460 results on '"Laursen, Alex"'
Search Results
52. Full fusion competence rescue of the enfuvirtide resistant HIV-1 gp41 genotype (43D) by a prevalent polymorphism (137K)
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Tolstrup, Martin, Selzer-Plön, Joanna, Laursen, Alex L, Bertelsen, Lone, Gerstoft, Jan, Duch, Mogens, Pedersen, Finn S, and Ostergaard, Lars
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- 2007
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53. Salmonella-infected left ventricular thrombus
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Egeblad, Henrik, Wierup, Per, and Laursen, Alex Lund
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- 2005
54. Declining risk of triple-class antiretroviral drug failure in Danish HIV-infected individuals
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Lohse, Nicolai, Obel, Niels, Kronborg, Gitte, Laursen, Alex, Pedersen, Court, Larsen, Carsten S, Kvinesdal, Birgit, Sørensen, Henrik Toft, and Gerstoft, Jan
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- 2005
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55. HIV/SIV Escape from Immune Surveillance: Focus on Nef
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Tolstrup, Martin, Ostergaard, Lars, Laursen, Alex L., Pedersen, Skou Finn, and Duch, Mogens
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- 2004
56. Tenofovir Treatment in an Unselected Cohort of Highly Antiretroviral Experienced HIV Positive Patients
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Lerbæk, ANNE, Kristiansen, THOMAS B., Katzenstein, TERESE L., Mathiesen, LARS, Gerstoft, JAN, Nielsen, CLAUS, Larsen, KLAUS, Nielsen, JENS O., Obel, NIELS, Laursen, ALEX L., and Nielsen, SUSANNE D.
- Published
- 2004
57. Activation of the respiratory burst by Pneumocystis carinii: Efficiency of different antibody isotypes, complement, lung surfactant protein D, and mannan-binding lectin
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LAURSEN, ALEX L., OBEL, NIELS, HOLMSKOV, UFFE, JENSENIUS, JENS C., ALIOUAT, EL MOUKHTAR, and ANDERSEN, PAUL L.
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- 2003
58. Lack of awareness of treatment failure among HIV‐1‐infected patients in Guinea‐Bissau – a retrospective cohort study
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Jespersen, Sanne, Hønge, Bo Langhoff, Medina, Candida, Té, David Silva, Correira, Faustino Gomes, Laursen, Alex Lund, Erikstrup, Christian, Østergaard, Lars, and Wejse, Christian
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Highly active antiretroviral therapy -- Statistics -- Patient outcomes ,HIV infection -- Statistics -- Drug therapy -- Patient outcomes ,Health - Abstract
Introduction: With more people receiving antiretroviral treatment (ART), the need to detect treatment failure and switch to second‐line ART has also increased. We assessed CD4 cell counts (as a marker of treatment failure), determined the rate of switching to second‐line treatment and evaluated mortality related to treatment failure among HIV‐infected patients in Guinea‐Bissau. Methods: In this retrospective cohort study, adult patients infected with HIV‐1 receiving ≥6 months of ART at an HIV clinic in Bissau were included from June 2005 to July 2014 and followed until January 2015. Treatment failure was defined as 1) a fall in CD4 count to baseline (or below) or 2) CD4 levels persistently below 100 cells/µL after ≥6 months of ART. Cox hazard models, with time since six months of ART as the time‐varying coefficient, were used to estimate the hazard ratio for death and loss to follow‐up. Results: We assessed 1,591 HIV‐1‐infected patients for immunological treatment failure. Treatment failure could not be determined in 594 patients (37.3%) because of missing CD4 cell counts. Among the remaining 997 patients, 393 (39.4%) experienced failure. Only 39 patients (9.9%) with failure were switched from first‐ to second‐line ART. The overall switching rate was 3.1 per 100 person‐years. Mortality rate was higher in patients with than without treatment failure, with adjusted hazard rate ratios (HRRs) 10.0 (95% CI: 0.9–107.8), 7.6 (95% CI: 1.6–35.5) and 3.1 (95% CI: 1.5–6.3) in the first, second and following years, respectively. During the first year of follow‐up, patients experiencing treatment failure had a higher risk of being lost to follow‐up than patients not experiencing treatment failure (adjusted HRR 4.4; 95% CI: 1.7–11.8). Conclusions: We found a high rate of treatment failure, an alarmingly high number of patients for whom treatment failure could not be assessed, and a low rate of switching to a second‐line therapy. These factors could lead to an increased risk of resistance development and excess mortality., Introduction With the rapid scale‐up of antiretroviral treatment (ART) availability in sub‐Saharan Africa, the need for appropriate treatment monitoring has also increased [1]. As more people receive ART, more will [...]
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- 2015
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59. Pyogenic brain abscess, a 15 year survey
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Helweg-Larsen Jannik, Astradsson Arnar, Richhall Humeira, Erdal Jesper, Laursen Alex, and Brennum Jannick
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Brain abscess ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Brain abscess is a potentially fatal disease. This study assesses clinical aspects of brain abscess in a large hospital cohort. Methods Retrospective review of adult patients with pyogenic brain abscess at Rigshospitalet University Hospital, Denmark between 1994 and 2009. Prognostic factors associated with Glasgow Outcome Score (GOS) (death, severe disability or vegetative state) were assessed by logistic regression. Results 102 patients were included. On admission, only 20% of patients had a triad of fever, headache and nausea, 39% had no fever, 26% had normal CRP and 49% had no leucocytosis. Median delay from symptom onset to antibiotic treatment was 7 days (range 0–97 days). Source of infection was contiguous in 36%, haematogenous in 28%, surgical or traumatic in 9% and unknown in 27% of cases. Abscess location did not accurately predict the portal of entry. 67% were treated by burr hole aspiration, 20% by craniotomy and 13% by antibiotics alone. Median duration of antibiotic treatment was 62 days. No cases of recurrent abscess were observed. At discharge 23% had GOS ≤3. The 1-, 3- and 12-month mortality was 11%, 17% and 19%. Adverse outcome was associated with a low GCS at admission, presence of comorbidities and intraventricular rupture of abscess. Conclusions The clinical signs of brain abscess are unspecific, many patients presented without clear signs of infection and diagnosis and treatment were often delayed. Decreased GCS, presence of comorbidities and intraventricular rupture of brain abscess were associated with poor outcome. Brain abscess remains associated with considerable morbidity and mortality.
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- 2012
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60. Soluble Macrophage Mannose Receptor (sCD206/sMR) as a Biomarker in HIV-infection
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Andersen, Morten Nørgaard, Hønge, Bo L, Jespersen, Sanne, Medina, Candida, Té, David da Silva, Laursen, Alex, Wejse, Christian, Erikstrup, Christian, Møller, Holger J, and Østergaard, Lars Jørgen
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virus diseases - Abstract
Macrophages play important roles during HIV-infection, reflected by changes in macrophage-activation biomarker sCD163. Here, we present data on the novel macrophage-activation biomarker soluble mannose receptor/CD206 (sMR/sCD206) in HIV-infection.We investigated sCD206 blood levels at baseline and follow-up with/without ART, in 212 patients with HIV-1, HIV-2, or dual infection.At baseline, there was no difference in sCD206 level between HIV-types, and sCD206 was unchanged at follow-up without ART. However, contrary to sCD163, sCD206 levels decreased significantly for both HIV-1 and HIV-2, but not for HIV-1/2 patients, during ART. Further investigations are needed to establish sCD206 as biomarker in HIV-infection.
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- 2018
61. Direct acting antiviral treatment of chronic hepatitis C in Denmark:factors associated with and barriers to treatment initiation
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Sølund, Christina, Hallager, Sofie, Pedersen, Martin S, Fahnøe, Ulrik, Ernst, Anja, Krarup, Henrik B, Røge, Birgit T, Christensen, Peer B, Laursen, Alex L, Gerstoft, Jan, Bélard, Erika, Madsen, Lone G, Schønning, Kristian, Pedersen, Anders G, Bukh, Jens, Weis, Nina, Krarup, Henrik, Hansen, Jesper Bach, and Mygind, Lone
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hepatitis C virus ,Liver Cirrhosis ,Male ,Sustained Virologic Response ,Denmark ,Hepacivirus ,Liver Cirrhosis/epidemiology ,medicine.disease_cause ,Cohort Studies ,Liver disease ,0302 clinical medicine ,Fibrosis ,Risk Factors ,030212 general & internal medicine ,Treatment Failure ,Antiviral Agents/therapeutic use ,biology ,Gastroenterology ,Middle Aged ,factors associated with treatment ,Hepatitis C, Chronic/complications ,HCV ,Practice Guidelines as Topic ,030211 gastroenterology & hepatology ,Female ,liver disease ,Liver cancer ,Direct acting ,treatment initiation ,Cohort study ,Adult ,medicine.medical_specialty ,Hepatitis C virus ,Hepacivirus/genetics ,Antiviral Agents ,Drug Administration Schedule ,liver cancer ,03 medical and health sciences ,Chronic hepatitis ,Direct Acting Antivirals ,Internal medicine ,medicine ,Humans ,DAA ,business.industry ,Hepatitis C, Chronic ,medicine.disease ,biology.organism_classification ,Denmark/epidemiology ,barriers to treatment ,Logistic Models ,Patient Compliance ,business - Abstract
OBJECTIVES: We describe factors associated with and barriers to initiation of Direct Acting Antiviral (DAA) treatment in patients with chronic hepatitis C, who fulfill national fibrosis treatment guidelines in Denmark.MATERIALS AND METHODS: In this nationwide cohort study, we included patients with chronic hepatitis C from The Danish Database for Hepatitis B and C (DANHEP) who fulfilled fibrosis treatment criteria. Factors associated with treatment initiation and treatment failure were determined by logistic regression analyses. Medical records were reviewed from patients who fulfilled fibrosis treatment criteria, but did not initiate DAA treatment to determine the cause.RESULTS: In 344 (49%) of 700 patients, who fulfilled treatment criteria, factors associated with DAA treatment initiation were transmission by other routes than injecting drug use odds ratio (OR) 2.13 (CI: 1.38-3.28), previous treatment failure OR 2.58 (CI: 1.84-3.61) and ALT above upper limit of normal OR 1.60 (CI: 1.18-2.17). The most frequent reasons for not starting treatment among 356 (51%) patients were non-adherence to medical appointments (n = 107/30%) and ongoing substance use (n = 61/17%). Treatment failure with viral relapse occurred in 19 (5.5%) patients, who were more likely to have failed previous treatment OR 4.53 (CI: 1.59-12.91).CONCLUSIONS: In this nationwide cohort study, we found non-adherence to medical appointments and active substance use to be major obstacles for DAA treatment initiation. Our findings highlight the need for interventions that can overcome these barriers and increase the number of patients who can initiate and benefit from curative DAA treatment.
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- 2018
62. The Prevalence of Human Immunodeficiency Virus Coinfection Among Patients Newly Diagnosed With Chronic Hepatitis B or C in Denmark:A Nationwide Cohort Study
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Hallager, Sofie, Lundh, Andreas, Ladelund, Steen, Gerstoft, Jan, Laursen, Alex Lund, Clausen, Mette Rye, Balslev, Ulla, and Weis, Nina
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Nationwide cohort study ,Prevalence ,Chronic viral hepatitis ,HIV - Abstract
Background: Early identification of patients with chronic viral hepatitis coinfected with human immunodeficiency virus (HIV) is essential for optimal care. The objectives of this study were to estimate the prevalence of HIV coinfection among patients newly diagnosed with chronic viral hepatitis, HIV testing prevalence, and identify factors associated with coinfection.Methods: Patients with chronic viral hepatitis newly enrolled in The Danish Database for Hepatitis B and C between 2002 and 2015 were identified. The HIV coinfection prevalence was calculated, and risk factors associated with HIV coinfection were estimated by logistic regression.Results: In total, 8490 patients were included: 3091 had chronic hepatitis B (CHB), 5305 had chronic hepatitis C (CHC), and 94 had CHB and CHC. The prevalence of HIV coinfection was 4.4% (95% confidence interval [CI], 4.0-4.9) and was higher among CHC and CHB-CHC patients than CHB patients with a prevalence of 5.3% (95% CI, 4.7-5.9), 6.4% (95% CI, 2.4-13.4), and 2.9 (95% CI, 2.3-3.5), respectively (P < .0001). The HIV testing prevalence increased from 65% to 88% between 2002 and 2014 concurrently with a decrease in the HIV coinfection prevalence from 7.8% (95% CI, 5.5-10.7) to 1.6% (95% CI, 0.7-3.2). Age 35-50 years, male sex, and sexual route of viral hepatitis transmission were associated with HIV coinfection with odds ratios of 4.42 (95% CI, 1.40-13.94), 2.21 (95% CI, 1.74-2.81), and 8.81 (95% CI, 6.30-12.33), respectively.Conclusions: The prevalence of HIV coinfection among patients with newly diagnosed chronic viral hepatitis decreased concurrently with an increase in HIV testing prevalence.
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- 2018
63. THU-193-4 week treatment for hepatitis C: A randomized controlled trial (4RIBC)
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Madsen, Lone Wulff, primary, Ovrehus, Anne, additional, Gerstoft, Jan, additional, Weis, Nina, additional, Barfod, Toke Seierøe, additional, Laursen, Alex, additional, Krarup, Henrik, additional, Ernst, Anja, additional, and Christensen, Peer Brehm, additional
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- 2019
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64. SAT-240-Metabolic liver function improves 12 weeks after successful sofosbuvir-based direct-acting antiviral therapy in patients with chronic hepatitis C and advanced liver disease
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Laursen, Tea Lund, primary, Siggard, Cecilie Brøckner, additional, Kazankov, Konstantin, additional, Sandahl, Thomas Damgaard, additional, Møller, Holger Jon, additional, Kristensen, Lena Hagelskjær, additional, Tarp, Britta, additional, Laursen, Alex, additional, and Grønbæk, Henning, additional
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- 2019
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65. Evaluation of cardiovascular biomarkers In HIV-infected patients switching to abacavir or tenofovir based therapy
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Langdahl Bente L, Nielsen Ulla S, Frederiksen Christian A, Melchjorsen Jesper, Tolstrup Martin, Rasmussen Thomas A, Østergaard Lars, and Laursen Alex L
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HIV ,abacavir ,tenofovir ,cardiovascular disease ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Our objective was to evaluate and compare the effect of abacavir on levels of biomarkers associated with cardiovascular risk. Methods In an open-label randomized trial, HIV-infected patients were randomized 1:1 to switch from zidovudine/lamivudine to abacavir/lamivudine or tenofovir/emtricitabine. In the present analysis, we measured levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), E-selectin, and myeloperoxidase (MPO) at baseline and 4, 12, and 48 weeks after randomization. D-dimer and fasting lipids were measured at baseline and weeks 12 and 48. Levels of biomarkers at all time points and changes from baseline were compared across study arms using Wilcoxon rank sum test. Results Of 40 included patients, 35 completed 48 weeks of randomized therapy and follow up. Levels of E-selectin (P = 0.004) and sVCAM-1 (P = 0.041) increased transiently from baseline to week 4 in the abacavir arm compared with the tenofovir arm, but no long-term increases were detected. We found no significant differences between study arms in the levels or changes in the levels of sICAM-1, MPO, d-dimer, IL-6, or hs-CRP. Levels of total cholesterol and high density lipoprotein (HDL) increased in the abacavir arm relative to the tenofovir arm, but no difference was found in total cholesterol/HDL ratio. Conclusion In patients randomized to abacavir-based HIV-treatment transient increases were seen in the plasma levels of E-selectin and sVCAM-1 compared with treatment with tenofovir, but no difference between study arms was found in other biomarkers associated with endothelial dysfunction, inflammation, or coagulation. The clinical significance of these findings is uncertain. Trial Regestration Clinicaltrials.gov identifier: NCT00647244.
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- 2011
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66. Effectiveness of treatment with pegylated interferon and ribavirin in an unselected population of patients with chronic hepatitis C: A Danish nationwide cohort study
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Bukh Jens, Møller Axel, Schlichting Poul, Krarup Henrik B, Laursen Alex L, Kjær Mette, Christensen Peer B, Obel Niels, Hansen Nanna, and Weis Nina
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Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The effect of peginterferon and ribavirin treatment on chronic hepatitis C virus (HCV) infection has been established in several controlled clinical studies. However, the effectiveness of treatment and predictors of treatment success in routine clinical practice remains to be established. Our aim was to estimate the effectiveness of peginterferon and ribavirin treatment in unselected HCV patients handled in routine clinical practice. The endpoint was sustained virological response (SVR), determined by the absence of HCV RNA 24 weeks after the end of treatment. Methods We determined the proportion of SVR in a nationwide, population-based cohort of 432 patients with chronic HCV infection who were starting treatment, and analyzed the impact of known covariates on SVR by using a logistic regression analysis. Results The majority of treated patients had genotype 1 (133 patients) and genotype 2/3 (285 patients) infections, with 44% and 72%, respectively, obtaining SVR. Other than genotype, the predictors of SVR were age ≤ 45 years at the start of treatment, completion of unmodified treatment, the absence of cirrhosis and non-European origin. Conclusions The effectiveness of peginterferon and ribavirin treatment for chronic hepatitis C in a routine clinical practice is comparable to that observed in controlled clinical trials, with a higher SVR rate in genotype 2 and 3 patients compared to genotype 1 patients. Our data further indicate that age at start of treatment is a strong predictor of SVR irrespective of HCV genotype, with patients 45 years or younger having a higher SVR rate.
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- 2011
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67. The prevalence of HIV co-infection among patients newly diagnosed with chronic hepatitis B or C in Denmark – a nationwide cohort study
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Hallager, Sofie, primary, Lundh, Andreas, additional, Ladelund, Steen, additional, Gerstoft, Jan, additional, Laursen, Alex Lund, additional, Clausen, Mette Rye, additional, Balslev, Ulla, additional, and Weis, Nina, additional
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- 2018
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68. Viremia in chronic hepatitis C patients evaluated by the Amplicor RT-PCR, a nested RT-PCR, and transaminase levels
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LAURSEN, ALEX L., INGERSLEV, JØRGEN, ANDERSEN, PAUL L., and ØSTERGAARD, LARS
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- 1998
69. Altered balance between collagen formation and degradation after successful direct‐acting antiviral therapy of chronic hepatitis C.
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Laursen, Tea Lund, Villesen, Ida Falk, Leeming, Diana Julie, Karsdal, Morten Asser, Sølund, Christina, Tarp, Britta, Kristensen, Lena Hagelskjær, Holmboe, Charlotte Henneberg, Leutscher, Peter, Laursen, Alex Lund, Gudmann, Natasja Stæhr, and Grønbæk, Henning
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CHRONIC hepatitis C ,HEPATITIS C ,COLLAGEN ,LIVER diseases - Abstract
The effect of direct‐acting antiviral (DAA) therapy on extracellular matrix (ECM) turnover, a prominent feature of chronic hepatitis C (CHC), is unknown. ECM protein degradation and formation generate fragments reflecting the tissue turnover balance when quantified in the blood. PRO‐C3 and PRO‐C4 reflect type III and IV collagen formation; C3M and C4M are degradation markers of type III and IV. We aimed to assess the markers' dynamics with DAA therapy in CHC patients. Plasma PRO‐C3, PRO‐C4, C3M and C4M were assessed before, during and up till one year after 12‐24 weeks of DAA therapy in 77 CHC patients with advanced fibrosis (n = 14) or cirrhosis (n = 63). Liver stiffness was evaluated using transient elastography. PRO‐C3, C3M and C4M levels decreased significantly (P <.00001) while PRO‐C4 was unchanged (P =.20) during the study period. There was a steep decrease in the PRO‐C3/C3M ratio during DAA therapy and follow‐up (P <.02). The PRO‐C4/C4M ratio was unchanged (P >.27). The dynamics of the collagen markers behaved similarly between patients with advanced fibrosis and cirrhosis. However, the cirrhosis patients had >20% higher levels of C3M, PRO‐C4 and C4M at all time points (P <.05). The collagen markers correlated with liver stiffness at baseline and follow‐up.Markers of type III and IV collagen formation and degradation decreased during and after successful DAA therapy in CHC patients with advanced liver disease, and associated with disease severity. These results indicate an altered balance between collagen formation and degradation after viral clearance suggesting favourable effects on liver fibrosis. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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70. Hepatocellular carcinoma in patients with chronic hepatitis C and cirrhosis in Denmark:a nationwide cohort study
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Hallager, Sofie, Ladelund, Steen, Kjaer, Mette S, Madsen, Lone G, Belard, Erika, Laursen, Alex Lund, Gerstoft, Jan, Røge, Birgit T, Grønbaek, Karin E, Krarup, Henrik B, Christensen, Peer B, Weis, Nina, Hallager, Sofie, Ladelund, Steen, Kjaer, Mette S, Madsen, Lone G, Belard, Erika, Laursen, Alex Lund, Gerstoft, Jan, Røge, Birgit T, Grønbaek, Karin E, Krarup, Henrik B, Christensen, Peer B, and Weis, Nina
- Abstract
Cirrhosis in patients with chronic hepatitis C increases the risk of hepatocellular carcinoma (HCC) and surveillance with ultrasound (US) and alpha-fetoprotein (AFP) is recommended. This study aimed to estimate changes in the HCC incidence rate (IR) over time, HCC stage and prognosis, and AFP and US performed in patients with hepatitis C and cirrhosis. Eligible patients were identified in the Danish Database for Hepatitis B and C and data from national health registries and patient charts were obtained. Tumor stage was based on Barcelona-Clinic Liver Cancer stage, TNM classification and size and number of lesions combined into stage 0 - 3. We included 1,075 patients with hepatitis C and cirrhosis, free of HCC and liver transplant at baseline. During 4,988 person years (PY) 115 HCC cases were diagnosed. The HCC incidence rate increased from 0.8/100 PY [CI95% 0.4 - 1.5] in 2002-2003 to 2.9/100 PY [2.4 - 3.4] in 2012-2013. One-year cumulative incidence of at least one AFP or US was 53% among all patients. The positive predictive value of an AFP ≥ 20 ng mL(-1) was 17%. Twenty-three (21%) patients were diagnosed with early stage HCC (stage 0/1) and 84 (79%) with late stage. Median survival after HCC for early stage HCC disease was 30.1 months and 7.4 months for advanced HCC (stage 2/3). The incidence rate of HCC increased over time among patients with hepatitis C and cirrhosis in Denmark. Application of AFP and US was suboptimal and most patients were diagnosed with advanced HCC with a poor prognosis. This article is protected by copyright. All rights reserved.
- Published
- 2018
71. Outcome and adverse events in patients with chronic hepatitis C treated with direct-acting antivirals:A clinical randomized study
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Sølund, Christina, Andersen, Ellen S., Mössner, Belinda, Laursen, Alex L., Røge, Birgit T., Kjær, Mette S., Gerstoft, Jan, Christensen, Peer B., Pedersen, Martin S., Schønning, Kristian, Fahnøe, Ulrik, Bukh, Jens, Weis, Nina, Sølund, Christina, Andersen, Ellen S., Mössner, Belinda, Laursen, Alex L., Røge, Birgit T., Kjær, Mette S., Gerstoft, Jan, Christensen, Peer B., Pedersen, Martin S., Schønning, Kristian, Fahnøe, Ulrik, Bukh, Jens, and Weis, Nina
- Abstract
Objective New potent direct-acting antiviral (DAA) regimens against hepatitis C virus have been approved in recent years. However, information about the rate of adverse events (AEs) across different DAA regimens is limited. We aimed to evaluate differences in AEs and treatment efficacy in patients with chronic hepatitis C (CHC), genotype (GT) 1 or 3, randomized to two different treatment arms, correspondingly. Patients and methods We randomly assigned 96 patients in a 1: 1 ratio, to treatment for 12 weeks with either paritaprevir/ombitasvir/ritonavir/dasabuvir/ribavirin (RBV) or ledipasvir/sofosbuvir (SOF)/RBV if infected with GT1 (72 patients) or to daclatasvir/SOF/RBV for 12 weeks or SOF/RBV for 24 weeks, if infected with GT3 (24 patients). Data on AEs were collected throughout the entire study period. Results A total of 70 (97%) patients with CHC with GT1 and 20 (83%) patients with GT3 achieved cure. The GT3 treatment arm was prematurely terminated, owing to change in national treatment guidelines. Thus, only AEs for GT1 patients are described. AEs occurred in 70 (97%) GT1 patients, and most common AEs were anemia (n=56/78%), fatigue (n=53/74%), and headache (n=33/46%). No difference was observed in relation to treatment group (P=1.0), anemia (P=1.0), or liver cirrhosis (P=0.53). In seven (11%) patients, AEs assessed by the investigator to be possibly related to the DAA regimen were still present 12 weeks after treatment. Conclusions We found no difference in AEs possibly related to the DAA regimen in patients with CHC, but surprisingly, AEs possibly related to the DAA regimen persisted in a significant number of patients after treatment. This finding can be of importance for clinicians in relation to patient information concerning AEs possibly related to DAA treatment.
- Published
- 2018
72. Grazoprevir, Ruzasvir, and Uprifosbuvir for HCV After NS5A Treatment Failure
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Wyles, David, Wedemeyer, Heiner, Ben-Ari, Ziv, Gane, Edward J, Hansen, Jesper Bach, Jacobson, Ira M, Laursen, Alex Lund, Luetkemeyer, Annie, Nahass, Ronald, Pianko, Stephen, Zeuzem, Stefan, Jumes, Patricia, Huang, Hsueh-Cheng, Butterton, Joan, Robertson, Michael, Wahl, Janice, Barr, Eliav, Joeng, Hee-Koung, Martin, Elizabeth, and Serfaty, Lawrence
- Subjects
Journal Article ,virus diseases ,digestive system diseases - Abstract
People with hepatitis C virus (HCV) infection who have failed treatment with an all-oral regimen represent a challenging treatment population. The present studies evaluated the safety and efficacy of grazoprevir, ruzasvir, and uprifosbuvir, with or without ribavirin, in participants who had failed an NS5A inhibitor-containing regimen. C-SURGE (PN-3682-021) and C-CREST Part C (PN-3682-011 and -012) were open-label, multicenter studies. Participants who had previously relapsed following an NS5A inhibitor-containing all-oral regimen were retreated with grazoprevir 100 mg, ruzasvir 60 mg, and uprifosbuvir 450 mg alone for 24 weeks or with ribavirin for 16 weeks. The primary efficacy endpoint was undetectable HCV RNA (CONCLUSION: Grazoprevir, ruzasvir, and uprifosbuvir, with or without ribavirin, for 16 or 24 weeks was safe and highly effective in participants with HCV infection who had previously failed NS5A inhibitor-containing therapy. This article is protected by copyright. All rights reserved.
- Published
- 2017
73. Does contrast enhancement predict survival in progressive multifocal leukoencephalopathy?
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Focosi, Daniele, Engsig, Frederik Neess, Hansen, Ann-Brit Eg, Omland, Lars Haukali, Kronborg, Gitte, Gerstoft, Jan, Laursen, Alex Lund, Pedersen, Court, Mogensen, Christian Backer, Nielsen, Lars, and Obel, Niels
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Leukoencephalopathy -- Development and progression ,Leukoencephalopathy -- Patient outcomes ,Leukoencephalopathy -- Diagnosis ,Leukoencephalopathy -- Care and treatment ,Highly active antiretroviral therapy -- Usage ,Highly active antiretroviral therapy -- Health aspects ,Magnetic resonance imaging -- Usage ,Health - Published
- 2009
74. Hepatitis B and C in the adult population of Bissau, Guinea-Bissau: a cross-sectional survey.
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Hønge, Bo Langhoff, Olesen, Jens Steen, Jensen, Mads Mose, Jespersen, Sanne, Silva, Zacarias José, Rodrigues, Amabélia, Laursen, Alex Lund, Wejse, Christian, Krarup, Henrik, Aaby, Peter, Erikstrup, Christian, and da Silva, Zacarias José
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HEPATITIS B ,HEPATITIS C virus ,HEPATITIS B virus ,BLOOD transfusion ,DEMOGRAPHIC surveys - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2020
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75. Time‐dependent improvement of liver inflammation, fibrosis and metabolic liver function after successful direct‐acting antiviral therapy of chronic hepatitis C.
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Laursen, Tea Lund, Siggaard, Cecilie Brøckner, Kazankov, Konstantin, Sandahl, Thomas Damgaard, Møller, Holger Jon, Tarp, Britta, Kristensen, Lena Hagelskjær, Laursen, Alex Lund, Leutscher, Peter, and Grønbæk, Henning
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CHRONIC hepatitis C ,HEPATITIS ,HEPATITIS C ,CHRONIC hepatitis B ,FIBROSIS ,LIVER ,LIVER diseases - Abstract
Sofosbuvir‐based direct‐acting antiviral (DAA) therapy generally cures chronic hepatitis C (CHC) infections, however, the effects on the underlying liver disease and the potential rate of recovery are unclear. We aimed to investigate the effects of DAA therapy on liver inflammation, fibrosis, metabolic function and cognitive function and the time course in CHC patients with advanced liver disease. Seventy‐one CHC patients with advanced liver disease were studied before, during and one year after successful sofosbuvir‐based DAA therapy. Liver inflammation was assessed by plasma sCD163 and sMR levels (ELISA), fibrosis by liver stiffness (transient elastography), function by galactose elimination capacity (GEC) and cognitive performance by continuous reaction time (CRT). During DAA therapy, we observed a rapid sCD163 decline from baseline to end of treatment (6.9 vs 3.8 mg/L, P <.0001), whereas the change in sMR was more subtle (0.37 vs 0.30 mg/L, P <.0001). Liver stiffness decreased by 20% at end of treatment (17.8 vs 14.3 kPa, P <.0001), together suggesting rapid resolution of liver inflammation. One year after treatment, liver stiffness decreased by an additional 15% (P <.0001), suggestive of fibrosis regression. The GEC improved at follow‐up (all: 1.74 vs 1.98 mmol/min), mainly at 12 weeks post‐treatment, both in patients with cirrhosis (n = 56) and those with advanced liver fibrosis (n = 15) (P <.001). The CRT improved at one‐year follow‐up (1.86 vs 2.09, P =.04). In conclusion, successful DAA therapy of CHC proves beneficial in advanced liver disease, with an initial rapid resolution of liver inflammation and a subsequent gradual but steady improvement in liver fibrosis, metabolic liver function and reaction time. [ABSTRACT FROM AUTHOR]
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- 2020
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76. Rapid and persistent decline in soluble CD163 with successful direct-acting antiviral therapy and associations with chronic hepatitis C histology
- Author
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Lund Laursen, Tea, primary, Brøckner Siggard, Cecilie, additional, Kazankov, Konstantin, additional, Damgaard Sandahl, Thomas, additional, Møller, Holger Jon, additional, Ong, Adrian, additional, Douglas, Mark W., additional, George, Jacob, additional, Tarp, Britta, additional, Hagelskjaer Kristensen, Lena, additional, Lund Laursen, Alex, additional, Hiramatsu, Akira, additional, Nakahara, Takashi, additional, Chayama, Kazuaki, additional, and Grønbaek, Henning, additional
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- 2018
- Full Text
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77. Doravirine versus ritonavir-boosted darunavir in antiretroviral-naive adults with HIV-1 (DRIVE-FORWARD): 48-week results of a randomised, double-blind, phase 3, non-inferiority trial
- Author
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Molina, Jean-Michel, primary, Squires, Kathleen, additional, Sax, Paul E, additional, Cahn, Pedro, additional, Lombaard, Johan, additional, DeJesus, Edwin, additional, Lai, Ming-Tain, additional, Xu, Xia, additional, Rodgers, Anthony, additional, Lupinacci, Lisa, additional, Kumar, Sushma, additional, Sklar, Peter, additional, Nguyen, Bach-Yen, additional, Hanna, George J, additional, Hwang, Carey, additional, Martins, Marcelo, additional, Cahn, Pedro Enrique, additional, Lopardo, Gustavo D., additional, Porteiro, Norma, additional, Bloch, Mark Theo, additional, Baker, David Alfred, additional, Roth, Norman, additional, Moore, Richard James, additional, Finlayson, Robert James, additional, McMahon, James, additional, Rieger, Armin, additional, Zoufaly, Alexander, additional, Hartl, Sylvia, additional, Zangerle, Robert, additional, Smaill, Fiona, additional, Walmsley, Sharon L., additional, Conway, Brian, additional, Rachlis, Anita, additional, Smith, Graham H.R., additional, Perez, Carlos, additional, Afani, Alejandro, additional, Campos Barker, Maria Isabel E., additional, Chahin, Carolina Eugenia, additional, Wolff Reyes, Marcelo, additional, Gerstoft, Jan, additional, Weis, Nina, additional, Laursen, Alex Lund, additional, Molina, Jean-Michel, additional, Yazdanpanah, Yazdan, additional, Cotte, Laurent, additional, Raffi, Francois, additional, Morlat, Philippe, additional, Girard, Pierre-Marie, additional, Katlama, Christine, additional, Rockstroh, Juergen K., additional, Arasteh, Keikawus, additional, Esser, Stefan, additional, Stoehr, Albrecht, additional, Stellbrink, Hans-Juergen, additional, Stoll, Matthias, additional, Schuermann, Dirk, additional, Faetkenheuer, Gerd, additional, Bogner, Johannes, additional, Lutz, Thomas, additional, Baumgarten, Axel, additional, Jaeger, Hans, additional, Gori, Andrea, additional, Coltan, Gabriel, additional, Constandis, Felicia, additional, Erscoiu, Simona Manuela, additional, Prisacariu, Liviu-Jany, additional, Rugina, Sorin, additional, Streinu-Cercel, Adrian, additional, Pokrovsky, Vadim Valentinovich, additional, Zakharova, Natalia V., additional, Shuldyakov, Andrey Anatolyevich, additional, Ryamova, Elena Pavlovna, additional, Kulagin, Valeriy Viktorovich, additional, Tsybakova, Olga Aleksandrovna, additional, Orlova-Morozova, Elena, additional, Nagimova, Firaya, additional, Voronin, Evgeniy, additional, Shimonova, Tatyana Evgenyevna, additional, Kozyrev, Oleg Anatolyevich, additional, Orrell, Catherine, additional, Lombaard, Johannes Jurgens, additional, Botes, Margaretha Elizabeth, additional, Portilla, Joaquin, additional, Gatell, Josep Maria, additional, Perez, Maria Jesus, additional, Arribas, Jose Ramon, additional, Negredo, Eugenia, additional, Podzamczer, Daniel, additional, Pulido, Federico, additional, Troya, Jesus, additional, De los Santos, Ignacio, additional, Berenguer, Juan, additional, Williams, Ian G., additional, Johnson, Margaret A., additional, Schembri, Gabriel, additional, Clarke, Amanda, additional, Gompels, Mark, additional, Fox, Julie Meriel, additional, Taylor, Steven John, additional, Kegg, Stephen, additional, Hagins, Debbie P., additional, Osiyemi, Olayemi O., additional, Prelutsky, David James, additional, Ramgopal, Moti N., additional, Dretler, Robin, additional, Sloan, Louis, additional, Lewis, Stanley T., additional, Clay, Patrick G., additional, Bellos, Nicholaos C., additional, Thompson, Melanie A., additional, Montero, Jose, additional, McDonald, Cheryl K., additional, Creticos, Catherine, additional, Shamblaw, David, additional, Terrelonge, Antonio E., additional, Valdes, Martin, additional, Tashima, Karen T., additional, Robbins, William J., additional, Felizarta, Franco Antonio, additional, Elion, Richard A., additional, Slim, Jihad, additional, Lalezari, Jacob Paul, additional, Lalla-Reddy, Sujata N., additional, Ruane, Peter Jerome, additional, Mills, Anthony, additional, Cade, Jerry L., additional, Campo, Rafael E., additional, Dietz, Craig A., additional, Blick, Gary, additional, Mayer, Cynthia, additional, Rondon, Juan Carlos, additional, Cook, Paul P., additional, Daar, Eric, additional, Kumar, Princy N., additional, Swindells, Susan, additional, Castro, Jose Guillermo, additional, Morales-Ramirez, Javier O., additional, Santiago, Lizette, additional, and Santana-Bagur, Jorge L., additional
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- 2018
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78. Increased mortality among HIV infected patients with cryptococcal antigenemia in Guinea-Bissau
- Author
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Thomsen, Ditte, primary, Hviid, Cecilie Juul, additional, H�nge, Bo Langhoff, additional, Medina, Candida, additional, da Silva Té, David, additional, Correira, Faustino Gomes, additional, Østergaard, Lars, additional, Erikstrup, Christian, additional, Wejse, Christian, additional, Laursen, Alex Lund, additional, and Jespersen, Sanne, additional
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- 2018
- Full Text
- View/download PDF
79. Decreased Activation of the Respiratory Burst in Neutrophils from AIDS Patients with Previous Pneumocystis carinii Pneumonia
- Author
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Laursen, Alex L., Rungby, Jørgen, and Andersen, Paul L.
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- 1995
80. Phagocytosis and Stimulation of the Respiratory Burst in Neutrophils by Pneumocystis carinii
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Laursen, Alex L., Obel, Niels, Rungby, Jergen, and Andersen, Paul L.
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- 1993
81. Sofosbuvir based treatment of chronic hepatitis C genotype 3 infections-A Scandinavian real-life study
- Author
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Dalgard, Olav, Weiland, Ola, Noraberg, Geir, Karlsen, Lars, Heggelund, Lars, Färkkilâ, Martti, Balslev, Ulla, Belard, Erika, Øvrehus, Anne, Skalshøi Kjær, Mette, Krarup, Henrik, Thorup Røge, Birgit, Hallager, Sofie, Madsen, Lone G, Lund Laursen, Alex, Lagging, Martin, Weis, Nina, Dalgard, Olav, Weiland, Ola, Noraberg, Geir, Karlsen, Lars, Heggelund, Lars, Färkkilâ, Martti, Balslev, Ulla, Belard, Erika, Øvrehus, Anne, Skalshøi Kjær, Mette, Krarup, Henrik, Thorup Røge, Birgit, Hallager, Sofie, Madsen, Lone G, Lund Laursen, Alex, Lagging, Martin, and Weis, Nina
- Abstract
BACKGROUND AND AIMS: Chronic hepatitis C virus (HCV) genotype 3 infection with advanced liver disease has emerged as the most challenging to treat. We retrospectively assessed the treatment outcome of sofosbuvir (SOF) based regimes for treatment of HCV genotype 3 infections in a real life setting in Scandinavia.METHODS: Consecutive patients with chronic HCV genotype 3 infection were enrolled at 16 treatment centers in Denmark, Sweden, Norway and Finland. Patients who had received a SOF containing regimen were included. The fibrosis stage was evaluated by liver biopsy or transient liver elastography. The following treatments were given according availability and local guidelines: 1) SOF + ribavirin (RBV) for 24 weeks, 2) SOF + daclatasvir (DCV) +/-RBV for 12-24 weeks, 3) SOF + pegylated interferon alpha (peg-IFN-α) + RBV for 12 weeks or 4) SOF/ledipasvir (LDV) + RBV for 12-16 weeks. The primary endpoint was sustained virological response (SVR) assessed at week 12 (SVR12) after end of treatment.RESULTS: We included 316 patients with a mean age of 55 years (range 24-79), 70% men, 49% treatment experienced, 58% with compensated cirrhosis and 12% with decompensated cirrhosis.In the modified intention to treat (mITT) population SVR12 was achieved in 284/311 (91%) patients. Among 26 treatment failures, five had non-response, 3 breakthrough and 18 relapse. Five patients were not included in the mITT population. Three patients died from reasons unrelated to treatment and two were lost to follow-up. The SVR12 rate was similar for all treatment regimens, but lower in men (p = 0.042), and in patients with decompensated liver disease (p = 0.004).CONCLUSION: We found that sofosbuvir based treatment in a real-life setting could offer SVR rates exceeding 90% in patients with HCV genotype 3 infection and advanced liver disease.
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- 2017
82. Safety and efficacy of an 8-week regimen of grazoprevir plus ruzasvir plus uprifosbuvir compared with grazoprevir plus elbasvir plus uprifosbuvir in participants without cirrhosis infected with hepatitis C virus genotypes 1, 2, or 3 (C-CREST-1 and C-CREST-2, part A):two randomised, phase 2, open-label trials
- Author
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Gane, Edward J., Pianko, Stephen, Roberts, Stuart K., Thompson, Alexander J., Zeuzem, Stefan, Zuckerman, Eli, Ben-Ari, Ziv, Foster, Graham R., Agarwal, Kosh, Laursen, Alex L., Gerstoft, Jan, Gao, Wei, Huang, Hsueh Cheng, Fitzgerald, Brian, Fernsler, Doreen, Li, Jerry J., Grandhi, Anjana, Liu, Hong, Su, Feng Hsiu, Wan, Shuyan, Zeng, Zhen, Chen, Huei Ling, Dutko, Frank J., Nguyen, Bach Yen T., Wahl, Janice, Robertson, Michael N., Barr, Eliav, Yeh, Wendy W., Plank, Rebeca M., Butterton, Joan R., Esteban, Rafael, Gane, Edward J., Pianko, Stephen, Roberts, Stuart K., Thompson, Alexander J., Zeuzem, Stefan, Zuckerman, Eli, Ben-Ari, Ziv, Foster, Graham R., Agarwal, Kosh, Laursen, Alex L., Gerstoft, Jan, Gao, Wei, Huang, Hsueh Cheng, Fitzgerald, Brian, Fernsler, Doreen, Li, Jerry J., Grandhi, Anjana, Liu, Hong, Su, Feng Hsiu, Wan, Shuyan, Zeng, Zhen, Chen, Huei Ling, Dutko, Frank J., Nguyen, Bach Yen T., Wahl, Janice, Robertson, Michael N., Barr, Eliav, Yeh, Wendy W., Plank, Rebeca M., Butterton, Joan R., and Esteban, Rafael
- Abstract
Background New hepatitis C virus (HCV) therapies with pan-genotypic efficacy are needed. The goals of part A of C-CREST-1 and C-CREST-2 were to compare the efficacies of two doses (300 mg or 450 mg once daily) of uprifosbuvir (MK-3682; NS5B inhibitor) in an 8-week regimen combined with grazoprevir (NS3/4A inhibitor; 100 mg once daily) and an NS5A inhibitor, either elbasvir (50 mg once daily) or ruzasvir (MK-8408; 60 mg once daily), and to evaluate the safety and tolerability of these combination regimens in individuals infected with genotypes 1, 2, or 3. Methods Part A of these phase 2, randomised, multicentre, open-label, clinical trials enrolled participants from 11 countries, aged 18 years or older, chronically infected with HCV genotypes 1, 2, or 3, with HCV RNA of at least 10 000 IU/mL, without evidence of cirrhosis, who had not received previous treatment for HCV infection. Within each HCV genotype, participants were randomly assigned (1:1:1:1) with a block size of 4, to open-label treatment to one of four treatment groups: grazoprevir (100 mg/day) plus ruzasvir (60 mg/day) plus uprifosbuvir (300 mg/day); grazoprevir (100 mg/day) plus ruzasvir (60 mg/day) plus uprifosbuvir (450 mg/day); grazoprevir (100 mg/day) plus elbasvir (50 mg/day) plus uprifosbuvir (300 mg/day); or grazoprevir (100 mg/day) plus elbasvir (50 mg/day) plus uprifosbuvir (450 mg/day), according to a computer-generated allocation schedule. Randomisation was centrally implemented using an interactive voice response system and integrated web response system. The primary endpoint was the proportion of participants achieving sustained virological response at 12 weeks (SVR12; HCV RNA less than the lower limit of quantitation at 12 weeks after the end of all study therapy) in the per-protocol analysis set, which included all participants who were randomised and received at least one dose of study drug. The trials are registered with ClinicalTrials.gov, numbers NCT02332707 and NCT02332720. Finding
- Published
- 2017
83. Detection of Pneumocystis jirovecii in oral wash from immunosuppressed patients as a diagnostic tool
- Author
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Hviid, Cecilie Juul, Ellermann-Eriksen, Svend, Jespersen, Bente, Dam, Mette Yde, Dahlerup, Jens Frederik, Benfield, Thomas, Jespersen, Sanne, Østergaard, Lars Jørgen, Laursen, Alex Lund, Hviid, Cecilie Juul, Ellermann-Eriksen, Svend, Jespersen, Bente, Dam, Mette Yde, Dahlerup, Jens Frederik, Benfield, Thomas, Jespersen, Sanne, Østergaard, Lars Jørgen, and Laursen, Alex Lund
- Abstract
BACKGROUND: Diagnosis of Pneumocystis jirovecii (PJ) pneumonia ordinarily requires invasive procedures that could be avoided by PCR methodologies, if these could be designed with adequate cut-off values for confounding background carriage.METHODS: We designed a novel quantitative real-time PCR assay to detect the mitochondrial large subunit rRNA gene of PJ in oral washes. To benchmark levels of PJ carriage versus infection, we tested asymptomatic immunosuppressed patients including Danish (n = 88) and West African HIV-infected (n = 142) patients, renal transplant recipients (n = 51), rheumatologic patients (n = 102), patients with inflammatory bowel diseases (n = 98), and healthy blood donors (controls, n = 50). The fungal burden in patients with PJ pneumonia (PCP, n = 7) was also investigated.RESULTS: Danish HIV-infected patients (with viremia/low CD4) and recent transplant recipients were at most risk of being carriers (prevalence of 23% and 16.7% respectively), whereas PJ was rarely detected among rheumatologic patients, patients with inflammatory bowel diseases, and untreated West African HIV patients. PJ was not detected among healthy controls. The fungal burden in patients with PCP fell rapidly on treatment.CONCLUSIONS: The quantitative PCR method described could conceivably discriminate between carriage and disease, given suitable threshold values for the former, and predict treatment efficacy by measures of the fungal burden in daily oral washes.
- Published
- 2017
84. Mortality Rates in Patients With Chronic Hepatitis C and Cirrhosis Compared With the General Population:A Danish Cohort Study
- Author
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Hallager, Sofie, Brehm Christensen, Peer, Ladelund, Steen, Clausen, Mette Rye, Lund Laursen, Alex, Møller, Axel, Schlicthting, Poul, Galmstrup Madsen, Lone, Gerstoft, Jan, Lunding, Suzanne, Grønbæk, Karin Elmegård, Bygum Krarup, Henrik, Weis, Nina, Hallager, Sofie, Brehm Christensen, Peer, Ladelund, Steen, Clausen, Mette Rye, Lund Laursen, Alex, Møller, Axel, Schlicthting, Poul, Galmstrup Madsen, Lone, Gerstoft, Jan, Lunding, Suzanne, Grønbæk, Karin Elmegård, Bygum Krarup, Henrik, and Weis, Nina
- Abstract
Background: Knowledge about mortality rates (MRs) in patients with chronic hepatitis C (CHC) with cirrhosis is limited. This study aimed to estimate all-cause MRs among patients with CHC with or without cirrhosis in Denmark compared with the general population.Methods: Patients registered in the Danish Database for Hepatitis B and C with CHC and a liver fibrosis assessment were eligible for inclusion. Liver fibrosis was assessed by means of liver biopsy, transient elastography, and clinical cirrhosis. Up to 20 sex- and age-matched individuals per patient were identified in the general population. Data were extracted from nationwide registries.Results: A total of 3410 patients with CHC (1014 with cirrhosis), and 67 315 matched individuals were included. Adjusted MR ratios (MRRs) between patients with or without cirrhosis and their comparison cohorts were 5.64 (95% confidence interval [CI], 4.76-6.67) and 1.94 (1.55-2.42), respectively. Cirrhosis among patients was associated with an MRR of 4.03 (95% CI, 3.43-4.72). A cure for CHC was associated with an MRR of 0.64 (95% CI, 0.40-1.01) among cirrhotic patients and 2.33 (1.47-3.67) compared with the general population.Conclusions: MRs were high among patients with CHC with or without cirrhosis compared with the general population. Curing CHC was associated with a reduction in MR among cirrhotic patients, but the MR remained higher than the general population.
- Published
- 2017
85. Brain abscess with an unexpected finding: Actinomyces meyeri CNS infection
- Author
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Eiset, Andreas Halgreen, Thomsen, Marianne Kragh, Wejse, Christian, and Laursen, Alex Lund
- Subjects
CNS abcess ,Actinomyces meyeri ,Case Reports ,CNS infection - Abstract
Background:CNS infection caused by Actinomyces spp. is rare and the subtype Actinomyces meyeri even rarer. Risk factors include periodontal disease and alcohol overuse. We present a case report of a 54-year-old female with dental and lung foci. Case history:A female was hospitalised with tonic-clonic convulsions. She reported a week of headaches, dizziness, fever, respiratory chest pain, and productive cough, following six months of night sweats and an unintended weight loss of 7-8 kg. She appeared dyspnoeic, and fatigued, with a temperature of 37.7°C, leucocytosis, thrombocytosis, and CRP at 68. Lobar pneumonia was suspected and penicillin treatment initiated. Chest x-ray showed a pulmonary nodule; CT-scan of chest and abdomen without tumour-suspicion showed bilateral basal atelectasis. Tonic-clonic seizures were observed. CT-cerebrum revealed a tumour in the left frontotemporal region with surrounding oedema. By MRI an abscess was suspected and the patient was transferred to the department of neurosurgery, where drainage was performed. Microscopy revealed gram-positive cocci and gram-negative rods and iv. treatment with ceftriaxone 4g x 1 and metronidazole 1g x 1 was commenced. Pus cultures showed Prevotella spp. and A. meyeri and the initial treatment was changed to penicillin G 5 MIU x 4 and metronidazole 500 mg x 3 for four weeks followed by oral amoxicillin 500 mg x 3 for three months. The abscess regressed on this treatment and there were no CNS related symptoms at three months follow-up. The source of infection was most likely periodontitis with spread to the lungs from aspiration or oropharyngeal secretion into the respiratory tract, alternatively from haematogenous spread. Conclusions:We report of the successful treatment of a cerebral abscess caused by A. meyeri with narrow spectrum antibiotics. The optimal treatment of A. meyeri CNS infection has not yet been established – case reports are important in reaching this goal.
- Published
- 2016
86. Sofosbuvir based treatment of chronic hepatitis C genotype 3 infections—A Scandinavian real-life study
- Author
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Dalgard, Olav, primary, Weiland, Ola, additional, Noraberg, Geir, additional, Karlsen, Lars, additional, Heggelund, Lars, additional, Färkkilâ, Martti, additional, Balslev, Ulla, additional, Belard, Erika, additional, Øvrehus, Anne, additional, Skalshøi Kjær, Mette, additional, Krarup, Henrik, additional, Thorup Røge, Birgit, additional, Hallager, Sofie, additional, Madsen, Lone G., additional, Lund Laursen, Alex, additional, Lagging, Martin, additional, and Weis, Nina, additional
- Published
- 2017
- Full Text
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87. Mortality in patients with Chronic Hepatitis C and cirrhosis compared to the general population – a Danish cohort study
- Author
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Hallager, Sofie, primary, Brehm Christensen, Peer, additional, Ladelund, Steen, additional, Rye Clausen, Mette, additional, Lund Laursen, Alex, additional, Møller, Axel, additional, Schlicthting, Poul, additional, Galmstrup Madsen, Lone, additional, Gerstoft, Jan, additional, Lunding, Suzanne, additional, Elmegaard Grønbæk, Karin, additional, Bygum Krarup, Henrik, additional, and Weis, Nina, additional
- Published
- 2016
- Full Text
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88. Interobserver variation of the rapid test SD Bioline HIV-1/2 3.0 for HIV type discrimination:experiences from Guinea-Bissau
- Author
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Hønge, Bo Langhoff, Jespersen, Sanne, Obinah, Magnus Petur Bjarnason, Medina, Candida, Té, David da Silva, da Silva, Zacarias José, Østergaard, Lars, Laursen, Alex Lund, Erikstrup, Christian, and Wejse, Christian
- Published
- 2015
89. Soluble Macrophage Mannose Receptor (sCD206/sMR) as a Biomarker in Human Immunodeficiency Virus Infection.
- Author
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Andersen, Morten N, Hønge, Bo L, Jespersen, Sanne, Medina, Candida, Té, David da Silva, Laursen, Alex, Wejse, Christian, Erikstrup, Christian, Møller, Holger J, Group, Bissau HIV Cohort Study, da Silva Té, David, and Bissau HIV Cohort Study Group
- Subjects
HIV infections ,ANTIRETROVIRAL agents ,HIV-positive persons ,MACROPHAGES ,T cells - Abstract
Macrophages play important roles during human immunodeficiency virus (HIV) infection, reflected by changes in macrophage-activation biomarker soluble CD163 (sCD163). Here, we present data on the novel macrophage-activation biomarker soluble mannose receptor/CD206 (sCD206) in HIV infection. We investigated sCD206 blood levels at baseline and follow-up with/without antiretroviral therapy (ART), in 212 patients with HIV type 1 (HIV-1), HIV type 2 (HIV-2), or dual infection. At baseline, there was no difference in sCD206 level between HIV types, and sCD206 was unchanged at follow-up without ART. However, in contrast to sCD163, sCD206 levels decreased significantly for both HIV-1 and HIV-2, but not for HIV-1/2 patients, during ART. Further investigations are needed to establish sCD206 as a biomarker in HIV infection. [ABSTRACT FROM AUTHOR]
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- 2018
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90. Liver-related morbidity and mortality in patients with Chronic Hepatitis C and cirrhosis with and without sustained virologic response
- Author
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Hallager, Sofie, Ladelund, Steen, Christensen, Peer B., Clausen, Mette, Laursen, Alex L., Moller, Axel, Schlicthting, Poul, Madsen, Lone Galmstrup, Gerstoft, Jan, Lunding, Suzanne, Grønbæk, Karin Elmegård, Krarup, Henrik, Weis, Nina, Hallager, Sofie, Ladelund, Steen, Christensen, Peer B., Clausen, Mette, Laursen, Alex L., Moller, Axel, Schlicthting, Poul, Madsen, Lone Galmstrup, Gerstoft, Jan, Lunding, Suzanne, Grønbæk, Karin Elmegård, Krarup, Henrik, and Weis, Nina
- Published
- 2016
91. Hepatitis B and Delta Virus Are Prevalent but Often Subclinical Co-Infections among HIV Infected Patients in Guinea-Bissau, West Africa: A Cross-Sectional Study
- Author
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Hønge, Bo Langhoff, Jespersen, Sanne, Medina, Candida, Té, David da Silva, da Silva, Zacarias José, Lewin, Sharon, Østergaard, Lars, Erikstrup, Christian, Wejse, Christian, Laursen, Alex Lund, Krarup, Henrik, and Sodemann, Morten
- Subjects
Male ,Viral Diseases ,Gastroenterology and hepatology ,viruses ,lcsh:Medicine ,HIV Infections ,medicine.disease_cause ,Hepatitis ,Liver disease ,Immunodeficiency Viruses ,Risk Factors ,Hepatitis Delta ,Prevalence ,Guinea-Bissau ,lcsh:Science ,Multidisciplinary ,Coinfection ,virus diseases ,Hepatitis B ,Middle Aged ,Hepatitis D ,Infectious hepatitis ,Infectious Diseases ,Medical Microbiology ,Viral Pathogens ,Female ,Hepatitis Delta Virus ,Research Article ,Adult ,Hepatitis B virus ,Microbiology ,Virus ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Humans ,Microbial Pathogens ,Liver diseases ,Medicine and health sciences ,Hepatitis B Surface Antigens ,business.industry ,lcsh:R ,Correction ,Biology and Life Sciences ,HIV ,medicine.disease ,Virology ,digestive system diseases ,Cross-Sectional Studies ,Immunology ,Mutation ,lcsh:Q ,business - Abstract
The members of the Bissau HIV cohort study group are: Amabelia Rodrigues, David da Silva, Zacarias da Silva, Candida Medina, Ines Oliviera-Souto, Lars ∅stergaard, Alex Laursen, Morten Sodemann, Peter Aaby, Anders Fomsgaard, Christian Erikstrup, Jesper Eugen-Olsen and Christian Wejse (chair). Background: Co-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) may lead to accelerated hepatic disease progression with higher rates of liver cirrhosis and liver-related mortality compared with HBV mono-infection. Co or super-infection with hepatitis Delta virus (HDV) may worsen the liver disease and complicate treatment possibilities. Methods: In this cross-sectional study we included HIV-infected individuals who had a routine blood analysis performed at an HIV clinic in Bissau, Guinea-Bissau between the 28th of April and 30th of September 2011. All patients were interviewed, had a clinical exam performed and had a blood sample stored. The patients' samples were tested for HBV and HDV serology, and HBV/HDV viral loads were analyzed using in-house real-time PCR methods. Results: In total, 576 patients (417 HIV-1, 104 HIV-2 and 55 HIV-1/2) were included in this study. Ninety-four (16.3%) patients were HBsAg positive of whom 16 (17.0%) were HBeAg positive. In multivariable logistic regression analysis, CD4 cell count
- Published
- 2014
92. In Process Citation
- Author
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Laursen, Alex Lund
- Published
- 2014
93. Performance of 3 rapid tests for discrimination between HIV-1 and HIV-2 in Guinea-Bissau, West Africa
- Author
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Hønge, Bo Langhoff, Bjarnason Obinah, Magnús Pétur, Jespersen, Sanne, Medina, Candida, Té, David da Silva, da Silva, Zacarias José, Østergaard, Lars, Laursen, Alex Lund, Wejse, Christian, Erikstrup, Christian, and Sodemann, Morten
- Subjects
Adult ,Male ,medicine.medical_specialty ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Sensitivity and Specificity ,West africa ,Internal medicine ,medicine ,Antiretroviral treatment ,Humans ,Pharmacology (medical) ,Guinea-Bissau ,business.industry ,Coinfection ,AIDS serodiagnosis ,AIDS Serodiagnosis ,virus diseases ,Gold standard (test) ,Middle Aged ,medicine.disease ,CD4 Lymphocyte Count ,Infectious Diseases ,Guinea bissau ,HIV-2 ,HIV-1 ,Female ,business - Abstract
As HIV-2 is intrinsically resistant to nonnucleoside reverse transcriptase inhibitors, it is mandatory to discriminate between HIV types before initiating antiretroviral treatment. Guinea-Bissau has the world's highest prevalence of HIV-2 and HIV-1/HIV-2 dually infected individuals. We evaluated 3 rapid tests for discrimination between HIV-1, HIV-2, and dual infections among 219 patients from Guinea-Bissau by comparing with the gold standard (INNO-LIA). Genie III HIV-1/HIV-2 was the best performer with regard to discriminatory capacity (agreement 91.8%), followed by Immunoflow HIV1-HIV2 (agreement 90.9%) and SD Bioline HIV-1/2 3.0 (agreement 84.5%). Our results underscore the need for evaluation of tests in relevant populations before implementation.
- Published
- 2014
94. Clinical presentation and opportunistic infections in HIV-1, HIV-2 and HIV-1/2 dual seropositive patients in Guinea-Bissau
- Author
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Sørensen, Allan, primary, Jespersen, Sanne, additional, Katzenstein, Terese L, additional, Medina, Candida, additional, Té, David da Silva, additional, Correira, Faustino Gomes, additional, Hviid, Cecilie Juul, additional, Laursen, Alex Lund, additional, and Wejse, Christian, additional
- Published
- 2016
- Full Text
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95. High prevalence and excess mortality of late presenters among HIV-1, HIV-2 and HIV-1/2 dually infected patients in Guinea-Bissau - a cohort study from West Africa
- Author
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Honge, Bo Langhoff, primary, Jespersen, Sanne, additional, Aunsborg, Johanna, additional, Mendes, Delfim Vicente, additional, Medina, Candida, additional, Silva, David da, additional, Laursen, Alex Lund, additional, Erikstrup, Christian, additional, Wejse, Christian, additional, and HIV, the Bissau, additional
- Published
- 2016
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96. Endothelial dysfunction, increased inflammation, and activated coagulation in HIV-infected patients improve after initiation of highly active antiretroviral therapy
- Author
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Arildsen, H, Sørensen, K E, Ingerslev, J M, Østergaard, L J, and Laursen, Alex Lund
- Abstract
Endothelial dysfunction and inflammation have been demonstrated to be markers of cardiovascular risk. We investigated the effects of HIV infection per se and the antiretroviral treatment prescribed on the levels of risk factors of cardiovascular disease.
- Published
- 2013
97. Direct acting antiviral treatment of chronic hepatitis C in Denmark: factors associated with and barriers to treatment initiation.
- Author
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Sølund, Christina, Hallager, Sofie, Pedersen, Martin S., Fahnøe, Ulrik, Ernst, Anja, Krarup, Henrik B., Røge, Birgit T., Christensen, Peer B., Laursen, Alex L., Gerstoft, Jan, Bélard, Erika, Madsen, Lone G., Schønning, Kristian, Pedersen, Anders G., Bukh, Jens, Weis, Nina, and The Danhep Group
- Subjects
CHRONIC hepatitis C ,FIBROSIS ,HEPATITIS B ,ODDS ratio ,HEPATOLOGY - Abstract
Objectives: We describe factors associated with and barriers to initiation of Direct Acting Antiviral (DAA) treatment in patients with chronic hepatitis C, who fulfill national fibrosis treatment guidelines in Denmark. Materials and Methods: In this nationwide cohort study, we included patients with chronic hepatitis C from The Danish Database for Hepatitis B and C (DANHEP) who fulfilled fibrosis treatment criteria. Factors associated with treatment initiation and treatment failure were determined by logistic regression analyses. Medical records were reviewed from patients who fulfilled fibrosis treatment criteria, but did not initiate DAA treatment to determine the cause. Results: In 344 (49%) of 700 patients, who fulfilled treatment criteria, factors associated with DAA treatment initiation were transmission by other routes than injecting drug use odds ratio (OR) 2.13 (CI: 1.38-3.28), previous treatment failure OR 2.58 (CI: 1.84-3.61) and ALT above upper limit of normal OR 1.60 (CI: 1.18-2.17). The most frequent reasons for not starting treatment among 356 (51%) patients were non-adherence to medical appointments (n = 107/30%) and ongoing substance use (n = 61/17%). Treatment failure with viral relapse occurred in 19 (5.5%) patients, who were more likely to have failed previous treatment OR 4.53 (CI: 1.59-12.91). Conclusions: In this nationwide cohort study, we found non-adherence to medical appointments and active substance use to be major obstacles for DAA treatment initiation. Our findings highlight the need for interventions that can overcome these barriers and increase the number of patients who can initiate and benefit from curative DAA treatment. [ABSTRACT FROM AUTHOR]
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- 2018
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98. Assessment of simple risk markers for early mortality among HIV-infected patients in Guinea-Bissau:a cohort study
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Oliveira, Inés, Andersen, Andreas, Furtado, Alcino, Medina, Candida, da Silva, David, da Silva, Zacarias J, Aaby, Peter, Laursen, Alex Lund, Wejse, Christian, and Eugen-Olsen, Jesper
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Risk ,Africa ,HIV ,Biomarker - Abstract
Background: Decisions about when to start anantiretroviral therapy (ART) are normally based on CD4cell counts and viral load (VL). However, thesemeasurements require equipment beyond the capacityof most laboratories in low-income and middle-incomesettings. Thus, there is an urgent need to identify andtest simple markers to guide the optimal time forstarting and for monitoring the effect of ART indeveloping countries.Objectives: (1) To evaluate anthropometricmeasurements and measurement of plasma-solubleform of the urokinase plasminogen activator receptor(suPAR) levels as potential risk factors for earlymortality among HIV-infected patients; (2) to assesswhether these markers could help identify patients towhom ART should be prioritised and (3) to determineif these markers may add information to CD4 cell countwhen VL is not available.Design: An observational study.Setting: The largest ART centre in Bissau, Guinea-Bissau.Participants: 1083 ART-naïve HIV-infected patients.Outcome measures: Associations between baselineanthropometric measurements, CD4 cell counts,plasma suPAR levels and survival were examined usingCox proportional hazards models.Results: Low body mass index (BMI≤18.5 kg/m2),low mid-upper-arm-circumference (MUAC≤250 mm),low CD4 cell count (≤350 cells/μl) and high suPARplasma levels (>5.3 ng/ml) were independentpredictors of death. Furthermore, mortality amongpatients with low CD4 cell count, low MUAC orlow BMI was concentrated in the highest suPARquartile.Conclusions: Irrespective of ART initiation andbaseline CD4 count, MUAC and suPAR plasma levelswere independent predictors of early mortality inthis urban cohort. These markers could be useful inidentifying patients at the highest risk of short-termmortality and may aid triage for ART when CD4 cellcount is not available or when there is shortness ofantiretroviral drugs. BACKGROUND: Decisions about when to start an antiretroviral therapy (ART) are normally based on CD4 cell counts and viral load (VL). However, these measurements require equipment beyond the capacity of most laboratories in low-income and middle-income settings. Thus, there is an urgent need to identify and test simple markers to guide the optimal time for starting and for monitoring the effect of ART in developing countries. OBJECTIVES: (1) To evaluate anthropometric measurements and measurement of plasma-soluble form of the urokinase plasminogen activator receptor (suPAR) levels as potential risk factors for early mortality among HIV-infected patients; (2) to assess whether these markers could help identify patients to whom ART should be prioritised and (3) to determine if these markers may add information to CD4 cell count when VL is not available. DESIGN: An observational study. SETTING: The largest ART centre in Bissau, Guinea-Bissau. PARTICIPANTS: 1083 ART-naïve HIV-infected patients. OUTCOME MEASURES: Associations between baseline anthropometric measurements, CD4 cell counts, plasma suPAR levels and survival were examined using Cox proportional hazards models. RESULTS: Low body mass index (BMI≤18.5 kg/m(2)), low mid-upper-arm-circumference (MUAC≤250 mm), low CD4 cell count (≤350 cells/μl) and high suPAR plasma levels (>5.3 ng/ml) were independent predictors of death. Furthermore, mortality among patients with low CD4 cell count, low MUAC or low BMI was concentrated in the highest suPAR quartile. CONCLUSIONS: Irrespective of ART initiation and baseline CD4 count, MUAC and suPAR plasma levels were independent predictors of early mortality in this urban cohort. These markers could be useful in identifying patients at the highest risk of short-term mortality and may aid triage for ART when CD4 cell count is not available or when there is shortness of antiretroviral drugs.
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- 2012
99. Infektionssygdomme
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Larsen, Carsten Schade, Arildsen, Hanne, Benfield, Thomas, Larsen, Helle Kiellberg, Laursen, Alex Lund, Leutscher, Peter Derek Christian, Mogensen, Trine Hyrup, Ovesen, Therese, Wejse, Christian, Bladbjerg, Else Marie, Sandbæk, Annelli, and Stallknect, Bente Merete
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- 2012
100. Treatment for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection - Danish national guidelines 2011
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Christensen, Peer Brehm, Clausen, Mette Rye, Krarup, Henrik, Laursen, Alex Lund, Schlichting, Poul, and Weis, Nina
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Liver Cirrhosis ,Hepatitis B virus ,Hepatitis B, Chronic ,Liver Function Tests ,Humans ,Mass Screening ,Hepacivirus ,Hepatitis C, Chronic ,Esophageal and Gastric Varices ,Antiviral Agents - Abstract
The Danish Society of Infectious Diseases and Danish Society of Gastroenterology and Hepatology set up a committee in 2007 to produce national guidelines for treatment of viral hepatitis B and C. The 2011 version of the guidelines have been endorsed by the scientific societies and are presented below. Annual updates will be available at the websites of the societies. As this present English version has been written six months after the Danish 2011 version, it contains minor changes that will be integrated in the Danish 2012 version, available at the end this year. Epidemiology: Viral hepatitis is not common in Denmark. The prevalence has not been determined by national surveys, but it is estimated that 10,000-15,000 patients are chronically infected with hepatitis B and 15,000-20,000 with chronic hepatitis C. The majority of patients with HBV infection in Denmark are emigrants from high endemic countries, probably infected at birth or early childhood in their country of origin, while the majority of patients with HCV infection have been infected by drug use. For both groups it is estimated that only half of the patients have been diagnosed, of whom only 20% attends specialized care for their chronic viral hepatitis. Clinical care: According to the Danish National Board of Health, patients with chronic viral hepatitis should be followed with regular intervals, at clinics specialized in either infectious diseases or gastroenterology/hepatology. The primary aim is to identify patients with significant liver disease to initiate treatment in order to prevent development of cirrhosis and death. This is primarily done by liver biopsy, but screening for fibrosis with non-invasive methods such as elastography may be sufficient in some patients. Patients with established cirrhosis should enter screening programs for complications such as esophageal varices and hepatocellular carcinoma.
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- 2012
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