, M.C.A. Wegdam, A. van Eeden, J. Nellen, W. Brokking, L.J.M. Elsenburg, H. Nobel, M.E.E. van Kasteren, M.A.H. Berrevoets, A.E. Brouwer, A. Adams, R. van Erve, B.A.F.M. de Kruijf-van de Wiel, S. Keelan-Phaf, B. van de Ven, A.G.M. Buiting, J.L. Murck, T.E.M.S. de Vries-Sluijs, H.I. Bax, E.C.M. van Gorp, N.C. de Jong-Peltenburg, M. de Mendonça Melo, E. van Nood, J.L. Nouwen, B.J.A. Rijnders, C. Rokx, C.A.M. Schurink, L. Slobbe, A. Verbon, N. Bassant, J.E.A. van Beek, M. Vriesde, L.M. van Zonneveld, J. de Groot, C.A.B. Boucher, M.P.G. Koopmans, J.J.A. van Kampen, J. Branger, R.A. Douma, A.S. Cents-Bosma, C.J.H.M. Duijf-van de Ven, E.F. Schippers, C. van Nieuwkoop, J.M. van IJperen, J. Geilings, N.D. van Burgel, E.M.S. Leyten, G. van der Hut, L.B.S. Gelinck, F. Mollema, S. Davids-Veldhuis, C. Tearno, G.S. Wildenbeest, E. Heikens, P.H.P. Groeneveld, J.W. Bouwhuis, A.J.J. Lammers, S. Kraan, A.G.W. van Hulzen, M.S.M. Kruiper, G.L. van der Bliek, P.C.J. Bor, S.B. Debast, G.H.J. Wagenvoort, F.P. Kroon, M.G.J. de Boer, H. Jolink, M.M.C. Lambregts, A.H.E. Roukens, H. Scheper, W. Dorama, N. van Holten, E.C.J. Claas, E. Wessels, J.G. den Hollander, C.J. Brouwer, J.V. Smit, D. Struik-Kalkman, T. van Niekerk, R. El Moussaoui, K. Pogany, O. Pontesilli, S.H. Lowe, A.M.L. Oude Lashof, D. Posthouwer, M.E. van Wolfswinkel, R.P. Ackens, K. Burgers, J. Schippers, B. Weijenberg-Maes, I.H.M. van Loo, T.R.A. Havenith, M.G.A. van Vonderen, L.M. Kampschreur, S. Faber, R. Steeman-Bouma, A. Al Moujahid, G.J. Kootstra, C.E. Delsing, M. van der Burg-van de Plas, L. Scheiberlich, W. Kortmann, G. van Twillert, R. Renckens, D. Ruiter-Pronk, F.A. van Truijen-Oud, J.W.T. Cohen Stuart, E.R. Jansen, M. Hoogewerf, W. Rozemeijer, W.A. van der Reijden, J.C. Sinnige, K. Brinkman, G.E.L. van den Berk, W.L. Blok, K.D. Lettinga, M. de Regt, W.E.M. Schouten, J.E. Stalenhoef, J. Veenstra, S.M.E. Vrouenraets, H. Blaauw, G.F. Geerders, M.J. Kleene, M. Kok, M. Knapen, I.B. van der Meché, E. Mulder-Seeleman, A.J.M. Toonen, S. Wijnands, E. Wttewaal, D. Kwa, R. van Crevel, A.S.M. Dofferhoff, H.J.M. ter Hofstede, J. Hoogerwerf, M. Keuter, O. Richel, M. Albers, K.J.T. Grintjes-Huisman, M. de Haan, M. Marneef, R. Strik-Albers, J. Rahamat-Langendoen, F.F. Stelma, D. Burger, E.H. Gisolf, R.J. Hassing, M. Claassen, G. ter Beest, P.H.M. van Bentum, N. Langebeek, R. Tiemessen, C.M.A. Swanink, S.F.L. van Lelyveld, R. Soetekouw, L.M.M. van der Prijt, J. van der Swaluw, N. Bermon, R. Jansen, B.L. Herpers, D. Veenendaal, D.W.M. Verhagen, F.N. Lauw, M.C. van Broekhuizen, M. van Wijk, W.F.W. Bierman, M. Bakker, J. Kleinnijenhuis, E. Kloeze, A. Middel, D.F. Postma, Y. Stienstra, M. Wouthuyzen-Bakker, A. Boonstra, H. de Groot-de Jonge, P.A. van der Meulen, D.A. de Weerd, H.G.M. Niesters, C.C. van Leer-Buter, M. Knoester, A.I.M. Hoepelman, J.E. Arends, R.E. Barth, A.H.W. Bruns, P.M. Ellerbroek, T. Mudrikova, J.J. Oosterheert, E.M. Schadd, B.J. van Welzen, K. Aarsman, B.M.G. Griffioen-van Santen, I. de Kroon, M. van Berkel, C.S.A.M. van Rooijen, R. Schuurman, F. Verduyn-Lunel, A.M.J. Wensing, P. Reiss, S. Zaheri, A.C. Boyd, D.O. Bezemer, A.I. van Sighem, C. Smit, M. Hillebregt, A. de Jong, T. Woudstra, D. Bergsma, R. Meijering, L. van de Sande, T. Rutkens, S. van der Vliet, L. de Groot, M. van den Akker, Y. Bakker, A. El Berkaoui, M. Bezemer, N. Brétin, E. Djoechro, M. Groters, E. Kruijne, K.J. Lelivelt, C. Lodewijk, E. Lucas, L. Munjishvili, F. Paling, B. Peeck, C. Ree, R. Regtop, Y. Ruijs, M. Schoorl, P. Schnörr, A. Scheigrond, E. Tuijn, L. Veenenberg, K.M. Visser, E.C. Witte, Infectious diseases, Medical Microbiology and Infection Prevention, AII - Infectious diseases, APH - Global Health, Global Health, APH - Aging & Later Life, APH - Quality of Care, Center of Experimental and Molecular Medicine, Landsteiner Laboratory, AII - Inflammatory diseases, Obstetrics and Gynaecology, ARD - Amsterdam Reproduction and Development, Gastroenterology and Hepatology, APH - Health Behaviors & Chronic Diseases, APH - Methodology, APH - Digital Health, APH - Personalized Medicine, Internal medicine, ACS - Diabetes & metabolism, General practice, Internal Medicine, and Medical Microbiology & Infectious Diseases

Subjects
0301 basic medicine, Adult, Male, Epidemiology, Immunology, HIV Infections, Hepacivirus, Antiviral Agents, Men who have sex with men, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Virology, Medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, Substance Abuse, Intravenous, Netherlands, Retrospective Studies, Proportional hazards model, business.industry, Coinfection, Incidence (epidemiology), Incidence, Retrospective cohort study, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, 030112 virology, Chronic infection, Infectious Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Cohort, HIV-1, Female, business, Demography
Abstract

Contains fulltext : 232443.pdf (Publisher’s version ) (Closed access) BACKGROUND: In the Netherlands, access to direct-acting antivirals (DAAs) against hepatitis C virus (HCV) has been unrestricted for chronic infection since 2015. We evaluated whether the nationwide incidence of HCV infections in individuals with HIV has changed since 2015. METHODS: In this retrospective cohort study, data from the ATHENA cohort of people with HIV aged 18 years or older attending any of the 24 HIV treatment centres in the Netherlands between 2000 and 2019 were assessed. We used parametric proportional hazards models with a piecewise exponential survival function to model HCV primary infection and reinfection incidence per 1000 person-years. FINDINGS: Of the 23 590 individuals without previous HCV infection, 1269 cases of HCV primary infection were documented (incidence 5·2 per 1000 person-years [95% CI 5·0-5·5]). The highest incidence was observed in men who have sex with men (MSM; 7·7 per 1000 person-years [7·3-8·2]) and was lower in people who inject drugs (PWID; 1·7 per 1000 person-years [0·7-4·1]) and other key populations (1·0 per 1000 person-years [0·8-1·2]). In MSM, incidence increased in 2007 to 14·3 per 1000 person-years and fluctuated between 8·7 and 13·0 per 1000 person-years from 2008 to 2015. In 2016, incidence declined to 6·1 cases per 1000 person-years and remained steady between 4·1 and 4·9 per 1000 person-years from 2017 to 2019. Of the 1866 individuals with a previous HCV infection, 274 reinfections were documented (incidence 26·9 per 1000 person-years [95% CI 23·9-30·3]). The highest incidence rate was observed in MSM (38·5 per 1000 person-years [33·9-43·7]) and was lower in PWID (10·9 per 1000 person-years [3·5-33·8]) and other key populations (8·9 per 1000 person-years [6·3-12·5]). In MSM, reinfection incidence fluctuated between 38·0 and 88·9 per 1000 person-years from 2006 to 2015, reaching 55·6 per 1000 person-years in 2015. In 2016, reinfection incidence declined to 41·4 per 1000 person-years, followed by further decreases to 24·4 per 1000 person-years in 2017 and 11·4 per 1000 person-years in 2019. INTERPRETATION: The sharp decline in HCV incidence in MSM with HIV shortly after restrictions on DAAs were lifted suggests a treatment-as-prevention effect. HCV incidence was already low in PWID and other groups before unrestricted access. Ongoing HCV transmission is occurring in MSM, as illustrated by a declining but high rate of reinfection, stressing the need for additional preventive measures. FUNDING: Dutch Ministry of Health, Welfare, and Sport.

Published
2021
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3. The prevalence of feeding problems in children formerly treated in a neonatal intensive care unit

Author

Henk Groen, Arend F. Bos, Tjitske Nieuwenhuis, H. J. ter Horst, M. W. G. van Dijk, M Hoogewerf, Methods in Medicines evaluation & Outcomes research (M2O), Reproductive Origins of Adult Health and Disease (ROAHD), Developmental Psychology, and Value, Affordability and Sustainability (VALUE)

Subjects
Male, Pediatrics, Neonatal intensive care unit, Severity of Illness Index, Cohort Studies, 0302 clinical medicine, Risk Factors, 030212 general & internal medicine, Netherlands, Obstetrics and Gynecology, Gestational age, MOTOR DEVELOPMENT, Child, Preschool, Infant, Small for Gestational Age, SKILLS, GROWTH, Female, medicine.symptom, Infant, Premature, BEHAVIOR, Cohort study, medicine.medical_specialty, BIRTH, Feeding and Eating Disorders, 03 medical and health sciences, Enteral Nutrition, AGE, Intensive Care Units, Neonatal, PRETERM INFANTS, 030225 pediatrics, Severity of illness, medicine, Humans, SUCKING, Neonatology, business.industry, Infant, Newborn, Infant, Infant, Low Birth Weight, Length of Stay, medicine.disease, Low birth weight, Logistic Models, Parenteral nutrition, FULL-TERM INFANTS, Multivariate Analysis, Pediatrics, Perinatology and Child Health, PATTERNS, Small for gestational age, business
Abstract

OBJECTIVE: To determine the prevalence of oral feeding problems in neonatal intensive care unit (NICU) graduates at 1 to 2 years, and to identify clinical risk factors during NICU admission.STUDY DESIGN: Observational cohort study of 378 children, who received level III/IV NICU care for 4 days or more in 2011 to 2012, chromosomal abnormalities excluded. We detected feeding problems in four gestational age (GA) groups (RESULTS: The prevalence of feeding problems was higher in NICU (20.4%) than in reference (15.0%) population (P = 0.024), but similar for all GA groups (P = 0.468). Prolonged tube feeding, that is, > 30 days (odds ratio (OR) 2.50, confidence interval (CI) 1.13 to 5.56) and being born small for GA (OR 4.79, CI 1.64 to 14.03) were the most prevalent risk factors in children with GA >= 32 and GA CONCLUSION: Feeding problems are more prevalent in NICU graduates, with prolonged tube feeding as most important risk factor.

Published
2017
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4. Prognostic factors for early clinical failure in patients with severe community-acquired pneumonia

Author

I M Hoepelman, Eelko Hak, M Hoogewerf, Jan Jelrik Oosterheert, and Marc J. M. Bonten

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, community-acquired pneumonia, Adolescent, Pneumonia severity index, Severity of Illness Index, Cohort Studies, Community-acquired pneumonia, Anti-Infective Agents, Risk Factors, Internal medicine, Severity of illness, medicine, Humans, Treatment Failure, risk-factors, Prospective cohort study, Hospitals, Teaching, Clinical failure, Netherlands, Academic Medical Centers, business.industry, Mortality rate, Respiratory disease, General Medicine, Pneumonia, medicine.disease, Prognosis, Surgery, Community-Acquired Infections, Infectious Diseases, outcome, Regression Analysis, Female, business, management, Cohort study
Abstract

For patients with community-acquired pneumonia (CAP), clinical response during the first days of treatment is predictive of clinical outcome. As risk assessments can improve the efficiency of pneumonia management, a prospective cohort study to assess clinical, biochemical and microbiological predictors of early clinical failure was conducted in patients with severe CAP (pneumonia severity index score of >90 or according to the American Thoracic Society definition). Failure was assessed at day 3 and was defined as death, a need for mechanical ventilation, respiratory rate >25/min, PaO2 38°C or confusion. Of 260 patients, 80 (31%) had early clinical failure, associated mainly with a respiratory rate >25/minute (n = 34), oxygen saturation

Published
2006
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5. A leg with an ulcer

Author

P A M, Kracht, V, Sigurdsson, M, Hoogewerf, and J E, Arends

Subjects
Aged, 80 and over, Diagnosis, Differential, Male, Immunocompromised Host, Leg Ulcer, Antitubercular Agents, Humans, Tuberculosis, Cutaneous
Published
2012

6. Distant embolisation in infective endocarditis: characteristics and outcomes.

Author

Duffels MGJ, Germans T, Bos-Schaap A, Drexhage O, Wagenaar JFP, van der Zant FM, Hoogewerf M, Knol RJJ, and Umans VAWM

Abstract

Background: Infective endocarditis is a severe and potentially lethal cardiac disease. Recognition of the clinical features of endocarditis, such as distant embolisation, and adequate treatment should be initiated promptly given the grim perspective of upcoming virulent pathogens., Methods: We report on our registry-based experience with outcomes of consecutive patients with infective endocarditis with distant embolisation. We aimed to describe the patient characteristics of infective endocarditis complicated by distant organ embolisation and the safety aspects of continuing endocarditis treatment at home in these patients., Results: From November 2018 through April 2022, 157 consecutive patients were diagnosed with infective endocarditis. Of them, 38 patients (24%) experienced distant embolisation, either in the cerebrum (n = 18), a visceral organ (n = 5), the lungs (n = 7) or the myocardium (n = 8). Pathogens identified in blood cultures were predominantly streptococcal variants (43%), with only one culture-negative endocarditis case. Of the 18 patients with cerebral embolisation, 12 had neurological complaints and most often discrete abnormal findings on neurological examination. Six of the 8 cardiac embolism patients experienced chest pain before admission. Visceral organ and pulmonary embolism occurred silently. Of the 38 patients with distant embolisation, 17 could be discharged earlier by providing antibiotic treatment at home without complications., Conclusion: This registry-based single-centre experience showed an incidence of distant embolisation in daily care of 24%. Cerebral and coronary embolisation provoked symptoms, while visceral emboli remained silent. Pulmonary emboli may present with inflammatory signs. Distant embolisation was not in itself a contra-indication for outpatient endocarditis@home treatment., (© 2023. The Author(s).)

Published
2023
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7. Endovascular repair of a ruptured, extremely tortuous, descending thoracic aorta aneurysm with aortic coarctation.

Author

Hoogewerf M, van Geldorp MWA, Scholten JGF, Vos JA, and Heijmen RH

Abstract

We have presented a case of a ruptured descending aortic aneurysm that was accompanied by extreme tortuosity and a pseudocoarctation at the level of the ligamentum arteriosum. We performed successful endovascular repair, covering the left subclavian artery, using a transapical-to-femoral artery (through-and-through) guidewire technique to overcome the tortuosity, with the option to perform balloon angioplasty in the case of an increased gradient over the coarctation. In the present case report, we have underlined the role of close collaborations with aortic expertise centers., (© 2022 The Author(s).)

Published
2022
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8. Application of local gentamicin in the treatment of deep sternal wound infection: a randomized controlled trial.

Author

Vos RJ, van Putte BP, de Mol BAJM, Hoogewerf M, Mandigers TJ, and Kloppenburg GTL

Subjects
Anti-Bacterial Agents therapeutic use, Humans, Retrospective Studies, Sternotomy adverse effects, Sternum surgery, Surgical Wound Infection, Treatment Outcome, Cardiac Surgical Procedures adverse effects, Gentamicins therapeutic use
Abstract

Objectives: In patients with deep sternal wound infection (DSWI), primary closure of the sternal bone over high negative pressure Redon drains has shown to be a safe and feasible treatment method. Addition of local gentamicin could accelerate healing and improve clinical outcomes., Methods: We conducted a randomized controlled trial to evaluate the effectiveness of local gentamicin in the treatment of DSWI. In the treatment group, collagenous carriers containing gentamicin were left between the sternal halves during sternal refixation. In the control group, no local antibiotics were used. Primary outcome was hospital stay. Secondary outcomes were mortality, reoperation, wound sterilization time, time till removal of all drains and duration of intravenous antibiotic treatment., Results: Forty-one patients were included in the trial of which 20 were allocated to the treatment group. Baseline characteristics were similar in both groups. Drains could be removed after a median of 8.5 days in the treatment group and 14.5 days in the control group (P-value: 0.343). Intravenous antibiotics were administered for a median of 23.5 days in the treatment group and 38.5 days in the control group (P-value: 0.343). The median hospital stay was 27 days in the treatment group and 28 days in the control group (P-value: 0.873). Mortality rate was 10% in the treatment group and 9.5% in the control group (P-value: 0,959). No side effects were observed., Conclusions: This randomized controlled trial showed that addition of local gentamicin in the treatment of DSWI did not result in shorter length of stay., Clinical Trial Registration Number: 2014-001170-33., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2022
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9. Sutureless versus Hand-Sewn Coronary Anastomoses: A Systematic Review and Meta-Analysis.

Author

Hoogewerf M, Schuurkamp J, Kelder JC, Jacobs S, and Doevendans PA

Abstract

Background: Sutureless coronary anastomotic devices are intended to facilitate minimally invasive coronary artery bypass grafting (MICS-CABG) by easing and eventually standardizing the anastomotic technique. Within this systematic review and meta-analysis, we aim to determine patency and to evaluate safety outcomes for the sutureless anastomoses., Methods: CENTRAL, MEDLINE, and EMBASE were searched from database start till August 2021 in a predefined search strategy combining the key concepts: 'coronary artery bypass grafting', 'sutureless coronary anastomoses', and 'hand-sewn coronary anastomoses' by the Boolean operation 'AND'. Study characteristics, patient demographics, interventional details, and all available outcome data were extracted. A meta-analysis was performed on patency at longest follow-up. Safety outcomes were presented., Results: A total of eleven trials towards six sutureless anastomotic devices were included, comprising 3724 patients (490 sutureless and 3234 hand-sewn). There was no significant difference in patency at a mean follow-up duration of 546.3 (range 1.5-2691) days, with a risk ratio of 0.77 (95% CI 0.55-1.06). MACE was reported in 4.5% sutureless and 3.9% hand-sewn patients, including all-cause mortality (resp. 1.3 vs. 1.9%), myocardial infarction (resp. 1.6 vs. 1.7%), and coronary revascularization (resp. 1.8 vs. 0.5%). Incomplete hemostasis occurred in 24.8% of the sutureless anastomoses. Intra-operative device failure forced conversion to hand-sewn or redo-anastomosis in 5.8% of the sutureless cases., Conclusion: Based on the systematic review and meta-analysis including six devices, we conclude that sutureless coronary anastomotic devices appear safe and effective when used by well-trained and dedicated surgical teams.

Published
2022
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10. Automated Broad-Range Molecular Detection of Bacteria in Clinical Samples.

Author

Budding AE, Hoogewerf M, Vandenbroucke-Grauls CM, and Savelkoul PH

Subjects
Child, Preschool, Female, Humans, Middle Aged, RNA, Ribosomal, 16S genetics, RNA, Ribosomal, 23S genetics, Sensitivity and Specificity, Time Factors, Automation, Laboratory methods, Bacteria classification, Bacteria isolation & purification, Bacterial Infections diagnosis, Bacteriological Techniques methods, DNA, Intergenic genetics, Molecular Diagnostic Techniques methods
Abstract

Molecular detection methods, such as quantitative PCR (qPCR), have found their way into clinical microbiology laboratories for the detection of an array of pathogens. Most routinely used methods, however, are directed at specific species. Thus, anything that is not explicitly searched for will be missed. This greatly limits the flexibility and universal application of these techniques. We investigated the application of a rapid universal bacterial molecular identification method, IS-pro, to routine patient samples received in a clinical microbiology laboratory. IS-pro is a eubacterial technique based on the detection and categorization of 16S-23S rRNA gene interspace regions with lengths that are specific for each microbial species. As this is an open technique, clinicians do not need to decide in advance what to look for. We compared routine culture to IS-pro using 66 samples sent in for routine bacterial diagnostic testing. The samples were obtained from patients with infections in normally sterile sites (without a resident microbiota). The results were identical in 20 (30%) samples, IS-pro detected more bacterial species than culture in 31 (47%) samples, and five of the 10 culture-negative samples were positive with IS-pro. The case histories of the five patients from whom these culture-negative/IS-pro-positive samples were obtained suggest that the IS-pro findings are highly clinically relevant. Our findings indicate that an open molecular approach, such as IS-pro, may have a high added value for clinical practice., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)

Published
2016
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11. A leg with an ulcer.

Author

Kracht PA, Sigurdsson V, Hoogewerf M, and Arends JE

Subjects
Aged, 80 and over, Diagnosis, Differential, Humans, Immunocompromised Host, Leg Ulcer drug therapy, Male, Tuberculosis, Cutaneous drug therapy, Antitubercular Agents therapeutic use, Leg Ulcer diagnosis, Tuberculosis, Cutaneous diagnosis
Published
2012

12. No influence of haemodialysis on interferon production in the QuantiFERON-TB Gold-In-Tube test.

Author

Hoogewerf M, Boland GJ, Hoepelman AI, Boer WH, and Mudrikova T

Subjects
Adult, Aged, Aged, 80 and over, Analysis of Variance, Biomarkers blood, Female, Humans, Kidney Failure, Chronic immunology, Latent Tuberculosis immunology, Latent Tuberculosis microbiology, Male, Middle Aged, Netherlands, Predictive Value of Tests, T-Lymphocytes microbiology, Time Factors, Enzyme-Linked Immunospot Assay, Interferon-gamma blood, Kidney Failure, Chronic therapy, Latent Tuberculosis diagnosis, Mycobacterium tuberculosis immunology, Renal Dialysis adverse effects, T-Lymphocytes immunology
Abstract

Background: Immunodeficiency in end-stage renal disease (ESRD) can be aggravated by haemodialysis (HD). This results in an increased incidence of reactivation of tuberculosis (TB) in HD patients. The tuberculin skin test to detect a latent TB infection (LTBI) has its limitations in these patients because of a high rate of false negative results due to anergy of T cells. Data on the influence of HD on the performance of interferon-gamma release assays are limited. The aim of this study was to determine the effect of HD on the performance of the QuantiFERON-TB Gold (QFT-G) assay in ESRD patients before, during and after the HD session., Methods: In HD patients older than 18 years without immunosuppressive medication or other immunocompromising conditions, the QFT-G assay was performed just before starting HD, 30 minutes after start and immediately after the finish of the HD session., Results: Twenty patients were included. No statistically significant differences were found in interferon-gamma production in the nil- and antigen tubes between pre-HD, during and after HD. In 1 patient the predialysis result was indeterminate (one of 60 samples, 1.67%). In all 3 patients with a history of LTBI, the QFT-G test tube results were positive at all time points. In the other 16 patients, all test tubes showed negative results., Conclusions: The QFT-G assay could be a useful test for the evaluation of the immunological response against Mycobacterium tuberculosis in HD patients. The time point of blood sampling does not seem to affect the interpretation of test results.

Published
2011
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