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1. Cellular immune responses and viral diversity in individuals treated during acute and early HIV-1 infection.

Author

Altfeld, M, Rosenberg, ES, Shankarappa, R, Mukherjee, JS, Hecht, FM, Eldridge, RL, Addo, MM, Poon, SH, Phillips, MN, Robbins, GK, Sax, PE, Boswell, S, Kahn, JO, Brander, C, Goulder, PJ, Levy, JA, Mullins, JI, and Walker, BD

Subjects
T-Lymphocytes, Helper-Inducer, T-Lymphocytes, Cytotoxic, Humans, HIV-1, HIV Infections, HIV Seropositivity, Acute Disease, RNA, Viral, DNA Primers, Epitopes, Antiretroviral Therapy, Highly Active, Cohort Studies, Longitudinal Studies, Immunity, Cellular, Amino Acid Sequence, Base Sequence, Time Factors, Molecular Sequence Data, Female, Male, Genetic Variation, cytotoxic T lymphocytes, T helper cell responses, viral evolution, cytotoxic T lymphocyte epitopes, human leukocyte antigen, Antiretroviral Therapy, Highly Active, Immunity, Cellular, RNA, Viral, T-Lymphocytes, Cytotoxic, Helper-Inducer, Medical and Health Sciences, Immunology
Abstract

Immune responses induced during the early stages of chronic viral infections are thought to influence disease outcome. Using HIV as a model, we examined virus-specific cytotoxic T lymphocytes (CTLs), T helper cells, and viral genetic diversity in relation to duration of infection and subsequent response to antiviral therapy. Individuals with acute HIV-1 infection treated before seroconversion had weaker CTL responses directed at fewer epitopes than persons who were treated after seroconversion. However, treatment-induced control of viremia was associated with the development of strong T helper cell responses in both groups. After 1 yr of antiviral treatment initiated in acute or early infection, all epitope-specific CTL responses persisted despite undetectable viral loads. The breadth and magnitude of CTL responses remained significantly less in treated acute infection than in treated chronic infection, but viral diversity was also significantly less with immediate therapy. We conclude that early treatment of acute HIV infection leads to a more narrowly directed CTL response, stronger T helper cell responses, and a less diverse virus population. Given the need for T helper cells to maintain effective CTL responses and the ability of virus diversification to accommodate immune escape, we hypothesize that early therapy of primary infection may be beneficial despite induction of less robust CTL responses. These data also provide rationale for therapeutic immunization aimed at broadening CTL responses in treated primary HIV infection.

Published
2001

2. IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic

Author

Hall, A, Clement, N, Ojeda-Thies, C, Maclullich, A, Toro, G, Johansen, A, White, T, Duckworth, A, Abdul-Jabar, H, Abu-Rajab, R, Abugarja, A, Adam, K, Aguado Hernández, H, Améstica Lazcano, G, Anderson, S, Ansar, M, Antrobus, J, Aragón Achig, E, Archunan, M, Arrieta Salinas, M, Ashford-Wilson, S, Assens Gibert, C, Athanasopoulou, K, Awadelkarim, M, Baird, S, Bajada, S, Balakrishnan, S, Balasubramanian, S, Ballantyne, J, Bárcena Goitiandia, L, Barkham, B, Barmpagianni, C, Barres-Carsi, M, Barrett, S, Baskaran, D, Bell, J, Bell, K, Bell, S, Bellelli, G, Benchimol, J, Boietti, B, Boswell, S, Braile, A, Brennan, C, Brent, L, Brooke, B, Bruno, G, Burahee, A, Burns, S, Calabrò, G, Campbell, L, Carabelli, G, Carnegie, C, Carretero Cristobal, G, Caruana, E, Cassinello Ogea, M, Castellanos Robles, J, Castillon, P, Chakrabarti, A, Cecere, A, Chen, P, Clarke, J, Collins, G, Corrales Cardenal, J, Corsi, M, Cózar Adelantado, G, Craxford, S, Crooks, M, Cuarental-García, J, Cuthbert, R, Dall, G, Daskalakis, I, De Cicco, A, Diana, D, Demaria, P, Dereix, J, Díaz Jiménez, J, Dinamarca Montecinos, J, Do Le, H, Donoso Coppa, J, Drosos, G, Duffy, A, East, J, Eastwood, D, Elbahari, H, Elias de Molins Peña, C, Elmamoun, M, Emmerson, B, Escobar Sánchez, D, Faimali, M, Farré-Mercadé, M, Farrow, L, Fayez, A, Fell, A, Fenner, C, Ferguson, D, Finlayson, L, Flores Gómez, A, Freeman, N, French, J, Gabardo Calvo, S, Gagliardo, N, Garcia Albiñana, J, García Cruz, G, García de Cortázar Antolín, U, García Virto, V, Gealy, S, Gil Caballero, S, Gill, M, González González, M, Gopireddy, R, Guntley, D, Gurung, B, Guzmán Rosales, G, Haddad, N, Hafeez, M, Haller, P, Halligan, E, Hardie, J, Hawker, I, Helal, A, Herrera Cruz, M, Herreros Ruiz-Valdepeñas, R, Horton, J, Howells, S, Howieson, A, Hughes, L, Hünicken Torrez, F, Hurtado Ortega, A, Huxley, P, Hamid, H, Ilahi, N, Iliadis, A, Inman, D, Jadhao, P, Jandoo, R, Jawad, L, Jayatilaka, M, Jenkins, P, Jeyapalan, R, Johnson, D, Johnston, A, Joseph, S, Kapoor, S, Karagiannidis, G, Karanam, K, Kattakayam, F, Konarski, A, Kontakis, G, Labrador Hernández, G, Lancaster, V, Landi, G, Le, B, Liew, I, Logishetty, K, Lopez Marquez, A, Lopez, J, Lum, J, Macpherson, G, Madan, S, Mahroof, S, Malik-Tabassum, K, Mallina, R, Maqsood, A, Marson, B, Martin Legorburo, M, Martin-Perez, E, Martínez Jiménez, T, Martinez Martin, J, Mayne, A, Mayor, A, Mcalinden, G, Mclean, L, Mcdonald, L, Mcintyre, J, Mckay, P, Mckean, G, Mcshane, H, Medici, A, Meeke, C, Meldrum, E, Mendez, M, Mercer, S, Merino Perez, J, Mesa-Lampré, M, Mighton, S, Milne, K, Mohamed Yaseen, M, Moppett, I, Mora, J, Morales-Zumel, S, Moreno Fenoll, I, Mousa, A, Murray, A, Murray, E, Nair, R, Neary, F, Negri, G, Negus, O, Newham-Harvey, F, Ng, N, Nightingale, J, Noor Mohamed Anver, S, Nunag, P, O'Hare, M, Ollivere, B, Ortés Gómez, R, Owens, A, Page, S, Palloni, V, Panagiotopoulos, A, Panagiotopoulos, E, Panesar, P, Papadopoulos, A, Spyridon, P, Pareja Sierra, T, Park, C, Parwaiz, H, Paterson-Byrne, P, Patton, S, Pearce, J, Porter, M, Pellegrino, A, Pèrez Cuellar, A, Pezzella, R, Phadnis, A, Pinder, C, Piper, D, Powell-Bowns, M, Prieto Martín, R, Probert, A, Ramesh, A, Ramírez de Arellano, M, Renton, D, Rickman, S, Robertson, A, Roche Albero, A, Rodrigo Verguizas, J, Rodríguez Couso, M, Rooney, J, Sáez-López, P, Saldaña-Díaz, A, Santulli, A, Sanz Pérez, M, Sarraf, K, Scarsbrook, C, Scott, C, Scott, J, Shah, S, Sharaf, S, Sharma, S, Shirley, D, Siano, A, Simpson, J, Singh, A, Sinnett, T, Sisodia, G, Smith, P, Sophena Bert, E, Steel, M, Stewart, A, Stewart, C, Sugand, K, Sullivan, N, Sweeting, L, Symes, M, Tan, D, Tancredi, F, Tatani, I, Thomas, P, Thomson, F, Toner, N, Tong, A, Toro, A, Tosounidis, T, Tottas, S, Trinidad Leo, A, Tucker, D, Vemulapalli, K, Ventura Garces, D, Vernon, O, Viveros Garcia, J, Ward, A, Ward, K, Watson, K, Weerasuriya, T, Wickramanayake, U, Wilkinson, H, Windley, J, Wood, J, Wynell-Mayow, W, Zatti, G, Zeiton, M, Zurrón Lobato, M, Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, MacLullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdus, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioannis, De Cicco, Annalisa, Diana, de la Fuente de Dios, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Luis, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgios, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nicholas, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, James, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexis, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgios, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgios, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatius, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, McAlinden, Gavan, McLean, Lucille, McDonald, Lorna, McIntyre, Joshua, McKay, Pamela, McKean, Greg, McShane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesus, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Jess, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, AnneMarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andreas, Panagiotopoulos, Elias, Panesar, Paul, Papadopoulos, Antonios, Spyridon, Papagiannis, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andres, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, James, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoros, Tottas, Stylianos, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlos, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, Zurrón Lobato, Miriam, Hall, A, Clement, N, Ojeda-Thies, C, Maclullich, A, Toro, G, Johansen, A, White, T, Duckworth, A, Abdul-Jabar, H, Abu-Rajab, R, Abugarja, A, Adam, K, Aguado Hernández, H, Améstica Lazcano, G, Anderson, S, Ansar, M, Antrobus, J, Aragón Achig, E, Archunan, M, Arrieta Salinas, M, Ashford-Wilson, S, Assens Gibert, C, Athanasopoulou, K, Awadelkarim, M, Baird, S, Bajada, S, Balakrishnan, S, Balasubramanian, S, Ballantyne, J, Bárcena Goitiandia, L, Barkham, B, Barmpagianni, C, Barres-Carsi, M, Barrett, S, Baskaran, D, Bell, J, Bell, K, Bell, S, Bellelli, G, Benchimol, J, Boietti, B, Boswell, S, Braile, A, Brennan, C, Brent, L, Brooke, B, Bruno, G, Burahee, A, Burns, S, Calabrò, G, Campbell, L, Carabelli, G, Carnegie, C, Carretero Cristobal, G, Caruana, E, Cassinello Ogea, M, Castellanos Robles, J, Castillon, P, Chakrabarti, A, Cecere, A, Chen, P, Clarke, J, Collins, G, Corrales Cardenal, J, Corsi, M, Cózar Adelantado, G, Craxford, S, Crooks, M, Cuarental-García, J, Cuthbert, R, Dall, G, Daskalakis, I, De Cicco, A, Diana, D, Demaria, P, Dereix, J, Díaz Jiménez, J, Dinamarca Montecinos, J, Do Le, H, Donoso Coppa, J, Drosos, G, Duffy, A, East, J, Eastwood, D, Elbahari, H, Elias de Molins Peña, C, Elmamoun, M, Emmerson, B, Escobar Sánchez, D, Faimali, M, Farré-Mercadé, M, Farrow, L, Fayez, A, Fell, A, Fenner, C, Ferguson, D, Finlayson, L, Flores Gómez, A, Freeman, N, French, J, Gabardo Calvo, S, Gagliardo, N, Garcia Albiñana, J, García Cruz, G, García de Cortázar Antolín, U, García Virto, V, Gealy, S, Gil Caballero, S, Gill, M, González González, M, Gopireddy, R, Guntley, D, Gurung, B, Guzmán Rosales, G, Haddad, N, Hafeez, M, Haller, P, Halligan, E, Hardie, J, Hawker, I, Helal, A, Herrera Cruz, M, Herreros Ruiz-Valdepeñas, R, Horton, J, Howells, S, Howieson, A, Hughes, L, Hünicken Torrez, F, Hurtado Ortega, A, Huxley, P, Hamid, H, Ilahi, N, Iliadis, A, Inman, D, Jadhao, P, Jandoo, R, Jawad, L, Jayatilaka, M, Jenkins, P, Jeyapalan, R, Johnson, D, Johnston, A, Joseph, S, Kapoor, S, Karagiannidis, G, Karanam, K, Kattakayam, F, Konarski, A, Kontakis, G, Labrador Hernández, G, Lancaster, V, Landi, G, Le, B, Liew, I, Logishetty, K, Lopez Marquez, A, Lopez, J, Lum, J, Macpherson, G, Madan, S, Mahroof, S, Malik-Tabassum, K, Mallina, R, Maqsood, A, Marson, B, Martin Legorburo, M, Martin-Perez, E, Martínez Jiménez, T, Martinez Martin, J, Mayne, A, Mayor, A, Mcalinden, G, Mclean, L, Mcdonald, L, Mcintyre, J, Mckay, P, Mckean, G, Mcshane, H, Medici, A, Meeke, C, Meldrum, E, Mendez, M, Mercer, S, Merino Perez, J, Mesa-Lampré, M, Mighton, S, Milne, K, Mohamed Yaseen, M, Moppett, I, Mora, J, Morales-Zumel, S, Moreno Fenoll, I, Mousa, A, Murray, A, Murray, E, Nair, R, Neary, F, Negri, G, Negus, O, Newham-Harvey, F, Ng, N, Nightingale, J, Noor Mohamed Anver, S, Nunag, P, O'Hare, M, Ollivere, B, Ortés Gómez, R, Owens, A, Page, S, Palloni, V, Panagiotopoulos, A, Panagiotopoulos, E, Panesar, P, Papadopoulos, A, Spyridon, P, Pareja Sierra, T, Park, C, Parwaiz, H, Paterson-Byrne, P, Patton, S, Pearce, J, Porter, M, Pellegrino, A, Pèrez Cuellar, A, Pezzella, R, Phadnis, A, Pinder, C, Piper, D, Powell-Bowns, M, Prieto Martín, R, Probert, A, Ramesh, A, Ramírez de Arellano, M, Renton, D, Rickman, S, Robertson, A, Roche Albero, A, Rodrigo Verguizas, J, Rodríguez Couso, M, Rooney, J, Sáez-López, P, Saldaña-Díaz, A, Santulli, A, Sanz Pérez, M, Sarraf, K, Scarsbrook, C, Scott, C, Scott, J, Shah, S, Sharaf, S, Sharma, S, Shirley, D, Siano, A, Simpson, J, Singh, A, Sinnett, T, Sisodia, G, Smith, P, Sophena Bert, E, Steel, M, Stewart, A, Stewart, C, Sugand, K, Sullivan, N, Sweeting, L, Symes, M, Tan, D, Tancredi, F, Tatani, I, Thomas, P, Thomson, F, Toner, N, Tong, A, Toro, A, Tosounidis, T, Tottas, S, Trinidad Leo, A, Tucker, D, Vemulapalli, K, Ventura Garces, D, Vernon, O, Viveros Garcia, J, Ward, A, Ward, K, Watson, K, Weerasuriya, T, Wickramanayake, U, Wilkinson, H, Windley, J, Wood, J, Wynell-Mayow, W, Zatti, G, Zeiton, M, Zurrón Lobato, M, Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, MacLullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdus, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioannis, De Cicco, Annalisa, Diana, de la Fuente de Dios, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Luis, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgios, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nicholas, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, James, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexis, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgios, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgios, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatius, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, McAlinden, Gavan, McLean, Lucille, McDonald, Lorna, McIntyre, Joshua, McKay, Pamela, McKean, Greg, McShane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesus, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Jess, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, AnneMarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andreas, Panagiotopoulos, Elias, Panesar, Paul, Papadopoulos, Antonios, Spyridon, Papagiannis, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andres, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, James, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoros, Tottas, Stylianos, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlos, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, and Zurrón Lobato, Miriam

Abstract

Aims: This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods: A multicentre collaboration among 112 centres in 14 countries collected data on all patients presenting with a hip fracture between 1st March-31st May 2020. Demographics, residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, management, ASA grade, length of stay, COVID-19 and 30-day mortality status were recorded. Results: A total of 7090 patients were included, with a mean age of 82.2 (range 50–104) years and 4959 (69.9%) being female. Of 651 (9.2%) patients diagnosed with COVID-19, 225 (34.6%) were positive at presentation and 426 (65.4%) were positive postoperatively. Positive COVID-19 status was independently associated with male sex (odds ratio (OR) 1.38, p = 0.001), residential care (OR 2.15, p < 0.001), inpatient fall (OR 2.23, p = 0.003), cancer (OR 0.63, p = 0.009), ASA grades 4 (OR 1.59, p = 0.008) or 5 (OR 8.28, p < 0.001), and longer admission (OR 1.06 for each increasing day, p < 0.001). Patients with COVID-19 at any time had a significantly lower chance of 30-day survival versus those without COVID-19 (72.7% versus 92.6%, p < 0.001). COVID-19 was independently associated with an increased 30-day mortality risk (hazard ratio (HR) 2.83, p < 0.001). Increasing age (HR 1.03, p = 0.028), male sex (HR 2.35, p < 0.001), renal disease (HR 1.53, p = 0.017), and pulmonary disease (HR 1.45, p = 0.039) were independently associated with a higher 30-day mortality risk in patients with COVID-19 when adjusting for confounders. Conclusion: The prevalence of COVID-19 in hip fracture patients during the first wave of the pandemic was 9%, and was independently associated with a three-fold increased 30-day mortality risk.

Published
2022

6. A Hybrid Multi-Population Approach to the Project Portfolio Selection and Scheduling Problem for Future Force Design

Author

Harrison, KR ; https://orcid.org/0000-0002-1443-3005, Elsayed, S ; https://orcid.org/0000-0003-0836-6122, Garanovich, IL, Weir, T, Galister, M, Boswell, S, Taylor, R, Sarker, R ; https://orcid.org/0000-0002-1363-2774, Harrison, KR ; https://orcid.org/0000-0002-1443-3005, Elsayed, S ; https://orcid.org/0000-0003-0836-6122, Garanovich, IL, Weir, T, Galister, M, Boswell, S, Taylor, R, and Sarker, R ; https://orcid.org/0000-0002-1363-2774

Abstract

Future Force Design (FFD) is a strategic planning activity that decides the programming of defence capability options. This is a complex problem faced by the Australian Department of Defence (DoD) and requires the simultaneous selection and scheduling of projects. Specifically, this is a NP-hard problem known as the Project Portfolio Selection and Scheduling Problem (PPSSP). While the PPSSP is a complex problem itself, its complexity is further increased when coupled with the additional characteristics that arise in the context of defence-oriented planning, such as long planning periods and complex operational constraints. As a result, many previous studies examined only a small number of projects over a short planning period and are largely unsuitable for the scale required in the defence sector. To address this issue, two primary contributions are made in this paper. Firstly, this study describes a complex practical PPSSP, inspired by the FFD process, and develops a corresponding mathematical model. Problem instances are derived from real-world, publicly-available defence data. Secondly, to address instances of the problem, two existing meta-heuristics are considered and a hybrid, multi-population approach is proposed. Results are compared against those attained by a commercial exact solver and indicate that there is no statistically significant difference in performance between the proposed multi-population approach and the exact solver. A key benefit of the proposed meta-heuristic approach is that its run time is not significantly influenced by the complexity of the problem instance. Additionally, many interesting practical insights regarding the solution of selection and scheduling problems are uncovered.

Published
2021

9. Multi-Period Project Selection and Scheduling for Defence Capability-Based Planning

Author

Harrison, KR ; https://orcid.org/0000-0002-1443-3005, Elsayed, S ; https://orcid.org/0000-0003-0836-6122, Weir, T, Garanovich, IL, Galister, M, Boswell, S, Taylor, R, Sarker, R ; https://orcid.org/0000-0002-1363-2774, Harrison, KR ; https://orcid.org/0000-0002-1443-3005, Elsayed, S ; https://orcid.org/0000-0003-0836-6122, Weir, T, Garanovich, IL, Galister, M, Boswell, S, Taylor, R, and Sarker, R ; https://orcid.org/0000-0002-1363-2774

Abstract

Future force design is a crucial task that assists in the creation of an effective future defence force. The primary objective of this task is to select a set of projects, within a fixed planning window and subject to budgetary constraints, that will lead to improved capabilities. While inherently related to the well-known multi-period knapsack problem, addressing this problem in the context of the defence sector gives rise to a number of unique nuances and associated challenges. Furthermore, the literature pertaining to the selection and scheduling of projects for capability-based planning in the defence sector is rather limited. To address this literature gap, this paper formalizes a multi-period project selection and scheduling problem inspired by future force design. Numerous heuristics, both random and deterministic, along with a hybrid genetic algorithm, are employed to optimize a set of instances of the proposed problem formulation with various characteristics derived from real-world, public defence data made available by the Australian Department of Defence.

Published
2020

10. Portfolio Optimization for Defence Applications

Author

Harrison, KR ; https://orcid.org/0000-0002-1443-3005, Elsayed, S ; https://orcid.org/0000-0003-0836-6122, Garanovich, I, Weir, T, Galister, M, Boswell, S, Taylor, R, Sarker, R ; https://orcid.org/0000-0002-1363-2774, Harrison, KR ; https://orcid.org/0000-0002-1443-3005, Elsayed, S ; https://orcid.org/0000-0003-0836-6122, Garanovich, I, Weir, T, Galister, M, Boswell, S, Taylor, R, and Sarker, R ; https://orcid.org/0000-0002-1363-2774

Abstract

The problem of designing an effective future defense force is quite complex and challenging. One methodology that is often employed in this domain is portfolio optimization, whereby the objective is to select a diverse set of assets that maximize the return on investment. In the defense context, the return on investment is often measured in terms of the capabilities that the investments will provide. While the field of portfolio optimization is well established, applications in the defense sector pose unique challenges not seen in other application domains. However, the literature regarding portfolio optimization for defense applications is rather sparse. To this end, this paper provides a structured review of recent applications and identifies a number of areas that warrant further investigation.

Published
2020

15. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study

Author

Rohner E., Butikofer L., Schmidlin K., Sengayi M., Maskew M., Giddy J., Garone D., Moore R. D., D'Souza G., Goedert J. J., Achenbach C., Gill M. J., Kitahata M. M., Patel P., Silverberg M. J., Castilho J., McGowan C., Chen Y. -M. A., Law M., Taylor N., Paparizos V., Bonnet F., Verbon A., Fatkenheuer G., Post F. A., Sabin C., Mocroft A., Le Moing V., Dronda F., Obel N., Grabar S., Spagnuolo V., Antinori A., Quiros-Roldan E., Mussini C., Miro J. M., Meyer L., Hasse B., Konopnicki D., Roca B., Barger D., Raben D., Clifford G. M., Franceschi S., Brockmeyer N., Chakraborty R., Egger M., Bohlius J., Judd A., Zangerle R., Touloumi G., Warszawski J., Dabis F., Krause M. M., Ghosn J., Leport C., Wittkop L., Reiss P., Wit F., Prins M., Bucher H., Gibb D., Del Amo J., Thorne C., Kirk O., Stephan C., Perez-Hoyos S., Hamouda O., Bartmeyer B., Chkhartishvili N., Noguera-Julian A., Monforte A. D., Prieto L., Conejo P. R., Soriano-Arandes A., Battegay M., Kouyos R., Tookey P., Casabona J., Castagna A., Konopnick D., Goetghebuer T., Sonnerborg A., Teira R., Garrido M., Haerry D., De Wit S., Costagliola D., D'Arminio-Monforte A., Chene G., Schwimmer C., Termote M., Campbell M., Frederiksen C. M., Friis-Moller N., Kjaer J., Brandt R. S., Berenguer J., Bouteloup V., Cozzi-Lepri A., Davies M. -A., Dorrucci M., Dunn D., Furrer H., Guiguet M., Lambotte O., Leroy V., Lodi S., Matheron S., Monge S., Nakagawa F., Paredes R., Phillips A., Puoti M., Schomaker M., Smit C., Sterne J., Thiebaut R., Torti C., Van Der Valk M., Tanser F., Vinikoor M., MacEte E., Wood R., Stinson K., Fatti G., Phiri S., Chimbetete C., Malisita K., Eley B., Fritz C., Hobbins M., Kamenova K., Fox M., Prozesky H., Technau K., Sawry S., Benson C. A., Bosch R. J., Kirk G. D., Boswell S., Mayer K. H., Grasso C., Hogg R. S., Harrigan P. R., Montaner J. S. G., Yip B., Zhu J., Salters K., Gabler K., Buchacz K., Brooks J. T., Gebo K. A., Carey J. T., Rodriguez B., Horberg M. A., Thorne J. E., Rabkin C., Margolick J. B., Jacobson L. P., Klein M. B., Rourke S. B., Rachlis A. R., Cupido P., Hunter-Mellado R. F., Mayor A. M., Deeks S. G., Martin J. N., Saag M. S., Mugavero M. J., Willig J., Eron J. J., Napravnik S., Crane H. M., Drozd D. R., Haas D., Rebeiro P., Turner M., Bebawy S., Rogers B., Justice A. C., Dubrow R., Fiellin D., Gange S. J., Anastos K., Althoff K. N., McKaig R. G., Freeman A. M., Lent C., Van Rompaey S. E., Morton L., McReynolds J., Lober W. B., Abraham A. G., Lau B., Zhang J., Jing J., Modur S., Wong C., Hogan B., Desir F., Liu B., You B., Cahn P., Cesar C., Fink V., Sued O., Dell'Isola E., Perez H., Valiente J., Yamamoto C., Grinsztejn B., Veloso V., Luz P., De Boni R., Wagner S. C., Friedman R., Moreira R., Pinto J., Ferreira F., Maia M., De Menezes Succi R. C., MacHado D. M., De Fatima Barbosa Gouvea A., Wolff M., Cortes C., Rodriguez M. F., Allendes G., Pape J. W., Rouzier V., Marcelin A., Perodin C., Luque M. T., Padgett D., Madero J. S., Ramirez B. C., Belaunzaran P., Vega Y. C., Gotuzzo E., Mejia F., Carriquiry G., McGowan C. C., Shepherd B. E., Sterling T., Jayathilake K., Person A. K., Rebeiro P. F., Giganti M., Duda S. N., Maruri F., Vansell H., Ly P. S., Khol V., Zhang F. J., Zhao H. X., Han N., Lee M. P., Li P. C. K., Lam W., Chan Y. T., Kumarasamy N., Saghayam S., Ezhilarasi C., Pujari S., Joshi K., Gaikwad S., Chitalikar A., Merati T. P., Wirawan D. N., Yuliana F., Yunihastuti E., Imran D., Widhani A., Tanuma J., Oka S., Nishijima T., Choi J. Y., Na S., Kim J. M., Sim B. L. H., Gani Y. M., David R., Kamarulzaman A., Syed Omar S. F., Ponnampalavanar S., Azwa I., Ditangco R., Uy E., Bantique R., Wong W. W., Ku W. W., Wu P. C., Ng O. T., Lim P. L., Lee L. S., Ohnmar P. S., Avihingsanon A., Gatechompol S., Phanuphak P., Phadungphon C., Kiertiburanakul S., Sungkanuparph S., Chumla L., Sanmeema N., Chaiwarith R., Sirisanthana T., Kotarathititum W., Praparattanapan J., Kantipong P., Kambua P., Ratanasuwan W., Sriondee R., Nguyen K. V., Bui H. V., Nguyen D. T. H., Nguyen D. T., Cuong D. D., An N. V., Luan N. T., Sohn A. H., Ross J. L., Petersen B., Cooper D. A., Law M. G., Jiamsakul A., Boettiger D. C., Ellis D., Bloch M., Agrawal S., Vincent T., Allen D., Smith D., Rankin A., Baker D., Templeton D. J., Jackson E., McCallum K., Ryder N., Sweeney G., Cooper D., Carr A., MacRae K., Hesse K., Finlayson R., Gupta S., Langton-Lockton J., Shakeshaft J., Brown K., Idle S., Arvela N., Varma R., Lu H., Couldwell D., Eswarappa S., Smith D. E., Furner V., Cabrera G., Fernando S., Cogle A., Lawrence C., Mulhall B., Boyd M., Petoumenos K., Puhr R., Huang R., Han A., Gunathilake M., Payne R., O'Sullivan M., Croydon A., Russell D., Cashman C., Roberts C., Sowden D., Taing K., Marshall P., Orth D., Youds D., Rowling D., Latch N., Warzywoda E., Dickson B., Donohue W., Moore R., Edwards S., Boyd S., Roth N. J., Lau H., Read T., Silvers J., Zeng W., Hoy J., Watson K., Bryant M., Price S., Woolley I., Giles M., Korman T., Williams J., Nolan D., Allen A., Guelfi G., Mills G., Wharry C., Raymond N., Bargh K., Templeton D., Medical Microbiology & Infectious Diseases, Global Health, Infectious diseases, APH - Aging & Later Life, AII - Infectious diseases, APH - Global Health, Graduate School, APH - Digital Health, APH - Personalized Medicine, Bohlius, Julia, Cohere In, Eurocoord, Castagna, Antonella, Rohner, E, Butikofer, L, Schmidlin, K, Sengayi, M, Maskew, M, Giddy, J, Garone, D, Moore, R, D'Souza, G, Goedert, J, Achenbach, C, Gill, M, Kitahata, M, Patel, P, Silverberg, M, Castilho, J, Mcgowan, C, Chen, Y, Law, M, Taylor, N, Paparizos, V, Bonnet, F, Verbon, A, Fatkenheuer, G, Post, F, Sabin, C, Mocroft, A, Le Moing, V, Dronda, F, Obel, N, Grabar, S, Spagnuolo, V, Antinori, A, Quiros-Roldan, E, Mussini, C, Miro, J, Meyer, L, Hasse, B, Konopnicki, D, Roca, B, Barger, D, Raben, D, Clifford, G, Franceschi, S, Brockmeyer, N, Chakraborty, R, Egger, M, Bohlius, J, Judd, A, Zangerle, R, Touloumi, G, Warszawski, J, Dabis, F, Krause, M, Ghosn, J, Leport, C, Wittkop, L, Reiss, P, Wit, F, Prins, M, Bucher, H, Gibb, D, Del Amo, J, Thorne, C, Kirk, O, Stephan, C, Perez-Hoyos, S, Hamouda, O, Bartmeyer, B, Chkhartishvili, N, Noguera-Julian, A, Monforte, A, Prieto, L, Conejo, P, Soriano-Arandes, A, Battegay, M, Kouyos, R, Tookey, P, Casabona, J, Castagna, A, Konopnick, D, Goetghebuer, T, Sonnerborg, A, Teira, R, Garrido, M, Haerry, D, De Wit, S, Costagliola, D, D'Arminio-Monforte, A, Chene, G, Schwimmer, C, Termote, M, Campbell, M, Frederiksen, C, Friis-Moller, N, Kjaer, J, Brandt, R, Berenguer, J, Bouteloup, V, Cozzi-Lepri, A, Davies, M, Dorrucci, M, Dunn, D, Furrer, H, Guiguet, M, Lambotte, O, Leroy, V, Lodi, S, Matheron, S, Monge, S, Nakagawa, F, Paredes, R, Phillips, A, Puoti, M, Schomaker, M, Smit, C, Sterne, J, Thiebaut, R, Torti, C, Van Der Valk, M, Tanser, F, Vinikoor, M, Macete, E, Wood, R, Stinson, K, Fatti, G, Phiri, S, Chimbetete, C, Malisita, K, Eley, B, Fritz, C, Hobbins, M, Kamenova, K, Fox, M, Prozesky, H, Technau, K, Sawry, S, Benson, C, Bosch, R, Kirk, G, Boswell, S, Mayer, K, Grasso, C, Hogg, R, Harrigan, P, Montaner, J, Yip, B, Zhu, J, Salters, K, Gabler, K, Buchacz, K, Brooks, J, Gebo, K, Carey, J, Rodriguez, B, Horberg, M, Thorne, J, Rabkin, C, Margolick, J, Jacobson, L, Klein, M, Rourke, S, Rachlis, A, Cupido, P, Hunter-Mellado, R, Mayor, A, Deeks, S, Martin, J, Saag, M, Mugavero, M, Willig, J, Eron, J, Napravnik, S, Crane, H, Drozd, D, Haas, D, Rebeiro, P, Turner, M, Bebawy, S, Rogers, B, Justice, A, Dubrow, R, Fiellin, D, Gange, S, Anastos, K, Althoff, K, Mckaig, R, Freeman, A, Lent, C, Van Rompaey, S, Morton, L, Mcreynolds, J, Lober, W, Abraham, A, Lau, B, Zhang, J, Jing, J, Modur, S, Wong, C, Hogan, B, Desir, F, Liu, B, You, B, Cahn, P, Cesar, C, Fink, V, Sued, O, Dell'Isola, E, Perez, H, Valiente, J, Yamamoto, C, Grinsztejn, B, Veloso, V, Luz, P, De Boni, R, Wagner, S, Friedman, R, Moreira, R, Pinto, J, Ferreira, F, Maia, M, De Menezes Succi, R, Machado, D, De Fatima Barbosa Gouvea, A, Wolff, M, Cortes, C, Rodriguez, M, Allendes, G, Pape, J, Rouzier, V, Marcelin, A, Perodin, C, Luque, M, Padgett, D, Madero, J, Ramirez, B, Belaunzaran, P, Vega, Y, Gotuzzo, E, Mejia, F, Carriquiry, G, Shepherd, B, Sterling, T, Jayathilake, K, Person, A, Giganti, M, Duda, S, Maruri, F, Vansell, H, Ly, P, Khol, V, Zhang, F, Zhao, H, Han, N, Lee, M, Li, P, Lam, W, Chan, Y, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Merati, T, Wirawan, D, Yuliana, F, Yunihastuti, E, Imran, D, Widhani, A, Tanuma, J, Oka, S, Nishijima, T, Choi, J, Na, S, Kim, J, Sim, B, Gani, Y, David, R, Kamarulzaman, A, Syed Omar, S, Ponnampalavanar, S, Azwa, I, Ditangco, R, Uy, E, Bantique, R, Wong, W, Ku, W, Wu, P, Ng, O, Lim, P, Lee, L, Ohnmar, P, Avihingsanon, A, Gatechompol, S, Phanuphak, P, Phadungphon, C, Kiertiburanakul, S, Sungkanuparph, S, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kantipong, P, Kambua, P, Ratanasuwan, W, Sriondee, R, Nguyen, K, Bui, H, Nguyen, D, Cuong, D, An, N, Luan, N, Sohn, A, Ross, J, Petersen, B, Cooper, D, Jiamsakul, A, Boettiger, D, Ellis, D, Bloch, M, Agrawal, S, Vincent, T, Allen, D, Smith, D, Rankin, A, Baker, D, Templeton, D, Jackson, E, Mccallum, K, Ryder, N, Sweeney, G, Carr, A, Macrae, K, Hesse, K, Finlayson, R, Gupta, S, Langton-Lockton, J, Shakeshaft, J, Brown, K, Idle, S, Arvela, N, Varma, R, Lu, H, Couldwell, D, Eswarappa, S, Furner, V, Cabrera, G, Fernando, S, Cogle, A, Lawrence, C, Mulhall, B, Boyd, M, Petoumenos, K, Puhr, R, Huang, R, Han, A, Gunathilake, M, Payne, R, O'Sullivan, M, Croydon, A, Russell, D, Cashman, C, Roberts, C, Sowden, D, Taing, K, Marshall, P, Orth, D, Youds, D, Rowling, D, Latch, N, Warzywoda, E, Dickson, B, Donohue, W, Edwards, S, Boyd, S, Roth, N, Lau, H, Read, T, Silvers, J, Zeng, W, Hoy, J, Watson, K, Bryant, M, Price, S, Woolley, I, Giles, M, Korman, T, Williams, J, Nolan, D, Allen, A, Guelfi, G, Mills, G, Wharry, C, Raymond, N, and Bargh, K

Subjects
Male, viruses, HIV Infections, Men who have sex with men, Cohort Studies, 0302 clinical medicine, Risk Factors, Antiretroviral therapy, Cohort study, HIV, Kaposi sarcoma, Adolescent, Adult, Anti-Retroviral Agents, CD4 Lymphocyte Count, Female, HIV-1, Humans, Middle Aged, Sarcoma, Kaposi, Viral Load, Young Adult, 030212 general & internal medicine, Articles and Commentaries, Incidence (epidemiology), Hazard ratio, virus diseases, Sarcoma, 3. Good health, Infectious Diseases, 030220 oncology & carcinogenesis, Cohort, Coinfection, Microbiology (medical), antiretroviral therapy, 610 Medicine & health, Kaposi, 03 medical and health sciences, SDG 3 - Good Health and Well-being, 360 Social problems & social services, medicine, cohort study, business.industry, medicine.disease, Confidence interval, business, Demography
Abstract

Background We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. Methods We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). Results We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were

Published
2017
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17. Using Sediment Provenance to Study Ice Streams in the Weddell Sea Embayment of Antarctica

Author

Hemming, Sidney R., Williams, Trevor, Boswell, S., Licht, Kathy, Agrios, L., Brachfeld, Stefanie, van de Flierdt, Tina, Kuhn, Gerhard, Hillenbrand, Claus-Dieter, Zhai, X., Hemming, Sidney R., Williams, Trevor, Boswell, S., Licht, Kathy, Agrios, L., Brachfeld, Stefanie, van de Flierdt, Tina, Kuhn, Gerhard, Hillenbrand, Claus-Dieter, and Zhai, X.

Abstract

The geochemical and geochronological fingerprint of rock debris eroded and carried by ice streams may be used to identify the provenance of iceberg-rafted debris (IRD) in the marine sediment record. During deglacial times it has been shown that there is an increase in IRD accumulation in marine sediments underlying the western limb of the Weddell Gyre. We seek to find the provenance of this IRD, identify the ice streams contributing to the IRD load, and interpret the geographic sequence of ice sheet retreat in the Weddell Sea embayment for the last three deglaciations. In December 2014 we conducted fieldwork to collect samples of rock and sediment debris carried by three of the major ice streams draining the Weddell Sea embayment: the Foundation Ice Stream, the Academy Glacier, and the Recovery Glacier. We sampled both modern moraines at the edges of the ice streams and older till on hillsides next to the ice streams. In addition to rocks representing the geology of local outcrops, we found that each of the three ice streams carries a characteristic set of erratic lithologies from further upstream, giving clues to the geology hidden under the ice sheet. Downstream, subglacial till and proximal glaciomarine sediment from existing core sites located at the edge of the Filchner and Ronne Ice Shelves, collected on past expeditions of the RV Polarstern, characterize the geochemical and geochronological fingerprint along ice flow lines extending from the ice streams. Finally, two deep-water RV Polarstern sites contain a continuous record of IRD sourced from the set of Weddell embayment ice streams over the last few glacial cycles. Here we present new 40Ar/39Ar hornblende and biotite thermochronological data from individual mineral grains, K-Ar from the silt fraction, and U-Pb zircon geochronology from the onshore tills and offshore sediments. Using this data we will discuss provenance matching between the IRD and the ice streams, and the possibilities for using provenance

Published
2016

18. Baseball Pitcher Shoulder Internal and External Rotational Range of Motion as an Injury Risk Indicator

Author

Shifflett J, Hyatt Mc, Holhouser C, Lail C, Brent Harper, Kristen Jagger, Steinberger K, Adrian Aron, and Boswell S

Subjects
medicine.medical_specialty, Physical medicine and rehabilitation, business.industry, Injury risk, Medicine, Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine, business, Range of motion
Published
2016
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20. PO-0608 Pain Evaluation In The Preterm

Author

Ahmed, M, primary, Sobithadevi, DN, additional, Mostafa, S, additional, Pore, P, additional, Maiden, J, additional, Boswell, S, additional, Molnar, M, additional, and Reynolds, T, additional

Published
2014
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22. Forced over-expression of the myeloid zinc finger gene MZF-1 inhibits apoptosis and promotes oncogenesis in interleukin-3-dependent FDCP.1 cells

Author

Hromas R, Boswell S, Rn, Shen, Burgess G, Davidson A, Kenneth Cornetta, Sutton J, and Robertson K

Subjects
Kruppel-Like Transcription Factors, Gene Expression, Apoptosis, Zinc Fingers, DNA-Binding Proteins, Mice, Cell Transformation, Neoplastic, Bone Marrow, Animals, Humans, Interleukin-3, Cells, Cultured, Neoplasm Transplantation, Transcription Factors
Abstract

The myeloid zinc finger protein MZF-1 is important in hematopoiesis. Previous studies have found that reducing expression of MZF-1 inhibited G-CSF-driven human marrow colony formation assays. In this study we found that retrovirally overexpressing MZF-1 in IL-3-dependent FDCP.1 cells inhibited their apoptosis when IL-3 was withdrawn. The MZF-1-transduced FDCP.1 cells also formed tumors when injected into congenic mice, whereas control FDCP.1 cells did not.

Published
1996

25. ENDARTERECTOMY FOR ASYMPTOMATIC CAROTID-ARTERY STENOSIS

Author

WALKER, M, MARLER, J, GOLDSTEIN, M, GRADY, P, TOOLE, J, BAKER, W, CASTALDO, J, CHAMBLESS, L, MOORE, W, ROBERTSON, J, YOUNG, B, HOWARD, V, PURVIS, S, VERNON, D, NEEDHAM, K, BECK, P, DOZIER, M, LEFKOWITZ, D, HOWARD, G, CROUSE, J, HERRINGTON, D, FURBERG, C, ESSICK, K, HICKS, R, NELSON, J, BALL, W, BLAND, E, CONDON, S, ELLIOTT, T, GRIZZLE, J, HAYES, D, HENLEY, S, JOHNSON, J, LOCKLEAR, J, MISCH, M, PATON, C, SCHWARTZ, S, WALKER, C, WILLIAMS, O, EASTON, J, GOLDSTONE, J, HALLENBECK, J, HOFF, J, KARP, H, KRONMAL, R, BROTT, T, TOMSICK, T, BRODERICK, J, SAUERBECK, L, BLUM, C, DYKEN, M, BRUST, J, DICK, A, GOTSHALL, R, HEYMAN, A, SWANSON, P, ADAMS, H, DEMPSEY, R, ERNST, C, ROTHROCK, J, COHEN, S, NICHOLAS, G, LONGENECKER, J, BARBOUR, P, BERGER, A, CELANI, V, ECKERT, N, GOODREAU, J, HUTCHINSON, J, JENNY, D, LIN, Z, MCDONALD, K, PISTONE, W, RAEGRANT, A, REDENBAUGH, J, REX, J, WOHLBERG, C, KARANJIA, P, SWANSON, M, LOBNER, S, KOLTS, R, KUEHNER, M, HINER, B, MADDEN, K, CARLSON, R, DAVIS, J, GALLANT, T, WARNER, J, FAUST, A, FRYZA, N, HASENAUER, J, REGNER, M, RONKIN, L, SCHAEFER, S, STRACK, D, TURNER, L, WALGENBACH, A, GRAVES, J, MICHALSKI, S, SCHUETTE, L, MOHR, J, TATEMICHI, T, MARSHALL, R, MAST, H, RAMOS, O, CORRELL, J, LIBMAN, R, PETTY, G, CABRERE, A, OROPEZA, L, GONZALEZ, T, PETTIGREW, C, SADLER, R, ENDEAN, E, SHERROW, J, HAUER, M, LEE, C, NORTON, J, MCQUILLEN, M, MATTINGLY, S, DEKOSKY, S, MASSEY, A, SIMARD, D, TURCOTTE, J, BENGUIGUI, C, COTE, J, BOUCHARD, J, ROBERGE, C, BRUNET, D, BEDARD, F, LANGELIER, R, LAJEUNESSE, M, BIGAOUETTE, J, PARENT, J, LYDEN, P, HYE, R, LEWIS, S, CALI, G, BABCOCK, T, TAFTALVAREZ, B, BRODY, M, ZWEIFLER, R, SEDWITZ, M, STABILE, B, FREISCHLAG, J, WOLF, Y, SIVO, J, FORSYTHE, J, ADAME, M, GUPTA, S, BURKE, K, GREISLER, H, LITTOOY, F, KELLY, M, PULSINELLI, W, CAMPBELL, J, CROCKARELL, J, WATRIDGE, C, ACKER, J, ERKULWATER, S, JACEWICZ, M, WALKER, G, OSULLIVAN, P, SAUER, C, VASU, K, GAINES, K, BAKHITIAN, B, BERTORINI, T, BENNETT, S, THOMAS, T, STAHL, N, TAYLOR, C, GIAMPAPA, M, CONNELL, J, RILEY, J, BRADLEY, A, NEWMAN, K, MANNING, R, MCCREA, M, HACHINSKI, V, FERGUSON, G, MAYER, C, BARNETT, J, PEERLESS, S, BUCHAN, A, REICHMAN, H, KERTESZ, A, LOWNIE, S, WHITE, C, FOX, A, RANKIN, R, SPENCE, J, BARR, H, PADDOCKELIASZIW, L, ASSIS, L, PEXMAN, J, DICICCO, M, TATE, B, JAMES, C, RAKER, E, COATSWORTH, J, HARRIS, S, BEEBE, H, BIRCHFIELD, R, BUTLERLEVY, K, CRANE, R, FRYER, D, MACLEAN, J, PATTERSON, L, QUIGLEY, T, RAVITS, J, TAYLOR, L, PULLEN, S, BOSWELL, S, KENNY, K, ROEDERSHEIMER, L, FOWL, R, TEW, J, KEMPCZINSKI, R, REED, R, WELLING, R, SCHOMAKER, B, MCWHORTER, J, BRANCH, C, SATTERFIELD, J, CORDELL, R, DEAN, R, PLONK, G, HARPOLD, G, WALKER, F, NUNN, C, MYERS, L, TEGELER, C, HARDIN, S, MEADS, D, LOFTUS, C, VINING, L, BENDIXEN, B, BILLER, J, CORSON, J, DAVIS, P, GODERSKY, J, GORDON, D, JACOBY, M, KAPPELLE, L, KRESOWIK, T, MARSH, E, LOVE, B, SHAMMA, A, GRIMSMAN, K, KARBOSKI, D, MILLER, E, JOHNSON, C, JONES, C, STONE, B, MAGUIRE, M, EARLEY, C, KAPLAN, P, CAVALUZZI, J, WATERS, G, CHACHICH, B, AUER, A, LOGAN, W, WILCOX, M, GREEN, B, HURLEY, J, PENNELL, R, WOODS, J, LEVINE, R, NEPUTE, J, THOMASSON, J, BLACKBURN, C, FOLDES, M, KLEMP, K, NAPPIER, B, RUTHERFORD, K, SCHROER, S, HOGAN, J, THORPE, L, FEINBERG, W, HUNTER, G, BRUCK, D, BERNHARD, V, MCINTYRE, K, CARTER, L, LABADIE, E, JOHNSON, D, MOSCHONAS, C, HAMILTON, R, FORRER, S, SEEGER, J, CARMODY, R, VOLD, B, LAGUNA, J, KRIKAWA, J, DEVINE, J, CASTRILLO, A, KISTLER, S, LEDBETTER, B, DORR, K, SMITH, R, HAERER, A, BROWN, R, RUSSELL, W, RIGDON, E, RHODES, R, SMITH, E, GRAEBER, M, DOORENBOS, D, SUBRAMONY, S, ATNIP, R, BRENNAN, R, FRIEDMAN, D, NEUMYER, M, THIELE, B, SMITH, F, BARR, J, DUCKROW, R, JANESKY, C, MEILSTRUP, J, MCNAMARA, K, RODICHOK, L, STEWART, L, SULLIVAN, M, WENGROVITZ, M, CLAGETT, G, UNWIN, H, BRYAN, W, MATKINS, C, PATTERSON, C, ALWAY, C, BOYD, P, INMAN, M, ALBISTON, C, SCOGGINS, E, SWILLING, J, WALDEN, K, AHN, S, AMOS, E, BAKER, J, DOBKIN, B, DONAYRE, C, GELABERT, H, JORDAN, S, MACHLEDER, H, QUINONESBALDRICH, W, SAVER, J, ELSADEN, S, HOLGATE, R, JABOUR, B, JACOBS, J, ABRAHAM, T, VESCERA, C, VONRAJCS, J, CARTER, V, CARTER, D, DIXGOSS, D, HERNANDEZ, E, COULL, B, LOBOA, L, MONETA, G, PORTER, J, YEAGER, R, WHITTAKER, L, BRASS, L, GUSBERG, R, LOVEJOY, A, FAYAD, P, SUMPIO, B, MEIER, G, CHANG, V, MARZITELLI, K, CHYATTE, D, HAMMERS, L, LEPORE, F, PAVALKIS, F, MELE, J, KISIEL, D, BARNES, R, CHESSER, M, ARCHER, R, THOMPSON, B, MACDONALD, C, BARONE, G, EIDT, J, HARSHFIELD, D, MCFARLAND, D, NICKOLS, J, HOWARD, C, NIX, M, OVERSTREET, J, TROILLETT, R, TAYLOR, J, LEE, H, AKINS, P, HARBISON, J, PRIDGEON, R, FELTON, W, POSNER, M, SOBEL, M, CLIFTON, G, CONWAY, C, COCKRELL, A, STRINGER, W, WINGO, J, NICHOLS, B, SMOKER, W, FISHER, R, SPETZLER, R, FREY, J, ZABRAMSKI, J, HUNSLEY, S, JAHNKE, H, PLENGE, K, HOLLAND, R, TURNER, R, STRAVA, D, STUMPFF, S, HODAK, J, FLOM, R, DEAN, B, THOMPSON, R, HUGHES, R, LEPLER, B, BOWEN, J, BENOIT, C, HOLLIER, L, OCHSNER, J, STRUB, R, LANG, V, CAHANIN, V, HOBSON, R, WEISBROT, F, KAMIN, S, BACK, T, JAMIL, Z, ROGERS, C, LAINSON, B, HART, L, CAPLAN, L, ODONNELL, T, BARRON, L, PESSIN, M, DEWITT, D, MACKEY, W, BELKIN, M, MCGLAUGHLIN, R, HEGGERICK, P, WELCH, K, WILCZEWSKI, J, ROBERTSON, W, DALEY, S, ELLIOT, J, REDDY, D, SHEPHARD, A, LEVINE, S, RAMADAN, N, TIETJEN, G, MITSIAS, P, GORMAN, M, MCPHARLIN, M, PATEL, S, DEVESHWAR, R, LEE, N, KOKKINOS, J, WEINSTEIN, E, KUNKEL, J, KRATOCHVIL, A, JOHNSON, E, STEEL, S, NORRIS, J, ROWED, D, BOWYER, B, GAWEL, M, COOPER, P, BRODIE, D, KIRKLAND, J, SCHECTER, J, FARRAR, N, CAPPS, R, RHODES, E, ROGERS, D, GLASS, J, NAGUSZEWSKI, R, NAGUSZEWSKI, W, MADDOX, B, DOLLISON, B, MOULTON, L, COLE, P, KINSELLA, P, ANSLEY, A, BRITZ, N, BIVINS, D, WILLIAMS, E, DAVIDSON, J, ELIAS, W, ATKINS, D, TURNER, P, BURCH, J, NOLAN, D, SPEESE, R, FOLEY, C, MILLETTE, T, LANE, K, ALMOND, C, MESTAYER, R, CALANCHINI, P, SZARNICKI, R, RADOSEVICH, P, ELIAS, L, MCCORMICK, P, GOULD, C, NORRIS, F, DENYS, E, BERNSTEIN, R, DUBONO, D, ATKINSON, K, PETERS, M, COHEN, B, YAO, J, ROSTON, S, BLACKBURN, D, CHADWICK, L, MCCARTHY, W, PEARCE, W, FRANK, J, FERNANDEZBEER, E, PATRICK, J, GREEN, R, SATRAN, R, RICOTTA, J, DEWEESE, J, HOLLANDER, J, OBRIEN, M, MCNAMARA, J, ROSE, S, COHEN, D, FURLAN, A, LITTLE, J, BRYERTON, B, SILA, C, AWAD, I, CHIMOWITZ, M, ROBERTSON, S, BECKER, C, PAUSHTER, D, OLEARY, D, JONES, A, GEE, W, SHEBEL, N, FISHER, M, SCHENK, E, FUTRELL, N, MILLIKAN, C, DIENER, H, FIELDS, W, FOLSTEIN, M, GAUTIER, J, HARRISON, M, HASS, W, HENNERICI, M, SPENCER, M, and VONREUTERN, G

Published
1995

26. Risk of End‐Stage Renal Disease in HIV‐Positive Potential Live Kidney Donors

Author

Muzaale, A. D., Althoff, K. N., Sperati, C. J., Abraham, A. G., Kucirka, L. M., Massie, A. B., Kitahata, M. M., Horberg, M. A., Justice, A. C., Fischer, M. J., Silverberg, M. J., Butt, A. A., Boswell, S. L., Rachlis, A. R., Mayor, A. M., Gill, M. J., Eron, J. J., Napravnik, S., Drozd, D. R., Martin, J. N., Bosch, R. J., Durand, C. M., Locke, J. E., Moore, R. D., Lucas, G. M., and Segev, D. L.

Abstract

New federal regulations allow HIV‐positive individuals to be live kidney donors; however, potential candidacy for donation is poorly understood given the increased risk of end‐stage renal disease (ESRD) associated with HIV infection. To better understand this risk, we compared the incidence of ESRDamong 41 968 HIV‐positive participants of North America AIDSCohort Collaboration on Research and Design followed for a median of 5 years with the incidence of ESRDamong comparable HIV‐negative participants of National Health and Nutrition Examination IIIfollowed for a median of 14 years. We used risk associations from multivariable Cox proportional hazards regression to derive cumulative incidence estimates for selected HIV‐positive scenarios (no history of diabetes, hypertension, AIDS, or hepatitis C viruscoinfection) and compared these estimates with those from similarly selected HIV‐negative scenarios. For 40‐year‐old HIV‐positive individuals with health characteristics that were similar to those of age‐matched kidney donors, viral load <400 copies/mL, and CD4+count ≥500 cells/μL, the 9‐year cumulative incidence of ESRDwas higher than that of their HIV‐negative peers, yet still low: 2.5 versus 1.1 per 10 000 among white women, 3.0 versus 1.3 per 10 000 among white men, 13.2 versus 3.6 per 10 000 among black women, and 15.8 versus 4.4 per 10 000 among black men. HIV‐positive individuals with no comorbidities and well‐controlled disease may be considered low‐risk kidney donor candidates. This North American study demonstrates that HIV‐positive individuals with no comorbidities and well‐controlled disease may be considered low‐risk live kidney donor candidates. See Steiner's editorial on page 1701.

Published
2017
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33. Quantitative evaluation of sway as an indicator of functional balance in post-traumatic brain injury

Author

Jf, Lehmann, Boswell S, Price R, Burleigh A, Bj, Delateur, Km, Jaffe, and Hertling D

Subjects
Adult, Adolescent, Reference Values, Brain Injuries, Posture, Humans, Reproducibility of Results, Postural Balance
Abstract

The test of sway, using different conditions of stance with measurements of the average radial deviation of the center of pressure and its path length of sway per unit of time, has been shown to be a useful clinical tool in determining balance problems in traumatic brain injury (TBI) patients. Normative values were established to determine if an individual patient's sway values fell within the normal range (mean +/- 2SD). The tests have shown good test-retest reliability for TBI patients. In addition, it has been shown that the sensitivity of the test is sufficient to identify changes in patients' performances as their clinical conditions change. It has been demonstrated that the different stance conditions of the battery of tests become progressively more difficult to perform (from comfortable stance, eyes open and eyes closed, through narrow stance, eyes open and eyes closed, to tandem stance with right or left foot forward, eyes open and eyes closed). By using these subtests, it is easy to distinguish between the performances of able-bodied patients and TBI patients with very mild balance problems. The validity of the measure has been documented by correlating the sway performance with clinical functional performance tests. The test performance also correlates with the patient's own assessment of his or her gait difficulties. The limited data available suggest that the test of sway relates difficulties in static balance to the frequency of falls. Finally, subtests permit identification of specific problems in maintaining balance as a basis for therapeutic intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1990

48. Immunologic and virologic effects of subcutaneous interleukin 2 in combination with antiretroviral therapy: A randomized controlled trial.

Author

Davey RT Jr., Murphy RL, Graziano FM, Boswell SL, Pavia AT, Cancio M, Nadler JP, Chaitt DG, Dewar RL, Sahner DK, Duliege A, Capra WB, Leong W, Giedlin MA, Lane HC, Kahn JO, Davey, R T Jr, Murphy, R L, Graziano, F M, and Boswell, S L

Abstract

Context: While interleukin 2 (IL-2) is capable of inducing a marked expansion of the CD4 T-lymphocyte pool, limited data exist on whether IL-2 treatment can add significantly to the immunologic and virologic effects of potent antiretroviral therapy (ART).Objective: To determine the rate and magnitude of CD4 cell recovery and viral suppression when using a combination therapy of IL-2 and ART compared with ART alone.Design and Setting: Randomized, controlled multicenter trial conducted from April 1996 through April 1998 at 8 clinical sites in the United States.Patients: Eighty-two adult outpatients who were infected with human immunodeficiency virus (HIV) and had baseline CD4 cell counts of 200 x 10(6)/L to 500 x 10(6)/L and baseline RNA levels of fewer than 10,000 copies/mL were randomized; 78 completed the study.Interventions: Thirty-nine patients were randomly assigned to receive a combination therapy of subcutaneous IL-2 (administered in 5-day courses every 8 weeks at a starting dosage of 7.5 mIU twice per day) and ART; 43 were to receive ART therapy alone.Main Outcome Measures: Interleukin 2 safety and differential effects on CD4 cell counts, CD4 cell percentages, and plasma HIV RNA levels.Results: The mean (SD) percentage increase in CD4 cell counts at 1 year for patients who received IL-2 was 112% (113%) compared with 18% (35%) in recipients of ART alone (P<.001). Both groups had mean (SD) increases in CD4 cell percentage: from 20.4% (6.3%) to 32.3% (12.4%) for the combination therapy group compared with 20.4% (5.1%) to 23.0% (7.2%) for recipients of ART alone (P<.001). Using a sensitive viral RNA assay, mean viral load changes were -0.28 and 0.09 log(10) copies for IL-2 recipients and control patients, respectively (P=.03). Twenty (67%) of 30 evaluable patients receiving IL-2 achieved final viral loads of fewer than 50 copies/mL compared with 13 (36%) of 36 control patients (P=.02). Toxic effects were common among patients who received IL-2 and were managed with antipyretics, hydration, rest, and dosage reduction as needed.Conclusions: Intermittent therapy with IL-2 and ART produced a substantially greater increase in CD4 cells and was associated with a larger decrease in viral load than ART alone. Clinical end-point trials will be necessary to determine whether the enhanced viral suppression and CD4 cell increases associated with IL-2 therapy will translate into improved clinical outcomes. JAMA. 2000;284:183-189 [ABSTRACT FROM AUTHOR]

Published
2000
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49. HIV/AIDS patients' perspectives on adhering to regimens containing protease inhibitors.

Author

Stone, Valerie E., Clarke, Jennifer, Lovell, Joan, Steger, Kathleen A., Hirschhorn, Lisa R., Boswell, Stephen, Monroe, Alicia D., Stein, Michael D., Tyree, Tamra J., Mayer, Kenneth H., Stone, Stone, V E, Clarke, J, Lovell, J, Steger, K A, Hirschhorn, L R, Boswell, S, Monroe, A D, Stein, M D, and Tyree, T J

Subjects
AIDS patients, PROTEASE inhibitors, PUBLIC opinion
Abstract

Objective: To gather qualitative data regarding HIV/AIDS patients' perspectives about HIV-1 protease inhibitors (PIs), and about their experiences taking and adhering to regimens containing PIs.Design: Six focus groups of persons under care for HIV were conducted between September and November 1996 regarding participants' knowledge, awareness, experiences when taking, and adherence to antiretroviral regimens containing PIs. An identical discussion guide was used to facilitate all six groups. Focus group proceedings were audiotaped, transcribed, coded for themes, and analyzed qualitatively.Setting: HIV/AIDS practices of three teaching hospitals and two community health centers.Patients/participants: Fifty-six patients with HIV disease: 28 men and 28 women.Measurements and Main Results: Knowledge and positive impressions of PIs were prevalent among this diverse group of persons with HIV, and did not differ by race/ethnicity or gender. Most knew that these were new, potent medications for treating HIV/AIDS. Networks of persons with HIV and medical providers were the most important information sources. Those taking PIs were aware that adherence to the regimen is important, and most were using special strategies to maximize their own adherence, but expressed considerable frustration about the central role these medication regimens had assumed in their life. A subset who did not believe they would adhere to these regimens had declined treatment with them. Motivating factors for taking and adhering to these complex regimens were improving CD4 counts and viral loads and the patient-provider relationship.Conclusions: Among those with HIV/AIDS, awareness of PIs and their effectiveness is substantial, owing to the impact of informal networks and medical providers. This early positive "reputation" of PIs may enhance motivation for adherence. Those who are taking PIs invest substantial effort adhering to these complex regimens, but resent the need to make medications the focus of their lives. [ABSTRACT FROM AUTHOR]

Published
1998
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