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4. The case for simplifying and using absolute targets for viral hepatitis elimination goals

Author

Razavi, H. Blach, S. Razavi-Shearer, D. Abaalkhail, F. Abbas, Z. Abdallah, A. Abrao Ferreira, P. Abu Raddad, L.J. Adda, D. Agarwal, K. Aghemo, A. Ahmed, A. Al-Busafi, S.A. Al-hamoudi, W. Al-Kaabi, S. Al-Romaihi, H. Aljarallah, B. AlNaamani, K. Alqahtani, S. Alswat, K. Altraif, I. Asselah, T. Bacon, B. Bessone, F. Bizri, A.R. Block, T. Bonino, F. Brandão-Mello, C.E. Brown, K. Bruggmann, P. Brunetto, M.R. Buti, M. Cabezas, J. Calleja, J.L. Castro Batänjer, E. Chan, H.L.-Y. Chang, H. Chen, C.-J. Christensen, P.B. Chuang, W.-L. Cisneros, L. Cohen, C. Colombo, M. Conway, B. Cooper, C. Craxi, A. Crespo, J. Croes, E. Cryer, D. Cupertino de Barros, F.P. Derbala, M. Dillon, J. Doss, W. Dou, X. Doyle, J. Duberg, A.-S. Dugan, E. Dunn, R. Dusheiko, G. El Khayat, H. El-Sayed, M.H. Eshraghian, A. Esmat, G. Esteban Mur, R. Ezzat, S. Falconer, K. Fassio, E. Ferrinho, P. Flamm, S. Flisiak, R. Foster, G. Fung, J. García-Samaniego, J. Gish, R.G. Gonçales, F. Halota, W. Hamoudi, W. Hassany, M. Hatzakis, A. Hay, S. Himatt, S. Hoepelman, I.M. Hsu, Y.-C. Hui, Y.T. Hunyady, B. Jacobson, I. Janjua, N. Janssen, H. Jarcuska, P. Kabagambe, K. Kanto, T. Kao, J.-H. Kaymakoglu, S. Kershenobich, D. Khamis, F. Kim, D.J. Kim, D.Y. Kondili, L.A. Kottilil, S. Kramvis, A. Kugelmas, M. Kurosaki, M. Lacombe, K. Lagging, M. Lao, W.-C. Lavanchy, D. Lazarus, J.V. Lee, A. Lee, S.S. Levy, M. Liakina, V. Lim, Y.-S. Liu, S. Maddrey, W. Malekzadeh, R. Marinho, R.T. Mathur, P. Maticic, M. Mendes Correa, M.C. Mera, J. Merat, S. Mogawer, S. Mohamed, R. Muellhaupt, B. Muljono, D. Mostafa, I. Nahum, M.S. Nawaz, A. Negro, F. Ninburg, M. Ning, Q. Ntiri- Reid, B. Nymadawa, P. Oevrehus, A. Ormeci, N. Orrego, M. Osman, A. Oyunsuren, T. Pan, C. Papaevangelou, V. Papatheodoridis, G. Popping, S. Prasad, P. Prithiviputh, R. Qureshi, H. Ramji, A. Razavi-Shearer, K. Reddy, R. Remak, W. Richter, C. Ridruejo, E. Robaeys, G. Roberts, S. Roberts, L. Roudot-Thoraval, F. Saab, S. Said, S. Salamat, A. Sanai, F. Sanchez-Avila, J.F. Schiff, E. Schinazi, R. Sebastiani, G. Seguin-Devaux, C. Shanmugam, R.P. Sharara, A. Shilton, S. Shouval, D. Sievert, W. Simonova, M. Sohrabpour, A.A. Sonderup, M. Soza, A. Wendy Spearman, C. Steinfurth, N. Sulkowski, M. Tan, S.-S. Tanaka, J. Tashi, D. Thein, H.-H. Thompson, P. Tolmane, I. Toy, M. Valantinas, J. Van de Vijver, D. Vélez-Möller, P. Vince, A. Waked, I. Wang, S. Wedemeyer, H. Wong, V. Xie, Q. Yamada, S. Yang, H.-I. Yesmembetov, K. Yilmaz, Y. Younossi, Z. Yu, M.-L. Yuen, M.-F. Yurdaydin, C. Yusuf, A. Zekry, A. Zeuzem, S. Polaris Observatory Collaborators

Subjects
digestive system diseases
Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit. © 2020 John Wiley & Sons Ltd

Published
2021

5. The case for simplifying and using absolute targets for viral hepatitis elimination goals.

Author

Razavi H., Blach S., Razavi-Shearer D., Abaalkhail F., Abbas Z., Abdallah A., Abrao Ferreira P., Abu Raddad L.J., Adda D., Agarwal K., Aghemo A., Ahmed A., Al-Busafi S.A., Al-hamoudi W., Al-Kaabi S., Al-Romaihi H., Aljarallah B., AlNaamani K., Alqahtani S., Alswat K., Altraif I., Asselah T., Bacon B., Bessone F., Bizri A.R., Block T., Bonino F., Brandao-Mello C.E., Brown K., Bruggmann P., Brunetto M.R., Buti M., Cabezas J., Calleja J.L., Castro Batanjer E., Chan H.L.-Y., Chang H., Chen C.-J., Christensen P.B., Chuang W.-L., Cisneros L., Cohen C., Colombo M., Conway B., Cooper C., Craxi A., Crespo J., Croes E., Cryer D., Cupertino de Barros F.P., Derbala M., Dillon J., Doss W., Dou X., Doyle J., Duberg A.-S., Dugan E., Dunn R., Dusheiko G., El Khayat H., El-Sayed M.H., Eshraghian A., Esmat G., Esteban Mur R., Ezzat S., Falconer K., Fassio E., Ferrinho P., Flamm S., Flisiak R., Foster G., Fung J., Garcia-Samaniego J., Gish R.G., Goncales F., Halota W., Hamoudi W., Hassany M., Hatzakis A., Hay S., Himatt S., Hoepelman I.M., Hsu Y.-C., Hui Y.T., Hunyady B., Jacobson I., Janjua N., Janssen H., Jarcuska P., Kabagambe K., Kanto T., Kao J.-H., Kaymakoglu S., Kershenobich D., Khamis F., Kim D.J., Kim D.Y., Kondili L.A., Kottilil S., Kramvis A., Kugelmas M., Kurosaki M., Lacombe K., Lagging M., Lao W.-C., Lavanchy D., Lazarus J.V., Lee A., Lee S.S., Levy M., Liakina V., Lim Y.-S., Liu S., Maddrey W., Malekzadeh R., Marinho R.T., Mathur P., Maticic M., Mendes Correa M.C., Mera J., Merat S., Mogawer S., Mohamed R., Muellhaupt B., Muljono D., Mostafa I., Nahum M.S., Nawaz A., Negro F., Ninburg M., Ning Q., Ntiri- Reid B., Nymadawa P., Oevrehus A., Ormeci N., Orrego M., Osman A., Oyunsuren T., Pan C., Papaevangelou V., Papatheodoridis G., Popping S., Prasad P., Prithiviputh R., Qureshi H., Ramji A., Razavi-Shearer K., Reddy R., Remak W., Richter C., Ridruejo E., Robaeys G., Roberts S., Roberts L., Roudot-Thoraval F., Saab S., Said S., Salamat A., Sanai F., Sanchez-Avila J.F., Schiff E., Schinazi R., Sebastiani G., Seguin-Devaux C., Shanmugam R.P., Sharara A., Shilton S., Shouval D., Sievert W., Simonova M., Sohrabpour A.A., Sonderup M., Soza A., Wendy Spearman C., Steinfurth N., Sulkowski M., Tan S.-S., Tanaka J., Tashi D., Thein H.-H., Thompson P., Tolmane I., Toy M., Valantinas J., Van de Vijver D., Velez-Moller P., Vince A., Waked I., Wang S., Wedemeyer H., Wong V., Xie Q., Yamada S., Yang H.-I., Yesmembetov K., Yilmaz Y., Younossi Z., Yu M.-L., Yuen M.-F., Yurdaydin C., Yusuf A., Zekry A., Zeuzem S., Razavi H., Blach S., Razavi-Shearer D., Abaalkhail F., Abbas Z., Abdallah A., Abrao Ferreira P., Abu Raddad L.J., Adda D., Agarwal K., Aghemo A., Ahmed A., Al-Busafi S.A., Al-hamoudi W., Al-Kaabi S., Al-Romaihi H., Aljarallah B., AlNaamani K., Alqahtani S., Alswat K., Altraif I., Asselah T., Bacon B., Bessone F., Bizri A.R., Block T., Bonino F., Brandao-Mello C.E., Brown K., Bruggmann P., Brunetto M.R., Buti M., Cabezas J., Calleja J.L., Castro Batanjer E., Chan H.L.-Y., Chang H., Chen C.-J., Christensen P.B., Chuang W.-L., Cisneros L., Cohen C., Colombo M., Conway B., Cooper C., Craxi A., Crespo J., Croes E., Cryer D., Cupertino de Barros F.P., Derbala M., Dillon J., Doss W., Dou X., Doyle J., Duberg A.-S., Dugan E., Dunn R., Dusheiko G., El Khayat H., El-Sayed M.H., Eshraghian A., Esmat G., Esteban Mur R., Ezzat S., Falconer K., Fassio E., Ferrinho P., Flamm S., Flisiak R., Foster G., Fung J., Garcia-Samaniego J., Gish R.G., Goncales F., Halota W., Hamoudi W., Hassany M., Hatzakis A., Hay S., Himatt S., Hoepelman I.M., Hsu Y.-C., Hui Y.T., Hunyady B., Jacobson I., Janjua N., Janssen H., Jarcuska P., Kabagambe K., Kanto T., Kao J.-H., Kaymakoglu S., Kershenobich D., Khamis F., Kim D.J., Kim D.Y., Kondili L.A., Kottilil S., Kramvis A., Kugelmas M., Kurosaki M., Lacombe K., Lagging M., Lao W.-C., Lavanchy D., Lazarus J.V., Lee A., Lee S.S., Levy M., Liakina V., Lim Y.-S., Liu S., Maddrey W., Malekzadeh R., Marinho R.T., Mathur P., Maticic M., Mendes Correa M.C., Mera J., Merat S., Mogawer S., Mohamed R., Muellhaupt B., Muljono D., Mostafa I., Nahum M.S., Nawaz A., Negro F., Ninburg M., Ning Q., Ntiri- Reid B., Nymadawa P., Oevrehus A., Ormeci N., Orrego M., Osman A., Oyunsuren T., Pan C., Papaevangelou V., Papatheodoridis G., Popping S., Prasad P., Prithiviputh R., Qureshi H., Ramji A., Razavi-Shearer K., Reddy R., Remak W., Richter C., Ridruejo E., Robaeys G., Roberts S., Roberts L., Roudot-Thoraval F., Saab S., Said S., Salamat A., Sanai F., Sanchez-Avila J.F., Schiff E., Schinazi R., Sebastiani G., Seguin-Devaux C., Shanmugam R.P., Sharara A., Shilton S., Shouval D., Sievert W., Simonova M., Sohrabpour A.A., Sonderup M., Soza A., Wendy Spearman C., Steinfurth N., Sulkowski M., Tan S.-S., Tanaka J., Tashi D., Thein H.-H., Thompson P., Tolmane I., Toy M., Valantinas J., Van de Vijver D., Velez-Moller P., Vince A., Waked I., Wang S., Wedemeyer H., Wong V., Xie Q., Yamada S., Yang H.-I., Yesmembetov K., Yilmaz Y., Younossi Z., Yu M.-L., Yuen M.-F., Yurdaydin C., Yusuf A., Zekry A., and Zeuzem S.

Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries' progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to <=5 per 100 000, reduce HBV prevalence among 1-year-olds to <=0.1%, reduce HBV and HCV mortality to <=5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.Copyright © 2020 John Wiley & Sons Ltd

Published
2021

9. Infectieziekten

Author

Hoepelman, I.M., primary, Dutilh, J.C., additional, Maarschalk-Ellerbroek, L. J., additional, van Lelyveld, S.F.L., additional, Troelstra, A., additional, and Verheij, Th.J.M., additional

Published
2010
Full Text
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14. Reversible opening of the blood-brain barrier by anti-bacterial antibodies

Author

Tuomanen, Elaine I., Prasad, Sudha M., George, Jonathan S., Hoepelman, I.M. Andy, Ibsen, Per, Heron, Iver, and Starzyk, Ruth M.

Subjects
Blood -- Agglutination, Endothelium -- Research, Science and technology
Abstract

It was assumed that filamentous hemagglutinin (FHA), an adhesion of the bacterium Bordetella pertussis, imitates the native ligand for the leukocyte adhesion molecule CR3 integrin on endothelial cells, and that anti-FHA antibodies cause endothelial permeability, disrupt leukocyte recruitment and bind to endothelial cells. CR3 enhances leukocyte transmigration into tissues, while FHA binds CR3. A close dependent rise in blood-brain barrier permeability, large enough to enhance the delivery of intravenously administered therapeutic agents to brain parenchyma, was caused by in vivo antibody binding, which also disrupted transmigration of leukocytes into cerebrospinal fluid.

Published
1993

15. Chronic Q fever: patient and treatment-related factors influencing long-term quality of life

Author

Roeden, S.E. van, Reukers, D.F.M., Jaarsveld, C.H.M. van, Kampschreur, L.M., Hoepelman, I.M., Wever, P.C., Bleeker-Rovers, C.P., Oosterheert, J.J., Roeden, S.E. van, Reukers, D.F.M., Jaarsveld, C.H.M. van, Kampschreur, L.M., Hoepelman, I.M., Wever, P.C., Bleeker-Rovers, C.P., and Oosterheert, J.J.

Abstract

Item does not contain fulltext, Background: Chronic Q fever is accompanied by high mortality and morbidity, and requires prolonged antibiotic treatment. Little is known on long-term quality of life (LQOL) in chronic Q fever patients treated with antibiotics. Aim: To identify patient and treatment-related factors associated with impaired LQOL in chronic Q fever patients treated with antibiotics, and to assess patients' perception on treatment. Design: Cross-sectional study. Methods: LQOL was assessed with a validated questionnaire from the Nijmegen Clinical Screening Instrument. Patients' perception on treatment was measured with three newly developed questions. Results: We included 64 patients: LQOL was impaired in 55% (n = 35) after a median follow-up of 5 years. Median treatment duration was 27 months. In multivariable analysis, treatment duration was significantly associated with impaired LQOL (OR 1.07; 95%CI 1.02-1.12, P < 0.01 per month increase). Age, gender, number of antibiotic regimens, surgical intervention, complications, diagnostic classification, focus of infection or registration of side effects during treatment were not associated with impaired LQOL. After start of treatment, 17 patients (27%) perceived improvement of their condition. Disadvantages of treatment were experienced on a daily basis by 24 patients (69%) with impaired LQOL and 13 patients (46%) without impaired LQOL (P = 0.04). Conclusions: LQOL in chronic Q fever patients treated with antibiotics is impaired in more than half of patients 5 years after diagnosis. Antibiotic treatment duration was the only variable associated with impaired LQOL. The majority of patients experienced disadvantages on a daily basis, highlighting the high burden of disease and treatment.

Published
2018

16. High treatment uptake in human immunodeficiency virus/ hepatitis C virus-coinfected patients after unrestricted access to direct-acting antivirals in the Netherlands

Author

Boerekamps, A. (Anne), Newsum, A.M. (Astrid M.), Smit, C. (Colette), Arends, J.E. (Joop), Richter, C. (Clemens), Reiss, P. (Peter), Rijnders, B.J.A. (Bart), Brinkman, K. (Kees), Valk, M. (Marc) van der, Geerlings, S.E. (Suzanne), Godfried, M.H., Goorhuis, A. (Abraham), Hovius, J.W.R. (Joppe), Meer, J.T.M. (J. T M) van der, Kuijpers, T.W. (Taco W.), Nellen, F.J.B. (F. J B), Van Der Poll, D.T. (D. T.), Prins, J.M. (Jan), Van Vugt, H.J.M. (H. J.M.), Wiersinga, W.J. (W. J.), Wit, F.W.N.M. (Ferdinand), Van Duinen, M. (M.), Van Eden, J., Van Hes, A.M.H., Mutschelknauss, M., Nobel, H.E., Pijnappel, F.J.J., Weijsenfeld, A.M., Jurriaans, S. (Suzanne), Back, N. (Nicole), Zaaijer, H.L. (Hans), Berkhout, B. (Ben), Cornelissen, M. (Marion), Schinkel, C.J., Wolthers, K.C. (Katja), Van Den Berge, M., Stegeman, A., Baas, S., Hage De Looff, L. (L.), Wintermans, B. (B.), Veenemans, J. (J.), Pronk, M.J.H. (Marjolijn), Ammerlaan, H.S.M. (Heidi), De Munnik, E.S., Jansz, A.R. (A. R.), Tjhie, J. (J.), Wegdam, M.C.A., Deiman, B. (B.), Scharnhorst, V., Eeden, A. (Arne) van, Brokking, W. (W.), Groot, M.M. (Marieke), Elsenburg, L.J.M. (L. J.M.), Damen, M. (M.), Kwa, I.S., Kasteren, M.E.E. (Marjo) van, Brouwer, A.E., Van Erve, R. (R.), De Kruijf-Van De Wiel, B.A.F.M. (B. A.F.M.), Keelan-Pfaf, S. (S.), Van Der Ven, B. (B.), Van Der Ven, B., Buiting, A.G.M. (Anton), Kabel, P.J. (P. J.), Versteeg, D., Ende, M.E. (Marchina) van der, Bax, H.I. (Hannelore), Gorp, E.C.M. (Eric) van, Nouwen, J.L. (Jan), Schurink, C.A.M. (Carolina), Verbon, A. (Annelies), Vriessluijs, T.E.M.S. (Theodora) de, De Jong-Peltenburg, N.C. (N. C.), Bassant, N., Van Beek, J.E.A., Vriesde, M., van Zonneveld, L. (Laura), Van Den Berg-Cameron, H.J., Groot, J.C. (Jan Cees) de, De Zeeuw-De Man, M., Boucher, C.A.B. (Charles), Koopmans D.V.M., M.P.G. (Marion), Kampen, J.J.A. (Jeroen) van, Pas, S.D. (Suzan), Branger, J., Rijkeboer-Mes, A. (A.), Duijf-Van De Ven, C.J.H.M., Schippers, E.F. (E. F.), Nieuwkoop, C. (Cees) van, Van IJperen, J.M. (J. M.), Geilings, J. (J.), Van Der Hut, G., Burgel, N.D. (Nathalie ) van, Leyten, E.M.S. (Eliane), Gelinck, L.B.S. (Luc), Van Hartingsveld, A.Y. (A. Y.), Meerkerk, C., Wildenbeest, G.S., Heikens, E. (E.), Groeneveld, P.H.P. (P. H.P.), Bouwhuis, J.W. (Jolande), Lammers, A.J.J. (A. J.J.), Kraan, S. (S.), Van Hulzen, A.G.W., Van Der Bliek, G.L. (G. L.), Bor, P.C.J., Bloembergen, P. (Peter), Wolfhagen, M.J.H.M., Ruijs, G. (G.), Kroon, F.P. (F. P.), Boer, M.G.J. (Mark) de, Scheper, H. (H.), Jolink, A. (Albert), Vollaard, A. (Albert), Dorama, W. (Willemien), Van Holten, N. (N.), Claas, E.C.J. (Eric), Wessels, E. (E.), Hollander, J.G. (Jan) den, Pogány, K. (Katalin), Roukens, A. (A.), Kastelijns, M. (M.), Smit, J.V., Smit, E., Struik-Kalkman, D. (D.), Tearno, C. (C.), Van Niekerk, T., Pontesilli, O. (Oscar), Lowe, S.H. (S. H.), Oude Lashof, A. (A.), Posthouwer, D. (Dirk), Ackens, R.P. (R. P.), Burgers, K. (K.), Schippers, J., Weijenberg-Maes, B. (B.), Loo, I. (Inge) van, Havenith, T., Mulder, J.W. (J. W.), Vrouenraets, B.C. (Bart), Lauw, F.N. (F. N.), van Broekhuizen, M. (Marjolein), Vlasblom, D.J., Smits, P.H.M. (Paul), Weijer, S. (S.), El Moussaoui, R., Bosma, A.S. (A. S.), Vonderen, M.G.A. van, Van Houte, D.P.F., Kampschreur, L.M., Dijkstra, K. (K.), Faber, S., Weel, J. (J.), Kootstra, J.G. (Jille), Delsing, C.E. (C. E.), Van Der Burg-Van De Plas, M. (M.), Heins, H., Lucas, E. (E.), Kortmann, B., Van Twillert, G. (G.), Renckens, R. (Rosemarijn), Ruiter-Pronk, D. (D.), Van Truijen-Oud, F.A., Cohen Stuart, J.W.T. (James), IJzerman, E.P.F. (Ed), Jansen, R.J. (Roel), Rozemeijer, W. (Wouter), Van Der Reijden, W.A. (W. A.), Berk, G.E.L. (Guido) van den, Blok, W.L. (Willem), Frissen, P.H.J., Lettinga, K.D. (Kamilla), Schouten, W.E.M.I. (Ineke), Veenstra, J. (Jan), Brouwer, C.J., Geerders, G.F., Hoeksema, K., Kleene, M.J., Van Der Meché, I.B., Spelbrink, M. (M.), Toonen, A.J.M., Wijnands, S. (S.), Kwa, S.L.S. (Stefan), Regez, R.M. (Rosa), Crevel, R. (Reinout) van, Keuter, M. (Monique), Ven, A.D. (Andre´) van, Ter Hofstede, H.J.M. (H. J.M.), Dofferhoff, A.S.M. (Anton), Hoogerwerf, J. (J.), Grintjes-Huisman, K.J.T., De Haan, M. (M.), Marneef, M. (M.), Hairwassers, A. (A.), Rahamat-Langendoen, J. (J.), Stelma, F.F. (Foekje), Burger, D.M. (David), Gisolf, E.H. (Elisabeth), Hassing, R.J. (Robert), Claassen, M.A.A. (Mark), Ter Beest, G. (G.), Van Bentum, P.H.M., Langebeek, N. (Nienke), Tiemessen, R. (R.), Swanink, C. (Caroline), Lelyveld, S.F.L. van, Soetekouw, R. (Robert), Van Der Prijt, L.M.M., Van Der Swaluw, J. (J.), Bermon, N. (N.), Jansen, R. (R.), Herpers, B.L. (B. L.), Veenendaal, D. (Dick), Verhagen, D.W.M. (Dominique), Van Wijk, M. (M.), Bierman, W.F.W. (Wouter), Bakker, M. (M.), Kleinnijenhuis, J. (J.), Kloeze, E. (E.), Stienstra, Y. (Y.), Wilting, K.R., Wouthuyzen-Bakker, M. (Marjan), Boonstra, P.A. (André), Van Der Meulen, P.A., De Weerd, D.A., Niesters, H.G.M. (Bert), Van Leer-Buter, C. (Coretta), Knoester, M. (M.), Hoepelman, I.M. (Ilja Mohandas), Barth, R.E. (R. E.), Bruns, A.H.W. (A. H.W.), Ellerbroek, P.M. (P.), Mudrikova, T. (Tania Tania), Oosterheert, J.J. (Jan Jelrik), Schadd, E.M. (E. M.), Wassenberg, M.W.M., Van Zoelen, M.A.D. (M. A.D.), Aarsman, K. (K.), Van Elst-Laurijssen, D.H.M. (D. H.M.), De Kroon, I. (I.), Van Rooijen, C.S.A.M. (C. S.A.M.), Van Berkel, M. (M.), Schuurman, R. (Rob), Verduyn-Lunel, F., Wensing, A. (Amj), Peters, E.J.G., Van Agtmael, M.A. (M. A.), Bomers, M., Heitmuller, M. (M.), Laan, L.M., Ang, C.W. (Wim), Houdt, R. van, Pettersson, A. (Annika), Vandenbroucke-Grauls, C.M.J.E. (Christina), Bezemer, D.O. (Daniela), Sighem, A.I. (Ard) van, Smit, C. (Cees), Wit, F. (Ferdinand), Boender, T.S. (T. S.), Zaheri, S. (S.), Hillebregt, M.M.J. (Mariska), De Jong, A., Bergsma, D., Grivell, S., Jansen, A. (A.), Raethke, M., Meijering, R., Rutkens, T. (T.), De Groot, L. (L.), Van Den Akker, M. (M.), Bakker, Y., Bezemer, M. 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(Caroline), Lelyveld, S.F.L. van, Soetekouw, R. (Robert), Van Der Prijt, L.M.M., Van Der Swaluw, J. (J.), Bermon, N. (N.), Jansen, R. (R.), Herpers, B.L. (B. L.), Veenendaal, D. (Dick), Verhagen, D.W.M. (Dominique), Van Wijk, M. (M.), Bierman, W.F.W. (Wouter), Bakker, M. (M.), Kleinnijenhuis, J. (J.), Kloeze, E. (E.), Stienstra, Y. (Y.), Wilting, K.R., Wouthuyzen-Bakker, M. (Marjan), Boonstra, P.A. (André), Van Der Meulen, P.A., De Weerd, D.A., Niesters, H.G.M. (Bert), Van Leer-Buter, C. (Coretta), Knoester, M. (M.), Hoepelman, I.M. (Ilja Mohandas), Barth, R.E. (R. E.), Bruns, A.H.W. (A. H.W.), Ellerbroek, P.M. (P.), Mudrikova, T. (Tania Tania), Oosterheert, J.J. (Jan Jelrik), Schadd, E.M. (E. M.), Wassenberg, M.W.M., Van Zoelen, M.A.D. (M. A.D.), Aarsman, K. (K.), Van Elst-Laurijssen, D.H.M. (D. H.M.), De Kroon, I. (I.), Van Rooijen, C.S.A.M. (C. S.A.M.), Van Berkel, M. (M.), Schuurman, R. (Rob), Verduyn-Lunel, F., Wensing, A. (Amj), Peters, E.J.G., Van Agtmael, M.A. (M. A.), Bomers, M., Heitmuller, M. (M.), Laan, L.M., Ang, C.W. (Wim), Houdt, R. van, Pettersson, A. (Annika), Vandenbroucke-Grauls, C.M.J.E. (Christina), Bezemer, D.O. (Daniela), Sighem, A.I. (Ard) van, Smit, C. (Cees), Wit, F. (Ferdinand), Boender, T.S. (T. S.), Zaheri, S. (S.), Hillebregt, M.M.J. (Mariska), De Jong, A., Bergsma, D., Grivell, S., Jansen, A. (A.), Raethke, M., Meijering, R., Rutkens, T. (T.), De Groot, L. (L.), Van Den Akker, M. (M.), Bakker, Y., Bezemer, M. (M.), Claessen, E., El Berkaoui, A. (A.), Geerlinks, J. (J.), Koops, J. (J.), Kruijne, E., Lodewijk, C., Van Der Meer, R. (R.), Munjishvili, L., Paling, F. (F.), Peeck, B., Ree, C., Regtop, R., Ruijs, Y., Schoorl, M. (Marianne), Timmerman, A. (A.), Tuijn, E., Veenenberg, L., Van Der Vliet, S. (S.), Wisse, A. (A.), De Witte, E.C. (E. C.), Woudstra, T., and Tuk, B. (B.)

Abstract

Background The Netherlands has provided unrestricted access to direct-acting antivirals (DAAs) since November 2015. We analyzed the nationwide hepatitis C virus (HCV) treatment uptake among patients coinfected with human immunodeficiency virus (HIV) and HCV. Methods Data were obtained from the ATHENA HIV observational cohort in which >98% of HIV-infected patients ever registered since 1998 are included. Patients were included if they ever had 1 positive HCV RNA result, did not have spontaneous clearance, and were known to still be in care. Treatment uptake and outcome were assessed. When patients were treated more than once, data were included from only the most recent treatment episode. Data were updated until February 2017. In addition, each treatment center was queried in April 2017 for a data update on DAA treatment and achieved sustained virological response. Results Of 23574 HIV-infected patients ever linked to care, 1471 HCV-coinfected patients (69% men who have sex with men, 15% persons who [formerly] injected drugs, and 15% with another HIV transmission route) fulfilled the inclusion criteria. Of these, 87% (1284 of 1471) had ever initiated HCV treatment between 2000 and 2017, 76% (1124 of 1471) had their HCV infection cured; DAA treatment results were pending in 6% (92 of 1471). Among men who have sex with men, 83% (844 of 1022) had their HCV infection cured, and DAA treatment results were pending in 6% (66 of 1022). Overall, 187 patients had never initiated treatment, DAAs had failed in 14, and a pegylated interferon-alfa–based regimen had failed in 54. Conclusions Fifteen months after unrestricted DAA availability the majority of HIV/HCV-coinfected patients in the Netherlands have their HCV infection cured (76%) or are awaiting DAA treatment results (6%). This rapid treatment scale-up may contribute to future HCV elimination among these patients.

Published
2018
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20. Transmission of HIV drug resistance and the predicted effect on current first-line regimens in Europe

Author

Hofstra, L.M. Sauvageot, N. Albert, J. Alexiev, I. Garcia, F. Struck, D. Van De Vijver, D.A.M.C. Åsjö, B. Beshkov, D. Coughlan, S. Descamps, D. Griskevicius, A. Hamouda, O. Horban, A. Van Kasteren, M. Kolupajeva, T. Kostrikis, L.G. Liitsola, K. Linka, M. Mor, O. Nielsen, C. Otelea, D. Paraskevis, D. Paredes, R. Poljak, M. Puchhammer-Stöckl, E. Sönnerborg, A. Staneková, D. Stanojevic, M. Van Laethem, K. Zazzi, M. Lepej, S.Z. Boucher, C.A.B. Schmit, J.-C. Wensing, A.M.J. Puchhammer-Stockl, E. Sarcletti, M. Schmied, B. Geit, M. Balluch, G. Vandamme, A.-M. Vercauteren, J. Derdelinckx, I. Sasse, A. Bogaert, M. Ceunen, H. De Roo, A. De Wit, S. Echahidi, F. Fransen, K. Goffard, J.-C. Goubau, P. Goudeseune, E. Yombi, J.-C. Lacor, P. Liesnard, C. Moutschen, M. Pierard, D. Rens, R. Schrooten, Y. Vaira, D. Vandekerckhove, L.P.R. Van Den Heuvel, A. Van Der Gucht, B. Van Ranst, M. Van Wijngaerden, E. Vandercam, B. Vekemans, M. Verhofstede, C. Clumeck, N. Begovac, J. Demetriades, I. Kousiappa, I. Demetriou, V. Hezka, J. Maly, M. Machala, L. Jørgensen, L.B. Gerstoft, J. Mathiesen, L. Pedersen, C. Nielsen, H. Laursen, A. Kvinesdal, B. Ristola, M. Suni, J. Sutinen, J. Assoumou, L. Castor, G. Grude, M. Flandre, P. Storto, A. Kücherer, C. Berg, T. Braun, P. Poggensee, G. Däumer, M. Eberle, J. Heiken, H. Kaiser, R. Knechten, H. Korn, K. Müller, H. Neifer, S. Schmidt, B. Walter, H. Gunsenheimer-Bartmeyer, B. Harrer, T. Hatzakis, A. Zavitsanou, A. Vassilakis, A. Lazanas, M. Chini, M. Lioni, A. Sakka, V. Kourkounti, S. Paparizos, V. Antoniadou, A. Papadopoulos, A. Poulakou, G. Katsarolis, I. Protopapas, K. Chryssos, G. Drimis, S. Gargalianos, P. Xylomenos, G. Lourida, G. Psichogiou, M. Daikos, G.L. Sipsas, N.V. Kontos, A. Gamaletsou, M.N. Koratzanis, G. Sambatakou, E. Mariolis, H. Skoutelis, A. Papastamopoulos, V. Georgiou, O. Panagopoulos, P. Maltezos, E. De Gascun, C. Byrne, C. Duffy, M. Bergin, C. Reidy, D. Farrell, G. Lambert, J. O'Connor, E. Rochford, A. Low, J. Coakely, P. O'Dea, S. Hall, W. Levi, I. Chemtob, D. Grossman, Z. De Luca, A. Balotta, C. Riva, C. Mussini, C. Caramma, I. Capetti, A. Colombo, M.C. Rossi, C. Prati, F. Tramuto, F. Vitale, F. Ciccozzi, M. Angarano, G. Rezza, G. Vasins, O. Lipnickiene, V. Hemmer, R. Arendt, V. Michaux, C. Staub, T. Sequin-Devaux, C. Van Kessel, A. Van Bentum, P.H.M. Brinkman, K. Connell, B.J. Van Der Ende, M.E. Hoepelman, I.M. Kuipers, M. Langebeek, N. Richter, C. Santegoets, R.M.W.J. Schrijnders-Gudde, L. Schuurman, R. Van De Ven, B.J.M. Kran, A.-M.B. Ormaasen, V. Aavitsland, P. Stanczak, J.J. Stanczak, G.P. Firlag-Burkacka, E. Wiercinska-Drapalo, A. Jablonowska, E. Maolepsza, E. Leszczyszyn-Pynka, M. Szata, W. Camacho, R. Palma, C. Borges, F. Paixão, T. Duque, V. Araújo, F. Paraschiv, S. Tudor, A.M. Cernat, R. Chiriac, C. Dumitrescu, F. Prisecariu, L.J. Jevtovic, Dj. Salemovic, D. Stanekova, D. Habekova, M. Chabadová, Z. Drobkova, T. Bukovinova, P. Shunnar, A. Truska, P. Lunar, M. Babic, D. Tomazic, J. Vidmar, L. Vovko, T. Karner, P. Monge, S. Moreno, S. Del Amo, J. Asensi, V. Sirvent, J.L. De Mendoza, C. Delgado, R. Gutiérrez, F. Berenguer, J. Garcia-Bujalance, S. Stella, N. De Los Santos, I. Blanco, J.R. Dalmau, D. Rivero, M. Segura, F. Elías, M.J.P. Alvarez, M. Chueca, N. Rodríguez-Martín, C. Vidal, C. Palomares, J.C. Viciana, I. Viciana, P. Cordoba, J. Aguilera, A. Domingo, P. Galindo, M.J. Miralles, C. Del Pozo, M.A. Ribera, E. Iribarren, J.A. Ruiz, L. De La Torre, J. Vidal, F. Clotet, B. Heidarian, A. Aperia-Peipke, K. Axelsson, M. Mild, M. Karlsson, A. Thalme, A. Navér, L. Bratt, G. Blaxhult, A. Gisslén, M. Svennerholm, B. Björkman, P. Säll, C. Mellgren, Å. Lindholm, A. Kuylenstierna, N. Montelius, R. Azimi, F. Johansson, B. Carlsson, M. Johansson, E. Ljungberg, B. Ekvall, H. Strand, A. Mäkitalo, S. Öberg, S. Holmblad, P. Höfer, M. Holmberg, H. Josefson, P. Ryding, U. Bergbrant, I. SPREAD Program

Abstract

Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)-infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%-9.5%) in 2008-2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected. © The Author 2015.

Published
2016

21. Primary resistance to integrase strand-transfer inhibitors in Europe

Author

Casadellà, M. van Ham, P.M. Noguera-Julian, M. van Kessel, A. Pou, C. Hofstra, L.M. Santos, J.R. Garcia, F. Struck, D. Alexiev, I. Bakken Kran, A.M. Hoepelman, A.I. Kostrikis, L.G. Somogyi, S. Liitsola, K. Linka, M. Nielsen, C. Otelea, D. Paraskevis, D. Poljak, M. Puchhammer-Stöckl, E. Staneková, D. Stanojevic, M. Van Laethem, K. Zidovec Lepej, S. Clotet, B. Boucher, C.A.B. Paredes, R. Wensing, A.M.J. Puchhammer-Stöckl, E. Sarcletti, M. Schmied, B. Geit, M. Balluch, G. Vandamme, A.M. Vercauteren, J. Derdelinckx, I. Sasse, A. Bogaert, M. Ceunen, H. De Roo, A. De Wit, S. Echahidi, F. Fransen, K. Goffard, J.C. Goubau, P. Goudeseune, E. Yombi, J.C. Lacor, P. Liesnard, C. Moutschen, M. Pierard, D. Rens, R. Schrooten, Y. Vaira, D. Vandekerckhove, L.P. Van den Heuvel, A. Van Der Gucht, B. Van Ranst, M. Van Wijngaerden, E. Vandercam, B. Vekemans, M. Verhofstede, C. Clumeck, N. Van Laethem, K. Beshkov, D. Alexiev, I. Zidovec Lepej, S. Begovac, J. Demetriades, I. Kousiappa, I. Demetriou, V. Hezka, J. Linka, M. Machala, L. Maly, M. Nielsen, C. Jørgensen, L.B. Gerstoft, J. Mathiesen, L. Pedersen, C. Nielsen, H. Laursen, A. Kvinesdal, B. Liitsola, K. Ristola, M. Suni, J. Sutinen, J. Hamouda, O. Kücherer, C. Berg, T. Braun, P. Poggensee, G. Däumer, M. Eberle, J. Heiken, H. Kaiser, R. Knechten, H. Korn, K. Müller, H. Neifer, S. Schmidt, B. Walter, H. Gunsenheimer-Bartmeyer, B. Harrer, T. Paraskevis, D. Hatzakis, A. Magiorkinis, E. Hatzitheodorou, E. Haida, C. Zavitsanou, A. Magiorkinis, G. Lazanas, M. Chini, M. Magafas, N. Tsogas, N. Paparizos, V. Kourkounti, S. Antoniadou, A. Papadopoulos, A. Panagopoulos, P. Poulakou, G. Sakka, V. Chryssos, G. Drimis, S. Gargalianos, P. Lelekis, M. Chilomenos, G. Psichogiou, M. Daikos, G.L. Sabatakou, H. Panos, G. Haratsis, G. Kordossis, T. Kontos, A. Koratzanis, G. Theodoridou, M. Mostrou, G. Spoulou, V. Schmit, J.C. Struck, D. Hemmer, R. Arendt, V. Staub, T. Schneider, F. Roman, F. Wensing, A.M. Boucher, C.A. van de Vijver, D.A. van Kessel, A. van, P.H. Brinkman, K. Op de, E.L. van der Ende, M.E. Hoepelman, I.M. van Kasteren, M. Juttmann, J. Kuipers, M. Langebeek, N. Richter, C. Santegoets, R.M. Schrijnders-Gudde, L. Schuurman, R. van de Ven, B.J. Åsjö, B. Bakken, A.M. Ormaasen, V. Aavitsland, P. Otelea, D. Paraschiv, S. Tudor, A.M. Jevtovic, D. Salemovic, D. Stanekova, D. Habekova, M. Mokras, M. Truska, P. Poljak, M. Lunar, M. Babic, D. Tomazic, J. Vidmar, L. Vovko, T. Karner, P. Clotet, B. Garcia, F. Domingo, P. Galindo, M.J. Miralles, C. Del, M.A. Ribera, E. Iribarren, J.A. Ruiz, L. de la Torre, J. Vidal, F. Garcia, F. Paredes, R. on behalf of the SPREAD programme

Abstract

Objectives: The objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. Methods: This was a multicentre, cross-sectional study within the European SPREAD HIV resistance surveillance programme. A representative set of 300 samples was selected from 1950 naive HIV-positive subjects newly diagnosed in 2006-07. The prevalence of InSTI resistance was evaluated using quality-controlled baseline population sequencing of integrase. Signature raltegravir, elvitegravir and dolutegravir resistance mutations were defined according to the IAS-USA 2014 list. In addition, all integrase substitutions relative to HXB2 were identified, including those with a Stanford HIVdb score=10 to at least one InSTI. To rule out circulation of minority InSTIresistant HIV, 65 samples were selected for 454 integrase sequencing. Results: For the population sequencing analysis, 278 samples were retrieved and successfully analysed. No signature resistance mutations to any of the InSTIswere detected. Eleven (4%) subjects hadmutations at resistance-associated positions with an HIVdb score =10. Of the 56 samples successfully analysed with 454 sequencing, no InSTI signature mutationsweredetected, whereas integrase substitutionswithanHIVdbscore=10were found in8(14.3%) individuals. Conclusions:No signature InSTI-resistant variantswere circulating in Europe before the introduction of InSTIs. However, polymorphisms contributing to InSTI resistancewere not rare. As InSTI use becomes more widespread, continuous surveillance of primary InSTI resistance is warranted. These data will be key to modelling the kinetics of InSTI resistance transmission in Europe in the coming years. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Published
2015

24. Persistence of frequently transmitted drug-resistant HIV-1 variants can be explained by high viral replication capacity

Author

Pingen, M. (Marieke), Wensing, A.M.J. (Annemarie), Fransen, K. (K.), Bel, A.V. (Annelies) de, Jong, D. (Dorien) de, Hoepelman, I.M. (Ilja Mohandas), Magiorkinis, G. (Gkikas), Paraskevis, D. (Dimitrios), Lunar, M.M. (Maja M.), Poljak, M. (Mario), Nijhuis, M. (Monique), Boucher, C.A.B. (Charles), Pingen, M. (Marieke), Wensing, A.M.J. (Annemarie), Fransen, K. (K.), Bel, A.V. (Annelies) de, Jong, D. (Dorien) de, Hoepelman, I.M. (Ilja Mohandas), Magiorkinis, G. (Gkikas), Paraskevis, D. (Dimitrios), Lunar, M.M. (Maja M.), Poljak, M. (Mario), Nijhuis, M. (Monique), and Boucher, C.A.B. (Charles)

Abstract

Background: In approximately 10% of newly diagnosed individuals in Europe, HIV-1 variants harboring transmitted drug resistance mutations (TDRM) are detected. For some TDRM it has been shown that they revert to wild type while other mutations persist in the absence of therapy. To understand the mechanisms explaining persistence we investigated the in vivo evolution of frequently transmitted HIV-1 variants and their impact on in vitro replicative capacity. Results: We selected 31 individuals infected with HIV-1 harboring frequently observed TDRM such as M41L or K103N in reverse transcriptase (RT) or M46L in protease. In all these samples, polymorphisms at non-TDRM positions were present at baseline (median protease: 5, RT: 6). Extensive analysis of viral evolution of protease and RT demonstrated that the majority of TDRM (51/55) persisted for at least a year and even up to eight years in the plasma. During follow-up only limited selection of additional polymorphisms was observed (median: 1). Conclusions: We demonstrate limited in vivo evolution of protease and RT harbouring frequently observed TDRM in the plasma. This is in line with the high in vitro replication capacity of patient-derived viruses harbouring TDRM compared to site-directed mutant viruses harbouring TDRM. As site-directed mutant viruses have a lower replication capacity than the patient-derived viruses with similar mutational patterns, we propose that (baseline) polymorphisms function as compensatory mutations improving viral replication capacity.

Published
2014
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26. Tracing the HIV-1 subtype B mobility in Europe: A phylogeographic approach

Author

Paraskevis, D. Pybus, O. Magiorkinis, G. Hatzakis, A. Wensing, A.M.J. van de Vijver, D.A. Albert, J. Angarano, G. Åsjö, B. Balotta, C. Boeri, E. Camacho, R. Chaix, M.-L. Coughlan, S. Costagliola, D. De Luca, A. de Mendoza, C. Derdelinckx, I. Grossman, Z. Hamouda, O. Hoepelman, I.M. Horban, A. Korn, K. Kücherer, C. Leitner, T. Loveday, C. MacRae, E. Maljovic-Berry, I. Meyer, L. Nielsen, C. Op de Coul, E.L.M. Ormaasen, V. Perrin, L. Puchhammer-Stöckl, E. Ruiz, L. Salminen, M.O. Schmit, J.-C. Schuurman, R. Soriano, V. Stanczak, J. Stanojevic, M. Struck, D. Van Laethem, K. Violin, M. Yerly, S. Zazzi, M. Boucher, C.A. Vandamme, A.-M.

Abstract

Background: The prevalence and the origin of HIV-1 subtype B, the most prevalent circulating clade among the long-term residents in Europe, have been studied extensively. However the spatial diffusion of the epidemic from the perspective of the virus has not previously been traced. Results: In the current study we inferred the migration history of HIV-1 subtype B by way of a phylogeography of viral sequences sampled from 16 European countries and Israel. Migration events were inferred from viral phylogenies by character reconstruction using parsimony. With regard to the spatial dispersal of the HIV subtype B sequences across viral phylogenies, in most of the countries in Europe the epidemic was introduced by multiple sources and subsequently spread within local networks. Poland provides an exception where most of the infections were the result of a single point introduction. According to the significant migratory pathways, we show that there are considerable differences across Europe. Specifically, Greece, Portugal, Serbia and Spain, provide sources shedding HIV-1; Austria, Belgium and Luxembourg, on the other hand, are migratory targets, while for Denmark, Germany, Italy, Israel, Norway, the Netherlands, Sweden, Switzerland and the UK we inferred significant bidirectional migration. For Poland no significant migratory pathways were inferred. Conclusion: Subtype B phylogeographies provide a new insight about the geographical distribution of viral lineages, as well as the significant pathways of virus dispersal across Europe, suggesting that intervention strategies should also address tourists, travellers and migrants. © 2009 Paraskevis et al; licensee BioMed Central Ltd.

Published
2009

28. [Less ventilator-associated pneumonia after oral decontamination with chlorhexidine; a randomised trial]

Author

Koeman, M., Ven, A.J.A.M. van der, Hak, E., Joore, J.C., Kaasjager, H.A.H., Smet, A.M. de, Ramsay, G., Dormans, T.P.J., Aarts, L.P., Bel, E.E. de, Hustinx, W.N., Tweel, I. van de, Hoepelman, I.M., and Bonten, M.J.

Subjects
Pathogenesis and modulation of inflammation [N4i 1], Infectious diseases and international health [NCEBP 13], Effective Primary Care and Public Health [EBP 3], Poverty-related infectious diseases [N4i 3], Microbial pathogenesis and host defense [UMCN 4.1], Infection and autoimmunity [NCMLS 1]
Abstract

Item does not contain fulltext OBJECTIVE: To determine the effect of oral decontamination with either chlorhexidine (CHX, 2%) or the combination chlorhexidine-colistin (CHX-COL, 2%-2%) on the frequency and the time to onset of ventilator-associated pneumonia in Intensive Care patients. DESIGN: Double blind, placebo-controlled, multicentre, randomised trial. METHODS: Consecutive ICU patients needing at least 48 h of mechanical ventilation were enrolled in a randomized trial with 3 arms: CHX, CHX-COL, and placebo (PLAC). The trial medication was administered in the oral cavity every 6 h. Oropharyngeal swabs were obtained daily and analysed quantitatively for Gram-positive and Gram-negative microorganisms. Endotracheal colonisation was monitored twice weekly. Ventilator-associated pneumonia was diagnosed on the basis of a combination of clinical, radiological and microbiological criteria. RESULTS: Of 385 patients included, 130 received PLAC, 127 CHX and 128 CHX-COL. Baseline characteristics in the three groups were comparable. The daily risk of ventilator-associated pneumonia was reduced in both treatment groups compared to PLAC: 65% (HR= 0.352; 95% CI: 0.160-0.791; p = 0.012) for CHX and 55% (HR= 0.454; 95%/ CI: 0.224-0.925; p = 0.030) for CHX-COL. CHX-COL provided a significant reduction in oropharyngeal colonisation with both Gram-negative and Gram-positive microorganisms, whereas CHX significantly affected only colonisation with Gram-positive microorganisms. There were no differences in the duration of mechanical ventilation, ICU-stay or ICU-survival. CONCLUSION: Oral decontamination of the oropharyngeal cavity with chlorhexidine or the combination chlorhexidine-colistin reduced the incidence and the time to onset ofventilator-associated pneumonia.

Published
2008

30. A model-based approach to improved prescription of antibiotics

Author

Lucas, P., Schurink, C.A.M., Hoepelman, I.M., and Bonten, M.

Subjects
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Software Science
Abstract

Contains fulltext : 112470.pdf (Author’s version preprint ) (Open Access)

Published
2003

33. Isolation rooms for highly infectious diseases : an inventory of capabilities in European countries

Author

Fusco, F.M., Puro, V., Baka, A., Bannister, B., Brodt, H.-R., Brouqui, P., Follin, Per, Gjorup, I.E., Gottschalk, R., Hemmer, R., Hoepelman, I.M., Jarhall, Boo, Kutsar, K., Lanini, S., Lyytikainen, O., Maltezou, H.C., Mansinho, K., Marti, M.C., Ott, K., Peleman, R., Perronne, C., Sheehan, G., Siikamakii, H., Skinhoj, P., Trilla, A., Vetter, N., Ippolito, G., Fusco, F.M., Puro, V., Baka, A., Bannister, B., Brodt, H.-R., Brouqui, P., Follin, Per, Gjorup, I.E., Gottschalk, R., Hemmer, R., Hoepelman, I.M., Jarhall, Boo, Kutsar, K., Lanini, S., Lyytikainen, O., Maltezou, H.C., Mansinho, K., Marti, M.C., Ott, K., Peleman, R., Perronne, C., Sheehan, G., Siikamakii, H., Skinhoj, P., Trilla, A., Vetter, N., and Ippolito, G.

Abstract

Isolation of patients with highly infectious diseases (HIDs) in hospital rooms with adequate technical facilities is essential to reduce the risk of spreading disease. The European Network for Infectious Diseases (EUNID), a project co-funded by European Commission and involving 16 European Union member states, performed an inventory of high level isolation rooms (HIRs, hospital rooms with negative pressure and anteroom). In participating countries, HIRs are available in at least 211 hospitals, with at least 1789 hospital beds. The adequacy of this number is not known and will depend on prevailing circumstances. Sporadic HID cases can be managed in the available HIRs. HIRs could also have a role in the initial phases of an influenza pandemic. However, large outbreaks due to natural or to bioterrorist events will need management strategies involving healthcare facilities other than HIRs.

Published
2009
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34. Tracing the HIV-1 subtype B mobility in Europe: A phylogeographic approach

Author

Paraskevis, D. (Dimitrios), Pybus, O. (Oliver), Magiorkinis, G. (Gkikas), Hatzakis, A. (Angelos), Wensing, A.M.J. (Annemarie), Vijver, D.A.M.C. (David) van de, Albert, J. (Jan), Angarano, G. (Guiseppe), Åsjö, B. (Birgitta), Balotta, C. (Claudia), Boeri, E. (Enzo), Camacho, R.J. (Ricardo Jorge), Chaix, M.L. (Marie Laure), Coughlan, S. (Suzie), Costagliola, D. (Dominique), Luca, A. (Andrea) de, Mendoza, C. (Carmen) de, Derdelinck, I. (Inge), Grossman, Z. (Zehava), Hamouda, O. (Osamah), Hoepelman, I.M. (Ilja Mohandas), Horban, A. (Andrzej), Korn, K. (Klaus), Kücherer, C. (Claudia), Leitner, T. (Thomas), Loveday, C. (Clive), MacRae, E. (Eilidh), Maljovic-Berry, I. (Inam), Meyer, L. (Laurence), Nielsen, C. (Claus Vinther), Op de Coul, E.L.M. (Eline), Ormaasen, V. (Vidar), Perrin, L. (Luc Henri), Puchhammer-Stöckl, E. (Elisabeth), Ruiz, L. (Lidia), Paraskevis, D. (Dimitrios), Pybus, O. (Oliver), Magiorkinis, G. (Gkikas), Hatzakis, A. (Angelos), Wensing, A.M.J. (Annemarie), Vijver, D.A.M.C. (David) van de, Albert, J. (Jan), Angarano, G. (Guiseppe), Åsjö, B. (Birgitta), Balotta, C. (Claudia), Boeri, E. (Enzo), Camacho, R.J. (Ricardo Jorge), Chaix, M.L. (Marie Laure), Coughlan, S. (Suzie), Costagliola, D. (Dominique), Luca, A. (Andrea) de, Mendoza, C. (Carmen) de, Derdelinck, I. (Inge), Grossman, Z. (Zehava), Hamouda, O. (Osamah), Hoepelman, I.M. (Ilja Mohandas), Horban, A. (Andrzej), Korn, K. (Klaus), Kücherer, C. (Claudia), Leitner, T. (Thomas), Loveday, C. (Clive), MacRae, E. (Eilidh), Maljovic-Berry, I. (Inam), Meyer, L. (Laurence), Nielsen, C. (Claus Vinther), Op de Coul, E.L.M. (Eline), Ormaasen, V. (Vidar), Perrin, L. (Luc Henri), Puchhammer-Stöckl, E. (Elisabeth), and Ruiz, L. (Lidia)

Abstract

Background: The prevalence and the origin of HIV-1 subtype B, the most prevalent circulating clade among the long-term residents in Europe, have been studied extensively. However the spatial diffusion of the epidemic from the perspective of the virus has not previously been traced. Results: In the current study we inferred the migration history of HIV-1 subtype B by way of a phylogeography of viral sequences sampled from 16 European countries and Israel. Migration events were inferred from viral phylogenies by character reconstruction using parsimony. With regard to the spatial dispersal of the HIV subtype B sequences across viral phylogenies, in most of the countries in Europe the epidemic was introduced by multiple sources and subsequently spread within local networks. Poland provides an exception where most of the infections were the result of a single point introduction. According to the significant migratory pathways, we show that there are considerable differences across Europe. Specifically, Greece, Portugal, Serbia and Spain, provide sources shedding HIV-1; Austria, Belgium and Luxembourg, on the other hand, are migratory targets, while for Denmark, Germany, Italy, Israel, Norway, the Netherlands, Sweden, Switzerland and the UK we inferred significant bidirectional migration.

Published
2009
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35. Plasma HCV-RNA decline in the first 48 h identifies hepatitis C virus mono-infected but not HCV/HIV-coinfected patients with an undetectable HCV viral load at week 4 of peginterferon-alfa-2a/ribavirin therapy.

Author

Infection & Immunity, MS Infectieziekten, MS MDL 1, MMB, CTI, Arends, J.E., Stuart, C., Baak, L., van der Ende, M.E., van Erpecum, K.J., Simons, C.P., Boland, G.J., van Baarle, D., Hoepelman, I.M., Infection & Immunity, MS Infectieziekten, MS MDL 1, MMB, CTI, Arends, J.E., Stuart, C., Baak, L., van der Ende, M.E., van Erpecum, K.J., Simons, C.P., Boland, G.J., van Baarle, D., and Hoepelman, I.M.

Published
2009

36. A clinical prediction rule for urinary tract infections in patients with type 2 diabetes mellitus in primary care.

Author

Circulatory Health, Infection & Immunity, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, MS Infectieziekten, Epidemiology & Health Economics, Cluster B, Venmans, L.M., Gorter, K.J., Rutten, G.E.H.M., Schellevis, F.G., Hoepelman, I.M., Hak, E., Circulatory Health, Infection & Immunity, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, MS Infectieziekten, Epidemiology & Health Economics, Cluster B, Venmans, L.M., Gorter, K.J., Rutten, G.E.H.M., Schellevis, F.G., Hoepelman, I.M., and Hak, E.

Published
2009

37. Identification of genotypically diverse Cryptococcus neoformans and Cryptococcus gattii isolates by Luminex xMAP Technology

Author

Bovers, M., Diaz, M.R., Hagen, F., Spanjaard, L., Duim, B., Visser, C.E., Hoogveld, H.L., Scharringa, J., Hoepelman, I.M., Fell, J.W., Boekhout, T., Bovers, M., Diaz, M.R., Hagen, F., Spanjaard, L., Duim, B., Visser, C.E., Hoogveld, H.L., Scharringa, J., Hoepelman, I.M., Fell, J.W., and Boekhout, T.

Abstract

A Luminex suspension array, which had been developed for identification of Cryptococcus neoformans and Cryptococcus gattii isolates, was tested by genotyping a set of 58 mostly clinical isolates. All genotypes of C. neoformans and C. gattii were included. In addition, cerebrospinal fluid (CSF) obtained from patients with cryptococcal meningitis was used to investigate the feasibility of the technique for identification of the infecting strain. The suspension array correctly identified haploid isolates in all cases. Furthermore, hybrid isolates possessing two alleles of the Luminex probe region could be identified as hybrids. In CSF specimens, the genotype of the cryptococcal strains responsible for infection could be identified after optimization of the PCR conditions. However, further optimization of the DNA extraction protocol is needed to enhance the usability of the method in clinical practice., A Luminex suspension array, which had been developed for identification of Cryptococcus neoformans and Cryptococcus gattii isolates, was tested by genotyping a set of 58 mostly clinical isolates. All genotypes of C. neoformans and C. gattii were included. In addition, cerebrospinal fluid (CSF) obtained from patients with cryptococcal meningitis was used to investigate the feasibility of the technique for identification of the infecting strain. The suspension array correctly identified haploid isolates in all cases. Furthermore, hybrid isolates possessing two alleles of the Luminex probe region could be identified as hybrids. In CSF specimens, the genotype of the cryptococcal strains responsible for infection could be identified after optimization of the PCR conditions. However, further optimization of the DNA extraction protocol is needed to enhance the usability of the method in clinical practice.

Published
2007

39. Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: implications for clinical management

Author

Wensing, A.M.J., van de Vijver, D.A.M.C., Augarano, G., Asjo, B., Balotta, C., Boeri, E., Camacho, R., Chaix, M.L., Costagliola, D., De Luca, A., Derdelinckx, I., Grosman, Z., Hamouda, O., Hatzakis, A., Hemmer, R., Hoepelman, I.M., Horban, A., Korn, K., Kucherer, C., Leitner, T., Loveday, C., MacRae, E., Malikovic, I., Mendoza, C., Meyer, L., Nielsen, C., Op de Coul, E.L., Ormaassen, V., Paraskevis, D., Perrin, L., Puchhammer-Stockl, E., Ruiz, L., Salminen, M., Schmit, J.C., Schneider, F., Schuurman, R., Soriano, E., Stanzak, G., Stanojevic, M., Vandamme, A.M., Van Laethem, K., Violin, M., Wilbe, K., Yerly, S., Zazzi, M., Boucher, C.A.B., Wensing, A.M.J., van de Vijver, D.A.M.C., Augarano, G., Asjo, B., Balotta, C., Boeri, E., Camacho, R., Chaix, M.L., Costagliola, D., De Luca, A., Derdelinckx, I., Grosman, Z., Hamouda, O., Hatzakis, A., Hemmer, R., Hoepelman, I.M., Horban, A., Korn, K., Kucherer, C., Leitner, T., Loveday, C., MacRae, E., Malikovic, I., Mendoza, C., Meyer, L., Nielsen, C., Op de Coul, E.L., Ormaassen, V., Paraskevis, D., Perrin, L., Puchhammer-Stockl, E., Ruiz, L., Salminen, M., Schmit, J.C., Schneider, F., Schuurman, R., Soriano, E., Stanzak, G., Stanojevic, M., Vandamme, A.M., Van Laethem, K., Violin, M., Wilbe, K., Yerly, S., Zazzi, M., and Boucher, C.A.B.

Published
2005

40. Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: implications for clinical management

Author

MMB, MS Infectieziekten, Wensing, A.M.J., van de Vijver, D.A.M.C., Augarano, G., Asjo, B., Balotta, C., Boeri, E., Camacho, R., Chaix, M.L., Costagliola, D., De Luca, A., Derdelinckx, I., Grosman, Z., Hamouda, O., Hatzakis, A., Hemmer, R., Hoepelman, I.M., Horban, A., Korn, K., Kucherer, C., Leitner, T., Loveday, C., MacRae, E., Malikovic, I., Mendoza, C., Meyer, L., Nielsen, C., Op de Coul, E.L., Ormaassen, V., Paraskevis, D., Perrin, L., Puchhammer-Stockl, E., Ruiz, L., Salminen, M., Schmit, J.C., Schneider, F., Schuurman, R., Soriano, E., Stanzak, G., Stanojevic, M., Vandamme, A.M., Van Laethem, K., Violin, M., Wilbe, K., Yerly, S., Zazzi, M., Boucher, C.A.B., MMB, MS Infectieziekten, Wensing, A.M.J., van de Vijver, D.A.M.C., Augarano, G., Asjo, B., Balotta, C., Boeri, E., Camacho, R., Chaix, M.L., Costagliola, D., De Luca, A., Derdelinckx, I., Grosman, Z., Hamouda, O., Hatzakis, A., Hemmer, R., Hoepelman, I.M., Horban, A., Korn, K., Kucherer, C., Leitner, T., Loveday, C., MacRae, E., Malikovic, I., Mendoza, C., Meyer, L., Nielsen, C., Op de Coul, E.L., Ormaassen, V., Paraskevis, D., Perrin, L., Puchhammer-Stockl, E., Ruiz, L., Salminen, M., Schmit, J.C., Schneider, F., Schuurman, R., Soriano, E., Stanzak, G., Stanojevic, M., Vandamme, A.M., Van Laethem, K., Violin, M., Wilbe, K., Yerly, S., Zazzi, M., and Boucher, C.A.B.

Published
2005

42. Isolation rooms for highly infectious diseases: an inventory of capabilities in European countries

Author

Fusco, F.M., primary, Puro, V., additional, Baka, A., additional, Bannister, B., additional, Brodt, H.-R., additional, Brouqui, P., additional, Follin, P., additional, Gjorup, I.E., additional, Gottschalk, R., additional, Hemmer, R., additional, Hoepelman, I.M., additional, Jarhall, B., additional, Kutsar, K., additional, Lanini, S., additional, Lyytikainen, O., additional, Maltezou, H.C., additional, Mansinho, K., additional, Marti, M.C., additional, Ott, K., additional, Peleman, R., additional, Perronne, C., additional, Sheehan, G., additional, Siikamakii, H., additional, Skinhoj, P., additional, Trilla, A., additional, Vetter, N., additional, and Ippolito, G., additional

Published
2009
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46. Long-term infectious complications and their relation to treatment duration in catheter-related Staphylococcus aureus bacteremia.

Author

Zeylemaker, M.M., Jaspers, C.A., Visser, M.R., Hoepelman, I.M., Kraaij, M.G.J. van, Zeylemaker, M.M., Jaspers, C.A., Visser, M.R., Hoepelman, I.M., and Kraaij, M.G.J. van

Abstract

Item does not contain fulltext, The optimal duration of treatment for catheter-related Staphylococcus aureus bacteremia is not known. Short courses (< or = 2 weeks) of therapy should be viewed with caution because essential data on late complications, such as osteomyelitis and metastatic abscesses, are lacking. This study represents a retrospective analysis of the data from 49 adult patients hospitalised in the period 1994-1996 (mean age, 57 years; range, 20-90 years; 47% male) and from whom Staphylococcus aureus was cultured concomitantly from peripheral blood and catheter segments. Forty-six venous catheters, two arterial catheters, and one unknown type of catheter were used. Forty-four patients were treated with effective anti-Staphylococcus aureus antibiotics. Twenty patients had a favourable outcome, defined as no complication and no death during 1 year of follow-up, 24 patients had complications, 14 patients died due to attributable mortality, and 5 other patients died of an underlying disease without showing signs or symptoms of a complication. Patients were categorised according to the duration of treatment. There were small differences between a shorter (1-14 days) and a longer (>14 days) course of antibiotics with regard to favourable outcome (41% vs. 33%), complications (48% vs. 53%), attributable death (31% vs. 20%), and death due to underlying disease (41% vs. 33%), respectively. The rates of complications and death were high, but a definite conclusion cannot be drawn because the study was underpowered. More randomised trials are needed, but, until the results of such trials are available, the duration of therapy should not be shortened to less than 14 days.

Published
2001

47. Selective digestive decontamination in patients in intensive care

Author

Bonten, M.J., Kullberg, B.J., Dalen, R. van, Girbes, A.R.J., Hoepelman, I.M., Hustinx, W.N., Meer, J.W.M. van der, Speelman, P., Stobberingh, E.E., Verbrugh, H.A., Verhoef, J., Zwaveling, J.H., Bonten, M.J., Kullberg, B.J., Dalen, R. van, Girbes, A.R.J., Hoepelman, I.M., Hustinx, W.N., Meer, J.W.M. van der, Speelman, P., Stobberingh, E.E., Verbrugh, H.A., Verhoef, J., and Zwaveling, J.H.

Abstract

Item does not contain fulltext

Published
2000

48. Selective digestive decontamination in patients in intensive care

Author

Bonten, M.J.M., Kullberg, B.J., Dalen, R. van, Girbes, A.R.J., Hoepelman, I.M., Hustinx, W., Meer, J.W.M. van der, Speelman, P., Stobberingh, E.E., Verbrugh, H.A., Verhoef, J., Zwaveling, J.H., Bonten, M.J.M., Kullberg, B.J., Dalen, R. van, Girbes, A.R.J., Hoepelman, I.M., Hustinx, W., Meer, J.W.M. van der, Speelman, P., Stobberingh, E.E., Verbrugh, H.A., Verhoef, J., and Zwaveling, J.H.

Abstract

Item does not contain fulltext

Published
2000

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