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1. Temporal trends of time to antiretroviral treatment initiation, interruption and modification: Examination of patients diagnosed with advanced HIV in Australia

Author

Wright, ST, Law, MG, Cooper, DA, Keen, P, McDonald, A, Middleton, M, Woolley, I, Kelly, M, Petoumenos, K, Ellis, D, Bloch, M, Agrawal, S, Vincent, T, Allen, D, Little, JL, Smith, D, Mincham, C, Baker, D, Ieroklis, V, Templeton, DJ, O'Connor, CC, Phan, S, Jackson, E, McCallum, K, Grotowski, M, Taylor, S, Carr, A, Lee, F, Hesse, K, Sinn, K, Norris, R, Finlayson, R, Prone, I, Patel, A, Varma, R, Shakeshaft, J, Brown, K, McGrath, V, Halligan, S, Wray, L, Read, P, Lu, H, Couldwell, D, Furner, V, Fernando, S, Chuah, J, Watson, J, Lawrence, C, Mulhall, B, McManus, H, Bendall, C, Boyd, M, Ryder, N, Payne, R, Russell, D, Doyle-Adams, S, Sowden, D, Taing, K, McGill, K, Orth, D, Youds, D, Gibson, A, Magon, H, Dickson, B, Donohue, W, Moore, R, Edwards, S, Liddle, R, Locke, P, Roth, NJ, Lau, H, Read, T, Silvers, J, Zeng, W, Hoy, J, Watson, K, Bryant, M, Price, S, Giles, M, Williams, J, Nolan, D, Robinson, J, Morwood, K, Roth, N, Choong, K, Li, PCK, Lee, MP, Vanar, S, Faridah, S, Kamarulzaman, A, Choi, JY, Vannary, B, Ditangco, R, Tsukada, K, Pujari, S, Makane, A, Ng, OT, and Sasisopin, AJ

Subjects
Adult, Male, Logistic Models, Time Factors, Anti-HIV Agents, Australia, Humans, HIV Infections, Female, Viral Load, Middle Aged, CD4 Lymphocyte Count, Aged
Abstract

© 2015 Wright ST et al; licensee International AIDS Society. Introduction: HIV prevention strategies are moving towards reducing plasma HIV RNA viral load in all HIV-positive persons, including those undiagnosed, treatment naïve, on or off antiretroviral therapy. A proxy population for those undiagnosed are patients that present late to care with advanced HIV. The objectives of this analysis are to examine factors associated with patients presenting with advanced HIV, and establish rates of treatment interruption and modification after initiating ART. Methods: We deterministically linked records from the Australian HIV Observational Database to the Australian National HIV Registry to obtain information related to HIV diagnosis. Logistic regression was used to identify factors associated with advanced HIV diagnosis.We used survival methods to evaluate rates of ART initiation by diagnosis CD4 count strata and by calendar year of HIV diagnosis. Cox models were used to determine hazard of first ART treatment interruption (duration >30 days) and time to first major ART modification. Results: Factors associated (p

Published
2015

2. Temporal trends of time to antiretroviral treatment initiation, interruption and modification: Examination of patients diagnosed with advanced HIV in Australia.

Author

Kelly M., Donohue W., Moore R., Edwards S., Agrawal S., Vincent T., Allen D., Little J.L., Smith D.E., Mincham C., Baker D., Ieroklis V., Templeton D.J., O'Connor C.C., Phan S., Jackson E., McCallum K., Grotowski M., Taylor S., Carr A., Lee F., Hesse K., Sinn K., Norris R., Finlayson R., Prone I., Patel A., Varma R., Shakeshaft J., Brown K., McGrath C., Halligan S., Wray L., Read P., Lu H., Couldwell D., Furner V., Fernando S., Chuah J., Watson J., Lawrence C., Mulhall B., McManus H., Bendall C., Boyd M.A., Ryder N., Payne R., Russell D., Doyle-Adams S., Sowden D., Taing K., McGill K., Orth D., Youds D., Gibson A., Magon H., Kamarulzaman A., Choi J.Y., Vannary B., Ditangco R., Tsukada K., Pujari S., Makane A., Ng O.T., Sasisopin A.J., Liddle R., Locke P., Roth N.J., Lau H., Read T., Silvers J., Zeng W., Korman T., Watson K., Bryant M., Price S., Giles M., Hoy J., Williams J., Nolan D., Robinson J., Morwood K., Roth N., Choong K., Li P.C.K., Lee M.P., Vanar S., Faridah S., Wright S.T., Law M.G., Cooper D., Keen P., McDonald A., Middleton M., Woolley I., Dickson B., Petoumenos K., Ellis D., Bloch M., Kelly M., Donohue W., Moore R., Edwards S., Agrawal S., Vincent T., Allen D., Little J.L., Smith D.E., Mincham C., Baker D., Ieroklis V., Templeton D.J., O'Connor C.C., Phan S., Jackson E., McCallum K., Grotowski M., Taylor S., Carr A., Lee F., Hesse K., Sinn K., Norris R., Finlayson R., Prone I., Patel A., Varma R., Shakeshaft J., Brown K., McGrath C., Halligan S., Wray L., Read P., Lu H., Couldwell D., Furner V., Fernando S., Chuah J., Watson J., Lawrence C., Mulhall B., McManus H., Bendall C., Boyd M.A., Ryder N., Payne R., Russell D., Doyle-Adams S., Sowden D., Taing K., McGill K., Orth D., Youds D., Gibson A., Magon H., Kamarulzaman A., Choi J.Y., Vannary B., Ditangco R., Tsukada K., Pujari S., Makane A., Ng O.T., Sasisopin A.J., Liddle R., Locke P., Roth N.J., Lau H., Read T., Silvers J., Zeng W., Korman T., Watson K., Bryant M., Price S., Giles M., Hoy J., Williams J., Nolan D., Robinson J., Morwood K., Roth N., Choong K., Li P.C.K., Lee M.P., Vanar S., Faridah S., Wright S.T., Law M.G., Cooper D., Keen P., McDonald A., Middleton M., Woolley I., Dickson B., Petoumenos K., Ellis D., and Bloch M.

Abstract

Introduction: HIV prevention strategies are moving towards reducing plasma HIV RNA viral load in all HIV-positive persons, including those undiagnosed, treatment naive, on or off antiretroviral therapy. A proxy population for those undiagnosed are patients that present late to care with advanced HIV. The objectives of this analysis are to examine factors associated with patients presenting with advanced HIV, and establish rates of treatment interruption and modification after initiating ART. Method(s): We deterministically linked records from the Australian HIV Observational Database to the Australian National HIV Registry to obtain information related to HIV diagnosis. Logistic regression was used to identify factors associated with advanced HIV diagnosis.We used survival methods to evaluate rates of ART initiation by diagnosis CD4 count strata and by calendar year of HIV diagnosis. Cox models were used to determine hazard of first ART treatment interruption (duration >30 days) and time to first major ART modification. Result(s): Factors associated (p<0.05) with increased odds of advanced HIV diagnosis were sex, older age, heterosexual mode of HIV exposure, born overseas and rural-regional care setting. Earlier initiation of ART occurred at higher rates in later periods (2007-2012) in all diagnosis CD4 count groups. We found an 83% (69, 91%) reduction in the hazard of first treatment interruption comparing 2007-2012 versus 1996-2001 (p<0.001), and no difference in ART modification for patients diagnosed with advanced HIV. Conclusion(s): Recent HIV diagnoses are initiating therapy earlier in all diagnosis CD4 cell count groups, potentially lowering community viral load compared to earlier time periods.We found a marked reduction in the hazard of first treatment interruption, and found no difference in rates of major modification to ART by HIV presentation status in recent periods.:Copyright © 2015 Wright ST et al; licensee International AIDS Society.

Published
2015

3. HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD).

Author

Lawrence C., Silvers J., Zeng W., Watson K., Bryant M., Price S., Woolley I., Korman T., Williams J., Nolan D., Skett J., Robinson J., Mean C.V., Saphonn V., Vohith K., Zhang F.J., Li P.C.K., Lee M.P., Kumarasamy N., Saghayam S., Ezhilarasi C., Pujari S., Joshi K., Makane A., Merati T.P., Wirawan D.N., Yuliana F., Yunihastuti E., Imran D., Widhani A., Oka S., Tanuma J., Nishijima T., Choi J.Y., Na S., Kim J.M., Lee C.K.C., Sim B.L.H., David R., Syed Omar S.F., Azwa I., Ditangco R., Uy E., Bantique R., Wong W.W., Ku W.W., Wu P.C., Ng O.T., Lim P.L., Lee L.S., Tan M.T., Phanuphak P., Ruxrungtham K., Avihingsanon A., Chusut P., Kiertiburanakul S., Sungkanuparph S., Chumla L., Sanmeema N., Chaiwarith R., Sirisanthana T., Kotarathititum W., Praparattanapan J., Kantipong P., Kambua P., Ratanasuwan W., Sriondee R., Nguyen V.K., Bui V.H., Cao T.T., Pham T.T., Cuong D.D., Ha H.L., Sohn A.H., Durier N., Petersen B., Jiamsakul A., Boettiger D., Kelly M., Gibson A., Magon H., Donohue W., Moore R., Edwards S., Han N., Wright S.T., O'Connor C.C., Hoy J., Ponnampalavanar S., Grotowski M., Zhao H.X., Kamarulzaman A., Ellis D., Bloch M., Franic T., Agrawal S., McCann L., Cunningham N., Vincent T., Allen D., Little J.L., Smith D., Gray C., Baker D., Vale R., Templeton D.J., Dijanosic C., Jackson E., McCallum K., Taylor S., Cooper D.A., Carr A., Lee F., Hesse K., Sinn K., Norris R., Finlayson R., Prone I., Shakeshaft J., Brown K., McGrath C., McGrath V., Halligan S., Wray L., Read P., Lu H., Couldwell D., Furner V., Watson J., Giles M., Mulhall B., Law M., Petoumenos K., McManus H., Bendall C., Boyd M., Kulatunga A., Knibbs P., Chuah J., Ngieng M., Dickson B., Russell D., Downing S., Sowden D., Broom J., Taing K., Johnston C., McGill K., Orth D., Youds D., Liddle R., Locke P., Roth N.J., Nicolson J., Lau H., Read T., Lawrence C., Silvers J., Zeng W., Watson K., Bryant M., Price S., Woolley I., Korman T., Williams J., Nolan D., Skett J., Robinson J., Mean C.V., Saphonn V., Vohith K., Zhang F.J., Li P.C.K., Lee M.P., Kumarasamy N., Saghayam S., Ezhilarasi C., Pujari S., Joshi K., Makane A., Merati T.P., Wirawan D.N., Yuliana F., Yunihastuti E., Imran D., Widhani A., Oka S., Tanuma J., Nishijima T., Choi J.Y., Na S., Kim J.M., Lee C.K.C., Sim B.L.H., David R., Syed Omar S.F., Azwa I., Ditangco R., Uy E., Bantique R., Wong W.W., Ku W.W., Wu P.C., Ng O.T., Lim P.L., Lee L.S., Tan M.T., Phanuphak P., Ruxrungtham K., Avihingsanon A., Chusut P., Kiertiburanakul S., Sungkanuparph S., Chumla L., Sanmeema N., Chaiwarith R., Sirisanthana T., Kotarathititum W., Praparattanapan J., Kantipong P., Kambua P., Ratanasuwan W., Sriondee R., Nguyen V.K., Bui V.H., Cao T.T., Pham T.T., Cuong D.D., Ha H.L., Sohn A.H., Durier N., Petersen B., Jiamsakul A., Boettiger D., Kelly M., Gibson A., Magon H., Donohue W., Moore R., Edwards S., Han N., Wright S.T., O'Connor C.C., Hoy J., Ponnampalavanar S., Grotowski M., Zhao H.X., Kamarulzaman A., Ellis D., Bloch M., Franic T., Agrawal S., McCann L., Cunningham N., Vincent T., Allen D., Little J.L., Smith D., Gray C., Baker D., Vale R., Templeton D.J., Dijanosic C., Jackson E., McCallum K., Taylor S., Cooper D.A., Carr A., Lee F., Hesse K., Sinn K., Norris R., Finlayson R., Prone I., Shakeshaft J., Brown K., McGrath C., McGrath V., Halligan S., Wray L., Read P., Lu H., Couldwell D., Furner V., Watson J., Giles M., Mulhall B., Law M., Petoumenos K., McManus H., Bendall C., Boyd M., Kulatunga A., Knibbs P., Chuah J., Ngieng M., Dickson B., Russell D., Downing S., Sowden D., Broom J., Taing K., Johnston C., McGill K., Orth D., Youds D., Liddle R., Locke P., Roth N.J., Nicolson J., Lau H., and Read T.

Abstract

Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Method(s): Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Result(s): A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95% confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusion(s): The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.Copyright © 2014 British HIV Association.

Published
2015

5. Antiretroviral treatment change among HIV, hepatitis B virus and hepatitis C virus co-infected patients in the Australian HIV Observational Database.

Author

Wood H., Watson K., Anderson J., Moore R., Russell D., McGovern G., McNair R., Lowe K., Bal J., Medland N., Mallal S., French M., Skett J., Moore C., Petoumenos K., Ringland C., Goodman R., Gotowski M., Couldwell D., Lewis L., Austin D., Block M., Quan D., Gowers A., Brown K., Skobalj N., O'Connor C., Mitchell M., Templeton D., Liang M.T., Allen D., Strazdinis B., Mulhall B., Mutimer K., Armishaw J., Cooper D., Carr A., Lacey M., Pell C., Rohrsheim R., Finlayson R., Richardson R., Ellis D., Baker D., Kidd J., McFarlane R., Vale R., Canavan P., Law M., Smith D., Huffam S., Savage J., Morgan S., Knibbs P., Rogers G., Markinson S., Sullivan C., Downey F., Curry M., Oddy J., Thompson J., Ree H., Magon H., Sowden D., Walker A., Orth D., Lister G., Youds D., Chuah J., James R., Frankhauser W., Dickson B., Bradford D., Leamy J., D'Arcy Evans C., Reid T., Laing J., Woolley I., Korman T., Padiglione A., Visvanathan K., Roth N., Eu B., Strecker S., Mijch A., Hoy J., Pierce A., McCormack C., Wood H., Watson K., Anderson J., Moore R., Russell D., McGovern G., McNair R., Lowe K., Bal J., Medland N., Mallal S., French M., Skett J., Moore C., Petoumenos K., Ringland C., Goodman R., Gotowski M., Couldwell D., Lewis L., Austin D., Block M., Quan D., Gowers A., Brown K., Skobalj N., O'Connor C., Mitchell M., Templeton D., Liang M.T., Allen D., Strazdinis B., Mulhall B., Mutimer K., Armishaw J., Cooper D., Carr A., Lacey M., Pell C., Rohrsheim R., Finlayson R., Richardson R., Ellis D., Baker D., Kidd J., McFarlane R., Vale R., Canavan P., Law M., Smith D., Huffam S., Savage J., Morgan S., Knibbs P., Rogers G., Markinson S., Sullivan C., Downey F., Curry M., Oddy J., Thompson J., Ree H., Magon H., Sowden D., Walker A., Orth D., Lister G., Youds D., Chuah J., James R., Frankhauser W., Dickson B., Bradford D., Leamy J., D'Arcy Evans C., Reid T., Laing J., Woolley I., Korman T., Padiglione A., Visvanathan K., Roth N., Eu B., Strecker S., Mijch A., Hoy J., Pierce A., and McCormack C.

Abstract

Objectives: To assess the impact of highly active antiretroviral therapy (HAART) on rates of change of antiretroviral treatment among patients co-infected with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) in the Australian HIV Observational Database (AHOD). Method(s): Analysis was based on 805 of the 2218 patients recruited to the AHOD by March 2003, who had commenced HAART after 1 January 1997, who had recorded test results for HBV surface antigen and anti-HCV antibody, and who had follow-up of more than 3 months. The effect of hepatitis co-infection on the rate of antiretroviral treatment change after commencing HAART was assessed using a random-effect Poisson regression model. Result(s): Among those included in the analyses, the prevalences of HBV and HCV were 4.8% and 12.8%, respectively. The overall rate of combination antiretroviral treatment change was 0.74 combinations per year. Factors independently associated with an increased rate of change of combination antiretroviral treatment were: prior AIDS-defining illness; prior exposure to double combination antiretroviral therapy; and antiretroviral treatment class. Co-infection with HBV and/or HCV was not found to be significantly associated with the rate of combination antiretroviral treatment change. Conclusion(s): While both HBV and HCV co-infections are relatively common in the AHOD, they do not appear to be serious impediments to the treatment of HIV-infected patients. © 2005 British HIV Association.

Published
2012

6. HIV/HBV and HIV/HCV coinfection, and outcomes following highly active antiretroviral therapy

Author

Lincoln, D., Petoumenos, K., Dore, G.J., Finlayson, R., Clemons, J., Ellis, D., Baker, D., Kidd, J., McFarlane, R., Law, M., Smith, D., Huffam, D., Savage, J., Morgan, S., Knibbs, P., Rogers, G., Ree, H., Magon, H., Sowden, D., Walker, A., Orth, D., Lister, G.A., Chuah, J., James, R., Fankhauser, W., Dickson, B., Bradford, D., Wilson, C., Fairley, K., Roth, N., Eu, B., Strecker, S., Russell, D., Wood, H., Maijch, A., Hoy, J., Pierce, A., McCormack, C., Watson, K., Anderson, J.S., Moore, R., McGovern, G., McNair, R., Medland, N., Daye, J., Mallal, S., Lincoln, D., Petoumenos, K., Dore, G.J., Finlayson, R., Clemons, J., Ellis, D., Baker, D., Kidd, J., McFarlane, R., Law, M., Smith, D., Huffam, D., Savage, J., Morgan, S., Knibbs, P., Rogers, G., Ree, H., Magon, H., Sowden, D., Walker, A., Orth, D., Lister, G.A., Chuah, J., James, R., Fankhauser, W., Dickson, B., Bradford, D., Wilson, C., Fairley, K., Roth, N., Eu, B., Strecker, S., Russell, D., Wood, H., Maijch, A., Hoy, J., Pierce, A., McCormack, C., Watson, K., Anderson, J.S., Moore, R., McGovern, G., McNair, R., Medland, N., Daye, J., and Mallal, S.

Abstract

Objectives To assess the prevalence and risk factors for HBV and HCV coinfection in the Australia HIV Observational Database (AHOD), and examine outcomes of HIV disease following initiation of highly active antiretroviral therapy (HAART). Methods Analyses were based on 2086 participants recruited to AHOD by September 2002. Of these, 1605 (77%) had been tested for HBV surface antigen, 1704 (82%) for anti-HCV antibody and 1453 (70%) for both. Demographic and clinical predictors of HBV and HCV coinfection were examined. The impact of HBV and HCV coinfection on HIV disease progression was assessed by Kaplan-Meier survival curves and Cox proportional hazard model of time to AIDS events and death. Results Among those tested, prevalence of HBV surface antigen and HCV antibody were 6.3% and 13.1%, respectively (4.8% and 10.7%, respectively, among the entire cohort). In multivariate analyses, the only independent risk factor for HIV/HBV coinfection was coinfection with HCV. Independent risk factors for HIV/HCV coinfection were HIV exposure category (with people who reported injecting drug use [MSM & IDU, IDU only] or receipt of blood or blood products at markedly increased risk) and HBV coinfection. HIV disease outcomes following first initiation of a HAART regimen were similar for HIV/HBV and HIV/HCV coinfected patients compared with HIV-only patients in terms of AIDS-free survival and detectable HIV virus during the first 12 months. However, patients coinfected with HIV/HCV appeared to have a poorer response to HAART in terms of CD4 count changes, with a CD4 count increase of 32 cells/μL (95% CI 1–67) less than HIV-only patients. Conclusions Coinfection with HBV or HCV is relatively common among HIV-infected participants in AHOD. HIV disease outcomes following HAART do not appear to be adversely affected by HBV/HCV coinfection, except for slightly poorer CD4 count responses in HIV/HCV coinfected patients.

Published
2003

7. Rates of combination antiretroviral treatment change in Australia, 1997-2000

Author

Petoumenos, K., Austin, D., Baker, D., Block, M., Brown, K., Carr, A., Cooper, D., Couldwell, D., Ellis, D., Finlayson, R., Gorton, C., Gowers, A., Keeffe, N., Kidd, J., Law, M., Liang, M.T., McFarlane, R., Mutimer, K., Miller, J., O'Connor, C., Quan, D., Rooney, P., Taylor, S., Smith, D., Wheatley, D., Knibbs, P., Huffam, S., Morgan, S., Savage, J., Bradford, D., Chuah, J., Dickson, B., Fankhauser, W., Lister, G., Magon, H., Orth, D., Rawlinson, M., Ree, H., Sowden, D., Walker, A., Wilson, C., Anderson, J., Bal, J., Daye, J., Eu, B., Fairely, C.K., Hoy, J., McCormack, C., McGovern, G., McNair, R., Medland, N., Mijch, A., Moore, R., Pierce, A., Roth, N., Russell, D., Strecker, S., Watson, K., Wood, H., Cain, A., French, M., Mallal, S., Maxwell, D., Moore, C., Skett, J., Petoumenos, K., Austin, D., Baker, D., Block, M., Brown, K., Carr, A., Cooper, D., Couldwell, D., Ellis, D., Finlayson, R., Gorton, C., Gowers, A., Keeffe, N., Kidd, J., Law, M., Liang, M.T., McFarlane, R., Mutimer, K., Miller, J., O'Connor, C., Quan, D., Rooney, P., Taylor, S., Smith, D., Wheatley, D., Knibbs, P., Huffam, S., Morgan, S., Savage, J., Bradford, D., Chuah, J., Dickson, B., Fankhauser, W., Lister, G., Magon, H., Orth, D., Rawlinson, M., Ree, H., Sowden, D., Walker, A., Wilson, C., Anderson, J., Bal, J., Daye, J., Eu, B., Fairely, C.K., Hoy, J., McCormack, C., McGovern, G., McNair, R., Medland, N., Mijch, A., Moore, R., Pierce, A., Roth, N., Russell, D., Strecker, S., Watson, K., Wood, H., Cain, A., French, M., Mallal, S., Maxwell, D., Moore, C., and Skett, J.

Abstract

OBJECTIVE To estimate the rate of combination antiretroviral treatment change and factors associated with combination antiretroviral treatment change among patients recruited in the Australian HIV Observational Database (AHOD). METHODS Analyses were based on patients in the AHOD who had commenced combination antiretroviral treatment after 1 January 1997. Combination antiretroviral treatment change was defined as the addition or change of at least one antiretroviral drug. A random-effect Poisson regression model was used to assess factors associated with increased rates of combination antiretroviral treatment change. RESULTS A total of 596 patients in the AHOD were included in the analysis, with a median follow-up of 2.3 years. The overall rate of antiretroviral treatment change in this group was 0.45 combinations per year. In a multivariate analysis, a low CD4 count (< 200 cells/microL) at baseline was associated with an increased rate of treatment change [rate ratio (RR)=1.43; 95% confidence interval (CI), 1.13, 1.80; P=0.003)]. Combinations including a nonnucleoside reverse transcriptase inhibitor were also associated with slower rates of change than treatment combinations including a protease inhibitor (RR=0.64, 95% CI, 0.51, 0.80, P < 0.001). CONCLUSION Initiating combination antiretroviral at a CD4 cell count < 200 cells/microL may be associated with poorer patient outcomes. However, the possibility that clinician or patient concerns about low immunological status led to faster rates of treatment change in this group cannot be discounted.

Published
2002

8. Time trends in antiretroviral treatment use in Australia, 1997-2000

Author

Rooney, P., Taylor, S., Couldwell, D., Austin, D., Block, M., Quan, D., Gowers, A., O'Conner, C., Gorton, C., Allen, D., Mulhall, B., Mutimer, K., Smith, D., Keeffe, N., Cooper, D., Carr, A., Miller, J., Finlayson, R., Wheatley, D., Ellis, D., Baker, D., Kidd, J., McFarlane, R., Liang, M.T., Brown, K., Petoumenos, K., Law, M., Huffam, S., Savage, J., Morgan, S., Knibbs, P., Sowden, D., Rawlinson, M., Walker, A., Orth, D., Lister, G., Chuah, J., Fankhauser, W., Dickson, B., Bradford, D., Wilson, C., Ree, H., Magon, H., Fairley, C.K., Roth, N., Eu, B., Strecker, S., Russel, D., Wood, H., Mijch, A., Hoy, J., Pierce, A., McCormack, C., Watson, K., Anderson, J., Moore, R., Russell, D., McGovern, G., McNair, R., Bal, J., Medland, N., Daye, J., Mallal, S., French, M., Skett, J., Moore, C., Maxwell, D., Cain, A., Rooney, P., Taylor, S., Couldwell, D., Austin, D., Block, M., Quan, D., Gowers, A., O'Conner, C., Gorton, C., Allen, D., Mulhall, B., Mutimer, K., Smith, D., Keeffe, N., Cooper, D., Carr, A., Miller, J., Finlayson, R., Wheatley, D., Ellis, D., Baker, D., Kidd, J., McFarlane, R., Liang, M.T., Brown, K., Petoumenos, K., Law, M., Huffam, S., Savage, J., Morgan, S., Knibbs, P., Sowden, D., Rawlinson, M., Walker, A., Orth, D., Lister, G., Chuah, J., Fankhauser, W., Dickson, B., Bradford, D., Wilson, C., Ree, H., Magon, H., Fairley, C.K., Roth, N., Eu, B., Strecker, S., Russel, D., Wood, H., Mijch, A., Hoy, J., Pierce, A., McCormack, C., Watson, K., Anderson, J., Moore, R., Russell, D., McGovern, G., McNair, R., Bal, J., Medland, N., Daye, J., Mallal, S., French, M., Skett, J., Moore, C., Maxwell, D., and Cain, A.

Abstract

Objectives: To assess how developing knowledge surrounding combination antiretroviral treatment for people living with HIV infection since mid-1 996 has altered how drugs are used in Australia. Methods: Time trends in use of antiretroviral treatment were calculated on patients recruited to the Australian HIV Observational Database. For each six month period, patients were on one or more antiretroviral drugs for at least two weeks. Other patients were in the no-treatment group. Patients receiving antiretrovirals for more than two weeks were allocated to the category of treatment (mono, double or triple-plus therapy) they received for the longest period. Results: 1476 patients were recruited by September 2000. Of patients currently receiving antiretroviral therapy, 32 per cent took three or more antiretrovirals including an HIV protease inhibitor (PI) and 27 per cent took triple-plus therapy including a nonnucleoside reverse transcriptase inhibitor (NNRTI). The proportion of patients receiving regimens containing stavudine (D4T) decreased from 60 per cent in January to June 1999 to 46 per cent in July to September 2000. The proportion of patients receiving zidovudine (AZT) increased slightly from 26 per cent to 30 per cent. The addition of ritonavir to PI- containing regimens increased from 12 per cent in January to June 1999 to 33 per cent in July to September 2000. The proportion of patients ceasing treatment also increased. By July to September 2000, 10 per cent of patients had ceased treatment for more than three months. Conclusion: Antiretroviral treatment use has changed in Australia. Whether these changes are associated with improved clinical outcomes remains uncertain.

Published
2001

10. © A COMPARISON OF THE PHYSICOCHEMICAL PROPERTIES OF CARCINOEMBRYONIC ANTIGEN IN EXTRACTS OF TUMOUR TISSUE, ASCITIC AND CYST FLUID FROM OVARIAN CANCER.

Author

Hill, R., Daunter, B., Magon, H., Khoo, S.K., and Mackay, E.V.

Abstract

Compares the properties of ovarian carcinoembryonic antigen (CEA) obtained from extracts of ovarian tumor tissue, ascitic fluid and cyst fluid. Indications that the ovarian CEA possesses similar properties to those of colonic CEA; Isoelectric point of CEA from tumor tissue and cyst fluid differing from that of ascitic fluid; Influence of the loss of sialic acid from the CEA into ascitic fluid.

Published
1981
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12. Time trends in antiretroviral treatment use in Australia, 1997-2000

Author

Rooney, P., Taylor, S., Couldwell, D., Austin, D., Block, M., Quan, D., Gowers, A., O Connor, C., Gorton, C., Allen, D., Mulhall, B., Mutimer, K., Smith, D., Keeffe, N., Cooper, D., Carr, A., Miller, J., Finlayson, R., Wheatley, D., Ellis, D., Baker, D., Kidd, J., Mcfarlane, R., Liang, M. T., Brown, K., Petoumenos, K., Law, M., Huffam, S., Savage, J., Morgan, S., Knibbs, P., Sowden, D., Rawlinson, M., Walker, A., Orth, D., Lister, G., Chuah, J., Fankhauser, W., Dickson, B., Bradford, D., Wilson, C., Ree, H., Magon, H., Fairley Christopher, Roth, N., Eu, B., Strecker, S., Russel, D., Wood, H., Mijch, A., Hoy, J., Pierce, A., Mccormack, C., Watson, K., Anderson, J., Moore, R., Russell, D., Mcgovern, G., Mcnair, R., Bal, J., Medland, N., Daye, J., Mallal, S., French, M., Skett, J., Moore, C., Maxwell, D., and Cain, A.

15. Predictors of trend in CD4-positive T-cell count and mortality among HIV-1 infected individuals with virological failure to all three antiretroviral-drug classes

Author

Ledergerber, B, Lundgren, Jd, Walker, As, Sabin, C, Justice, A, Reiss, P, Mussini, C, Wit, F, d'Arminio Monforte, A, Weber, R, Fusco, G, Staszewski, S, Law, M, Hogg, R, Lampe, F, Gill, Mj, Castelli, Francesco, Phillips, An, Rooney, P. q, Taylor, S. q, Couldwell, D. r, Austin, D. s, Block, M. s, Clemons, J. s, Finlayson, R. s, Petoumenos, K. s, Quan, D. s, Smith, D. s, O'Connor, C. t, Gorton, C. t, Allen, D. u, Mulhall, B. u, Mutimer, K. v, Keeffe, N. v, Cooper, D. w, Carr, A. w, Miller, J. w, Pell, C. w, Ellis, D. x, Baker, D. y, Kidd, J. y, Mcfarlane, R. y, Liang, M. T. z, Brown, Aa, K., Huffam, Ab, S., Savage, Ab, J., Morgan, Knibbs, Ab, P., Sowden, Ac, D., Walker, Ac, A., Orth, Ad, D., Lister, Ad, G., Chuah, Ae, J., Fankhauser, Ae, W., Dickson, Ae, B., Bradford, Af, D., Wilson, Af, C., Ree, Ag, H., Magon, Anderson, Ah, J., Moore, Ah, R., Russell, Ah, D., Mcgovern, Ah, G., Mcnair, Bal, Fairley, Ah, K., Roth, Ai, N., Ai, B., Strecker, Ai, S., Ai, D., Wood, Ai, H., Mijch, Aj, A., Hoy, Aj, J., Pierce, Mccormack, Aj, C., Watson, Aj, K., Medland, Ak, N., Daye, Al, J., Mallal, Am, S., French, Am, M., Skett, Am, J., Maxwel, Am, D., Cain, Am, A., Montroni, An, M., Scalise, An, G., Costantini, An, A., Giacometti, Tirelli, Ao, U., Nasti, Ao, G., Pastore, Ap, G., Ladisa, Ap, N., Perulli, M. L., Ap, Suter, Aq, F., Arici, Aq, C., Maggiolo, Chiodo, Ar, F., Gritti, F. M., Ar, Colangeli, Ar, V., Fiorini, Ar, C., Guerra, Ar, L., Carosi, As, G., Cadeo, G. P., As, Minardi, As, C., Vangi, As, D., Paraninfo, Casari, As, S., Pan, As, A., Patroni, Torti, Quiros, Roldan, As, E., Tomasoni, As, L., Moretti, As, F., Nasta, As, P., Uccelli, M. C., As, Bertelli, Rizzardini, At, G., Migliorino, At, M., Abeli, At, C., Manconi, P. E., Au, Piano, Au, P., Ferraro, Av, T., Scerbo, Av, A., Pizzigallo, Aw, E., Ricci, Aw, F., Santoro, Ax, D., Pusterla, Ax, L., Carnevale, Ay, G., Galloni, Ay, D., Viganò, Az, P., Mena, Az, M., Ghinelli, Ba, F., Sighinolfi, Ba, L., Leoncini, Bb, F., Mazzotta, Pozzi, Bb, M., Caputo, Lo, Bb, S., Angarano, Bc, G., Grisorio, Bc, B., Ferrara, Bc, S., Grima, Bd, P., Tundo, Pagano, Be, G., Piersantelli, Be, N., Alessandrini, Be, A., Piscopo, Be, R., Toti, Bf, M., Chigiotti, Bf, S., Soscia, Bg, F., Tacconi, Bg, L., Orani, Bh, A., Perini, Bh, P., Nigro, Bh, M., Scasso, Bi, A., Vincenti, Scalzini, Bj, A., Fibbia, Bj, G., Moroni, Bk, M., Lazzarin, Bk, A., Cargnel, Vigevani, G. M., Bk, Caggese, Bk, L., Tordato, Bk, F., Novati, Bk, R., Galli, Merli, Bk, S., Pastecchia, Bk, C., Moioli, Esposito, Bl, R., Abrescia, Bm, N., Chirianni, Bm, A., Izzo, Bm, C., Piazza, Bm, M., Marco, De, Montesarchio, Bm, V., Manzillo, Bm, E., Nappa, Bm, S., Colomba, Bn, A., Abbadessa, Bn, V., Prestileo, Bn, T., Mancuso, Bn, S., Ferrari, Bo, C., Pzzaferri, Bo, P., Filice, Bp, G., Minoli, Bp, L., Bruno, Bp, R., Maserati, Bp, S., Tinelli, Bp, C., Pauluzzi, Bq, S., Baldelli, Bq, F., Petrelli, Br, E., Cioppi, Br, A., Alberici, Bs, F., Ruggieri, Bs, A., Menichetti, Bt, F., Martinelli, Bt, C., Stefano, De, Bu, C., Gala, La, Bu, A., Zauli, Bv, T., Ballardini, Bv, G., Magnani, Bw, G., Ursitti, M. A., Bw, Arlotti, Bx, M., Ortolani, Bx, P., Ortona, By, L., Dianzani, By, F., Ippolito, By, G., Antinori, Bz, A., Antonucci, Bz, G., D'Elia, Bz, S., Narciso, Bz, P., Petrosillo, Bz, N., Vullo, Bz, V., Luca, De, Del, Forno, Bz, L., Zaccarelli, Bz, M., Longis, De, Ciardi, D'Offizi, Noto, Lichtner, Capobianchi, M. R., Bz, Girardi, Bz, E., Pezzotti, Rezza, Mura, M. S., Ca, Mannazzu, Ca, M., Caramello, Cb, P., Sinicco, Cb, A., Soranzo, M. L., Cb, Gennero, Cb, L., Sciandra, Cb, M., Salassa, Cb, B., Grossi, P. A., Cc, Basilico, Cc, C., Poggio, Cd, A., Bottari, Cd, G., Raise, Ce, E., Pasquinucci, Ce, S., Lalla, De, Cf, F., Tositti, Cf, G., Resta, Cg, F., Chimienti, Cg, A., Lepri, Cozzi, Ch, A., Bachmann, Fb, S., Battegay, Fb, M., Bernasconi, Fb, E., Bucher, Fb, H., Bürgisser, Fb, P., Cattacin, Egger, Erb, Fierz, Fb, W., Fischer, Flepp, Fontana, Fb, A., Francioli, Furrer, H. J., Fb, Gorgievski, Günthard, Hirschel, Fb, B., Kaiser, Fb, L., Kind, Fb, C., Klimkait, Fb, T., Lauper, Fb, U., Opravil, Paccaud, Fb, F., Pantaleo, Fb, G., Perrin, Piffaretti, J. C., Fb, Rickenbach, Rudin, Schüpbach, Fb, J., Speck, Fb, R., Tarr, Telenti, Trkola, Vernazza, Yerly, Wolf, De, Ci, F., Van, Sighem, A. I., Ci, Van, Valkengoed, Ci, I., Gras, Ci, L., Bronsveld, Ci, W., Veldkamp, Ci, A., Prins, J. M., Cj, Bos, J. C., Cj, Schattenkerk, Eeftinck, J. K. M., Cj, Godfried, M. H., Cj, Lange, J. M. A., Cj, Lowe, S. H., Cj, van der Meer, J. T. M., Cj, Nellen, F. J. B., Cj, Pogany, Cj, K., van der Poll, Cj, T., Ruys, T. A., Cj, Sankatsing, Cj, S., van der Valk, Cj, M., Van, Vonderen, M. G. A., Cj, Wit, F. W. M. N., Cj, Van, Eeden, Cj, A., Ten, Veen, J. H., Cj, Van, Dam, P. S., Cj, Hillebrand, Haverkort, M. E., Cj, Brinkman, Frissen, P. H. J., Cj, Weigel, H. M., Cj, Mulder, J. W., Cj, Van, Gorp, E. C. M., Cj, Meenhorst, P. L., Cj, Mairuhu, A. T. A., Cj, Veenstra, Cj, J., Danner, S. A., Cj, Van, Agtmael, M. A., Cj, Claessen, F. A. P., Cj, Geerlings, S. E., Cj, Perenboom, R. M., Cj, Jurriaans, Back, N. K. T., Cj, Cuijpers, Rietra, P. J. G. M., Cj, Roozendaal, K. J., Cj, Pauw, Cj, W., Van, Zanten, A. P., Cj, Smits, P. H. M., Cj, Von, Blomberg, B. M. E., Cj, Savelkoul, Cj, P., Zaaijer, Cj, H., Beijnen, Crommentuyn, K. M. L., Cj, Huitema, A. D. R., Cj, Kappelhoff, Cj, B., Maat, De, M. M. R., Cj, Richter, Ck, C., van der Berg, Ck, J., Van, Leusen, Ck, R., Swanink, Vriesendorp, Cl, R., Jeurissen, F. J. F., Cl, Kauffmann, R. H., Cm, Koger, E. L. W., Cm, Franck, P. F. H., Cm, Lampe, A. S., Cm, Jansen, C. L., Cm, Bravenboer, Cn, B., Ten, Napel, C. H. H., Co, Mudrikova, Co, T., Hendriks, Co, R., Sprenger, H. G., Cp, Miesen, W. M. A. J., Cp, Schirm, Cp, J., Benne, Cp, D., Ten, Kate, R. W., Cq, Veenendaal, Cq, D., Van, Houte, D. P. F., Cr, Leemhuis, M. P., Cr, Pole, Cr, M., Storm, Cr, H., Van, Zeijl, J. H., Cr, Kroon, F. P., Cs, Schippers, E. F., Cs, Kroes, A. C. M., Cs, Claas, H. C. J., Cs, Schreij, Ct, G., van de Geest, Ct, S., Verbon, Ct, A., Bruggeman, C. A. M. V. A., Ct, Goossens, V. J., Ct, Koopmans, P. P., Cu, Telgt, Cu, M., van der Ven, A. J. A. M., Cu, Burger, D. M., Cu, Hugen, P. W. H., Cu, Galama, J. M. D., Cu, Poort, Y. A. G. M., Cu, van der Ende, M. E., Cv, Gyssens, I. C., Cv, Marie, De, Cv, S., Nouwen, J. L., Cv, Niesters, M. G., Cv, Osterhaus, A. D. M. E., Cv, Schutten, Cv, M., Juttmann, J. R., Cw, Buiting, A. G. M., Cw, Swaans, C. A. M., Cw, Schneider, M. M. E., Cx, Bonten, M. J. M., Cx, Borleffs, J. C. C., Cx, Hoepelman, I. M., Cx, Jaspers, C. A. J. J., Cx, Schouten, Cx, I., Schurink, C. A. M., Cx, Boucher, C. A. B., Cx, Schuurman, Cx, R., Blok, W. L., Cy, Groeneveld, P. H. P., Cz, Boel, Da, E., Jansz, A. F., Da, Dabis, Db, F., Thiebaut, Db, R., Chêne, Db, G., Lawson, Ayayi, Db, S., Meyer, Dc, L., Boufassa, Dc, F., Hamouda, Dd, O., De, P., De, G., Touloumi, Df, G., Hatzakis, Df, A., Karafoulidou, Katsarou, Df, O., Brettle, Dg, R., Del, Amo, Dh, J., Del, Romero, Van, Asten, Di, L., Van, Benthem, Di, B., Di, M., Coutinho, Di, R., Kirk, Dj, O., Pedersen, Dj, C., Hernández, Aguado, Dk, I., Pérez, Hoyos, Dk, S., Eskild, Dl, A., Bruun, J. N., Dl, Sannes, Dl, M., Lee, Dm, C., Johnson, A. M., Dn, Babiker, Dn, A., Darbyshire, Dn, J., Gill, Dn, N., Porter, Dn, K., Do, P., Vanhems, Do, M., Cooper, Dp, D., Kaldor, Dpdq, J., Ashton, Dp, L., Dq, D., Dq, L., Vizzard, Dq, J., Muga, Dr, R., Ds, P., Dt, J., Cayla, Du, J., Garcia de Olalla, Du, P., Day, N. E., Dv, Angelis, De, Dv, D., Fb, K., Dw, A., Dw, S., Dw, J., Tyrer, Dw, F., Beral, Fb, V., Fb, N., Raffanti, Becker, Scarsella, Braun, Most, Balu, Gilbert, Fleenor, Ising, Dieterich, Fb, D., Fusco, Losso, Dx, M., Duran, Dx, A., Vetter, Dy, N., Clumeck, Dz, N., Wit, De, Dz, S., Kabeya, Dz, K., Poll, Dz, B., Colebunders, Dz, R., Machala, Ea, L., Rozsypal, Ea, H., Nielsen, Eb, J., Lundgren, Eb, O., Olsen, C. H., Eb, Gerstoft, Katzenstein, Eb, T., Hansen, A. B. E., Eb, Skinhøj, Eb, P., Eb, C., Zilmer, Ec, K., Rauka, Ec, M., Katlama, Ed, C., De, Sa, Ed, M., Viard, J. P., Ed, Saint, Marc, Ed, T., Ed, P., Pradier, Dietrich, Ee, M., Manegold, Ee, C., Van, Lunzen, Ee, J., Stellbrink, H. J., Ee, Miller, Ee, V., Goebel, F. D., Ee, Salzberger, Ee, B., Rockstroh, Kosmidis, Ef, J., Gargalianos, Ef, P., Sambatakou, Ef, H., Perdios, Panos, Ef, G., Filandras, Ef, A., Banhegyi, Eg, D., Mulcahy, Eh, F., Yust, Ei, I., Burke, Ei, M., Pollack, Ei, S., Hassoun, Ei, J., Sthoeger, Ei, Z., Maayan, Vella, Ej, S., Chiesi, Ej, A., Ej, C., Pristerá, Ej, R., Ej, F., Gabbuti, Bedini, Ej, E., Ej, V., Santopadre, Ej, P., Franci, Ej, M., Castagna, Viksna, Ek, L., Rozentale, Ek, B., Chaplinskas, El, S., Hemmer, Em, R., Staub, Em, T., En, J., Maeland, En, A., Ormaasen, En, V., Knysz, Eo, B., Gasiorowski, Eo, J., Horban, Eo, A., Prokopowicz, Eo, D., Wiercinska, Drapalo, Boron, Kaczmarska, Pynka, Eo, M., Beniowski, Trocha, Eo, H., Smiatacz, Eo, T., Antunes, Ep, F., Mansinho, Ep, K., Maltez, Duiculescu, Eq, D., Streinu, Cercel, Eq, A., Mokrás, Er, M., Staneková, Er, D., González, Lahoz, Es, J., Diaz, Es, B., García, Benayas, Es, T., Martin, Carbonero, Es, L., Soriano, Es, V., Clotet, Jou, Es, A., Conejero, Tural, Es, C., Gatell, J. M., Es, Miró, Zamora, Blaxhult, Et, A., Karlsson, Pehrson, Et, P., Eu, P., Eu, B., Schiffer, Eu, V., Eu, H., Chentsova, Ev, N., Barton, Ew, S., A. M., Ew, Mercey, Ew, D., Phillips, Ew, A., Youle, Ew, M., M. A., Ew, Mocroft, Murphy, Weber, Ew, J., Scullard, Ew, G., Fisher, Ew, R., Loveday, Ew, C., Ex, B., Ruiz, Ex, L., Helm, E. B., Fb, Carlebach, Mösch, Müller, Haberl, Korn, Stephan, Bickel, Gute, Locher, Lutz, Klauke, Doerr, H. W., Fb, Stürmer, Dauer, Jennings, Alexander, Braitstein, Chan, Cote, Gataric, Harrigan, P. R., Fb, Harris, Bonner, Montaner, O'Shaughnessy, Yip, Chaloner, Gumley, Ransom, Sabin, C. A., Fb, Lipman, Ey, J., Read, Ey, R., Ez, F., Riccio, Fa, G., Borghi, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Infectious diseases, Global Health, Other departments, Public and occupational health, General Internal Medicine, Center of Experimental and Molecular Medicine, Ledergerber, B, Lundgren, Jd, Walker, A, Sabin, C, Justice, A, Reiss, P, Mussini, C, Wit, F, Monforte, Ad, Weber, R, Fusco, G, Staszewski, S, Law, M, Hogg, R, Lampe, F, Gill, Mj, Castelli, F, Phillips, An, Fusco, Gp, Rooney, P, Taylor, S, Couldwell, D, Austin, D, Block, M, Clemons, J, Finlayson, R, Petoumenos, K, Quan, D, Smith, D, O'Connor, C, Gorton, C, Allen, D, Mulhall, B, Mutimer, K, Keeffe, N, Cooper, D, Carr, A, Miller, J, Pell, C, Ellis, D, Baker, D, Kidd, J, Mcfarlane, R, Liang, Mt, Brown, K, Huffam, S, Savage, J, Morgan, S, Knibbs, P, Sowden, D, Orth, D, Lister, G, Chuah, J, Fankhauser, W, Dickson, B, Bradford, D, Wilson, C, Ree, H, Magon, H, Anderson, J, Moore, R, Russell, D, Mcgovern, G, Mcnair, R, Bal, J, Fairley, K, Roth, N, Eu, B, Strecker, S, Wood, H, Mijch, A, Hoy, J, Pierce, A, Mccormack, C, Watson, K, Medland, N, Daye, J, Mallal, S, French, M, Skett, J, Maxwel, D, Cain, A, Montroni, M, Scalise, G, Costantini, A, Giacometti, A, Tirelli, U, Nasti, G, Pastore, G, Ladisa, N, Perulli, Ml, Suter, F, Arici, C, Chiodo, F, Gritti, Fm, Colangeli, V, Fiorini, C, Guerra, L, Carosi, G, Cadeo, Gp, Minardi, C, Vangi, D, Rizzardini, G, Migliorino, G, Manconi, Pe, Piano, P, Ferraro, T, Scerbo, A, Pizzigallo, E, Ricci, F, Santoro, D, Pusterla, L, Carnevale, G, Galloni, D, Vigano, P, Mena, M, Ghinelli, F, Sighinolfi, L, Leoncini, F, Mazzotta, F, Pozzi, M, Lo Caputo, S, Angarano, G, Grisorio, B, Ferrara, S, Grima, P, Tundo, P, Pagano, G, Piersantelli, N, Alessandrini, A, Piscopo, R, Toti, M, Chigiotti, S, Soscia, F, Taccooni, L, Orani, A, Perini, P, Scasso, A, Vincenti, A, Scalzini, A, Fibbia, G, Moroni, M, Lazzarin, A, Cargnel, A, Vigevani, Gm, Caggese, L, Tordato, F, Novati, R, Galli, A, Merli, S, Pastecchia, C, Moioli, C, Esposito, R, Abrescia, N, Chirianni, A, Izzo, C, Piazza, M, De Marco, M, Montesarchio, V, Manzillo, E, Nappa, S, Colomba, A, Abbadessa, V, Prestileo, T, Mancuso, S, Ferrari, C, Pzzaferri, P, Filice, G, Minoli, L, Bruno, R, Maserati, R, Pauluzzi, S, Baldelli, F, Petrelli, E, Cioppi, A, Alberici, F, Ruggieri, A, Menichetti, F, Martinelli, C, De Stefano, C, La Gala, A, Zauli, T, Ballardini, G, Magnani, G, Ursitti, Ma, Arlotti, M, Ortolani, P, Ortona, L, Dianzani, F, Ippolito, G, Antinori, A, Antonucci, G, D'Elia, S, Narciso, P, Petrosillo, N, Vullo, V, De Luca, A, Del Forno, L, Zaccarelli, M, De Longis, P, Ciardi, M, D'Offizi, G, Noto, P, Lichtner, M, Capobianchi, Mr, Girardi, E, Pezzotti, P, Rezza, G, Mura, M, Mannazzu, M, Caramello, P, Sinicco, A, Soranzo, Ml, Gennero, L, Sciandra, M, Salassa, B, Grossi, Pa, Basilico, C, Poggio, A, Bottari, G, Raise, E, Pasquinucci, S, De Lalla, F, Tositti, G, Resta, F, Chimienti, A, Lepri, Ac, Bachmann, S, Battegay, M, Bernasconi, E, Bucher, H, Burgisser, P, Cattacin, S, Egger, M, Erb, P, Fierz, W, Fischer, M, Flepp, M, Fontana, A, Francioli, P, Furrer, Hj, Gorgievski, M, Hirschel, B, Kaiser, L, Kind, C, Klimkait, T, Lauper, U, Opravil, M, Paccaud, F, Pantaleo, G, Perrin, L, Piffaretti, Jc, Rickenbach, M, Rudin, C, Schupbach, J, Speck, R, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Yerly, S, de Wolf, F, van Sighem, Ai, van Valkengoed, I, Gras, L, Bronsveld, W, Prins, Jm, Bos, Jc, Schattenkerk, Jkme, Godfried, Mh, Lange, Jma, Lowe, Sh, van der Meer, Jtm, Nellen, Fjb, Pogany, K, van der Poll, T, Ruys, Ta, Sankatsing, S, van der Valk, M, van Vonderen, Mga, Wit, Fwmn, van Eeden, A, ten Veen, Jh, van Dam, P, Hillebrand Haverkort, Me, Brinkman, K, Frissen, Phj, Weigel, Hm, Mulder, Jw, van Gorp, Ecm, Meenhorst, Pl, Mairuhu, Ata, Veenstra, J, Danner, Sa, Van Agtmael, Ma, Claessen, Fap, Geerlings, Se, Perenboom, Rm, Richter, C, van der Berg, J, van Leusen, R, Vriesendorp, R, Jeurissen, Fjf, Kauffmann, Rh, Koger, Elw, Bravenboer, B, ten Napel, Chh, Mudrikova, T, Sprenger, Hg, Miesen, Wmaj, ten Kate, Rw, van Houte, Dpf, Leemhuis, Mp, Pole, M, Kroon, Fp, Schippers, Ef, Schreij, G, van de Geest, S, Verbon, A, Koopmans, Pp, Telgt, M, van der Ven, Ajam, van der Ende, Me, Gyssens, Ic, de Marie, S, Nouwen, Jl, Juttmann, Jr, Schneider, Mme, Bonten, Mjm, Borleffs, Jcc, Hoepelman, Im, Jaspers, Cajj, Schouten, I, Schurink, Cam, Blok, Wl, Groenveld, Php, Jurriaans, S, Back, Nkt, Cuijpers, T, Rietra, Pjgm, Roozendaal, Kj, Pauw, W, van Zanten, Ap, Smits, Phm, von Blomberg, Bme, Savelkoul, P, Zaaijer, H, Swanink, C, Franck, Pfh, Lampe, A, Jansen, Cl, Hendriks, R, Schirm, J, Benne, D, Veenendaal, D, Storm, H, van Zeijl, Jh, Kroes, Acm, Claas, Hcj, Bruggeman, Camva, Goossens, Vj, Galama, Jmd, Poort, Yagm, Niesters, Mg, Osterhaus, Adme, Schutten, M, Buiting, Agm, Swaans, Cam, Boucher, Cab, Schuurman, R, Boel, E, Jansz, Af, Veldkamp, A, Beijnen, Jh, Crommentuyn, Kml, Huitema, Adr, Kappelhoff, B, de Maat, Mmr, Burger, Dm, Hugen, Pwh, Dabis, F, Thiebaut, R, Chene, G, Lawson Ayayi, S, Meyer, L, Boufassa, F, Hamouda, O, Touloumi, G, Hatzakis, A, Karafoulidou, A, Katsarou, O, Brettle, R, Del Amo, J, del Romero, J, van Asten, L, van Benthem, B, Prins, M, Coutinho, R, Kirk, O, Pedersen, C, Aguado, Ih, Perez Hoyos, S, Eskild, A, Bruun, Jn, Sannes, M, Lee, C, Johnson, Am, Babiker, A, Darbyshire, J, Gill, N, Porter, K, Vanhems, P, Kaldor, J, Ashton, L, Vizzard, J, Muga, R, Gill, J, Cayla, J, de Olalla, Pg, Day, Ne, De Angelis, D, Walker, S, Tyrer, F, Beral, V, Raffanti, S, Becker, S, Scarsella, A, Braun, J, Most, B, Balu, R, Gilbert, L, Fleenor, R, Ising, T, Dieterich, D, Fusco, J, Losso, M, Duran, A, Vetter, N, Clumeck, N, De Wit, S, Kabeya, K, Poll, B, Colebunders, R, Machala, L, Rozsypal, H, Nielsen, J, Lundgren, J, Olsen, Ch, Gerstoft, J, Katzenstein, T, Hansen, Abe, Skinhoj, P, Zilmer, K, Rauka, M, Katlama, C, De Sa, M, Viard, Jp, Saint Marc, T, Pradier, C, Dietrich, M, Manegold, C, van Lunzen, J, Stellbrink, Hj, Miller, V, Goebel, Fd, Salzberger, B, Rockstroh, J, Kosmidis, J, Gargalianos, P, Sambatakou, H, Perdios, J, Panos, G, Filandras, A, Banhegyi, D, Mulcahy, F, Yust, I, Burke, M, Pollack, S, Hassoun, J, Sthoeger, Z, Maayan, S, Vella, S, Chiesi, A, Pristera, R, Gabbuti, A, Bedini, A, Montesarchio, E, Santopadre, P, Franci, P, Castagna, Antonella, Viksna, L, Rozentale, B, Chaplinskas, S, Hemmer, R, Staub, T, Bruun, J, Maeland, A, Ormaasen, V, Knysz, B, Gasiorowski, J, Horban, A, Prokopowicz, D, Wiercinska Drapalo, A, Boron Kaczmarska, A, Pynka, M, Beniowski, M, Trocha, H, Smiatacz, T, Antunes, F, Mansinho, K, Maltez, F, Duiculescu, D, Streinu Cercel, A, Mokras, M, Stanekova, D, Gonzalez Lahoz, J, Diaz, B, Garcia Benayas, T, Martin Carbonero, L, Soriano, V, Clotet, B, Jou, A, Conejero, J, Tural, C, Gatell, Jm, Miro, Jm, Zamora, L, Blaxhult, A, Karlsson, A, Pehrson, P, Schiffer, V, Furrer, H, Chentsova, N, Barton, S, Mercey, D, Phillips, A, Youle, M, Johnson, Ma, Mocroft, A, Murphy, M, Weber, J, Scullard, G, Fisher, M, Loveday, C, Ruiz, L, Helm, Eb, Carlebach, A, Mosch, M, Muller, A, Haberl, A, Korn, S, Stephan, C, Bickel, M, Gute, P, Locher, L, Lutz, T, Klauke, S, Doerr, Hw, Sturmer, M, Dauer, B, Jennings, B, Alexander, C, Braitstein, P, Chan, K, Cote, H, Gataric, N, Harrigan, Pr, Harris, M, Bonner, S, Montaner, J, O'Shaughnessy, M, Wood, E, Yip, B, Chaloner, C, Gumley, H, Ransom, D, Sabin, Ca, Lipman, M, Johnson, M, Read, R, Paraninfo, G, Casari, S, Pan, A, Patroni, A, Torti, C, Quiros Roldan, E, Tomasoni, L, Moretti, F, Nasta, P, Uccelli, Mc, Bertelli, D, Nigro, M, Migliorino, M, Abeli, C, Maggiolo, F, Novati, S, Tinelli, C, Riccio, G, Borghi, V, and Esposito, R.

Subjects
Male, HAART, Human immunodeficiency virus (HIV), CD4 cell count, HIV Infections, CLINICAL PROGRESSION, medicine.disease_cause, THERAPY, HAART REGIMEN, Cohort Studies, Risk Factors, Adult, Anti-Retroviral Agents, CD4 Lymphocyte Count, Cohort Studies, Female, Follow-Up Studies, HIV Infections, HIV Protease Inhibitors, HIV-1, Humans, Male, Middle Aged, Proportional Hazards Models, Reverse Transcriptase Inhibitors, Risk Factors, Treatment Failure, Viral Load, Medicine, Treatment Failure, Mortality rate, Medicine (all), INHIBITOR, General Medicine, Middle Aged, HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1), BLIND CONTROLLED-TRIAL, medicine.anatomical_structure, Anti-Retroviral Agents, Cohort, HUMAN-IMMUNODEFICIENCY-VIRUS, Reverse Transcriptase Inhibitors, Female, Off Treatment, Viral load, Cohort study, Adult, medicine.medical_specialty, Settore MED/17 - Malattie Infettive, T cell, Internal medicine, Humans, COHORT, Proportional Hazards Models, business.industry, Proportional hazards model, DISEASE PROGRESSION, HIV Protease Inhibitors, HIV-INFECTED INDIVIDUALS, CD4 Lymphocyte Count, VIRAL LOAD, Immunology, HIV-1, business, Follow-Up Studies
Abstract

Background Treatment strategies for patients in whom HIV replication is not suppressed after exposure to several drug classes remain unclear. We aimed to assess the inter-relations between viral load, CD4-cell count, and clinical outcome in patients who had experienced three-class virological failure.Methods We undertook collaborative joint analysis of 13 HIV cohorts from Europe, North America, and Australia, involving patients who had had three-class virological failure (viral load >1000 copies per mL for >4 months). Regression analyses were used to quantify the associations between CD4-cell-count slope, HIV-1 RNA concentration, treatment information, and demographic characteristics. Predictors of death were analysed by Cox's proportional-hazards models.Findings 2488 patients were included. 2118 (85%) had started antiretroviral therapy with single or dual therapy. During 5015 person-years of follow-up, 276 patients died (mortality rate 5.5 per 100 person-years; 3-year mortality risk 15.3% (95% Cl 13.5-17.3). Risk of death was strongly influenced by the latest CD4-cell count with a relative hazard of 15.8 (95% CI 9.28-27.0) for counts below 50 cells per muL versus above 200 cells per muL. The latest viral load did not independently predict death. For any given viral load, patients on treatment had more favourable CD4-cell-count slopes than those off treatment. For patients on treatment and with stable viral load, CD4-cell counts tended to be increasing at times when the current viral load was below 10 000 copies per mL or 1.5 log(10) copies per mL below off-treatment values.Interpretation In patients for whom viral-load suppression to below the level of detection is not possible, achievement and maintenance of a CD4-cell count above 200 per muL becomes the primary aim. Treatment regimens that maintain the viral load below 10 000 copies per mL or at least provide 1.5 log(10) copies per mL suppression below the off-treatment value do not seem to be associated with appreciable CD4-cell-count decline.

Published
2004

16. Patterns and Perceptions of Standard Order Set Use Among Physicians Working Within a Multihospital System: Mixed Methods Study.

Author

Naicker S, Tariq A, Donovan R, Magon H, White N, Simmons J, and McPhail SM

Subjects
Humans, Medical Order Entry Systems statistics & numerical data, Qualitative Research, Attitude of Health Personnel, Perception, Hospitals, Electronic Health Records statistics & numerical data, Physicians psychology
Abstract

Background: Electronic standard order sets automate the ordering of specific treatment, testing, and investigative protocols by physicians. These tools may help reduce unwarranted clinical variation and improve health care efficiency. Despite their routine implementation within electronic medical records (EMRs), little is understood about how they are used and what factors influence their adoption in practice., Objective: This study aims to (1) describe the patterns of use of standard order sets implemented in a widely used EMR (PowerPlans and Cerner Millennium) within a multihospital digital health care system; (2) explore the experiences and perceptions of implementers and users regarding the factors contributing to the use of these standard order sets; and (3) map these findings to the Capability, Opportunity, and Motivation Behavior (COM-B) model of behavior change to assist those planning to develop, improve, implement, and iterate the use of standard order sets in hospital settings., Methods: Quantitative data on standard order set usage were captured from 5 hospitals over 5-month intervals for 3 years (2019, 2020, and 2021). Qualitative data, comprising unstructured and semistructured interviews (n=15), were collected and analyzed using a reflexive thematic approach. Interview themes were then mapped to a theory-informed model of behavior change (COM-B) to identify determinants of standard order set usage in routine clinical practice. The COM-B model is an evidence-based, multicomponent framework that posits that human actions result from multiple contextual influences, which can be categorized across 3 dimensions: capability, opportunity, and motivation, all of which intersect., Results: The total count of standard order set usage across the health system during the 2019 observation period was 267,253, increasing to 293,950 in 2020 and 335,066 in 2021. There was a notable shift toward using specialty order sets that received upgrades during the study period. Four emergent themes related to order set use were derived from clinician interviews: (1) Knowledge and Skills; (2) Perceptions; (3) Technical Dependencies; and (4) Unintended Consequences, all of which were mapped to the COM-B model. Findings indicate a user preference for customized order sets that respond to local context and user experience., Conclusions: The study findings suggest that ongoing investment in the development and functionality of specialty order sets has the potential to enhance usage as these sets continue to be customized in response to local context and user experience. Sustained and continuous uptake of appropriate Computerized Provider Order Entry use may require implementation strategies that address the capability, opportunity, and motivational influencers of behavior., (©Sundresan Naicker, Amina Tariq, Raelene Donovan, Honor Magon, Nicole White, Joshua Simmons, Steven M McPhail. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.11.2024.)

Published
2024
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17. Adapting to change: exploring perceptions and demands of the coronavirus (COVID-19) workforce changes - an Australian multi-institutional radiation oncology survey.

Author

Magon H, Smith J, Besson J, Hau E, Taylor S, Ruben J, Jones D, Mabb K, Feldman J, Gholam Rezaei L, and Lee YY

Subjects
Humans, Australia, SARS-CoV-2, Surveys and Questionnaires, Burnout, Professional, Female, Male, Telemedicine, Adult, Attitude of Health Personnel, Teleworking, Pandemics, Radiation Oncologists, Middle Aged, Job Satisfaction, COVID-19 epidemiology, COVID-19 psychology, Radiation Oncology
Abstract

Objective To evaluate the perceptions of the coronavirus disease 2019 (COVID-19) initiated workplace strategies implemented in radiation oncology departments across Australia. Methods A multidisciplinary team from Princess Alexandra Hospital developed a survey to address the impact of the pandemic strategies on areas such as patient care, staff education, well-being, flexible working arrangements, and research. The survey was conducted from November 2020 to April 2021. Results Out of 210 respondents from seven institutions, 45% reported burnout and 57% experienced work work-related stress. A significant majority of respondents were in favour of continued remote work (86%, 131/153). Radiation oncologists identified administrative or non-clinical work (92%, 34/37), telehealth clinics (32%, 12/37), or radiation therapy planning (22%, 8/37) as suitable for remote work. Additionally, 54% (21/39) of the radiation oncologists plan to use telehealth more frequently, with 67% (26/39) feeling more confident with the technology. The majority (81%, 171/210) of participants favoured continuation of hybrid in-person and virtual meetings. Virtual solutions were adopted for quality assurance activities (72%, 118/165) and 52% (60/116) indicated preference for ongoing utility of virtual platforms. However, 38% (79/210) of the respondents expressed concerns about the negative impact on junior staff training. Conclusion These findings reveal a strong inclination towards technological advancements and remote work arrangements to enable flexible working conditions. Our study suggests the need for ongoing reforms, focusing on improving clinical service delivery efficiencies and enhancing job satisfaction among clinicians.

Published
2024
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18. A multiparametric approach to tumor markers detectable in serum in patients with carcinoma of the ovary or uterine cervix.

Author

Sarjadi S, Daunter B, Mackay E, Magon H, and Khoo SK

Subjects
Antigen-Antibody Complex analysis, Carcinoembryonic Antigen analysis, False Positive Reactions, Female, Fetal Hemoglobin analysis, Humans, L-Lactate Dehydrogenase blood, Regression Analysis, Serologic Tests, Sialyltransferases blood, beta 2-Microglobulin analysis, Ovarian Neoplasms blood, Uterine Cervical Neoplasms blood
Published
1980
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