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1. Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries.

Author

Lodi, S, Del Amo, J, Moreno, S, Bucher, HC, Furrer, H, Logan, R, Sterne, J, Pérez-Hoyos, S, Jarrín, I, Phillips, A, Olson, A, Van Sighem, A, Reiss, P, Sabin, C, Jose, S, Justice, A, Goulet, J, Miró, JM, Ferrer, E, Meyer, L, Seng, R, Vourli, G, Antoniadou, A, Dabis, F, Vandenhede, MA, Costagliola, D, Abgrall, S, Hernán, MA, Hernan, M, Bansi, L, Hill, T, Dunn, D, Porter, K, Glabay, A, Orkin, C, Thomas, R, Jones, K, Fisher, M, Perry, N, Pullin, A, Churchill, D, Gazzard, B, Nelson, M, Asboe, D, Bulbeck, S, Mandalia, S, Clarke, J, Delpech, V, Anderson, J, Munshi, S, Post, F, Easterbrook, P, Khan, Y, Patel, P, Karim, F, Duffell, S, Gilson, R, Man, SL, Williams, I, Gompels, M, Dooley, D, Schwenk, A, Ainsworth, J, Johnson, M, Youle, M, Lampe, F, Smith, C, Grabowska, H, Chaloner, C, Ismajani Puradiredja, D, Walsh, J, Weber, J, Kemble, C, Mackie, N, Winston, A, Leen, C, Wilson, A, Bezemer, DO, Gras, LAJ, Kesselring, AM, Van Sighem, AI, Zaheri, S, Van Twillert, G, Kortmann, W, Branger, J, Prins, JM, Kuijpers, TW, Scherpbier, HJ, Van Der Meer, JTM, Wit, FWMN, Godfried, MH, Van Der Poll, T, Nellen, FJB, and Lange, JMA

Subjects
Humans, AIDS-Related Opportunistic Infections, HIV Infections, Neoplasms, Anti-Retroviral Agents, Antiretroviral Therapy, Highly Active, Incidence, Developed Countries, Adolescent, Adult, Aged, Middle Aged, United States, Europe, Female, Male, Young Adult, HIV, immune reconstitution inflammatory syndrome, incidence, inverse probability weighting, unmasking, Antiretroviral Therapy, Highly Active, HIV/AIDS, Infectious Diseases, Genetics, Behavioral and Social Science, Infection, Rare Diseases, Lymphoma, Cancer, Hematology, Tuberculosis, Virology, Biological Sciences, Medical and Health Sciences, Psychology and Cognitive Sciences
Abstract

BackgroundThere is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis.MethodsWe identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, had CD4 cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4 cell count and HIV-RNA via inverse probability weighting.ResultsOut of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis.ConclusionWith the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries.

Published
2014

2. Durability of viral suppression with first-line antiretroviral therapy in patients with HIV in the UK: an observational cohort study

Author

Ainsworth, Jonathan, Allan, Sris, Anderson, Jane, Babiker, Abdel, Chadwick, David, Delpech, Valerie, Dunn, David, Fisher, Martin, Gazzard, Brian, Gilson, Richard, Gompels, Mark, Hay, Phillip, Hill, Teresa, Johnson, Margaret, Jose, Sophie, Kegg, Stephen, Leen, Clifford, Martin, Fabiola, Nelson, Mark, Orkin, Chloe, Palfreeman, Adrian, Phillips, Andrew, Pillay, Deenan, Post, Frank, Pritchard, Jillian, Sabin, Caroline, Sachikonye, Memory, Schwenk, Achim, Tariq, Anjum, Trevelion, Roy, Walsh, John, Glabay, A, Perry, N, Tilbury, S, Youssef, E, Churchill, D, Gazzard, B, Nelson, M, Everett, R, Asboe, D, Mandalia, S, Post, F, Korat, H, Taylor, C, Gleisner, Z, Ibrahim, F, Campbell, L, Gilson, R, Brima, N, Williams, I, Johnson, M, Youle, M, Lampe, F, Smith, C, Tsintas, R, Chaloner, C, Hutchinson, S, Sabin, C, Phillips, A, Hill, T, Jose, S, Thornton, A, Huntington, S, Walsh, J, Mackie, N, Winston, A, Weber, J, Ramzan, F, Carder, M, Orkin, C, Lynch, J, Hand, J, de Souza, C, Anderson, J, Munshi, S, Ainsworth, J, Schwenk, A, Miller, S, Wood, C, Leen, C, Wilson, A, Morris, S, Gompels, M, Allan, S, Palfreeman, A, Memon, K, Lewszuk, A, Chadwick, D, Cope, E, Gibson, J, Kegg, S, Main, P, Mitchell, S, Hunter, M, Dhillon, M, Martin, F, Russell-Sharpe, S, Harte, A, Clay, S, Tariq, A, Spencer, H, Jones, R, Pritchard, J, Cumming, S, Atkinson, C, Delpech, V, O'Connor, Jemma, Smith, Colette, Lampe, Fiona C, Johnson, Margaret A, Chadwick, David R, Winston, Alan, Post, Frank A, and Phillips, Andrew N

Published
2017
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3. Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents

Author

Byonanebye D. M., Polizzotto M. N., Begovac J., Grabmeier-Pfistershammer K., Abela I., Castagna A., de Wit S., Mussini C., Vehreschild J. J., d'Arminio Monforte A., Wit F. W. N. M., Pradier C., Chkhartishvili N., Sonnerborg A., Hoy J., Lundgren J., Neesgaard B., Bansi-Matharu L., Greenberg L., Llibre J. M., Vannappagari V., Gallant J., Necsoi C., Cichon P., Reiss P., Aho I., Tsertsvadze T., Mennozzi M., Rauch A., Muccini C., Law M., Mocroft A., Ryom L., Petoumenos K., Hillebregt M., Rose N., Zangerle R., Appoyer H., Delforge M., Wandeler G., Stephan C., Bucht M., Chokoshvili O., Rodano A., Tavelli A., Fanti I., Borghi V., Fontas E., Dollet K., Caissotti C., Casabona J., Miro J. M., Smith C., Lampe F., Johnson M., Burns F., Chaloner C., Lazzarin A., Poli A., Falconer K., Svedhem V., Gunthard H., Ledergerber B., Bucher H., Scherrer A., Wasmuth J. C., Rockstroh J., Fatkenheuer G., Stecher M., Schulze N., Franke B., Rooney J., Rogatto F., Garges H., Kowalska J., Raben D., Peters L., Anne A. V., Dedes N., Williams E. D., Bruguera A., Haubrich R., Svedhem-Johansson V., Bloch M., Braun D., Calmy A., Schuttfort G., Youle M., Zona S., Antinori A., Bolokadze N., Schwarze-Zander C., Duvivier C., Dragovic G., Radoi R., Oprea C., Vasylyev M., Matulionyte R., Mulabdic V., Marchetti G., Kuzovatova E., Coppola N., Martini S., Harxhi A., Waehre T., Pharris A., Vassilenko A., Bogner J., Maagaard A., Jablonowska E., Elbirt D., Marrone G., Leen C., Wyen C., Kundro M., Thorpe D., Volny-Anne A., Mendao L., Larsen J. F., Jakobsen M. L., Bruun T., Bojesen A., Hansen E. V., Elsing T. W., Kristensen D., Thomsen S., Weide T., Pelchen-Matthews A., Byonanebye, D. M., Polizzotto, M. N., Begovac, J., Grabmeier-Pfistershammer, K., Abela, I., Castagna, A., de Wit, S., Mussini, C., Vehreschild, J. J., d'Arminio Monforte, A., Wit, F. W. N. M., Pradier, C., Chkhartishvili, N., Sonnerborg, A., Hoy, J., Lundgren, J., Neesgaard, B., Bansi-Matharu, L., Greenberg, L., Llibre, J. M., Vannappagari, V., Gallant, J., Necsoi, C., Cichon, P., Reiss, P., Aho, I., Tsertsvadze, T., Mennozzi, M., Rauch, A., Muccini, C., Law, M., Mocroft, A., Ryom, L., Petoumenos, K., Hillebregt, M., Rose, N., Zangerle, R., Appoyer, H., Delforge, M., Wandeler, G., Stephan, C., Bucht, M., Chokoshvili, O., Rodano, A., Tavelli, A., Fanti, I., Borghi, V., Fontas, E., Dollet, K., Caissotti, C., Casabona, J., Miro, J. M., Smith, C., Lampe, F., Johnson, M., Burns, F., Chaloner, C., Lazzarin, A., Poli, A., Falconer, K., Svedhem, V., Gunthard, H., Ledergerber, B., Bucher, H., Scherrer, A., Wasmuth, J. C., Rockstroh, J., Fatkenheuer, G., Stecher, M., Schulze, N., Franke, B., Rooney, J., Rogatto, F., Garges, H., Kowalska, J., Raben, D., Peters, L., Anne, A. V., Dedes, N., Williams, E. D., Bruguera, A., Haubrich, R., Svedhem-Johansson, V., Bloch, M., Braun, D., Calmy, A., Schuttfort, G., Youle, M., Zona, S., Antinori, A., Bolokadze, N., Schwarze-Zander, C., Duvivier, C., Dragovic, G., Radoi, R., Oprea, C., Vasylyev, M., Matulionyte, R., Mulabdic, V., Marchetti, G., Kuzovatova, E., Coppola, N., Martini, S., Harxhi, A., Waehre, T., Pharris, A., Vassilenko, A., Bogner, J., Maagaard, A., Jablonowska, E., Elbirt, D., Marrone, G., Leen, C., Wyen, C., Kundro, M., Thorpe, D., Volny-Anne, A., Mendao, L., Larsen, J. F., Jakobsen, M. L., Bruun, T., Bojesen, A., Hansen, E. V., Elsing, T. W., Kristensen, D., Thomsen, S., Weide, T., and Pelchen-Matthews, A.

Subjects
0301 basic medicine, Anti-HIV Agents, Immunology, Integrase inhibitor, Blood lipids, HIV Infections, Tenofovir alafenamide, 03 medical and health sciences, 0302 clinical medicine, ANTIRETROVIRAL AGENTS, medicine, Humans, Immunology and Allergy, Protease inhibitor (pharmacology), Prospective Studies, HIV Integrase Inhibitors, 030212 general & internal medicine, Myocardial infarction, Dyslipidemias, business.industry, Incidence, Incidence (epidemiology), dyslipidemia, HIV, medicine.disease, Virology, antiretroviral agents, integrase inhibitors, 030104 developmental biology, Infectious Diseases, Anti-Retroviral Agents, Reverse Transcriptase Inhibitors, business, Dyslipidemia
Abstract

Objective: To compare the incidence of dyslipidemia in people with HIV receiving integrase inhibitors (INSTI) versus boosted protease inhibitors (PI/b) and nonnucleoside reverse transcriptase inhibitors (NNRTI) within RESPOND consortium of prospective cohorts. Methods: Participants were eligible if they were at least 18 years, without dyslipidemia and initiated or switched to a three-drug antiretroviral therapy (ART)-regimen consisting of either INSTI, NNRTI, or PI/b for the first time, between 1 January 2012 and 31 December 2018. Dyslipidemia was defined as random total cholesterol more than 240 mg/dl, HDL less than 35 mg/dl, triglyceride more than 200 mg/dl, or initiation of lipid-lowering therapy. Poisson regression was used to determine the adjusted incidence rate ratios. Follow-up was censored after 3 years or upon ART-regimen discontinuation or last lipid measurement or 31 December 2019, whichever occurred first. Results: Overall, 4577 people with HIV were eligible (INSTI = 66.9%, PI/b = 12.5%, and NNRTI = 20.6%), 1938 (42.3%) of whom were ART-naive. During 1.7 (interquartile range, 0.6 - 3.0) median years of follow-up, 1460 participants developed dyslipidemia [incidence rate: 191.6 per 1000 person-years, 95% confidence interval (CI) 182.0 - 201.7]. Participants taking INSTI had a lower incidence of dyslipidemia compared with those on PI/b (adjusted incidence rate ratio 0.71; CI 0.59 - 0.85), but higher rate compared with those on NNRTI (1.35; CI 1.15 - 1.58). Compared with dolutegravir, the incidence of dyslipidemia was higher with elvitegravir/cobicistat (1.20; CI 1.00 - 1.43) and raltegravir (1.24; CI 1.02 - 1.51), but lower with rilpivirine (0.77; CI 0.63 - 0.94). Conclusion: In this large consortium of heterogeneous cohorts, dyslipidemia was less common with INSTI than with PI/b. Compared with dolutegravir, dyslipidemia was more common with elvitegravir/cobicistat and raltegravir, but less common with rilpivirine.

Published
2021

6. Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium

Author

Byonanebye, Dathan M., Polizzotto, Mark N., Neesgaard, Bastian, Sarcletti, Mario, Matulionyte, Raimonda, Braun, Dominique L., Castagna, Antonella, de Wit, Stéphane, Wit, Ferdinand, Fontas, Eric, Vehreschild, J. rg Janne, Vesterbacka, Jan, Greenberg, Lauren, Hatleberg, Camilla, Garges, Harmony, Gallant, Joel, Volny Anne, Alain, Öllinger, Angela, Mozer-Lisewska, Iwona, Surial, Bernard, Spagnuolo, Vincenzo, Necsoi, Coca, van der Valk, Marc, Mocroft, Amanda, Law, Matthew, Ryom, Lene, Petoumenos, Kathy, Hillebregt, M., Rose, N., Hutchinson, J., Zangerle, R., Appoyer, H., Delforge, M., Stephan, C., Bucht, M., Chkhartishvili, N., Chokoshvili, O., Mussini, C., Borghi, V., Pradier, C., Dollet, K., Caissotti, C., Casabona, J., Miro, J. M., Smith, C., Lampe, F., Johnson, M., Burns, F., Chaloner, C., Lazzarin, A., Poli, A., Sönnerborg, A., Falconer, K., Svedhem, V., Günthard, H., Ledergerber, B., Bucher, H., Scherrer, A., Wasmuth, J. C., Rockstroh, J., Fätkenheuer, G., Stecher, M., Schulze, N., Franke, B., Rooney, J., McNicholl, I., Vannappagari, V., Wandeler, G., Lundgren, J., Kowalska, J., Raben, D., Mocroft, A., Peters, L., Williams, E. D., Necsoi, C., D’Arminio Monforte, A., Bruguera, A., Dedes, Nikos, Mendao, Luis, Larsen, J. F., Jaschinski, N., Jakobsen, M. L., Bruun, T., Bojesen, A., Hansen, E. V., Traytel, A. K., Elsing, T. W., Kristensen, D., Weide, T., Bansi-Matharu, L., Pelchen-Matthews, A., Infectious diseases, AII - Infectious diseases, APH - Aging & Later Life, APH - Digital Health, APH - Personalized Medicine, and APH - Global Health

Subjects
Adult, Aged, 80 and over, HIV, antiretroviral agents, hypertension, integrase inhibitors, Adolescent, Anti-HIV Agents, Health Policy, Incidence, virus diseases, 610 Medicine & health, HIV Infections, Integrase Inhibitors, Infectious Diseases, Anti-Retroviral Agents, Hypertension, Humans, Reverse Transcriptase Inhibitors, Pharmacology (medical), HIV Integrase Inhibitors
Abstract

OBJECTIVE To compare the incidence of hypertension in people living with HIV receiving integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) versus non-nucleoside reverse transcriptase inhibitors (NNRTIs) or boosted protease inhibitors (PIs) in the RESPOND consortium of HIV cohorts. METHODS Eligible people with HIV were aged ���18��years who initiated a new three-drug ART regimen for the first time (baseline), did not have hypertension, and had at least two follow-up blood pressure (BP) measurements. Hypertension was defined as two consecutive systolic BP measurements ���140��mmHg and/or diastolic BP ���90��mmHg or initiation of antihypertensives. Multivariable Poisson regression was used to determine adjusted incidence rate ratios (aIRRs) of hypertension, overall and in those who were ART na��ve or experienced at baseline. RESULTS Overall, 4606 people living with HIV were eligible (INSTIs��3164, NNRTIs��807, PIs��635). The median baseline systolic BP, diastolic BP, and age were 120 (interquartile range [IQR] 113-130) mmHg, 78 (70-82) mmHg, and 43 (34-50) years, respectively. Over 8380.4 person-years (median follow-up 1.5 [IQR 1.0-2.7]��years), 1058 (23.0%) participants developed hypertension (incidence rate 126.2/1000 person-years, 95% confidence interval [CI] 118.9-134.1). Participants receiving INSTIs had a higher incidence of hypertension than those receiving NNRTIs (aIRR 1.76; 95% CI 1.47-2.11), whereas the incidence was no different in those receiving PIs (aIRR 1.07; 95% CI 0.89-1.29). The results were similar when the analysis was stratified by ART status at baseline. CONCLUSION Although unmeasured confounding and channelling bias cannot be excluded, INSTIs were associated with a higher incidence of hypertension than were NNRTIs, but rates were similar to those of PIs overall, in ART-na��ve and ART-experienced participants within RESPOND.

Published
2022

7. Is physician assessment of alcohol consumption useful in predicting risk of severe liver disease among people with HIV and HIV/HCV co-infection?

Author

Shanyinde, M., Girardi, E., Puoti, M., De Luca, A., Sighinolfi, L., Caterina, U. F., Caramello, P., Lampe, F. C., D'Arminio Monforte, A., Cozzi-Lepri, A., Andreoni, M., Angarano, G., Antinori, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Perno, C. F., Von Schloesser, F., Viale, P., Castagna, A., Ceccherini-Silberstein, F., Caputo, S. L., Mussini, C., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cingolani, A., Cinque, P., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Maggiolo, F., Marchetti, G., Marcotullio, S., Monno, L., Nozza, S., Roldan, E. Q., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Valeriani, C., Santoro, C., Suardi, C., Donati, V., Verucchi, G., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Segala, D., Mazzotta, F., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Belvisi, V., Caramma, I., Chiodera, A., Milini, P., Rizzardini, G., Ridolfo, A. L., Piolini, R., Salpietro, S., Carenzi, L., Moioli, M. C., Tincati, C., Puzzolante, C., Abrescia, N., Chirianni, A., Borgia, G., Orlando, R., Di Martino, F., Maddaloni, L., Gentile, I., Bonadies, G., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Ursini, T., Magnani, G., Ursitti, M. A., Vullo, V., Cristaudo, A., Baldin, G., Cicalini, S., Gallo, L., Nicastri, E., Acinapura, R., Capozzi, M., Libertone, R., Savinelli, S., Latini, A., Iaiani, G., Sulekova, L. F., Cecchetto, M., Viviani, F., Mura, M. S., Rossetti, B., Francisci, D., Di Giuli, C., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., Shanyinde, M., Girardi, E., Puoti, M., De Luca, A., Sighinolfi, L., Caterina, U. F., Caramello, P., Lampe, F. C., D'Arminio Monforte, A., Cozzi-Lepri, A., Andreoni, M., Angarano, G., Antinori, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Perno, C. F., Von Schloesser, F., Viale, P., Castagna, A., Ceccherini-Silberstein, F., Caputo, S. L., Mussini, C., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Bonora, S., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cingolani, A., Cinque, P., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Maggiolo, F., Marchetti, G., Marcotullio, S., Monno, L., Nozza, S., Roldan, E. Q., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Valeriani, C., Santoro, C., Suardi, C., Donati, V., Verucchi, G., Minardi, C., Quirino, Viviana, Abeli, C., Manconi, P. E., Piano, P., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Segala, D., Mazzotta, F., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Belvisi, V., Caramma, I., Chiodera, A., Milini, P., Rizzardini, G., Ridolfo, A. L., Piolini, R., Salpietro, S., Carenzi, L., Moioli, M. C., Tincati, C., Puzzolante, C., Abrescia, N., Chirianni, A., Borgia, G., Orlando, R., Di Martino, F., Maddaloni, L., Gentile, I., Bonadies, G., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Ursini, T., Magnani, G., Ursitti, M. A., Vullo, V., Cristaudo, A., Baldin, G., Cicalini, S., Gallo, L., Nicastri, E., Acinapura, R., Capozzi, M., Libertone, R., Savinelli, S., Latini, A., Iaiani, G., Sulekova, L. F., Cecchetto, M., Viviani, F., Mura, M. S., Rossetti, B., Francisci, D., Di Giuli, C., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Pellizzer, G., Manfrin, V., Quirino, T., Manfrin, V, Uberti Foppa, C, Shanyinde M., Girardi E., Puoti M., De Luca A., Sighinolfi L., Caterina U.F., Caramello P., Lampe F.C., D'Arminio Monforte A., Cozzi-Lepri A., Andreoni M., Angarano G., Antinori A., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Perno C.F., Von Schloesser F., Viale P., Castagna A., Ceccherini-Silberstein F., Caputo S.L., Mussini C., Ammassari A., Balotta C., Bandera A., Bonfanti P., Bonora S., Borderi M., Calcagno A., Calza L., Capobianchi M.R., Cingolani A., Cinque P., Di Biagio A., Gianotti N., Gori A., Guaraldi G., Lapadula G., Lichtner M., Madeddu G., Maggiolo F., Marchetti G., Marcotullio S., Monno L., Nozza S., Roldan E.Q., Rossotti R., Rusconi S., Santoro M.M., Saracino A., Zaccarelli M., Fanti I., Galli L., Lorenzini P., Rodano A., Tavelli A., Carletti F., Carrara S., Di Caro A., Graziano S., Petrone F., Prota G., Quartu S., Truffa S., Giacometti A., Costantini A., Valeriani C., Santoro C., Suardi C., Donati V., Verucchi G., Minardi C., Quirino T., Abeli C., Manconi P.E., Piano P., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Segala D., Mazzotta F., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Mastroianni C., Belvisi V., Caramma I., Chiodera A., Milini P., Rizzardini G., Ridolfo A.L., Piolini R., Salpietro S., Carenzi L., Moioli M.C., Tincati C., Puzzolante C., Abrescia N., Chirianni A., Borgia G., Orlando R., Di Martino F., Maddaloni L., Gentile I., Bonadies G., Cascio A., Colomba C., Baldelli F., Schiaroli E., Parruti G., Ursini T., Magnani G., Ursitti M.A., Vullo V., Cristaudo A., Baldin G., Cicalini S., Gallo L., Nicastri E., Acinapura R., Capozzi M., Libertone R., Savinelli S., Latini A., Iaiani G., Sulekova L.F., Cecchetto M., Viviani F., Mura M.S., Rossetti B., Francisci D., Di Giuli C., Orofino G.C., Sciandra M., Bassetti M., Londero A., Pellizzer G., Manfrin V., Shanyinde, M, Girardi, E, Puoti, M, De Luca, A, Sighinolfi, L, Caterina, U, Caramello, P, Lampe, F, D'Arminio Monforte, A, Cozzi-Lepri, A, Andreoni, M, Angarano, G, Antinori, A, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Perno, C, Von Schloesser, F, Viale, P, Castagna, A, Ceccherini-Silberstein, F, Caputo, S, Mussini, C, Ammassari, A, Balotta, C, Bandera, A, Bonfanti, P, Bonora, S, Borderi, M, Calcagno, A, Calza, L, Capobianchi, M, Cingolani, A, Cinque, P, Di Biagio, A, Gianotti, N, Gori, A, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marchetti, G, Marcotullio, S, Monno, L, Nozza, S, Roldan, E, Rossotti, R, Rusconi, S, Santoro, M, Saracino, A, Zaccarelli, M, Fanti, I, Galli, L, Lorenzini, P, Rodano, A, Tavelli, A, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petrone, F, Prota, G, Quartu, S, Truffa, S, Giacometti, A, Costantini, A, Valeriani, C, Santoro, C, Suardi, C, Donati, V, Verucchi, G, Minardi, C, Quirino, T, Abeli, C, Manconi, P, Piano, P, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Segala, D, Mazzotta, F, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Mastroianni, C, Belvisi, V, Caramma, I, Chiodera, A, Milini, P, Rizzardini, G, Ridolfo, A, Piolini, R, Salpietro, S, Carenzi, L, Moioli, M, Tincati, C, Puzzolante, C, Abrescia, N, Chirianni, A, Borgia, G, Orlando, R, Di Martino, F, Maddaloni, L, Gentile, I, Bonadies, G, Cascio, A, Colomba, C, Baldelli, F, Schiaroli, E, Parruti, G, Ursini, T, Magnani, G, Ursitti, M, Vullo, V, Cristaudo, A, Baldin, G, Cicalini, S, Gallo, L, Nicastri, E, Acinapura, R, Capozzi, M, Libertone, R, Savinelli, S, Latini, A, Iaiani, G, Sulekova, L, Cecchetto, M, Viviani, F, Mura, M, Rossetti, B, Francisci, D, Di Giuli, C, Orofino, G, Sciandra, M, Bassetti, M, Londero, A, and Pellizzer, G

Subjects
Male, 030508 substance abuse, HIV Infections, Severity of Illness Index, Cohort Studies, Liver disease, 0302 clinical medicine, Risk Factors, Epidemiology, Medicine, HIV Infection, Alcohol consumption, Alcohol consumption, HIV-infected, HIV/HCV co-infection, Severe liver disease, 030212 general & internal medicine, education.field_of_study, Coinfection, Liver Disease, lcsh:Public aspects of medicine, Liver Diseases, Hazard ratio, Hepatitis C, Middle Aged, Italy, alcohol consumption, HIV-infected, HIV/HCV co-infection, severe liver disease, Female, 0305 other medical science, Human, Cohort study, Research Article, Adult, medicine.medical_specialty, Alcohol Drinking, Population, Severe liver disease, NO, 03 medical and health sciences, Environmental health, Humans, Risk factor, education, business.industry, Risk Factor, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, Cohort Studie, business
Abstract

BackgroundAlcohol consumption is a known risk factor for liver disease in HIV-infected populations. Therefore, knowledge of alcohol consumption behaviour and risk of disease progression associated with hazardous drinking are important in the overall management of HIV disease. We aimed at assessing the usefulness of routine data collected on alcohol consumption in predicting risk of severe liver disease (SLD) among people living with HIV (PLWHIV) with or without hepatitis C infection seen for routine clinical care in Italy.MethodsWe included PLWHIV from two observational cohorts in Italy (ICONA and HepaICONA). Alcohol consumption was assessed by physician interview and categorized according to the National Institute for Food and Nutrition Italian guidelines into four categories: abstainer; moderate; hazardous and unknown. SLD was defined as presence of FIB4 > 3.25 or a clinical diagnosis of liver disease or liver-related death. Cox regression analysis was used to evaluate the association between level of alcohol consumption at baseline and risk of SLD.ResultsAmong 9542 included PLWHIV the distribution of alcohol consumption categories was: abstainers 3422 (36%), moderate drinkers 2279 (23%), hazardous drinkers 637 (7%) and unknown 3204 (34%). Compared to moderate drinkers, hazardous drinking was associated with higher risk of SLD (adjusted hazard ratio, aHR = 1.45; 95% CI: 1.03–2.03). After additionally controlling for mode of HIV transmission, HCV infection and smoking, the association was attenuated (aHR = 1.32; 95% CI: 0.94–1.85). There was no evidence that the association was stronger when restricting to the HIV/HCV co-infected population.ConclusionsUsing a brief physician interview, we found evidence for an association between hazardous alcohol consumption and subsequent risk of SLD among PLWHIV, but this was not independent of HIV mode of transmission, HCV-infection and smoking. More efforts should be made to improve quality and validity of data on alcohol consumption in cohorts of HIV/HCV-infected individuals.

Published
2019

12. Low frequency of genotypic resistance in HIV-1-infected patients failing an atazanavir-containing regimen: a clinical cohort study

Author

Dolling, David I., Dunn, David T., Sutherland, Katherine A., Pillay, Deenan, Mbisa, Jean L., Parry, Chris M., Post, Frank A., Sabin, Caroline A., Cane, Patricia A., Aitken, Celia, Asboe, David, Webster, Daniel, Cane, Patricia, Castro, Hannah, Dunn, David, Dolling, David, Chadwick, David, Churchill, Duncan, Clark, Duncan, Collins, Simon, Delpech, Valerie, Geretti, Anna Maria, Goldberg, David, Hale, Antony, Hué, Stéphane, Kaye, Steve, Kellam, Paul, Lazarus, Linda, Leigh-Brown, Andrew, Mackie, Nicola, Orkin, Chloe, Rice, Philip, Pillay, Deenan, Phillips, Andrew, Sabin, Caroline, Smit, Erasmus, Templeton, Kate, Tilston, Peter, Tong, William, Williams, Ian, Zhang, Hongyi, Zuckerman, Mark, Greatorex, Jane, Wildfire, Adrian, OʼShea, Siobhan, Mullen, Jane, Mbisa, Tamyo, Cox, Alison, Tandy, Richard, Hale, Tony, Fawcett, Tracy, Hopkins, Mark, Ashton, Lynn, Booth, Claire, Garcia-Diaz, Ana, Shepherd, Jill, Schmid, Matthias L., Payne, Brendan, Hay, Phillip, Rice, Phillip, Paynter, Mary, Bibby, David, Kirk, Stuart, MacLean, Alasdair, Gunson, Rory, Coughlin, Kate, Fearnhill, Esther, Fradette, Lorraine, Porter, Kholoud, Ainsworth, Jonathan, Anderson, Jane, Babiker, Abdel, Fisher, Martin, Gazzard, Brian, Gilson, Richard, Gompels, Mark, Hill, Teresa, Johnson, Margaret, Kegg, Stephen, Leen, Clifford, Nelson, Mark, Palfreeman, Adrian, Post, Frank, Sachikonye, Memory, Schwenk, Achim, Walsh, John, Huntington, Susie, Jose, Sophie, Thornton, Alicia, Glabay, Adam, Orkin, C., Garrett, N., Lynch, J., Hand, J., de Souza, C., Fisher, M., Perry, N., Tilbury, S., Gazzard, B., Nelson, M., Waxman, M., Asboe, D., Mandalia, S., Delpech, V., Anderson, J., Munshi, S., Korat, H., Welch, J., Poulton, M., MacDonald, C., Gleisner, Z., Campbell, L., Gilson, R., Brima, N., Williams, I., Schwenk, A., Ainsworth, J., Wood, C., Miller, S., Johnson, M., Youle, M., Lampe, F., Smith, C., Grabowska, H., Chaloner, C., Puradiredja, D., Walsh, J., Weber, J., Ramzan, F., Mackie, N., Winston, A., Leen, C., Wilson, A., Allan, S., Palfreeman, A., Moore, A., and Wakeman, K.

Published
2013
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14. Associations between baseline characteristics, CD4 cell count response and virological failure on first-line efavirenz

Author

Stirrup, OT, Sabin, CA, Phillips, AN, Williams, I, Churchill, D, Tostevin, A, Hill, T, Dunn, DT, Asboe, D, Pozniak, A, Cane, P, Chadwick, D, Clark, D, Collins, S, Delpech, V, Douthwaite, S, Dunn, D, Fearnhill, E, Porter, K, Stirrup, O, Fraser, C, Geretti, AM, Gunson, R, Hale, A, Hue, S, Lazarus, L, Leigh-Brown, A, Mbisa, T, Mackie, N, Orkin, C, Nastouli, E, Pillay, D, Phillips, A, Sabin, C, Smit, E, Templeton, K, Tilston, P, Volz, E, Zhang, H, Fairbrother, K, Dawkins, J, O'Shea, S, Mullen, J, Cox, A, Tandy, R, Fawcett, T, Hopkins, M, Booth, C, Garcia-Diaz, A, Renwick, L, Schmid, ML, Payne, B, Hubb, J, Dustan, S, Kirk, S, Bradley-Stewart, A, Ainsworth, J, Allan, S, Anderson, J, Babiker, A, Gazzard, B, Gilson, R, Compels, M, Hay, P, Johnson, M, Jose, S, Kegg, S, Leen, C, Martin, F, Mital, D, Nelson, M, Palfreeman, A, Post, F, Pritchard, J, Schwenk, A, Tariq, A, Trevelion, R, Ustianowski, A, Walsh, J, Thornton, A, Huntington, S, Glabay, A, Shidfar, S, Lynch, J, Hand, J, De Souza, C, Perry, N, Tilbury, S, Youssef, E, Mabika, T, Mandalia, S, Munshi, S, Adefisan, A, Taylor, C, Gleisner, Z, Ibrahim, F, Campbell, L, Baillie, K, Brima, N, Miller, S, Wood, C, Youle, M, Lampe, F, Smith, C, Tsintas, R, Chaloner, C, Hutchinson, S, Winston, A, Weber, J, Ramzan, F, Carder, M, Wilson, A, Morris, S, Gompels, M, Lewszuk, A, Faleye, A, Ogunbiyi, V, Mitchell, S, Kemble, C, Russell-Sharpe, S, Gravely, J, Harte, A, Spencer, H, Jones, R, Cumming, S, Atkinson, C, Edgell, V, Allen, J, Murphy, C, and Gunder, I

Subjects
NNRTI, viral suppression, Science & Technology, drug resistance, MUTATIONS, Immunology, antiretroviral therapy, MODELS, viral failure, HIV, HIV-1 DRUG-RESISTANCE, TIME, INDIVIDUALS, Infectious Diseases, ADHERENCE, NRTI, Virology, INFECTION, UK, COMBINATION ANTIRETROVIRAL THERAPY, UK HIV Drug Resistance Database and the UK Collaborative HIV Cohort, Life Sciences & Biomedicine, ART, SUPPRESSION
Abstract

Objectives The aim of this study was to investigate associations between baseline characteristics and CD4 cell count response on first-line antiretroviral therapy and risk of virological failure (VF) with or without drug resistance. Methods We conducted an analysis of UK Collaborative HIV Cohort data linked to the UK HIV Drug Resistance Database. Inclusion criteria were viral sequence showing no resistance prior to initiation of first-line efavirenz + tenofovir disoproxil fumarate + emtricitabine and virological suppression within 6 months. Outcomes of VF (≥200 copies/mL) with or without drug resistance were assessed using a competing risks approach fitted jointly with a model for CD4 cell count recovery. Hazard ratios for each VF outcome were estimated for baseline CD4 cell count and viral load and characteristics of CD4 cell count response using latent variables on a standard normal scale. Results A total of 3640 people were included with 338 VF events; corresponding viral sequences were available in 134 with ≥1 resistance mutation in 36. VF with resistance was associated with lower baseline CD4 (0.30, 0.09–0.62), lower CD4 recovery (0.04, 0.00–0.17) and higher CD4 variability (4.40, 1.22–12.68). A different pattern of associations was observed for VF without resistance, but the strength of these results was less consistent across sensitivity analyses. Cumulative incidence of VF with resistance was estimated to be

Published
2019

31. Virological outcomes of boosted protease inhibitor-based first-line ART in subjects harbouring thymidine analogue-associated mutations as the sole form of transmitted drug resistance

Author

Geretti, AM, White, E, Orkin, C, Tostevin, A, Tilston, P, Chadwick, D, Leen, C, Sabin, C, Dunn, DT, Asboe, D, Pozniak, A, Cane, P, Churchill, D, Clark, D, Collins, S, Delpech, V, Douthwaite, S, Dunn, D, Fearnhill, E, Porter, K, Stirrup, O, Fraser, C, Gunson, R, Hale, A, Hue, S, Lazarus, L, Leigh-Brown, A, Mbisa, T, Mackie, N, Nastouli, E, Pillay, D, Phillips, A, Smit, E, Templeton, K, Volz, E, Williams, I, Zhang, H, Dawkins, J, O'Shea, S, Mullen, J, Cox, A, Tandy, R, Fawcett, T, Hopkins, M, Booth, C, Garcia-Diaz, A, Renwick, L, Schmid, ML, Payne, B, Hubb, J, Dustan, S, Kirk, S, Bradley-Stewart, A, Ainsworth, J, Allan, S, Anderson, J, Babiker, A, Gazzard, B, Gilson, R, Gompels, M, Hay, P, Hill, T, Johnson, M, Jose, S, Kegg, S, Martin, F, Mital, D, Nelson, M, Palfreeman, A, Post, F, Pritchard, J, Sabin, CA, Schwenk, A, Tariq, A, Trevelion, R, Ustianowski, A, Walsh, J, Thornton, A, Huntington, S, Glabay, A, Shidfar, S, Lynch, J, Hand, J, De Souza, C, Perry, N, Tilbury, S, Youssef, E, Mabika, T, Mandalia, S, Munshi, S, Adefisan, A, Taylor, C, Gleisner, Z, Ibrahim, F, Campbell, L, Baillie, K, Brima, N, Miller, S, Wood, C, Youle, M, Lampe, F, Smith, C, Tsintas, R, Chaloner, C, Hutchinson, S, Winston, A, Weber, J, Ramzan, F, Carder, M, Wilson, A, Morris, S, Lewszuk, A, Faleye, A, Ogunbiyi, V, Mitchell, S, Kemble, C, Russell-Sharpe, S, Gravely, J, Harte, A, Spencer, H, Jones, R, Cumming, S, Atkinson, C, Edgell, V, Allen, J, Murphy, C, and Gunder, I

Subjects
0301 basic medicine, Oncology, Male, HIV Infections, Drug resistance, Kaplan-Meier Estimate, chemistry.chemical_compound, 0302 clinical medicine, 1108 Medical Microbiology, Abacavir, Antiretroviral Therapy, Highly Active, INFECTION, Pharmacology (medical), Pharmacology & Pharmacy, 030212 general & internal medicine, Original Research, Proteolytic enzymes, Lamivudine, virus diseases, Viral Load, Prognosis, ANTIRETROVIRAL TREATMENT, Infectious Diseases, Treatment Outcome, Cohort, RNA, Viral, Female, 1115 Pharmacology and Pharmaceutical Sciences, UK HIV Drug Resistance Database and UK CHIC Study, Life Sciences & Biomedicine, Viral load, 0605 Microbiology, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, Efavirenz, Genotype, TRANSMISSION, Anti-HIV Agents, 030106 microbiology, REGIMENS, Emtricitabine, Microbiology, 03 medical and health sciences, Internal medicine, Drug Resistance, Viral, medicine, Humans, Protease Inhibitors, Alleles, Pharmacology, Science & Technology, TREATMENT-NAIVE PATIENTS, business.industry, HIV, INDIVIDUALS, chemistry, Amino Acid Substitution, Mutation, HIV-1, business
Abstract

Objectives: In subjects with transmitted thymidine analogue mutations (TAMs), boosted PIs (PI/b) are often chosen to overcome possible resistance to the NRTI backbone. However, data to guide treatment selection are limited. Our aim was to obtain firmer guidance for clinical practice using real-world cohort data.Methods: We analysed 1710 subjects who started a PI/b in combination with tenofovir or abacavir plus emtricitabine or lamivudine, and compared their virological outcomes with those of 4889 patients who started an NNRTI (predominantly efavirenz), according to the presence of ≥1 TAM as the sole form of transmitted drug resistance.Results: Participants with ≥1 TAM comprised predominantly MSM (213 of 269, 79.2%), subjects of white ethnicity (206 of 269, 76.6%) and HIV-1 subtype B infections (234 of 269, 87.0%). Most (203 of 269, 75.5%) had singleton TAMs, commonly a revertant of T215Y or T215F (112 of 269, 41.6%). Over a median of 2.5 years of follow-up, 834 of 6599 (12.6%) subjects experienced viraemia (HIV-1 RNA >50 copies/mL). The adjusted HR for viraemia was 2.17 with PI/b versus NNRTI-based therapy (95% CI 1.88-2.51; P Conclusions: In this cohort, patients harbouring ≥1 TAM as the sole form of transmitted drug resistance gained no apparent virological advantage from starting first-line ART with a PI/b.

Published
2018

36. Development and application of a new measure of engagement in out‐patient HIV care

Author

Howarth, AR, Burns, FM, Apea, V, Jose, S, Hill, T, Delpech, VC, Evans, A, Mercer, CH, Michie, S, Morris, S, Sachikonye, M, Sabin, C, Ainsworth, Jonathan, Allan, Sris, Anderson, Jane, Babiker, Abdel, Chadwick, David, Dunn, David, Fisher, Martin, Gazzard, Brian, Gilson, Richard, Gompels, Mark, Hay, Phillip, Johnson, Margaret, Kegg, Stephen, Leen, Clifford, Martin, Fabiola, Nelson, Mark, Orkin, Chloe, Palfreeman, Adrian, Phillips, Andrew, Pillay, Deenan, Post, Frank, Pritchard, Jillian, Schwenk, Achim, Tariq, Anjum, Trevelion, Roy, Walsh, John, Thornton, Alicia, Huntington, Susie, Glabay, Adam, Perry, N., Tilbury, S., Youssef, E., Churchill, D., Everett, R., Asboe, D., Mandalia, S., Korat, H., Taylor, C., Gleisner, Z., Ibrahim, F., Campbell, L., Brima, N., Williams, I., Youle, M., Lampe, F., Smith, C., Tsintas, R., Chaloner, C., Hutchinson, S., Mackie, N., Winston, A., Weber, J., Ramzan, F., Carder, M., Lynch, J., Hand, J., Souza, C., Anderson, J., Munshi, S., Miller, S., Wood, C., Leen, C., Wilson, A., Morris, S., Memon, K., Lewszuk, A., Cope, E., Gibson, J., Main, P., Mitchell, S., Hunter, M., Dhillon, M., Russell‐Sharpe, S., Harte, A., Clay, S., Tariq, A., Spencer, H., Jones, R., Cumming, S., and Atkinson, C.

Subjects
Adult, Male, patient engagement, Adolescent, HIV, HIV Infections, out‐patient care, retention measure, Middle Aged, Patient Acceptance of Health Care, United Kingdom, Cohort Studies, Interviews as Topic, Young Adult, cohort study, Ambulatory Care, Humans, Female, Original Research, Aged
Abstract

Objectives Commonly used measures of engagement in HIV care do not take into account that the frequency of attendance is related to changes in treatment and health status. This study developed a new measure of engagement in care (EIC) incorporating clinical factors. Methods We conducted semi‐structured interviews with eight HIV physicians to identify factors associated with the timing of patients' next scheduled appointments. These factors informed the development of an algorithm to classify each month of follow‐up as “in care” (on or before the time of the next expected attendance) or “out of care” (after the time of the next expected attendance). The EIC algorithm was applied to data from the UK Collaborative HIV Cohort (UK CHIC) study, a large clinical cohort study. Results The interviews indicated that time to next appointment varied depending on psychosocial and physical comorbidities, and clinical factors (time since diagnosis, AIDS diagnosis, treatment status, CD4 count and viral load). The resulting EIC algorithm was applied to 44 432 patients; 83.9% of the 3 021 224 person‐months were “in care”. Greater EIC was independently associated with older age, white ethnicity, HIV acquisition through sex between men, current use of antiretroviral therapy (ART), a higher nadir CD4 count, later calendar year and being seen at the clinic for the first time within the last year. Conclusions This algorithm describing engagement in HIV care incorporates a time‐updated measure of patients' treatment and health status. It adds to the options available for measuring this key performance indicator.

Published
2016

37. Risk factors and outcomes for the Q151M and T69 insertion HIV-1 resistance mutations in historic UK data

Author

Stirrup, OT, Dunn, DT, Tostevin, A, Sabin, CA, Pozniak, A, Asboe, D, Cox, A, Orkin, C, Martin, F, Cane, P, Fairbrother, K, Fearnhill, E, Hubb, J, Porter, K, Babiker, A, Lynch, J, Hand, J, De Souza, C, Churchill, D, Perry, N, Tilbury, S, Youssef, E, Clark, D, Gazzard, B, Nelson, M, Mabika, T, Mandalia, S, Anderson, J, Munshi, S, Post, F, Adefisan, A, Taylor, C, Gleisner, Z, Ibrahim, F, Campbell, L, Chadwick, D, Baillie, K, Gilson, R, Brima, N, Williams, I, Ainsworth, J, Schwenk, A, Miller, S, Wood, C, Johnson, M, Youle, M, Lampe, F, Smith, C, Tsintas, R, Chaloner, C, Hutchinson, S, Phillips, A, Hill, T, Jose, S, Huntington, S, Thornton, A, Walsh, J, Mackie, N, Winston, A, Weber, J, Ramzan, F, Carder, M, Leen, C, Wilson, A, Morris, S, Gompels, M, Allan, S, Palfreeman, A, Lewszuk, A, Kegg, S, Faleye, A, Ogunbiyi, V, Mitchell, S, Hay, P, Kemble, C, Russell-Sharpe, S, Gravely, J, Harte, A, Tariq, A, Spencer, H, Jones, R, Pritchard, J, Cumming, S, Atkinson, C, Mital, D, Edgell, V, Allen, J, Ustianowski, A, Murphy, C, and Gunder, I

Subjects
Multi-NRTI resistance, RESOURCE-LIMITED SETTINGS, Science & Technology, 151 complex, HIV, CHILDREN, Multidrug resistance, IMMUNODEFICIENCY-VIRUS TYPE-1, 69 insertion complex, UK Collaborative HIV Cohort, INFECTED INDIVIDUALS, PREVALENCE, EMERGENCE, Infectious Diseases, ANTIRETROVIRAL THERAPY, NRTI, 1ST-LINE REGIMENS, 1107 Immunology, Virology, COHORT, TRANSMITTED DRUG-RESISTANCE, Life Sciences & Biomedicine, UK HIV Drug Resistance Database
Abstract

Background: The prevalence of HIV-1 resistance to antiretroviral therapies (ART) has declined in high-income countries over recent years, but drug resistance remains a substantial concern in many low and middle-income countries. The Q151M and T69 insertion (T69i) resistance mutations in the viral reverse transcriptase gene can reduce susceptibility to all nucleoside/tide analogue reverse transcriptase inhibitors, motivating the present study to investigate the risk factors and outcomes associated with these mutations. Methods: We considered all data in the UK HIV Drug Resistance Database for blood samples obtained in the period 1997-2014. Where available, treatment history and patient outcomes were obtained through linkage to the UK Collaborative HIV Cohort study. A matched case-control approach was used to assess risk factors associated with the appearance of each of the mutations in ART-experienced patients, and survival analysis was used to investigate factors associated with viral suppression. A further analysis using matched controls was performed to investigate the impact of each mutation on survival. Results: A total of 180 patients with Q151M mutation and 85 with T69i mutation were identified, almost entirely from before 2006. Occurrence of both the Q151M and T69i mutations was strongly associated with cumulative period of virological failure while on ART, and for Q151M there was a particular positive association with use of stavudine and negative association with use of boosted-protease inhibitors. Subsequent viral suppression was negatively associated with viral load at sequencing for both mutations, and for Q151M we found a negative association with didanosine use but a positive association with boosted-protease inhibitor use. The results obtained in these analyses were also consistent with potentially large associations with other drugs. Analyses were inconclusive regarding associations between the mutations and mortality, but mortality was high for patients with low CD4 at detection. Conclusions: The Q151M and T69i resistance mutations are now very rare in the UK. Our results suggest that good outcomes are possible for people with these mutations. However, in this historic sample, viral load and CD4 at detection were important factors in determining prognosis.

Published
2018

38. Vergleich der radiologischen und klinischen Ergebnisse nach Knie-Totalendoprothese mit patientenspezifischen Instrumenten vs. Standardinstrumenten – Ergebnisse einer multizentrischen Studie

Author

Maus, U, Scheunemann, D, Lampe, F, Lazovic, D, Hommel, H, Vogel, D, Haunschild, M, and Pfitzner, T

Subjects
Patientenspezifische Instrumente, MRT, ddc: 610, PSI, 610 Medical sciences, Medicine, Knietotalendoprothetik, Knieendoprothetik
Abstract

Fragestellung: Die Verwendung von patientenspezifischen Instrumenten (PSI) auf der Basis von 3D-Bildgebung in der Knieendoprothetik dient der Erreichung einer größtmöglichen Präzision, Optimierung der Prothesenpositionierung und Verkürzung der Operationszeit. Ziel der vorliegenden[zum vollständigen Text gelangen Sie über die oben angegebene URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017)

Published
2017
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40. Virological failure and development of new resistance mutations according to CD4 count at combination antiretroviral therapy initiation

Author

Jose, S., Quinn, K., Dunn, D., Cox, A., Sabin, C., Fidler, S., Fisher, Martin, Gazzard, Brian, Gilson, Richard, Gompels, Mark, Hay, Phillip, Johnson, Margaret, Kegg, Stephen, Leen, C., Martin, Fabiola, Nelson, Mark, Palfreeman, Adrian, Post, F., Pritchard, Jillian, Sachikonye, Memory, Schwenk, Achim, Tariq, Anjum, Walsh, John, Hill, Teresa, Jose, Sophie, Phillips, Andrew, Sabin, Caroline, Thornton, Alicia, Dunn, David, Glabay, Adam, Fisher, M., Perry, N., Tilbury, S., Youssef, E., Churchill, D., Gazzard, B., Nelson, M., Everett, R., Asboe, D., Mandalia, S., Korat, H., Taylor, C., Gleisner, Z., Ibrahim, F., Campbell, L., Gilson, R., Brima, N., Williams, I., Johnson, M., Youle, M., Lampe, F., Smith, C., Tsintas, R., Chaloner, C., Hutchinson, S., Phillips, A., Hill, T., Thornton, A., Huntington, S., Walsh, J., Mackie, N., Winston, A., Weber, J., Ramzan, F., Carder, M., Orkin, C., Lynch, J., Hand, J., de Souza, C., Anderson, J., Munshi, S., Ainsworth, J., Schwenk, A., Miller, S., Wood, C., Wilson, A., Morris, S., Gompels, M., Allan, S., Palfreeman, A., Memon, K., Lewszuk, A., Chadwick, D., Cope, E., Gibson, J., Kegg, S., Main, P., Mitchell, Hunter, Hay, P., Dhillon, M., Martin, F., Russell-Sharpe, S., Harte, A., Clay, S., Tariq, A., Spencer, H., Jones, R., Pritchard, J., Cumming, S., Atkinson, C., Delpech, Valerie, Sachikony, M., Aitken, Celia, Asboe, David, Pozniak, Anton, Cane, Patricia, Chadwick, David, Churchill, Duncan, Clark, Duncan, Collins, Simon, Douthwaite, Samuel, Fearnhill, Esther, Porter, Kholoud, Tostevin, Anna, White, Ellen, Fraser, Christophe, Geretti, Anna Maria, Hale, Antony, Hué, Stéphane, Kaye, Steve, Kellam, Paul, Lazarus, Linda, Leigh-Brown, Andrew, Mbisa, Tamyo, Mackie, Nicola, Moses, Samuel, Orkin, Chloe, Nastouli, Eleni, Pillay, Deenan, Smit, Erasmus, Templeton, Kate, Tilston, Peter, Webster, Daniel, Williams, Ian, Zhang, Hongyi, Greatorex, Jane, O'Shea, Siobhan, Mullen, Jane, Cox, Alison, Tandy, Richard, Fawcett, Tracy, Hopkins, Mark, Ashton, Lynn, Booth, Claire, Garcia-Diaz, Ana, Shepherd, Jill, Schmid, Matthias L., Payne, Brendan, Pereira, Spiro, Hubb, Jonathan, Kirk, Stuart, Gunson, Rory, Bradley-Stewart, Amanda, and Medical Research Council (MRC)

Subjects
0301 basic medicine, Male, HAART, HIV Infections, Treatment failure, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Treatment Failure, virological failure, Health Policy, UK CHIC and UK HDRD Steering Committees, Virological failure, 3. Good health, Antiretroviral therapy, Patient benefit, Infectious Diseases, Female, medicine.symptom, Life Sciences & Biomedicine, Viral load, Cart, medicine.medical_specialty, Anti-HIV Agents, Short Communication, antiretroviral therapy, CD4 count, Asymptomatic, 03 medical and health sciences, HIV-INFECTION, Virology, Internal medicine, Drug Resistance, Viral, medicine, Humans, Science & Technology, business.industry, HIV resistance, 1103 Clinical Sciences, 030112 virology, CD4 Lymphocyte Count, Immunology, Mutation, business
Abstract

Objectives No randomized controlled trials have yet reported an individual patient benefit of initiating combination antiretroviral therapy (cART) at CD4 counts > 350 cells/μL. It is hypothesized that earlier initiation of cART in asymptomatic and otherwise healthy individuals may lead to poorer adherence and subsequently higher rates of resistance development. Methods In a large cohort of HIV-positive individuals, we investigated the emergence of new resistance mutations upon virological treatment failure according to the CD4 count at the initiation of cART. Results Of 7918 included individuals, 6514 (82.3%), 996 (12.6%) and 408 (5.2%) started cART with a CD4 count ≤ 350, 351–499 and ≥ 500 cells/μL, respectively. Virological rebound occurred while on cART in 488 (7.5%), 46 (4.6%) and 30 (7.4%) with a baseline CD4 count ≤ 350, 351–499 and ≥ 500 cells/μL, respectively. Only four (13.0%) individuals with a baseline CD4 count > 350 cells/μL in receipt of a resistance test at viral load rebound were found to have developed new resistance mutations. This compared to 107 (41.2%) of those with virological failure who had initiated cART with a CD4 count

Published
2015

47. Long-term mortality in HIV-positive individuals virally suppressed for >3 years with incomplete CD4 recovery

Author

Engsig, F. N., Zangerle, R., Katsarou, O., Dabis, F., Reiss, P., Gill, J., Porter, K., Sabin, C., Riordan, A., Fatkenheuer, G., Gutierrez, F., Raffi, F., Kirk, O., Mary-Krause, M., Stephan, C., de Olalla, P. G., Guest, J., Samji, H., Castagna, A., d'Arminio Monforte, A., Skaletz-Rorowski, A., Ramos, J., Lapadula, G., Mussini, C., Force, L., Meyer, L., Lampe, F., Boufassa, F., Bucher, H. C., De Wit, S., Burkholder, G. A., Teira, R., Justice, A. C., Sterling, T. R., M. Crane, H., Gerstoft, J., Grarup, J., May, M., Chene, G., Ingle, S. M., Sterne, J., Obel, N., Burkholder, G., Justice, A., R Sterling, T., Crane, H. M., Boulle, A., Brodt, H.-R., Casabona, J., Cavassini, M., Costagliola, D., D'Arminio Monforte, A., del Amo, J., Van Sighem, A., Hans-Ulrich Haerry, D., Hogg, R., Mocroft, A., Kitahata, M., Saag, M., Williams, M., Ingle, S., Touloumi, G., Warszawski, J., Krause, M. M., Ghosn, J., Leport, C., Wit, F., Prins, M., Gibb, D., Del Amo, J., Thorne, C., Perez-Hoyos, S., Hamouda, O., Gussenheimer-Bartmeyer, B., Noguera-Julian, A., Antinori, A., Brockmeyer, N., Battegay, M., Rauch, A., Tookey, P., Miro, J. M., de Wit, S., Goetghebuer, T., Torti, C., Garrido, M., Judd, A., Conejo, P. R., Haerry, D., Weller, I., d'Arminio-Monforte, A., Colin, C., Schwimmer, C., Termote, M., Kjaer, J., Campbell, M., Raben, D., Bohlius, J., Bouteloup, V., Bucher, H., Cozzi-Lepri, A., Dorrucci, M., Egger, M., Engsig, F., Furrer, H., Lambotte, O., Lewden, C., Lodi, S., Lodwick, R., Matheron, S., Miro, J., Monge, S., Nakagawa, F., Paredes, R., Phillips, A., Puoti, M., Reekie, J., Scherrer, A., Smit, C., Thiebaut, R., Wittkop, L., 2nd Blood Transfusion Center and Hemophilia Center, 'Laiko' General Hospital, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Structures et propriétés d'architectures moléculaire (SPRAM - UMR 5819), Institut Nanosciences et Cryogénie (INAC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS), Observatoire des Micro et Nano Technologies (OMNT - UMS 2920), Laboratoire d'Electronique et des Technologies de l'Information (CEA-LETI), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS), Southern Alberta Clinic, Research Department of Infection and Population Health [London], University College of London [London] (UCL), Equipe Perception et design sonores, Sciences et Technologies de la Musique et du Son (STMS), Université Pierre et Marie Curie - Paris 6 (UPMC)-IRCAM-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-IRCAM-Centre National de la Recherche Scientifique (CNRS), Equipe Interactions musicales temps-réel, Maladies infectieuses et tropicales, Université Pierre et Marie Curie - Paris 6 (UPMC), Institute of Biology, Neuchatel, Université de Neuchâtel (UNINE), School of Psychology, St Andrews, University of St Andrews [Scotland], Infectious Diseases, San Raffaele Scientific Institute, EA 4100, Histoire culturelle et sociale de l'art (HiCSA), Université Panthéon-Sorbonne (UP1)-Université Panthéon-Sorbonne (UP1), Laboratory of Inorganic Chemistry, Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology in Zürich [Zürich] (ETH Zürich), Princeton University, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Population Sciences, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Paläontologisches Institut und Museum, Universität Zürich [Zürich] (UZH), Laboratory, GD Deventer, Rigshospitalet [Copenhagen], Department of Social Medicine, University of Bristol [Bristol], Department of Infectious Diseases, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information (CEA-LETI), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), School of Psychology and Neuroscience [University of St. Andrews], Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris 1 Panthéon-Sorbonne (UP1), Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology [Zürich] (ETH Zürich), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Universität Zürich [Zürich] = University of Zurich (UZH), Royal GD [Deventer], Copenhagen University Hospital, Copenhagen University Hospital-Copenhagen University Hospital, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Engsig, F. N., Zangerle, R., Katsarou, O., Dabis, F., Reiss, P., Gill, J., Porter, K., Sabin, C., Riordan, A., Fatkenheuer, G., Gutierrez, F., Raffi, F., Kirk, O., Mary-Krause, M., Stephan, C., De Olalla, P. G., Guest, J., Samji, H., Castagna, A., D'arminio Monforte, A., Skaletz-Rorowski, A., Ramos, J., Lapadula, G., Mussini, C., Force, L., Meyer, L., Lampe, F., Boufassa, F., Bucher, H. C., De Wit, S., Burkholder, G. A., Teira, R., Justice, A. C., Sterling, T. R., M. Crane, H., Gerstoft, J., Grarup, J., May, M., Chene, G., Ingle, S. M., Sterne, J., Obel, N., Engsig, F, Zangerle, R, Katsarou, O, Dabis, F, Reiss, P, Gill, J, Porter, K, Sabin, C, Riordan, A, Fatkenheuer, G, Gutierrez, F, Raffi, F, Kirk, O, Mary-Krause, M, Stephan, C, De Olalla, P, Guest, J, Samji, H, Castagna, A, D'arminio Monforte, A, Skaletz-Rorowski, A, Ramos, J, Lapadula, G, Mussini, C, Force, L, Meyer, L, Lampe, F, Boufassa, F, Bucher, H, De Wit, S, Burkholder, G, Teira, R, Justice, A, Sterling, T, M. Crane, H, Gerstoft, J, Grarup, J, May, M, Chene, G, Ingle, S, Sterne, J, Obel, N, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Global Health, and Infectious diseases

Subjects
Male, Oncology, MESH: CD4 Lymphocyte Count, [SDV]Life Sciences [q-bio], HIV Infections, MESH: Logistic Models, Cohort Studies, MESH: Cause of Death, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Cause of Death, Medicine, HIV Infection, 030212 general & internal medicine, MESH: Anti-HIV Agents, MESH: Cohort Studies, Immunodeficiency, Cause of death, 0303 health sciences, MESH: Middle Aged, Hazard ratio, MESH: HIV Infections, Middle Aged, Viral Load, 3. Good health, Infectious Diseases, MESH: Substance-Related Disorders, HIV/AIDS, Female, MESH: Viral Load, Viral load, MESH: Heterosexuality, Human, Adult, Microbiology (medical), Cart, medicine.medical_specialty, Logistic Model, Anti-HIV Agents, Substance-Related Disorders, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Humans, sustained viral suppression, Heterosexuality, 030304 developmental biology, MESH: Humans, business.industry, Proportional hazards model, Risk Factor, Anti-HIV Agent, HIV, MESH: Adult, Substance-Related Disorder, medicine.disease, mortality, CD4 cell recovery, Confidence interval, MESH: Male, CD4 Lymphocyte Count, Logistic Models, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort Studie, business, MESH: Female
Abstract

Background. Some human immunodeficiency virus (HIV)-infected individuals initiating combination antiretroviral therapy (cART) with low CD4 counts achieve viral suppression but not CD4 cell recovery. We aimed to identify (1) risk factors for failure to achieve CD4 count >200 cells/μL after 3 years of sustained viral suppression and (2) the association of the achieved CD4 count with subsequent mortality.Methods. We included treated HIV-infected adults from 2 large international HIV cohorts, who had viral suppression (≤500 HIV type 1 RNA copies/mL) for >3 years with CD4 count ≤200 cells/μL at start of the suppressed period. Logistic regression was used to identify risk factors for incomplete CD4 recovery (≤200 cells/μL) and Cox regression to identify associations with mortality.Results. Of 5550 eligible individuals, 835 (15%) did not reach a CD4 count >200 cells/μL after 3 years of suppression. Increasing age, lower initial CD4 count, male heterosexual and injection drug use transmission, cART initiation after 1998, and longer time from initiation of cART to start of the virally suppressed period were risk factors for not achieving a CD4 count >200 cells/μL. Individuals with CD4 ≤200 cells/μL after 3 years of viral suppression had substantially increased mortality (adjusted hazard ratio, 2.60; 95% confidence interval, 1.86-3.61) compared with those who achieved CD4 count >200 cells/μL. The increased mortality was seen across different patient groups and for all causes of death.Conclusions. Virally suppressed HIV-positive individuals on cART who do not achieve a CD4 count >200 cells/μL have substantially increased long-term mortality. © The Author 2014.

Published
2014

48. Incomplete Reversibility of Estimated Glomerular Filtration Rate Decline Following Tenofovir Disoproxil Fumarate Exposure

Author

Jose, Sophie, Hamzah, Lisa, Campbell, Lucy J., Hill, Teresa, Fisher, Martin, Leen, Clifford, Gilson, Richard, Walsh, John, Nelson, Mark, Hay, Phillip, Johnson, Margaret, Chadwick, David, Nitsch, Dorothea, Jones, Rachael, Sabin, Caroline A., Post, Frank A., Ainsworth, Jonathan, Anderson, Jane, Babiker, Abdel, Delpech, Valerie, Dunn, David, Gazzard, Brian, Gompels, Mark, Kegg, Stephen, Orkin, Chloe, Palfreeman, Adrian, Phillips, Andrew, Pillay, Deenan, Post, Frank, Sabin, Caroline, Sachikonye, Memory, Schwenk, Achim, Huntington, Susie, Josie, Sophie, Thornton, Alicia, Glabay, Adam, Orkin, C., Garrett, N., Lynch, J., Hand, J., de Souza, C., Fisher, M., Perry, N., Tilbury, S., Churchill, D., Gazzard, B., Nelson, M., Waxman, M., Asboe, D., Mandalia, S., Delpech, V., Anderson, J., Munshi, S., Korat, H., Poulton, M., Taylor, C., Gleisner, Z., Campbell, L., Gilson, R., Brima, N., Williams, I., Schwenk, A., Ainsworth, J., Wood, C., Miller, S., Johnson, M., Youle, M., Lampe, F., Smith, C., Grabowska, H., Chaloner, C., Puradiredja, D., Walsh, J., Weber, J., Ramzan, F., Mackie, N., Winston, A., Leen, C., Wilson, A., Gompels, M., Allan, S., Palfreeman, A., Moore, A., Chadwick, D., Wakeman, K., Main, Paul, Mitchell, Hunter, and Dhillon, Mandip

Subjects
Adult, Male, eGFR slopes, kidney, Anti-HIV Agents, Adenine, renal function, Organophosphonates, HIV Infections, highly active antiretroviral therapy, Middle Aged, Viral Load, tenofovir, Drug Administration Schedule, Cohort Studies, Major Articles and Brief Reports, eGFR, HIV/AIDS, Humans, Female, Kidney Diseases, Glomerular Filtration Rate, Proportional Hazards Models
Abstract

Background. Tenofovir disoproxil fumarate (TDF) has been linked to renal impairment, but the extent to which this impairment is reversible is unclear. We aimed to investigate the reversibility of renal decline during TDF therapy. Methods. Cox proportional hazards models assessed factors associated with discontinuing TDF in those with an exposure duration of >6 months. In those who discontinued TDF therapy, linear piecewise regression models estimated glomerular filtration rate (eGFR) slopes before initiation of, during, and after discontinuation of TDF therapy. Factors associated with not achieving eGFR recovery 6 months after discontinuing TDF were assessed using multivariable logistic regression. Results. We observed declines in the eGFR during TDF exposure (mean slopes, −15.7 mL/minute/1.73 m2/year [95% confidence interval {CI}, −20.5 to −10.9] during the first 3 months and −3.1 mL/minute/1.73 m2/year [95% CI, −4.6 to −1.7] thereafter) and evidence of eGFR increases following discontinuation of TDF therapy (mean slopes, 12.5 mL/minute/1.73 m2/year [95% CI, 8.9–16.1] during the first 3 months and 0.8 mL/minute/1.73 m2/year [95% CI, .1–1.5] thereafter). Following TDF discontinuation, 38.6% of patients with a decline in the eGFR did not experience recovery. A higher eGFR at baseline, a lower eGFR after discontinuation of TDF therapy, and more-prolonged exposure to TDF were associated with an increased risk of incomplete recovery 6 months after discontinuation of TDF therapy. Conclusions. This study shows that a decline in the eGFR during TDF therapy was not fully reversible in one third of patients and suggests that prolonged TDF exposure at a low eGFR should be avoided.

Published
2014

49. Investigating Conceptual Models for the Relationship Between Depression and Condomless Sex Among Gay, Bisexual, and Other Men Who have Sex with Men: Using Structural Equation Modelling to Assess Mediation.

Author

Miltz, A. R., Rodger, A. J., Lepri, A. Cozzi, Sewell, J., Nwokolo, N. C., Allan, S., Scott, C., Ivens, D., Lascar, M., Speakman, A., Phillips, A. N., Sherr, L., Collins, S., Elford, J., and Lampe, F. C.

Subjects
DIAGNOSIS of mental depression, CONDOMS, MENTAL depression, MATHEMATICAL models, QUESTIONNAIRES, RISK assessment, RISK-taking behavior, SUBSTANCE abuse, THEORY, LGBTQ+ people, STRUCTURAL equation modeling, UNSAFE sex
Abstract

The aim of this study is to investigate five hypothesized mechanisms of causation between depression and condomless sex with ≥ 2 partners (CLS2+) among gay, bisexual, and other men who have sex with men (GBMSM), involving alternative roles of self-efficacy for sexual safety and recreational drug use. Data were from the AURAH cross-sectional study of 1340 GBMSM attending genitourinary medicine clinics in England (2013–2014). Structural equation modelling (SEM) was used to investigate which conceptual model was more consistent with the data. Twelve percent of men reported depression (PHQ-9 ≥ 10) and 32% reported CLS2+ in the past 3 months. AURAH data were more consistent with the model in which depression was considered to lead to CLS2+ indirectly via low self-efficacy for sexual safety (indirect Beta = 0.158; p < 0.001) as well as indirectly via higher levels of recreational drug use (indirect Beta = 0.158; p < 0.001). SEM assists in understanding the relationship between depression and CLS among GBMSM. [ABSTRACT FROM AUTHOR]

Published
2020
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