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1. Effectiveness of preventive treatment among different age groups and Mycobacterium tuberculosis infection status: a systematic review and individual-participant data meta-analysis of contact tracing studies

Author

Martinez, Leonardo, Seddon, James, Liu, Qiao, Acuna Villaorduna, Carlos, Bonnet, Maryline, Carvalho, Anna Cristina C., Chan, Pei-Chun, Hill, Philip C, Lopez-Varela, Elisa, Donkor, Simon, Graham, Stephen M., Villalba, Julian A., Grandjean, Louis, Zellweger, Jean-Pierre, Wang, Jann-Yuan, Verhagen, Lilly M, van Schalkwykn, Cari, van der Loeff, Maarten F Schim, Sloot, Rosa, Trieu, Lisa, Ahuja, Shama Desai, Yoshiyama, Takashi, Mazahir, Rufaida, Martinsonn, Neil A, Jones-López, Edward C., Altet, Neus, Kato, Seiya, Fang, Chi-Tai, Geis, Steffen, Hauri, Anja, Long, Richard, Dobler, Claudia C, Cayla, Joan A, Chakhaia, Tsira, Chen, Cheng, García-Basteiro, Alberto L., Triasih, Rina, Huang, Li-Min, Sharma, Surendra, Hannoun, Djohar, Malone, LaShaunda L., Ling, Du-Lin, Kritski, Afrânio, Stein, Catherine M., Malik, Amyn A, Augusto, Orvalho, Vashishtha, Richa, Boulahbal, Fadila, Boom, W. Henry, Shen, Ye, Hesseling, Anneke C, Horsburgh, C. Robert, Lange, Christoph, Mandalakas, Anna M., Seddon, James A, Horsburgh, C Robert, and Mandalakas, Anna M

Published
2024
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2. The risk of tuberculosis in children after close exposure: a systematic review and individual-participant meta-analysis

Author

Martinez, Leonardo, Cords, Olivia, Horsburgh, C Robert, Andrews, Jason R, Consortium, Pediatric TB Contact Studies, Acuna-Villaorduna, Carlos, Ahuja, Shama Desai, Altet, Neus, Augusto, Orvalho, Baliashvili, Davit, Basu, Sanjay, Becerra, Mercedes, Bonnet, Maryline, Boom, W Henry, Borgdorff, Martien, Boulahbal, Fadila, Carvalho, Anna Cristina C, Cayla, Joan A, Chakhaia, Tsira, Chan, Pei-Chun, Cohen, Ted, Croda, Julio, Datta, Sumona, del Corral, Helena, Denholm, Justin T, Dietze, Reynaldo, Dobler, Claudia C, Donkor, Simon, Egere, Uzochukwu, Ellner, Jerrold J, Espinal, Marcos, Evans, Carlton A, Fang, Chi-Tai, Fielding, Katherine, Fox, Greg J, García, Luis F, García-Basteiro, Alberto L, Geis, Steffen, Graham, Stephen M, Grandjean, Louis, Hannoun, Djohar, Hatherill, Mark, Hauri, Anja M, Hesseling, Anneke C, Hill, Philip C, Huang, Li-Min, Huerga, Helena, Hussain, Rabia, Jarlsberg, Leah, Jones-López, Edward C, Kato, Seiya, Kato-Maeda, Midori, Kampmann, Beate, Kirchner, H Lester, Kritski, Afrânio, Lange, Christoph, Lee, Chih-Hsin, Lee, Li-Na, Lee, Meng-Rui, Lemos, Antonio Carlos, Lienhardt, Christian, Ling, Du-Lin, Liu, Qiao, Lo, Nathan C, Long, Richard, Lopez-Varela, Elisa, Lu, Peng, Magee, Matthew, Malone, LaShaunda L, Mandalakas, Anna M, Martinson, Neil A, Mazahir, Rufaida, Murray, Megan B, Netto, Eduardo Martins, Otero, Larissa, Parsonnet, Julie, Reingold, Arthur, Schaaf, H Simon, Seddon, James A, Sharma, Surendra, Singh, Jitendra, Singh, Sarman, Sloot, Rosa, Sotgiu, Giovanni, Stein, Catherine M, Iqbal, Najeeha Talat, Triasih, Rina, Trieu, Lisa, van der Loeff, Maarten F Schim, Van der Stuyft, Patrick, van Schalkwyk, Cari, Vashishtha, Richa, Verhagen, Lilly M, Villalba, Julian A, Wang, Jann-Yuan, Whalen, Christopher C, Yoshiyama, Takashi, Zar, Heather J, Zellweger, Jean-Pierre, and Zhu, Limei

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Tuberculosis, Prevention, Rare Diseases, Pediatric, Infectious Diseases, Emerging Infectious Diseases, Infection, Good Health and Well Being, Adolescent, Age Factors, Child, Child, Preschool, Contact Tracing, Disease Transmission, Infectious, Family Characteristics, Female, Global Health, Humans, Incidence, Male, Mycobacterium tuberculosis, Risk Assessment, Sex Factors, Tuberculosis, Pulmonary, Pediatric TB Contact Studies Consortium, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundTens of millions of children are exposed to Mycobacterium tuberculosis globally every year; however, there are no contemporary estimates of the risk of developing tuberculosis in exposed children. The effectiveness of contact investigations and preventive therapy remains poorly understood.MethodsIn this systematic review and meta-analysis, we investigated the development of tuberculosis in children closely exposed to a tuberculosis case and followed for incident disease. We restricted our search to cohort studies published between Jan 1, 1998, and April 6, 2018, in MEDLINE, Web of Science, BIOSIS, and Embase electronic databases. Individual-participant data and a pre-specified list of variables were requested from authors of all eligible studies. These included characteristics of the exposed child, the index case, and environmental characteristics. To be eligible for inclusion in the final analysis, a dataset needed to include: (1) individuals below 19 years of age; (2) follow-up for tuberculosis for a minimum of 6 months; (3) individuals with household or close exposure to an individual with tuberculosis; (4) information on the age and sex of the child; and (5) start and end follow-up dates. Studies assessing incident tuberculosis but without dates or time of follow-up were excluded. Our analysis had two primary aims: (1) estimating the risk of developing tuberculosis by time-period of follow-up, demographics (age, region), and clinical attributes (HIV, tuberculosis infection status, previous tuberculosis); and (2) estimating the effectiveness of preventive therapy and BCG vaccination on the risk of developing tuberculosis. We estimated the odds of prevalent tuberculosis with mixed-effects logistic models and estimated adjusted hazard ratios (HRs) for incident tuberculosis with mixed-effects Poisson regression models. The effectiveness of preventive therapy against incident tuberculosis was estimated through propensity score matching. The study protocol is registered with PROSPERO (CRD42018087022).FindingsIn total, study groups from 46 cohort studies in 34 countries-29 (63%) prospective studies and 17 (37%) retrospective-agreed to share their data and were included in the final analysis. 137 647 tuberculosis-exposed children were evaluated at baseline and 130 512 children were followed for 429 538 person-years, during which 1299 prevalent and 999 incident tuberculosis cases were diagnosed. Children not receiving preventive therapy with a positive result for tuberculosis infection had significantly higher 2-year cumulative tuberculosis incidence than children with a negative result for tuberculosis infection, and this incidence was greatest among children below 5 years of age (19·0% [95% CI 8·4-37·4]). The effectiveness of preventive therapy was 63% (adjusted HR 0·37 [95% CI 0·30-0·47]) among all exposed children, and 91% (adjusted HR 0·09 [0·05-0·15]) among those with a positive result for tuberculosis infection. Among all children

Published
2020

3. Effectiveness of preventive treatment among different age groups and Mycobacterium tuberculosisinfection status: a systematic review and individual-participant data meta-analysis of contact tracing studies

Author

Martinez, Leonardo, Seddon, James A, Horsburgh, C Robert, Lange, Christoph, Mandalakas, Anna M, Martinez, Leonardo, Seddon, James, Liu, Qiao, Acuna Villaorduna, Carlos, Bonnet, Maryline, Carvalho, Anna Cristina C., Chan, Pei-Chun, Hill, Philip C, Lopez-Varela, Elisa, Donkor, Simon, Graham, Stephen M., Villalba, Julian A., Grandjean, Louis, Zellweger, Jean-Pierre, Wang, Jann-Yuan, Verhagen, Lilly M, van Schalkwykn, Cari, van der Loeff, Maarten F Schim, Sloot, Rosa, Trieu, Lisa, Ahuja, Shama Desai, Yoshiyama, Takashi, Mazahir, Rufaida, Martinsonn, Neil A, Jones-López, Edward C., Altet, Neus, Kato, Seiya, Fang, Chi-Tai, Geis, Steffen, Hauri, Anja, Long, Richard, Dobler, Claudia C, Cayla, Joan A, Chakhaia, Tsira, Chen, Cheng, García-Basteiro, Alberto L., Triasih, Rina, Huang, Li-Min, Sharma, Surendra, Hannoun, Djohar, Malone, LaShaunda L., Ling, Du-Lin, Kritski, Afrânio, Stein, Catherine M., Malik, Amyn A, Augusto, Orvalho, Vashishtha, Richa, Boulahbal, Fadila, Boom, W. Henry, Shen, Ye, Hesseling, Anneke C, Horsburgh, C. Robert, Lange, Christoph, and Mandalakas, Anna M.

Abstract

Tuberculosis is a preventable disease. However, there is debate regarding which individuals would benefit most from tuberculosis preventive treatment and whether these benefits vary in settings with a high burden and low burden of tuberculosis. We aimed to compare the effectiveness of tuberculosis preventive treatment in exposed individuals of differing ages and Mycobacterium tuberculosisinfection status while considering tuberculosis burden of the settings.

Published
2024
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4. Discovery and validation of a personalized risk predictor for incident tuberculosis in low transmission settings

Author

Gupta, Rishi K., Calderwood, Claire J., Yavlinsky, Alexei, Krutikov, Maria, Quartagno, Matteo, Aichelburg, Maximilian C., Altet, Neus, Diel, Roland, Dobler, Claudia C., Dominguez, Jose, Doyle, Joseph S., Erkens, Connie, Geis, Steffen, Haldar, Pranabashis, Hauri, Anja M., Hermansen, Thomas, Johnston, James C., Lange, Christoph, Lange, Berit, van Leth, Frank, Muñoz, Laura, Roder, Christine, Romanowski, Kamila, Roth, David, Sester, Martina, Sloot, Rosa, Sotgiu, Giovanni, Woltmann, Gerrit, Yoshiyama, Takashi, Zellweger, Jean-Pierre, Zenner, Dominik, Aldridge, Robert W., Copas, Andrew, Rangaka, Molebogeng X., Lipman, Marc, Noursadeghi, Mahdad, and Abubakar, Ibrahim

Published
2020
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5. Effect of Acute Illness on Contact Patterns, Malawi, 2017

Author

Glynn, Judith R., McLean, Estelle, Malava, Jullita, Dube, Albert, Katundu, Cynthia, Crampin, Amelia C., and Geis, Steffen

Subjects
Disease transmission -- Comparative analysis, Medical research -- Comparative analysis, Housing, Setting (Literature), Public transportation, Diseases, Health
Abstract

Knowledge of patterns of contact between persons is central to understanding transmission of infections and for designing control strategies (2-3). Until recently, models estimating the spread of infections assumed random [...]

Published
2020
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9. Evaluation of Host Biomarkers to Support the Development of a Point-of-Care Diagnostic Test to Guide Antibiotic Use in Bacterial/Non-Bacterial Acute Febrile Illness Cases

Author

Fernandez-Carballo, B. Leticia, primary, Atzeni, Michele, additional, Escadafal, Camille, additional, Vettoretti, Martina, additional, Harris, Victoria, additional, Siqueira, André M., additional, Moreira, Jose Duarte, additional, Brasil, Patricia, additional, Oliveira, Luciano S., additional, da Rocha Matos, Aline, additional, Costa Caetano, Braulia, additional, Siqueira, Marilda, additional, Bispo de Filippis, Ana Maria, additional, Damasceno dos Santos Rodrigues, Cintia, additional, Cardoso dos Santos, Carolina, additional, Lourenço, Maria Cristina S., additional, Ribeiro- da- Silva, Erica Aparecido dos Santos, additional, Geis, Steffen, additional, Malava, Jullita Kenala, additional, Banda, Louis, additional, Kabwende, Anita L., additional, Alabi, Ayodele, additional, Ondo, Juste Christin Bie, additional, Massinga-Loembe, anon, additional, Essone, Paulin N., additional, Agnandji, Selidji Todagbe, additional, Häring, Julia, additional, Günther, Anna, additional, Jakobi, Meike, additional, Phokarel, Sunil, additional, Ongarello, Stefano, additional, Hoogland, Christine, additional, Macé, Aurélien, additional, Lee, Sue J., additional, Di Camillo, Barbara, additional, and Dittrich, Sabine, additional

Published
2023
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12. Changes in severity of influenza A(H1N1)pdm09 infection from pandemic to first postpandemic season, Germany

Author

Lehners, Nicola, Geis, Steffen, Eisenbach, Christoph, Neben, Kai, and Schnitzler, Paul

Subjects
Mortality -- Germany -- Analysis, Influenza -- Analysis -- Health aspects, Health
Abstract

Influenza pandemics have been associated with increased illness and death. Each pandemic is different, and areas of uncertainty always exist when an influenza virus emerges and becomes pandemic. In April [...]

Published
2013
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13. Additional file 1 of Assessing the costs and efficiency of HIV testing and treatment services in rural Malawi: implications for future 'test and start' strategies

Author

Vyas, Seema, Songo, John, Guinness, Lorna, Dube, Albert, Geis, Steffen, Thokozani Kalua, Todd, Jim, Renju, Jenny, Crampin, Amelia, and Wringe, Alison

Subjects
InformationSystems_INFORMATIONSTORAGEANDRETRIEVAL, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, ComputingMilieux_COMPUTERSANDEDUCATION, Data_FILES, ComputerApplications_COMPUTERSINOTHERSYSTEMS
Abstract

Additional file 1. : Supplementary Tables.

Published
2020
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14. Discovery and validation of a personalized risk predictor for incident tuberculosis in low transmission settings

Author

Gupta, Rishi K, Calderwood, Claire J, Yavlinsky, Alexei, Krutikov, Maria, Quartagno, Matteo, Aichelburg, Maximilian C, Altet, Neus, Diel, Roland, Dobler, Claudia C, Dominguez, Jose, Doyle, Joseph S, Erkens, Connie, Geis, Steffen, Haldar, Pranabashis, Hauri, Anja M, Hermansen, Thomas, Johnston, James C, Lange, Christoph, Lange, Berit, van Leth, Frank, Muñoz, Laura, Roder, Christine, Romanowski, Kamila, Roth, David, Sester, Martina, Sloot, Rosa, Sotgiu, Giovanni, Woltmann, Gerrit, Yoshiyama, Takashi, Zellweger, Jean-Pierre, Zenner, Dominik, Aldridge, Robert W, Copas, Andrew, Rangaka, Molebogeng X, Lipman, Marc, Noursadeghi, Mahdad, Abubakar, Ibrahim, Gupta, Rishi K, Calderwood, Claire J, Yavlinsky, Alexei, Krutikov, Maria, Quartagno, Matteo, Aichelburg, Maximilian C, Altet, Neus, Diel, Roland, Dobler, Claudia C, Dominguez, Jose, Doyle, Joseph S, Erkens, Connie, Geis, Steffen, Haldar, Pranabashis, Hauri, Anja M, Hermansen, Thomas, Johnston, James C, Lange, Christoph, Lange, Berit, van Leth, Frank, Muñoz, Laura, Roder, Christine, Romanowski, Kamila, Roth, David, Sester, Martina, Sloot, Rosa, Sotgiu, Giovanni, Woltmann, Gerrit, Yoshiyama, Takashi, Zellweger, Jean-Pierre, Zenner, Dominik, Aldridge, Robert W, Copas, Andrew, Rangaka, Molebogeng X, Lipman, Marc, Noursadeghi, Mahdad, and Abubakar, Ibrahim

Abstract

The risk of tuberculosis (TB) is variable among individuals with latent Mycobacterium tuberculosis infection (LTBI), but validated estimates of personalized risk are lacking. In pooled data from 18 systematically identified cohort studies from 20 countries, including 80,468 individuals tested for LTBI, 5-year cumulative incident TB risk among people with untreated LTBI was 15.6% (95% confidence interval (CI), 8.0-29.2%) among child contacts, 4.8% (95% CI, 3.0-7.7%) among adult contacts, 5.0% (95% CI, 1.6-14.5%) among migrants and 4.8% (95% CI, 1.5-14.3%) among immunocompromised groups. We confirmed highly variable estimates within risk groups, necessitating an individualized approach to risk stratification. Therefore, we developed a personalized risk predictor for incident TB (PERISKOPE-TB) that combines a quantitative measure of T cell sensitization and clinical covariates. Internal-external cross-validation of the model demonstrated a random effects meta-analysis C-statistic of 0.88 (95% CI, 0.82-0.93) for incident TB. In decision curve analysis, the model demonstrated clinical utility for targeting preventative treatment, compared to treating all, or no, people with LTBI. We challenge the current crude approach to TB risk estimation among people with LTBI in favor of our evidence-based and patient-centered method, in settings aiming for pre-elimination worldwide.

Published
2020
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17. Bacterial versus non-bacterial infections: a methodology to support use-case-driven product development of diagnostics

Author

Escadafal, Camille, primary, Geis, Steffen, additional, Siqueira, A M, additional, Agnandji, Selidji T, additional, Shimelis, Techalew, additional, Tadesse, Birkneh Tilahun, additional, Massinga Loembé, Marguerite, additional, Harris, Victoria, additional, Fernandez-Carballo, B Leticia, additional, Macé, Aurélien, additional, Ongarello, Stefano, additional, Rodriguez, William, additional, and Dittrich, Sabine, additional

Published
2020
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18. Self-reported disability in relation to mortality in rural Malawi: a longitudinal study of over 16 000 adults

Author

Prynn, Josephine E, primary, Dube, Albert, additional, Mkandawire, Joseph, additional, Koole, Olivier, additional, Geis, Steffen, additional, Mwaiyeghele, Elenaus, additional, Mwiba, Oddie, additional, Price, Alison J, additional, Kachiwanda, Lackson, additional, Nyirenda, Moffat, additional, Kuper, Hannah, additional, and Crampin, Amelia C, additional

Published
2020
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25. HIV-1 Genetic Diversity Among Incident Infections in Mbeya, Tanzania

Author

Billings, Erik, primary, Sanders-Buell, Eric, additional, Bose, Meera, additional, Kijak, Gustavo H., additional, Bradfield, Andrea, additional, Crossler, Jacqueline, additional, Arroyo, Miguel A., additional, Maboko, Leonard, additional, Hoffmann, Oliver, additional, Geis, Steffen, additional, Birx, Deborah L., additional, Kim, Jerome H., additional, Michael, Nelson L., additional, Robb, Merlin L., additional, Hoelscher, Michael, additional, and Tovanabutra, Sodsai, additional

Published
2017
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27. The role of the signaling molecule Ca2+ in the signal transduction of the SC-1-induced apoptosis

Author

Geis, Steffen

Subjects
ddc:610
Abstract

In der vorliegenden Arbeit wurde das Thema "Die Rolle des Signalmoleküls Ca2+ in der Signaltransduktion der SC-1-induzierten Apoptose" anhand von immunhisto-chemischen, proteinbiochemischen und fluoreszenzmikroskopischen Methoden erarbeitet. Die SC-1-induzierte Apoptose stellt einen neuen intrinsischen, „death domain“-unabhängigen Signalweg in der Vermittlung des programmierten Zelltodes dar, der über die Bindung dieses Antikörpers an CD55SC-1 ausgelöst wird. Dem Signalmolekül Ca2+ galt besonderes Interesse bei der Charakterisierung der durch SC-1 ausgelösten Signaltransduktion. Nach Aktivierung von CD55SC-1 durch SC-1 steigt das intrazelluläre Ca2+ um Faktor 2,7 an, stabilisiert sich danach auf dem 1,5fachen Ausgangsniveau. Dies hat keinerlei Einfluss auf die Ausführung des Apoptoseprogramms, ist aber maßgeblich in das Expressionsverhalten involviert. Der Ca2+ - Einstrom ist somit nicht direkt in die Ausführung der Apoptose beteiligt, durch die Hochregulation der Expression des Apoptoserezeptors verstärkt es jedoch die Wahrscheinlichkeit der Tumorzelle, den programmierten Zelltod zu vollziehen, da durch die verstärkte Expression dieses Apoptose-induzierenden Rezeptors auch die Wahrscheinlichkeit steigt, dass mehrere SC-1-Antikörper binden können. Da die Quervernetzung mehrerer Rezeptoren mittels des SC-1-Antikörpers in der Apoptoseinduktion von Nöten ist, stellt diese durch Ca2+ getriggerte Überexpression von CD55SC-1 einen essentiellen Bestandteil in der Exekution dieses Selbstmordprogrammes dar. Dieses Ergebnis gibt einen interessanten Einblick in den Signalweg der durch SC-1 induzierten Apoptose. Weiterführende Experimente sind notwendig, um genauere Erkenntnisse dieser einzigartigen Form einer gewebespezifischen Apoptose zu erlangen., not applicable

Published
2005

29. Molecular Characterization of a Respiratory Syncytial Virus Outbreak in a Hematology Unit in Heidelberg, Germany

Author

Geis, Steffen, primary, Prifert, Christiane, additional, Weissbrich, Benedikt, additional, Lehners, Nicola, additional, Egerer, Gerlinde, additional, Eisenbach, Christoph, additional, Buchholz, Udo, additional, Aichinger, Elisabeth, additional, Dreger, Peter, additional, Neben, Kai, additional, Burkhardt, Ulrich, additional, Ho, Anthony D., additional, Kräusslich, Hans-Georg, additional, Heeg, Klaus, additional, and Schnitzler, Paul, additional

Published
2013
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32. Viral and Host Factors Associated With the HIV-1 Viral Load Setpoint in Adults From Mbeya Region, Tanzania

Author

Saathoff, Elmar, primary, Pritsch, Michael, additional, Geldmacher, Christof, additional, Hoffmann, Oliver, additional, Koehler, Rebecca N, additional, Maboko, Leonard, additional, Maganga, Lucas, additional, Geis, Steffen, additional, McCutchan, Francine E, additional, Kijak, Gustavo H, additional, Kim, Jerome H, additional, Arroyo, Miguel A, additional, Gerhardt, Martina, additional, Tovanabutra, Sodsai, additional, Robb, Merlin L, additional, Williamson, Carolyn, additional, Michael, Nelson L, additional, and Hoelscher, Michael, additional

Published
2010
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33. Early Depletion ofMycobacterium tuberculosis–Specific T Helper 1 Cell Responses after HIV‐1 Infection

Author

Geldmacher, Christof, primary, Schuetz, Alexandra, additional, Ngwenyama, Njabulo, additional, Casazza, Joseph P., additional, Sanga, Erica, additional, Saathoff, Elmar, additional, Boehme, Catharina, additional, Geis, Steffen, additional, Maboko, Leonard, additional, Singh, Mahavir, additional, Minja, Fred, additional, Meyerhans, Andreas, additional, Koup, Richard A., additional, and Hoelscher, Michael, additional

Published
2008
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34. A High Viral Burden Predicts the Loss of CD8 T-Cell Responses Specific for Subdominant Gag Epitopes during Chronic Human Immunodeficiency Virus Infection

Author

Geldmacher, Christof, primary, Gray, Clive, additional, Nason, Martha, additional, Currier, Jeffrey R., additional, Haule, Antelmo, additional, Njovu, Lilian, additional, Geis, Steffen, additional, Hoffmann, Oliver, additional, Maboko, Leonard, additional, Meyerhans, Andreas, additional, Cox, Josephine, additional, and Hoelscher, Michael, additional

Published
2007
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35. CD8 T-Cell Recognition of Multiple Epitopes within Specific Gag Regions Is Associated with Maintenance of a Low Steady-State Viremia in Human Immunodeficiency Virus Type 1-Seropositive Patients

Author

Geldmacher, Christof, primary, Currier, Jeffrey R., additional, Herrmann, Eva, additional, Haule, Antelmo, additional, Kuta, Ellen, additional, McCutchan, Francine, additional, Njovu, Lilian, additional, Geis, Steffen, additional, Hoffmann, Oliver, additional, Maboko, Leonard, additional, Williamson, Carolyn, additional, Birx, Deborah, additional, Meyerhans, Andreas, additional, Cox, Josephine, additional, and Hoelscher, Michael, additional

Published
2007
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36. Contributing and Terminating Factors of a Large RSV Outbreak in an Adult Hematology and Transplant Unit.

Author

Aichinger, Elisabeth, Schnitzler, Paul, Heeg, Klaus, Dederer, Wolfgang, Benz, Michael A., Buda, Silke, Dreger, Peter, Egerer, Gerlinde, Eisenbach, Christoph, Geis, Steffen, Haas, Walter, Ho, Anthony D., Lehners, Nicola, Neben, Kai, Pfaff, Guenter, Prifert, Christiane, Schwertz, Rainer, Thalheimer, Markus, Wagner-Wiening, Christiane, and Weißbrich, Benedikt

Published
2014
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38. Risk factors for HIV-1 infection in a longitudinal, prospective cohort of adults from the Mbeya Region, Tanzania.

Author

Geis S, Maboko L, Saathoff E, Hoffmann O, Geldmacher C, Mmbando D, Samky E, Michael NL, Birx DL, Robb ML, and Hoelscher M

Subjects
Adolescent, Adult, Age Factors, Alcohol Drinking, Cohort Studies, Educational Status, Female, HIV Infections virology, HIV Seropositivity epidemiology, HIV-1, Humans, Incidence, Longitudinal Studies, Male, Prospective Studies, Risk Factors, Tanzania epidemiology, Young Adult, HIV Infections epidemiology
Abstract

Background: To control the global HIV epidemic, targeted interventions to reduce the incidence of HIV infections are urgently needed until an effective HIV vaccine is available. This study describes HIV-1 incidence and associated risk factors in a general population cohort of adults from Mbeya region, Tanzania, who participated in a vaccine preparedness study., Methods: We conducted a closed prospective cohort study with 6-monthly follow-up from 2002 to 2006 enrolling adults from the general population. HIV-1 incidence and risk factors for HIV-1 acquisition were analyzed using Cox regression., Results: We observed 2578 seronegative participants for a mean period of 3.06 person years (PY) (7471 PY in total). Overall HIV-1 incidence was 1.35 per 100 PY (95% confidence interval [CI], 1.10-1.64/100 PY). The highest overall HIV-1 incidence was found in females from Itende village (1.55 per 100 PY; 95% CI, 0.99-2.30/100 PY); the highest age-specific incidence was observed in semiurban males aged 30 to 34 years (2.75 per 100 PY; 95% CI, 0.75-7.04). HIV-1 acquisition was independently associated with female gender (hazard ratio [HR], 1.64; 95% CI, 1.05-2.57), younger age at enrollment (age 18-19 versus 35-39 years: HR, 0.29; 95% CI, 0.11-0.75), alcohol consumption (almost daily versus none: HR, 2.01; 95% CI, 1.00-4.07), education level (secondary school versus none: HR, 0.39; 95% CI, 0.17-0.89), and number of lifetime sex partners (more than five versus one: HR, 2.22; 95% CI, 1.13-4.36)., Conclusions: A high incidence of HIV was observed in this cohort, and incident infection was strongly associated with young age, alcohol consumption, low school education level, and number of sex partners. Targeted interventions are needed to address the elevated risk associated with these factors.

Published
2011
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39. Viral and host factors associated with the HIV-1 viral load setpoint in adults from Mbeya Region, Tanzania.

Author

Saathoff E, Pritsch M, Geldmacher C, Hoffmann O, Koehler RN, Maboko L, Maganga L, Geis S, McCutchan FE, Kijak GH, Kim JH, Arroyo MA, Gerhardt M, Tovanabutra S, Robb ML, Williamson C, Michael NL, and Hoelscher M

Subjects
Adolescent, Adult, CD4 Lymphocyte Count, Cohort Studies, Female, Genes, MHC Class I, HIV Infections immunology, Humans, Male, Multivariate Analysis, Poisson Distribution, Risk Factors, Socioeconomic Factors, Tanzania epidemiology, Viremia epidemiology, Viremia immunology, Viremia virology, Young Adult, HIV Infections epidemiology, HIV Infections virology, HIV-1 classification, Viral Load
Abstract

Background: The viral load setpoint (VLS) is an important predictor of HIV disease progression, but there is a lack of information regarding the VLS and its possible determinants in African populations., Methods: Initially HIV-negative adults from 3 distinct groups(female bar workers, females, and males from the general population)were followed for up to 4 years. The VLS was calculated for 108 seroconverters and associations of the VLS with possible risk factors were analyzed using univariate and multivariate regression., Results: The median VLS for female bar workers, females, and males from the general population were 69,850, 28,600, and 158,000 RNA copies per milliliter, respectively. Significant associations with an elevated viral load were observed for male gender [risk ratio(RR) = 1.83, 95% confidence interval (95% CI) = 1.14 to 2.93], the expression of harmful HLA I alleles (RR = 1.73, 95% CI = 1.13 to 2.66) and multiple infection with different HIV-1 subtypes (RR =1.65, 95% CI = 1.03 to 2.66). Bar workers were considerably more often infected with different HIV-1 subtypes than participants from the general population., Conclusions: Our study confirms that gender and the expression of different HLA class I alleles are important determinants of the viremia at VLS, and it also corroborates an earlier finding that multiple infection with different HIV-1 subtypes is associated with a higher VLS.

Published
2010
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