12 results on '"Mguni S"'
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2. A highly virulent variant of HIV-1 circulating in the Netherlands
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Wymant, Chris, Bezemer, Daniela, Blanquart, François, Ferretti, Luca, Gall, Astrid, Hall, Matthew, Golubchik, Tanya, Bakker, Margreet, Ong, Swee Hoe, Zhao, Lele, Bonsall, David, de Cesare, Mariateresa, MacIntyre-Cockett, George, Abeler-Dörner, Lucie, Albert, Jan, Bannert, Norbert, Fellay, Jacques, Grabowski, M Kate, Gunsenheimer-Bartmeyer, Barbara, Günthard, Huldrych F, Kivelä, Pia, Kouyos, Roger D, Laeyendecker, Oliver, Meyer, Laurence, Porter, Kholoud, Ristola, Matti, van Sighem, Ard, Berkhout, Ben, Kellam, Paul, Cornelissen, Marion, Reiss, Peter, Fraser, Christophe, Aubert, V, Battegay, M, Bernasconi, E, Böni, J, Braun, D L, Bucher, H C, Burton-Jeangros, C, Calmy, A, Cavassini, M, Dollenmaier, G, Egger, M, Elzi, L, Fehr, J, Fellay, J, Furrer, H, Fux, C A, Gorgievski, M, Günthard, H, Haerry, D, Hasse, B, Hirsch, H H, Hoffmann, M, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kouyos, R, Kovari, H, Ledergerber, B, Martinetti, G, de Tejada, B Martinez, Marzolini, C, Metzner, K, Müller, N, Nadal, D, Nicca, D, Pantaleo, G, Rauch, A, Regenass, S, Rudin, C, Schöni-Affolter, F, Schmid, P, Speck, R, Stöckle, M, Tarr, P, Trkola, A, Vernazza, P, Weber, R, Yerly, S, van der Valk, M, Geerlings, S E, Goorhuis, A, Hovius, J W, Lempkes, B, Nellen, F J B, van der Poll, T, Prins, J M, Reiss, P, van Vugt, M, Wiersinga, W J, Wit, F W M N, van Duinen, M, van Eden, J, Hazenberg, A, van Hes, A M H, Pijnappel, F J J, Smalhout, S Y, Weijsenfeld, A M, Jurriaans, S, Back, N K T, Zaaijer, H L, Berkhout, B, Cornelissen, M T E, Schinkel, C J, Wolthers, K C, Peters, E J G, van Agtmael, M A, Autar, R S, Bomers, M, Sigaloff, K C E, Heitmuller, M, Laan, L M, Ang, C W, van Houdt, R, Jonges, M, Kuijpers, T W, Pajkrt, D, Scherpbier, H J, de Boer, C, van der Plas, A, van den Berge, M, Stegeman, A, Baas, S, Hage de Looff, L, Buiting, A, Reuwer, A, Veenemans, J, Wintermans, B, Pronk, M J H, Ammerlaan, H S M, van den Bersselaar, D N J, de Munnik, E S, Deiman, B, Jansz, A R, Scharnhorst, V, Tjhie, J, Wegdam, M C A, van Eeden, A, Nellen, J, Brokking, W, Elsenburg, L J M, Nobel, H, van Kasteren, M E E, Berrevoets, M A H, Brouwer, A E, Adams, A, van Erve, R, de Kruijf-van de Wiel, B A F M, Keelan-Phaf, S, van der Ven, B, Buiting, A G M, Murck, J L, de Vries-Sluijs, T E M S, Bax, H I, van Gorp, E C M, de Jong-Peltenburg, N C, de Mendonç A Melo, M, van Nood, E, Nouwen, J L, Rijnders, B J A, Rokx, C, Schurink, C A M, Slobbe, L, Verbon, A, Bassant, N, van Beek, J E A, Vriesde, M, van Zonneveld, L M, de Groot, J, Boucher, C A B, Koopmans, M P G, van Kampen, J J A, Fraaij, P L A, van Rossum, A M C, Vermont, C L, van der Knaap, L C, Visser, E, Branger, J, Douma, R A, Cents-Bosma, A S, Duijf-van de Ven, C J H M, Schippers, E F, van Nieuwkoop, C, van Ijperen, J M, Geilings, J, van der Hut, G, van Burgel, N D, Leyten, E M S, Gelinck, L B S, Mollema, F, Davids-Veldhuis, S, Tearno, C, Wildenbeest, G S, Heikens, E, Groeneveld, P H P, Bouwhuis, J W, Lammers, A J J, Kraan, S, van Hulzen, A G W, Kruiper, M S M, van der Bliek, G L, Bor, P C J, Debast, S B, Wagenvoort, G H J, Kroon, F P, de Boer, M G J, Jolink, H, Lambregts, M M C, Roukens, A H E, Scheper, H, Dorama, W, van Holten, N, Claas, E C J, Wessels, E, den Hollander, J G, El Moussaoui, R, Pogany, K, Smit, J V, Struik-Kalkman, D, van Niekerk, T, Pontesilli, O, Lowe, S H, Oude Lashof, A M L, Posthouwer, D, van Wolfswinkel, M E, Ackens, R P, Burgers, K, Schippers, J, Weijenberg-Maes, B, van Loo, I H M, Havenith, T R A, van Vonderen, M G A, Kampschreur, L M, Faber, S, Steeman-Bouma, R, Al Moujahid, A, Kootstra, G J, Delsing, C E, van der Burg-van de Plas, M, Scheiberlich, L, Kortmann, W, van Twillert, G, Renckens, R, Ruiter-Pronk, D, van Truijen-Oud, F A, Cohen Stuart, J W T, Jansen, E R, Hoogewerf, M, Rozemeijer, W, van der Reijden, W A, Sinnige, J C, Brinkman, K, van den Berk, G E L, Blok, W L, Lettinga, K D, de Regt, M, Schouten, W E M, Stalenhoef, J E, Veenstra, J, Vrouenraets, S M E, Blaauw, H, Geerders, G F, Kleene, M J, Kok, M, Knapen, M, van der Meché, I B, Mulder-Seeleman, E, Toonen, A J M, Wijnands, S, Wttewaal, E, Kwa, D, van Crevel, R, van Aerde, K, Dofferhoff, A S M, Henriet, S S V, Ter Hofstede, H J M, Hoogerwerf, J, Keuter, M, Richel, O, Albers, M, Grintjes-Huisman, K J T, de Haan, M, Marneef, M, Strik-Albers, R, Rahamat-Langendoen, J, Stelma, F F, Burger, D, Gisolf, E H, Hassing, R J, Claassen, M, Ter Beest, G, van Bentum, P H M, Langebeek, N, Tiemessen, R, Swanink, C M A, van Lelyveld, S F L, Soetekouw, R, van der Prijt, L M M, van der Swaluw, J, Bermon, N, Jansen, R, Herpers, B L, Veenendaal, D, Verhagen, D W M, Lauw, F N, van Broekhuizen, M C, van Wijk, M, Bierman, W F W, Bakker, M, Kleinnijenhuis, J, Kloeze, E, Middel, A, Postma, D F, Schölvinck, E H, Stienstra, Y, Verhage, A R, Wouthuyzen-Bakker, M, Boonstra, A, de Groot-de Jonge, H, van der Meulen, P A, de Weerd, D A, Niesters, H G M, van Leer-Buter, C C, Knoester, M, Hoepelman, A I M, Arends, J E, Barth, R E, Bruns, A H W, Ellerbroek, P M, Mudrikova, T, Oosterheert, J J, Schadd, E M, van Welzen, B J, Aarsman, K, Griffioen-van Santen, B M G, de Kroon, I, van Berkel, M, van Rooijen, C S A M, Schuurman, R, Verduyn-Lunel, F, Wensing, A M J, Bont, L J, Geelen, S P M, Loeffen, Y G T, Wolfs, T F W, Nauta, N, Rooijakkers, E O W, Holtsema, H, Voigt, R, van de Wetering, D, Alberto, A, van der Meer, I, Rosingh, A, Halaby, T, Zaheri, S, Boyd, A C, Bezemer, D O, van Sighem, A I, Smit, C, Hillebregt, M, de Jong, A, Woudstra, T, Bergsma, D, Meijering, R, van de Sande, L, Rutkens, T, van der Vliet, S, de Groot, L, van den Akker, M, Bakker, Y, El Berkaoui, A, Bezemer, M, Brétin, N, Djoechro, E, Groters, M, Kruijne, E, Lelivelt, K J, Lodewijk, C, Lucas, E, Munjishvili, L, Paling, F, Peeck, B, Ree, C, Regtop, R, Ruijs, Y, Schoorl, M, Schnörr, P, Scheigrond, A, Tuijn, E, Veenenberg, L, Visser, K M, Witte, E C, Van Frankenhuijsen, Maartje, Allegre, Thierry, Makhloufi, Djamila, Livrozet, Jean-Michel, Chiarello, Pierre, Godinot, Mathieu, Brunel-Dalmas, Florence, Gibert, Sylvie, Trepo, Christian, Peyramond, Dominique, Miailhes, Patrick, Koffi, Joseph, Thoirain, Valérie, Brochier, Corinne, Baudry, Thomas, Pailhes, Sylvie, Lafeuillade, Alain, Philip, Gisèle, Hittinger, Gilles, Assi, Assi, Lambry, Véronique, Rosenthal, Eric, Naqvi, Alissa, Dunais, Brigitte, Cua, Eric, Pradier, Christian, Durant, Jacques, Joulie, Aline, Quinsat, Denis, Tempesta, Serge, Ravaux, Isabelle, Martin, Isabelle Poizot, Faucher, Olivia, Cloarec, Nicolas, Champagne, Hélène, Pichancourt, Gilles, Morlat, Philippe, Pistone, Thierry, Bonnet, Fabrice, Mercie, Patrick, Faure, Isabelle, Hessamfar, Mojgan, Malvy, Denis, Lacoste, Denis, Pertusa, Marie-Carmen, Vandenhende, Marie-Anne, Bernard, Noëlle, Paccalin, François, Martell, Cédric, Roger-Schmelz, Julien, Receveur, Marie-Catherine, Duffau, Pierre, Dondia, Denis, Ribeiro, Emmanuel, Caltado, Sabrina, Neau, Didier, Dupont, Michel, Dutronc, Hervé, Dauchy, Frédéric, Cazanave, Charles, Vareil, Marc-Olivier, Wirth, Gaétane, Le Puil, Séverine, Pellegrin, Jean-Luc, Raymond, Isabelle, Viallard, Jean-François, Chaigne de Lalande, Severin, Garipuy, Daniel, Delobel, Pierre, Obadia, Martine, Cuzin, Lise, Alvarez, Muriel, Biezunski, Noemie, Porte, Lydie, Massip, Patrice, Debard, Alexa, Balsarin, Florence, Lagarrigue, Myriam, Prevoteau du Clary, François, Aquilina, Christian, Reynes, Jacques, Baillat, Vincent, Merle, Corinne, Lemoing, Vincent, Atoui, Nadine, Makinson, Alain, Jacquet, Jean Marc, Psomas, Christina, Tramoni, Christine, Aumaitre, Hugues, Saada, Mathieu, Medus, Marie, Malet, Martine, Eden, Aurélia, Neuville, Ségolène, Ferreyra, Milagros, Sotto, Albert, Barbuat, Claudine, Rouanet, Isabelle, Leureillard, Didier, Mauboussin, Jean-Marc, Lechiche, Catherine, Donsesco, Régine, Cabie, André, Abel, Sylvie, Pierre-Francois, Sandrine, Batala, Anne-Sophie, Cerland, Christophe, Rangom, Camille, Theresine, Nadine, Hoen, Bruno, Lamaury, Isabelle, Fabre, Isabelle, Schepers, Kinda, Curlier, Elodie, Ouissa, Rachida, Gaud, Catherine, Ricaud, Carole, Rodet, Roland, Wartel, Guillaume, Sautron, Carmele, Beck-Wirth, Geneviève, Michel, Catherine, Beck, Charles, Halna, Jean-Michel, Kowalczyk, Jakub, Benomar, Meryem, Drobacheff-Thiebaut, Christine, Chirouze, Catherine, Faucher, Jean-François, Parcelier, François, Foltzer, Adeline, Haffner-Mauvais, Cécile, Hustache Mathieu, Mathieu, Proust, Aurélie, Piroth, Lionel, Chavanet, Pascal, Duong, Michel, Buisson, Marielle, Waldner, Anne, Mahy, Sophie, Gohier, Sandrine, Croisier, Delphine, May, Thierry, Delestan, Mikael, Andre, Marie, Zadeh, Mahsa Mohseni, Martinot, Martin, Rosolen, Béatrice, Pachart, Anne, Martha, Benoît, Jeunet, Noëlle, Rey, David, Cheneau, Christine, Partisani, Maria, Priester, Michèle, Bernard-Henry, Claudine, Batard, Marie-Laure, Fischer, Patricia, Berger, Jean-Luc, Kmiec, Isabelle, Robineau, Olivier, Huleux, Thomas, Ajana, Faïza, Alcaraz, Isabelle, Allienne, Christophe, Baclet, Véronique, Meybeck, Agnès, Valette, Michel, Viget, Nathalie, Aissi, Emmanuelle, Biekre, Raphael, Cornavin, Pauline, Merrien, Dominique, Seghezzi, Jean-Christophe, Machado, Moise, Diab, Georges, Raffi, François, Bonnet, Bénédicte, Allavena, Clotilde, Grossi, Olivier, Reliquet, Véronique, Billaud, Eric, Brunet, Cecile, Bouchez, Sabelline, Morineau-Le Houssine, Pascale, Sauser, Fabienne, Boutoille, David, Besnier, Michel, Hue, Hervé, Hall, Nolwenn, Brosseau, Delphine, Souala, Faouzi, Michelet, Christian, Tattevin, Pierre, Arvieux, Cédric, Revest, Matthieu, Leroy, Helene, Chapplain, Jean-Marc, Dupont, Matthieu, Fily, Fabien, Patra-Delo, Solène, Lefeuvre, Céline, Bernard, Louis, Bastides, Frédéric, Nau, Pascale, Verdon, Renaud, de la Blanchardiere, Arnaud, Martin, Anne, Feret, Philippe, Geffray, Loïk, Daniel, Corinne, Rohan, Jennifer, Fialaire, Pascale, Chennebault, Jean Marie, Rabier, Valérie, Abgueguen, Pierre, Rehaiem, Sami, Luycx, Odile, Niault, Mathilde, Moreau, Philippe, Poinsignon, Yves, Goussef, Marie, Mouton-Rioux, Virginie, Houlbert, Dominique, Alvarez-Huve, Sandrine, Barbe, Frédérique, Haret, Sophie, Perre, Philippe, Leantez-Nainville, Sophie, Esnault, Jean-Luc, Guimard, Thomas, Suaud, Isabelle, Girard, Jean-Jacques, Simonet, Véronique, Debab, Yasmine, Schmit, Jean-Luc, Jacomet, Christine, Weinberck, Pierre, Genet, Claire, Pinet, Pauline, Ducroix, Sophie, Durox, Hélène, Denes, Éric, Abraham, Bruno, Gourdon, Florence, Antoniotti, Odile, Molina, Jean-Michel, Ferret, Samuel, Lascoux-Combe, Caroline, Lafaurie, Matthieu, Colin de Verdiere, Nathalie, Ponscarme, Diane, De Castro, Nathalie, Aslan, Alexandre, Rozenbaum, Willy, Pintado, Claire, Clavel, François, Taulera, Olivier, Gatey, Caroline, Munier, Anne-Lise, Gazaigne, Sandrine, Penot, Pauline, Conort, Guillaume, Lerolle, Nathalie, Leplatois, Anne, Balausine, Stéphanie, Delgado, Jeannine, Timsit, Julie, Tabet, Magda, Gerard, Laurence, Girard, Pierre-Marie, Picard, Odile, Tredup, Jürgen, Bollens, Diane, Valin, Nadia, Campa, Pauline, Bottero, Julie, Lefebvre, Benedicte, Tourneur, Muriel, Fonquernie, Laurent, Wemmert, Charlotte, Lagneau, Jean-Luc, Yazdanpanah, Yazdan, Phung, Bao, Pinto, Adriana, Vallois, Dorothée, Cabras, Ornella, Louni, Françoise, Pialoux, Gilles, Lyavanc, Thomas, Berrebi, Valérie, Chas, Julie, Lenagat, Sophie, Rami, Agathe, Diemer, Myriam, Parrinello, Maguy, Depond, Audrey, Salmon, Dominique, Guillevin, Loïc, Tahi, Tassadit, Belarbi, Linda, Loulergue, Pierre, Zak Dit Zbar, Olivier, Launay, Odile, Silbermann, Benjamin, Leport, Catherine, Alagna, Laura, Pietri, Marie-Pierre, Simon, Anne, Bonmarchand, Manuela, Amirat, Naouel, Pichon, François, Kirstetter, Myriam, Katlama, Christine, Valantin, Marc Antoine, Tubiana, Roland, Caby, Fabienne, Schneider, Luminita, Ktorza, Nadine, Calin, Ruxandra, Merlet, Audrey, Ben Abdallah, Saadia, Weiss, Laurence, Buisson, Martin, Batisse, Dominique, Karmochine, Marina, Pavie, Juliette, Minozzi, Catherine, Jayle, Didier, Castel, Philippe, Derouineau, Jean, Kousignan, Pascale, Eliazevitch, Murielle, Pierre, Isabelle, Collias, Lio, Viard, Jean-Paul, Gilquin, Jacques, Sobel, Alain, Slama, Laurence, Ghosn, Jade, Hadacek, Blanka, Thu-Huyn, Nugyen, Nait-Ighil, Lella, Cros, Agnes, Maignan, Aline, Duvivier, Claudine, Consigny, Paul Henri, Lanternier, Fanny, Shoai-Tehrani, Michka, Touam, Fatima, Jerbi, Saadia, Bodard, Loïc, Jung, Corinne, Goujard, Cécile, Quertainmont, Yann, Duracinsky, Martin, Segeral, Olivier, Blanc, Arnaud, Peretti, Delphine, Cheret, Antoine, Chantalat, Christelle, Dulucq, Marie Josée, Levy, Yves, Lelievre, Jean Daniel, Lascaux, Anne Sophie, Dumont, Cécile, Boue, François, Chambrin, Véronique, Abgrall, Sophie, Kansau, Imad, Raho-Moussa, Mariem, De Truchis, Pierre, Dinh, Aurélien, Davido, Benjamin, Marigot, Dhiba, Berthe, Huguette, Devidas, Alain, Chevojon, Pierre, Chabrol, Amélie, Agher, Nouara, Lemercier, Yvon, Chaix, Fabrice, Turpault, Isabelle, Bouchaud, Olivier, Honore, Patricia, Rouveix, Elisabeth, Reimann, Evelyne, Belan, Alix Greder, Godin Collet, Claire, Souak, Safia, Mortier, Emmanuel, Bloch, Martine, Simonpoli, Anne-Marie, Manceron, Véronique, Cahitte, Isabelle, Hiraux, Emmanuel, Lafon, Erik, Cordonnier, François, Zeng, Ai-Feng, Zucman, David, Majerholc, Catherine, Bornarel, Dominique, Uludag, Agnès, Gellen-Dautremer, Justine, Lefort, Agnès, Bazin, Christine, Daneluzzi, Vincent, Gerbe, Juliette, Jeantils, Vincent, Coupard, Mélissa, Patey, Olivier, Bantsimba, Jonas, Delllion, Sophie, Paz, Pauline Caraux, Cazenave, Benoit, Richier, Laurent, Garrait, Valérie, Delacroix, Isabelle, Elharrar, Brigitte, Vittecoq, Daniel, Bolliot, Claudine, Lepretre, Annie, Genet, Philippe, Masse, Virginie, Perrone, Véronique, Boussard, Jean-Luc, Chardon, Patricia, Froguel, Eric, Simon, Philippe, Tassi, Sylvie, Avettand Fenoel, Véronique, Barin, Francis, Bourgeois, Christine, Cardon, Fanny, Chaix, Marie-Laure, Delfraissy, Jean François, Essat, Asma, Fischer, Hugues, Lecuroux, Camille, Petrov-Sanchez, Ventzislava, Rouzioux, Christine, Saez-Cirion, Asier, Seng, Rémonie, Kuldanek, Kristin, Mullaney, Scott, Young, Carmel, Zucchetti, Antonella, Bevan, Margaret-Ann, McKernan, Sinead, Wandolo, Emily, Richardson, Celia, Youssef, Elaney, Green, Pippa, Faulkner, Sue, Faville, Rebecca, Herman, Sandra, Care, Christine, Blackman, Helen, Bellenger, Katharine, Fairbrother, Keith, Phillips, Andrew, Babiker, Abdel, Delpech, Valerie, Fidler, S, Clarke, Mindy, Fox, Julie, Gilson, R, Goldberg, David, Hawkins, David, Johnson, Anne, Johnson, Margaret, McLean, Ken, Nastouli, Eleni, Post, Frank, Kennedy, N, Pritchard, J, Andrady, U, Rajda, N, Donnelly, C, McKernan, S, Drake, S, Gilleran, G, White, D, Ross, J, Harding, J, Faville, R, Sweeney, J, Flegg, P, Toomer, S, Wilding, H, Woodward, R, Dean, G, Richardson, C, Perry, N, Gompels, M, Jennings, L, Bansaal, D, Browing, M, Connolly, L, Stanley, B, Estreich, S, Magdy, A, O'Mahony, C, Fraser, P, Jebakumar, S P R, David, L, Mette, R, Summerfield, H, Evans, M, White, C, Robertson, R, Lean, C, Morris, S, Winter, A, Faulkner, S, Goorney, B, Howard, L, Fairley, I, Stemp, C, Short, L, Gomez, M, Young, F, Roberts, M, Green, S, Sivakumar, K, Minton, J, Siminoni, A, Calderwood, J, Greenhough, D, DeSouza, C, Muthern, Lisa, Orkin, C, Murphy, S, Truvedi, M, McLean, K, Hawkins, D, Higgs, C, Moyes, A, Antonucci, S, McCormack, S, Lynn, W, Bevan, M, Fox, J, Teague, A, Anderson, J, Mguni, S, Post, F, Campbell, L, Mazhude, C, Russell, H, Carrick, G, Ainsworth, J, Waters, A, Byrne, P, Johnson, M, Kuldanek, K, Mullaney, S, Lawlor, V, Melville, R, Sukthankar, A, Thorpe, S, Murphy, C, Wilkins, E, Ahmad, S, Green, P, Tayal, S, Ong, E, Meaden, J, Riddell, L, Loay, D, Peacock, K, Blackman, H, Harindra, V, Saeed, A M, Allen, S, Natarajan, U, Williams, O, Lacey, H, Care, C, Bowman, C, Herman, S, Devendra, S V, Wither, J, Bridgwood, A, Singh, G, Bushby, S, Kellock, D, Young, S, Rooney, G, Snart, B, Currie, J, Fitzgerald, M, Arumainayyagam, J, Chandramani, S, Rajamanoharan, S, Robinson, T, Taylor, B, Brewer, C, Mayr, Christoph, Schmidt, Wolfgang, Speidel, Andrea, Strohbach, Frank, Arastéh, Keikawus, Cordes, Christiane, Stündel, Manfred, Claus, Jörg, Baumgarten, Axel, Carganico, Andreas, Ingiliz, Patrick, Dupke, Stephan, Freiwald, Matthias, Rausch, Michael, Moll, Arend, Schleehauf, Dorothea, Hintsche, Bettina, Klausen, Gerd, Jessen, Heiko, Jessen, Arne, Köppe, Siegfried, Kreckel, Peter, Schranz, Dietmar, Fischer, Klaus, Schulbin, Hubert, Speer, Miriam, Glaunsinger, Tobias, Wicke, Thomas, Bieniek, Bernhard, Hillenbrand, Heribert, Schlote, Frank, Lauenroth-Mai, Elke, Schuler, Christoph, Schürmann, Dirk, Wesselmann, Hans, Brockmeyer, Norbert, Gehring, Peter, Schmalöer, Dirk, Hower, Martin, Spornraft-Ragaller, Petra, Häussinger, Dieter, Reuter, Stefan, Esser, Stefan, Markus, Rudolf, Kreft, Burkhard, Berzow, Dirk, Christl, Andreas, Meyer, Andreas, Plettenberg, Andreas, Stoehr, Albrecht, Graefe, Katrin, Lorenzen, Thore, Adam, Axel, Schewe, Knut, Weitner, Lutwin, Fenske, Stefan, Hansen, Stefan, Stellbrink, Hans-Jürgen, Wiemer, Dorothea, Hertling, Sandra, Schmidt, Reinhold, Arbter, Peter, Claus, Bernd, Galle, Peter, Jäger, Hans, Jä Gel-Guedes, Eva, Postel, Nils, Fröschl, Monika, Spinner, Christoph, Bogner, Johannes, Salzberger, Bernd, Schölmerich, Jürgen, Audebert, Franz, Marquardt, Ties, Schaffert, Andreas, Schnaitmann, Eiko, Trein, Andreas, Frietsch, Bernhard, Müller, Marcus, Ulmer, Albrecht, Detering-Hübner, Barbara, Kern, Peter, Schubert, Franz, Dehn, Günther, Schreiber, Maria, Güler, Cengiz, Schmidt, Daniel, Meixenberger, Karolin, Medical Microbiology & Infectious Diseases, Internal Medicine, Virology, Pediatrics, Medical Microbiology and Infection Prevention, AII - Infectious diseases, Global Health, Infectious diseases, APH - Aging & Later Life, Centre interdisciplinaire de recherche en biologie (CIRB), Labex MemoLife, École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Internal medicine, VU University medical center, Surgery, AMS - Rehabilitation & Development, APH - Quality of Care, Psychiatry, Pediatric surgery, Neurology, Public and occupational health, APH - Mental Health, Pathology, Cardiology, ACS - Heart failure & arrhythmias, Anesthesiology, IOO, Rehabilitation medicine, Obstetrics and gynaecology, General practice, Gastroenterology and hepatology, Pulmonary medicine, ACS - Pulmonary hypertension & thrombosis, Medical oncology laboratory, Hematology, Epidemiology and Data Science, Physiology, Microbes in Health and Disease (MHD), University of Oxford, Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), European Bioinformatics Institute [Hinxton] (EMBL-EBI), EMBL Heidelberg, Amsterdam UMC - Amsterdam University Medical Center, The Wellcome Trust Sanger Institute [Cambridge], Karolinska Institutet [Stockholm], Robert Koch Institute [Berlin] (RKI), Ecole Polytechnique Fédérale de Lausanne (EPFL), Johns Hopkins University (JHU), Universität Zürich [Zürich] = University of Zurich (UZH), Helsinki University Hospital [Helsinki, Finlande], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, University College of London [London] (UCL), Kymab Ltd, Cambridge, England, Institut Pasteur [Paris] (IP), This study was funded by ERC Advanced Grant PBDR-339251 and a Li Ka Shing Foundation grant, both awarded to C.F. The ATHENA Cohort is managed by Stichting HIV Monitoring and supported by a grant from the Dutch Ministry of Health, Welfare and Sport through the Centre for Infectious Disease Control of the National Institute for Public Health and the Environment., We thank K. Fransen and G. Vanham for help with the Belgian data, O. Ratmann for help in identifying the Dutch clusters, K. Kusejko for testing for additional VB individuals in the SHCS, B. Foley for help with genome sharing, B. Dearlove and L. Thomson for help with software, and J. Herbeck and three other reviewers for helpful suggestions., Contributors and affiliations are listed in the supplementary materials., Department of Medicine, University of Helsinki, Infektiosairauksien yksikkö, HUS Inflammation Center, and Clinicum
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Adult ,Male ,HIV-1/genetics ,Genotype ,Anti-HIV Agents ,Evolution ,[SDV]Life Sciences [q-bio] ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,HIV Infections/drug therapy ,selection ,HIV Infections ,Genome, Viral ,heritability ,epidemic ,human-immunodeficiency-virus ,Evolution, Molecular ,SDG 3 - Good Health and Well-being ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Humans ,Viral ,Phylogeny ,Netherlands ,Multidisciplinary ,Genome ,model ,Virulence ,transmission ,Molecular ,setpoint viral load ,reverse-transcriptase ,dynamics ,Viral Load ,CD4 Lymphocyte Count ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,3121 General medicine, internal medicine and other clinical medicine ,Anti-HIV Agents/therapeutic use ,Mutation ,HIV-1 ,Female ,progression - Abstract
Comment in Does HIV-1 virulence matter in the ART era? Lewitus E, Rolland M. Med (N Y). 2022 Apr 8;3(4):217-219. doi: 10.1016/j.medj.2022.03.003. PMID: 35590149; International audience; We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log 10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV—CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences—is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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- 2022
3. HIV testing history and access to treatment among migrants living with HIV in Europe
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Fakoya, Ibidun, Arco, Débora Álvarez?Del, Monge, Susana, Copas, Andrew J., Gennotte, Anne?Francoise, Volny?Anne, Alain, Wengenroth, Claudia, Touloumi, Giota, Prins, Maria, Barros, Henrique, Darling, Katharine Ea, Prestileo, Tullio, Del Amo, Julia, Burns, Fiona M., Aerssens, A, Aguado, M, Alimi, B, Anagnostou, O, Anderson, J, Antoniadou, A, Arando, M, Barberà, Mj, Barthélemy, A, Belda?Ibáñez, J, Bertisch, B, Bil, J, Blanco, Jr, Block, K, Boesecke, C, Boura, M, Burgos, J, Cabo, J, Calabuig, E, Campbell, L, Cardoso, O, Claudia, W, Clumeck, N, Colucci, A, Corrao, S, Cuellar, S, Cunha, J, Daikos, G, Darling, K, Romero, J, Dellot, P, Domingo, P, Dronda, F, Ebeling, F, Engelhardt, A, Engler, B, Farrell, J, Fehr, J, Feijó, M, Fernández, E, García, E Fernández, Fernandez, T, Fortes, Al, Fox, J, De Olalla, P Garcia, García, F, Gargalianos?Kakolyris, P, Germano, I, Gilleran, G, Gilson, R, Goepel, S, Gogos, Ha, Sirvent, Jl Gómez, Gountas, I, Gregg, A, Gutiérrez, F, Gutierrez, Mm, Hermans, I, Iribarren, Ja, Knobel, H, Koulai, L, Kourkounti, S, La Morté, C, Lecompte, T, Ledergerber, B, Leonidou, L, Ligero, Mc, Lindergard, G, Lino, S, Lopes, Mj, Lirola, A Lopez, Louhenapessy, M, Lourida, G, Luzi, Am, Maltez, F, Manirankunda, L, Martín?Pérez, A, Martins, L, Masía, M, Mateu, Mg, Meireles, P, Mendes, A, Metallidis, S, Mguni, S, Milinkovic, A, Miró, Jm, Mohrmann, K, Montero, M, Mouhebati, T, Moutschen, M, Müller, M, Murphy, C, Nöstlinger, C, Ocaña, I, Okumu?Fransche, S, Onwuchekwa, G, Ospina, Je, Otiko, D, Pacheco, P, Palacios, R, Paparizos, V, Papastamopoulos, V, Paredes, V, Patel, N, Pellicer, T, Peña, A, Petrosillo, N, Pinheiro, A, Poças, J, Portillo, A, Post, F, Prestileo, F, Prins, P, Protopapas, K, Psichogiou, M, Pulido, F, Rebollo, J, Ribeirinho, A, Río, I, Robau, M, Rockstroh, Jk, Rodrigues, E, Rodríguez, M, Sajani, C, Salavert, M, Salman, R, Sanz, N, Schuettfort, G, Schüttfort, G, Zander, C Schwarze?, Serrão, R, Silva, D, Silva, V, Silverio, P, Skoutelis, A, Staehelin, C, Stephan, C, Stretton, C, Styles, F, Sutre, Af, Taylor, S, Teixeira, B, Thierfelder, C, Tsachouridou, O, Tudor, K, Valadas, E, Frankenhuijsen, M, Vázquez, M, Arribas, M Velasco, Vera, M, Vinciana, P, Voudouri, N, Wasmuth, Jc, Wilkins, E, Young, L, Yurdakul, S, Espinosa, T Zafra, Zuilhof, W, and Zuure, F
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HIV testing -- Surveys ,Immigrants -- Surveys -- Care and treatment ,HIV infection -- Surveys -- Diagnosis -- Care and treatment ,Health - Abstract
: Introduction: Migrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe. Methods: A cross‐sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV‐positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign‐born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men. Results: A total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post‐migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three‐quarters of people on antiretrovirals had an HIV viral load Conclusions: Migrants access healthcare in Europe and while many migrants had previously tested for HIV, that they went on to test positive at a later date suggests that opportunities for HIV prevention are being missed. Expansion of testing beyond sexual health and antenatal settings is still required and testing opportunities should be linked with combination prevention measures such as access to PrEP and treatment as prevention., Introduction The HIV epidemic in Europe is characterized by a disproportionate number of infections among migrants. Although foreign citizens only made up 7% of the population of the European Union [...]
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- 2018
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4. Validation of a Novel Multivariate Method of Defining HIV-Associated Cognitive Impairment
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Underwood, Jonathan, De Francesco, Davide, Cole, James H, Caan, Matthan W A, van Zoest, Rosan A, Schmand, Ben A, Sharp, David J, Sabin, Caroline A, Reiss, Peter, Winston, Alan Coolaboratori: Reiss P, Wit FWNM, Schouten J, Kooij KW, van Zoest RA, Elsenga BC, Janssen FR, Heidenrijk M, Zikkenheiner W, van der Valk M, Kootstra NA, Harskamp-Holwerda AM, Maurer I, Mangas Ruiz MM, Girigorie AF, Villaudy J, Frankin E, Pasternak A, Berkhout B, van der Kuyl T, Portegies P, Schmand BA, Geurtsen GJ, Ter Stege JA, Klein Twennaar M, Majoie CBLM, Caan MWA, Su T, Weijer K, Bisschop PHLT, Kalsbeek A, Wezel M, Visser I, Ruhé HG, Franceschi C, Garagnani P, Pirazzini C, Capri M, Dall'Olio F, Chiricolo M, Salvioli S, Hoeijmakers J, Pothof J, Prins M, Martens M, Moll S, Berkel J, Totté M, Kovalev S, Gisslén M, Fuchs D, Zetterberg H, Winston A, Underwood J, McDonald L, Stott M, Legg K, Lovell A, Erlwein O, Doyle N, Kingsley C, Sharp DJ, Leech R, Cole JH, Zaheri S, Hillebregt MMJ, Ruijs YMC, Benschop DP, Burger D, de Graaff-Teulen M, Guaraldi G, Bürkle A, Sindlinger T, Moreno-Villanueva M, Keller A, Sabin C, de Francesco D, Libert C, Dewaele S, Boffito M, Mallon P, Post F, Sachikonye M, Anderson J, Asboe D, Garvey L, Pozniak A, Vera J, Williams I, Campbell L, Yurdakul S, Okumu S, Pollard L, Otiko D, Phillips L, Laverick R, Fisher M, Clarke A, Bexley A, Richardson C, Macken A, Ghavani-Kia B, Maher J, Byrne M, Flaherty A, Mguni S, Clark R, Nevin-Dolan R, Pelluri S, Johnson M, Ngwu N, Hemat N, Jones M, Carroll A, Whitehouse A, Burgess L, Babalis D, Higgs C, Seah E, Fletcher S, Anthonipillai M, Moyes A, Deats K, Syed I, Matthews C., Underwood, Jonathan, De Francesco, Davide, Cole, James H, Caan, Matthan W A, van Zoest, Rosan A, Schmand, Ben A, Sharp, David J, Sabin, Caroline A, Reiss, Peter, Winston, Alan Coolaboratori: Reiss P, Wit FWNM, Schouten J, Kooij KW, van Zoest RA, Elsenga BC, Janssen FR, Heidenrijk M, Zikkenheiner W, van der Valk M, Kootstra NA, Harskamp-Holwerda AM, Maurer I, Mangas Ruiz MM, Girigorie AF, Villaudy J, Frankin E, Pasternak A, Berkhout B, van der Kuyl T, Portegies P, Schmand BA, Geurtsen GJ, Ter Stege JA, Klein Twennaar M, Majoie CBLM, Caan MWA, Su T, Weijer K, Bisschop PHLT, Kalsbeek A, Wezel M, Visser I, Ruhé HG, Franceschi C, Garagnani P, Pirazzini C, Capri M, Dall'Olio F, Chiricolo M, Salvioli S, Hoeijmakers J, Pothof J, Prins M, Martens M, Moll S, Berkel J, Totté M, Kovalev S, Gisslén M, Fuchs D, Zetterberg H, Winston A, Underwood J, McDonald L, Stott M, Legg K, Lovell A, Erlwein O, Doyle N, Kingsley C, Sharp DJ, Leech R, Cole JH, Zaheri S, Hillebregt MMJ, Ruijs YMC, Benschop DP, Burger D, de Graaff-Teulen M, Guaraldi G, Bürkle A, Sindlinger T, Moreno-Villanueva M, Keller A, Sabin C, de Francesco D, Libert C, Dewaele S, Boffito M, Mallon P, Post F, Sabin C, Sachikonye M, Winston A, Anderson J, Asboe D, Boffito M, Garvey L, Mallon P, Post F, Pozniak A, Sabin C, Sachikonye M, Vera J, Williams I, Winston A, Post F, Campbell L, Yurdakul S, Okumu S, Pollard L, Williams I, Otiko D, Phillips L, Laverick R, Fisher M, Clarke A, Vera J, Bexley A, Richardson C, Mallon P, Macken A, Ghavani-Kia B, Maher J, Byrne M, Flaherty A, Anderson J, Mguni S, Clark R, Nevin-Dolan R, Pelluri S, Johnson M, Ngwu N, Hemat N, Jones M, Carroll A, Whitehouse A, Burgess L, Babalis D, Winston A, Garvey L, Underwood J, Stott M, McDonald L, Boffito M, Asboe D, Pozniak A, Higgs C, Seah E, Fletcher S, Anthonipillai M, Moyes A, Deats K, Syed I, Matthews C., Molecular Genetics, Biomedical Engineering and Physics, Radiology and Nuclear Medicine, ACS - Atherosclerosis & ischemic syndromes, ACS - Diabetes & metabolism, ACS - Microcirculation, AMS - Restoration & Development, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neurovascular Disorders, Graduate School, AII - Infectious diseases, APH - Aging & Later Life, Medical Psychology, Amsterdam Neuroscience - Neurodegeneration, Global Health, Infectious diseases, APH - Mental Health, APH - Methodology, Commission of the European Communities, Imperial College Healthcare NHS Trust- BRC Funding, and National Institute for Health Research
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Multivariate statistics ,medicine.medical_specialty ,COmorBidity in Relation to AIDS (COBRA) Collaboration and the Pharmacokinetic and clinical Observations in PePle over fiftY (POPPY) Study Group ,Immunology ,Human immunodeficiency virus (HIV) ,Audiology ,medicine.disease_cause ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,multivariate ,SDG 3 - Good Health and Well-being ,Neuroimaging ,Medicine and Health Sciences ,medicine ,Major Article ,OLDER-PEOPLE ,030212 general & internal medicine ,VALIDITY ,Cognitive impairment ,cognitive impairment ,Science & Technology ,neuroimaging ,SCORES ,business.industry ,Biology and Life Sciences ,HIV ,MEN ,Cognition ,Mental health ,White matter microstructure ,PREVALENCE ,3. Good health ,Infectious Diseases ,Oncology ,REGISTRATION ,business ,Life Sciences & Biomedicine ,Neurocognitive ,030217 neurology & neurosurgery - Abstract
Background The optimum method of defining cognitive impairment in virally suppressed people living with HIV is unknown. We evaluated the relationships between cognitive impairment, including using a novel multivariate method (NMM), patient– reported outcome measures (PROMs), and neuroimaging markers of brain structure across 3 cohorts. Methods Differences in the prevalence of cognitive impairment, PROMs, and neuroimaging data from the COBRA, CHARTER, and POPPY cohorts (total n = 908) were determined between HIV-positive participants with and without cognitive impairment defined using the HIV-associated neurocognitive disorders (HAND), global deficit score (GDS), and NMM criteria. Results The prevalence of cognitive impairment varied by up to 27% between methods used to define impairment (eg, 48% for HAND vs 21% for NMM in the CHARTER study). Associations between objective cognitive impairment and subjective cognitive complaints generally were weak. Physical and mental health summary scores (SF-36) were lowest for NMM-defined impairment (P < .05). There were no differences in brain volumes or cortical thickness between participants with and without cognitive impairment defined using the HAND and GDS measures. In contrast, those identified with cognitive impairment by the NMM had reduced mean cortical thickness in both hemispheres (P < .05), as well as smaller brain volumes (P < .01). The associations with measures of white matter microstructure and brain-predicted age generally were weaker. Conclusion Different methods of defining cognitive impairment identify different people with varying symptomatology and measures of brain injury. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer self-reported health status. This may be due to the statistical advantage of using a multivariate approach., We have previously described a novel multivariate method (NMM) with theoretical statistical advantages over existing methods, which we assessed here in 3 cohorts of people living with HIV. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer self-reported health status.
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- 2019
5. Validation of a Novel Multivariate Method of Defining HIV-Associated Cognitive Impairment
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Underwood, J, de Francesco, D, Cole, JH, Caan, MWA, van Zoest, RA, Schmand, BA, Sharp, DJ, Sabin, CA, Reiss, P, Winston, A, Wit, FWNM, Schouten, J, Kooij, KW, Elsenga, BC, Janssen, FR, Heidenrijk, M, Zikkenheiner, W, van der Valk, M, Kootstra, NA, Harskamp-Holwerda, AM, Maurer, I, Ruiz, MMM, Girigorie, AF, Villaudy, J, Frankin, E, Pasternak, A, Berkhout, B, van der Kuyl, T, Portegies, P, Geurtsen, GJ, ter Stege, JA, Twennaar, MK, Majoie, CBLM, Su, T, Weijer, K, Bisschop, PHLT, Kalsbeek, A, Wezel, M, Visser, I, Ruhe, HG, Franceschi, C, Garagnani, P, Pirazzini, C, Capri, M, Dall'Olio, F, Chiricolo, M, Salvioli, S, Hoeijmakers, J, Pothof, J, Prins, M, Martens, M, Moll, S, Berkel, J, Totte, M, Kovalev, S, Gisslen, M, Fuchs, D, Zetterberg, H, McDonald, L, Stott, M, Legg, K, Lovell, A, Erlwein, O, Doyle, N, Kingsley, C, Leech, R, Zaheri, S, Hillebregt, MMJ, Ruijs, YMC, Benschop, DP, Burger, D, de Graaff-Teulen, M, Guaraldi, G, Buerkle, A, Sindlinger, T, Moreno-Villanueva, M, Keller, A, Sabin, C, Libert, C, Dewaele, S, Boffito, M, Mallon, P, Post, F, Sachikonye, M, Anderson, J, Asboe, D, Garvey, L, Pozniak, A, Vera, J, Williams, I, Campbell, L, Yurdakul, S, Okumu, S, Pollard, L, Otiko, D, Phillips, L, Laverick, R, Fisher, M, Clarke, A, Bexley, A, Richardson, C, Macken, A, Ghavani-Kia, B, Maher, J, Byrne, M, Flaherty, A, Mguni, S, Clark, R, Nevin-Dolan, R, Pelluri, S, Johnson, M, Ngwu, N, Hemat, N, Jones, M, Carroll, A, Whitehouse, A, Burgess, L, Babalis, D, Higgs, C, Seah, E, Fletcher, S, Anthonipillai, M, Moyes, A, Deats, K, Syed, I, Matthews, C, Underwood, J, de Francesco, D, Cole, JH, Caan, MWA, van Zoest, RA, Schmand, BA, Sharp, DJ, Sabin, CA, Reiss, P, Winston, A, Wit, FWNM, Schouten, J, Kooij, KW, Elsenga, BC, Janssen, FR, Heidenrijk, M, Zikkenheiner, W, van der Valk, M, Kootstra, NA, Harskamp-Holwerda, AM, Maurer, I, Ruiz, MMM, Girigorie, AF, Villaudy, J, Frankin, E, Pasternak, A, Berkhout, B, van der Kuyl, T, Portegies, P, Geurtsen, GJ, ter Stege, JA, Twennaar, MK, Majoie, CBLM, Su, T, Weijer, K, Bisschop, PHLT, Kalsbeek, A, Wezel, M, Visser, I, Ruhe, HG, Franceschi, C, Garagnani, P, Pirazzini, C, Capri, M, Dall'Olio, F, Chiricolo, M, Salvioli, S, Hoeijmakers, J, Pothof, J, Prins, M, Martens, M, Moll, S, Berkel, J, Totte, M, Kovalev, S, Gisslen, M, Fuchs, D, Zetterberg, H, McDonald, L, Stott, M, Legg, K, Lovell, A, Erlwein, O, Doyle, N, Kingsley, C, Leech, R, Zaheri, S, Hillebregt, MMJ, Ruijs, YMC, Benschop, DP, Burger, D, de Graaff-Teulen, M, Guaraldi, G, Buerkle, A, Sindlinger, T, Moreno-Villanueva, M, Keller, A, Sabin, C, Libert, C, Dewaele, S, Boffito, M, Mallon, P, Post, F, Sachikonye, M, Anderson, J, Asboe, D, Garvey, L, Pozniak, A, Vera, J, Williams, I, Campbell, L, Yurdakul, S, Okumu, S, Pollard, L, Otiko, D, Phillips, L, Laverick, R, Fisher, M, Clarke, A, Bexley, A, Richardson, C, Macken, A, Ghavani-Kia, B, Maher, J, Byrne, M, Flaherty, A, Mguni, S, Clark, R, Nevin-Dolan, R, Pelluri, S, Johnson, M, Ngwu, N, Hemat, N, Jones, M, Carroll, A, Whitehouse, A, Burgess, L, Babalis, D, Higgs, C, Seah, E, Fletcher, S, Anthonipillai, M, Moyes, A, Deats, K, Syed, I, and Matthews, C
- Abstract
BACKGROUND: The optimum method of defining cognitive impairment in virally suppressed people living with HIV is unknown. We evaluated the relationships between cognitive impairment, including using a novel multivariate method (NMM), patient- reported outcome measures (PROMs), and neuroimaging markers of brain structure across 3 cohorts. METHODS: Differences in the prevalence of cognitive impairment, PROMs, and neuroimaging data from the COBRA, CHARTER, and POPPY cohorts (total n = 908) were determined between HIV-positive participants with and without cognitive impairment defined using the HIV-associated neurocognitive disorders (HAND), global deficit score (GDS), and NMM criteria. RESULTS: The prevalence of cognitive impairment varied by up to 27% between methods used to define impairment (eg, 48% for HAND vs 21% for NMM in the CHARTER study). Associations between objective cognitive impairment and subjective cognitive complaints generally were weak. Physical and mental health summary scores (SF-36) were lowest for NMM-defined impairment ( P < .05).There were no differences in brain volumes or cortical thickness between participants with and without cognitive impairment defined using the HAND and GDS measures. In contrast, those identified with cognitive impairment by the NMM had reduced mean cortical thickness in both hemispheres ( P < .05), as well as smaller brain volumes ( P < .01). The associations with measures of white matter microstructure and brain-predicted age generally were weaker. CONCLUSION: Different methods of defining cognitive impairment identify different people with varying symptomatology and measures of brain injury. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer self-reported health status. This may be due to the statistical advantage of using a multivariate approach.
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- 2019
6. HIV testing history and access to treatment among migrants living with HIV in Europe
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Fakoya, I. Álvarez-Del Arco, D. Monge, S. Copas, A.J. Gennotte, A.-F. Volny-Anne, A. Wengenroth, C. Touloumi, G. Prins, M. Barros, H. Darling, K.E.A. Prestileo, T. Del Amo, J. Burns, F.M. Aerssens, A. Aguado, M. Alimi, B. Anagnostou, O. Anderson, J. Antoniadou, A. Arando, M. Barberà, M.J. Barthélemy, A. Belda-Ibáñez, J. Bertisch, B. Bil, J. Blanco, J.R. Block, K. Boesecke, C. Boura, M. Burgos, J. Cabo, J. Calabuig, E. Campbell, L. Cardoso, O. Claudia, W. Clumeck, N. Colucci, A. Corrao, S. Cuellar, S. Cunha, J. Daikos, G. Darling, K. del Romero, J. Dellot, P. Domingo, P. Dronda, F. Ebeling, F. Engelhardt, A. Engler, B. Farrell, J. Fehr, J. Feijó, M. Fernández, E. Fernández García, E. Fernandez, T. Fortes, A.L. Fox, J. Garcia de Olalla, P. García, F. Gargalianos-Kakolyris, P. Germano, I. Gilleran, G. Gilson, R. Goepel, S. Gogos, H.A. Gómez Sirvent, J.L. Gountas, I. Gregg, A. Gutiérrez, F. Gutierrez, M.M. Hermans, I. Iribarren, J.A. Knobel, H. Koulai, L. Kourkounti, S. La Morté, C. LeCompte, T. Ledergerber, B. Leonidou, L. Ligero, M.C. Lindergard, G. Lino, S. Lopes, M.J. Lopez Lirola, A. Louhenapessy, M. Lourida, G. Luzi, A.M. Maltez, F. Manirankunda, L. Martín-Pérez, A. Martins, L. Masía, M. Mateu, M.G. Meireles, P. Mendes, A. Metallidis, S. Mguni, S. Milinkovic, A. Miró, J.M. Mohrmann, K. Montero, M. Mouhebati, T. Moutschen, M. Müller, M. Murphy, C. Nöstlinger, C. Ocaña, I. Okumu-Fransche, S. Onwuchekwa, G. Ospina, J.E. Otiko, D. Pacheco, P. Palacios, R. Paparizos, V. Papastamopoulos, V. Paredes, V. Patel, N. Pellicer, T. Peña, A. Petrosillo, N. Pinheiro, A. Poças, J. Portillo, A. Post, F. Prestileo, F. Prins, P. Protopapas, K. Psichogiou, M. Pulido, F. Rebollo, J. Ribeirinho, A. Río, I. Robau, M. Rockstroh, J.K. Rodrigues, E. Rodríguez, M. Sajani, C. Salavert, M. Salman, R. Sanz, N. Schuettfort, G. Schüttfort, G. Schwarze- Zander, C. Serrão, R. Silva, D. Silva, V. Silverio, P. Skoutelis, A. Staehelin, C. Stephan, C. Stretton, C. Styles, F. Sutre, A.F. Taylor, S. Teixeira, B. Thierfelder, C. Tsachouridou, O. Tudor, K. Valadas, E. van Frankenhuijsen, M. Vázquez, M. Velasco Arribas, M. Vera, M. Vinciana, P. Voudouri, N. Wasmuth, J.C. Wilkins, E. Young, L. Yurdakul, S. Zafra Espinosa, T. Zuilhof, W. Zuure, F. the aMASE Study Team
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virus diseases - Abstract
Introduction: Migrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe. Methods: A cross-sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV-positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign-born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men. Results: A total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post-migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three-quarters of people on antiretrovirals had an HIV viral load
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- 2018
7. High levels of postmigration HIV acquisition within nine European countries
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Alvarez-Del Arco, D. Fakoya, I. Thomadakis, C. Pantazis, N. Touloumi, G. Gennotte, A.-F. Zuure, F. Barros, H. Staehelin, C. Göpel, S. Boesecke, C. Prestileo, T. Volny-Anne, A. Burns, F. Del Amo, J. Aerssens, A. Aguado, M. Alimi, B. Álvarez-Del Arco, D. Anagnostou, O. Anderson, J. Antoniadou, A. Arando, M. Barberà, M.J. Barthélemy, A. Belda-Ibáñez, J. Bertisch, B. Bil, J. Blanco, J.R. Block, K. Boesecke, C. Boura, M. Burgos, J. Burns, F.M. Cabo, J. Calabuig, E. Campbell, L. Cardoso, O. Claudia, W. Clumeck, N. Colucci, A. Corrao, S. Cuellar, S. Cunha, J. Daikos, G. Darling, K. Del Amo, J. Del Romero, J. Dellot, P. Dixneuf, M. Domingo, P. Dronda, F. Ebeling, F. Engelhardt, A. Engler, B. Fakoya, I. Farrell, J. Fehr, J. Feijó, M. Fernández, E. Fernández García, E. Fernandez, T. Fortes, A.L. Fox, J. Garcia De Olalla, P. García, F. Gargalianos-Kakolyris, P. Gennotte, A.F. Germano, I. Gilleran, G. Gilson, R. Goepel, S. Gogos, H.A. Gómez Sirvent, J.L. Gountas, I. Gregg, A. Gutiérrez, F. Gutierrez, M.M. Hermans, I. Iribarren, J.A. Knobel, H. Koulai, L. Kourkounti, S. La Morté, C. LeCompte, T. Ledergerber, B. Leonidou, L. Ligero, M.C. Lindergard, G. Lino, S. Lopes, M.J. Lopez Lirola, A. Louhenapessy, M. Lourida, G. Luzi, A.M. Maltez, F. Manirankunda, L. Martín-Pérez, A. Martins, L. Masía, M. Mateu, M.G. Meireles, P. Mendes, A. Metallidis, S. Mguni, S. Milinkovic, A. Miró, J.M. Mohrmann, K. Monge, S. Montero, M. Mouhebati, T. Moutschen, M. Müller, M. Murphy, C. Nöstlinger, C. Ocaña, I. Okumu-Fransche, S. Onwuchekwa, G. Ospina, J.E. Otiko, D. Pacheco, P. Palacios, R. Paparizos, V. Papastamopoulos, V. Paredes, V. Patel, N. Pellicer, T. Peña, A. Petrosillo, N. Pinheiro, A. Poças, J. Portillo, A. Post, F. Prestileo, F. Prestileo, T. Prins, M. Prins, P. Protopapas, K. Psichogiou, M. Pulido, F. Rebollo, J. Ribeirinho, A. Río, I. Robau, M. Rockstroh, J.K. Rodrigues, E. Rodríguez, M. Sajani, C. Salavert, M. Salman, R. Sanz, N. Schuettfort, G. Schüttfort, G. Schwarze-Zander, C. Serrão, R. Silva, D. Silva, V. Silverio, P. Skoutelis, A. Staehelin, C. Stephan, C. Stretton, C. Styles, F. Sutre, A.F. Taylor, S. Teixeira, B. Thierfelder, C. Touloumi, G. Tsachouridou, O. Tudor, K. Valadas, E. Van Frankenhuijsen, M. Vázquez, M. Velasco Arribas, M. Vera, M. Vinciana, P. Volny-Anne, A. Voudouri, N. Wasmuth, J.C. Wengenroth, C. Wilkins, E. Young, L. Yurdakul, S. Zafra Espinosa, T. Zuilhof, W. Zuure, F. Advancing Migrant Access to Health Services in Europe (aMASE) study team
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virus diseases - Abstract
Objective: We aimed to estimate the proportion of postmigration HIV acquisition among HIV-positive migrants in Europe. Design: To reach HIV-positive migrants, we designed a cross-sectional study performed in HIV clinics. Methods: The study was conducted from July 2013 to July 2015 in 57 clinics (nine European countries), targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Postmigration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4+ cell counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Postmigration acquisition risk factors were investigated with weighted logistic regression. Results: Of 2009 participants, 46% were MSM and a third originated from sub-Saharan Africa and Latin America & Caribbean, respectively. Median time in host countries was 8 years. Postmigration HIV acquisition was 63% (95% confidence interval: 57-67%); 72% among MSM, 58 and 51% in heterosexual men and women, respectively. Postmigration HIV acquisition was 71% for Latin America and Caribbean migrants and 45% for people from sub-Saharan Africa. Factors associated with postmigration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country and HIV diagnosis year. Conclusion: A substantial proportion of HIV-positive migrants living in Europe acquired HIV postmigration. This has important implications for European public health policies. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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- 2017
8. Microanalysis and dating for rock art studies: Towards a common analytical strategy
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Hœrlé, S., Loïc BERTRAND, Mguni, S., Jacobson, L., Bertrand, Loïc, Institut photonique d'analyse non-destructive européen des matériaux anciens (IPANEMA), Muséum national d'Histoire naturelle (MNHN)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Centre National de la Recherche Scientifique (CNRS)-Ministère de la Culture (MC), University of the Witwatersrand [Johannesburg] (WITS), Synchrotron SOLEIL (SSOLEIL), Centre National de la Recherche Scientifique (CNRS), Bushmans Kloof Wilderness Reserve and Retreat, University of Cape Town, McGregor Museum, Cape Peninsula University of Technology (CPUT), ARCUS Région Île-de-France, Department of Archaeology, and Faculty of Science
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[PHYS]Physics [physics] ,Microscopy ,[CHIM.MATE] Chemical Sciences/Material chemistry ,[SHS.ARCHEO] Humanities and Social Sciences/Archaeology and Prehistory ,[SHS.ARCHEO]Humanities and Social Sciences/Archaeology and Prehistory ,[CHIM.MATE]Chemical Sciences/Material chemistry ,[SHS.MUSEO]Humanities and Social Sciences/Cultural heritage and museology ,Imaging ,[PHYS] Physics [physics] ,South Africa ,Archaeology ,[SHS.MUSEO] Humanities and Social Sciences/Cultural heritage and museology ,Methods ,Rock Art ,Dating ,ComputingMilieux_MISCELLANEOUS ,Spectroscopy - Abstract
Usual questions that may require analytical work in rock art relate to investigations that seek correlations between archaeological deposits and the rock wall and human activities within the site, the relationships between sites (material sourcing, landscape use), dating (direct or relative chronology), and conservation studies (nature and causes of alterations). From early works to recent research in archaeology, South Africand France have had many fruitful interactions (e.g. Breuil 1930; Clottes 1996; Henshilwood 2002; Parkington 2005; Hœrlé 2007; Tournié 2010). Today, under the aegis of two international and interdisciplinary programmes linking South Africand France - GDRI-STAR "Science, Technologies, Art Rupestre" and ARCUS le-de-France/South Africa "Rock Art" - the aim, among other topics, is to foster the use of materials microanalytical tools in rock art studies. GDRI-STAR is an international research network gathering together teams of South African and French researchers from backgrounds as diverse as archaeology, linguistics, conservation, materialscience and geosciences, with a common interest in rock art studies. GDRI-STAR is jointly funded by the French Centre National de la Recherche Scientifique (CNRS) and the South African National Research Foundation (NRF). The ARCUS le-deFrance/South Africa "Rock Art" project aims at fostering research in the field of rock art by bringing together a cluster of analytical laboratories and archaeological teams in Région le-de-France, France, and leading South African academic centres. It is funded by the French Ministry of Foreign and European Affairs and the le-de-France provincial council, and managed through the CNRS and the Agence Française de Développement (AFD).
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- 2010
9. Point-of-care HIV testing in primary care and early detection of HIV (RHIVA2): a cluster randomised controlled trial
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Leber, W, primary, McMullen, H, additional, Marlin, N, additional, Bremner, S, additional, Santos, AC, additional, Terris-Prestholt, F, additional, Boomla, K, additional, Ashcroft, R, additional, Kerry, S, additional, Martineau, A, additional, Millett, D, additional, Mguni, S, additional, Creighton, S, additional, Hart, G, additional, Figueroa, J, additional, Anderson, J, additional, and Griffiths, C, additional
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- 2013
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10. HIV testing in non‐traditional settings: feasibility and acceptability in an acute admissions unit
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Cridford, R, Thornton, A, Rayment, M, Mguni, S, Millett, D, Mandalia, S, Nardone, A, Tenant?Flowers, M, Sullivan, A, Ghosh, R, and Anderson, J
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HIV testing -- Management ,Practice guidelines (Medicine) -- Evaluation ,Company business management ,Health - Abstract
7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK, Purpose of the study National guidelines recommend the routine offer of an HIV test to all acute medical admissions when the local diagnosed HIV prevalence exceeds 0.2%. We investigated the [...]
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- 2010
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11. HIV testing history and access to treatment among migrants living with HIV in Europe
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Giota Touloumi, Tullio Prestileo, Maria Prins, Ibidun Fakoya, Julia del Amo, Fiona Burns, Andrew Copas, Katharine Ea Darling, Henrique Barros, Anne-Francoise Gennotte, Debora Alvarez-del Arco, Alain Volny-Anne, Claudia Wengenroth, Susana Monge, Unión Europea. Comisión Europea. 7 Programa Marco, National Institute for Health Research (Reino Unido), Fundación para la Investigación y la Prevención del Sida en España, Centro de Investigación Biomedica en Red - CIBER, APH - Global Health, Infectious diseases, aMASE Study Team, Aerssens, A., Aguado, M., Alimi, B., Anagnostou, O., Anderson, J., Antoniadou, A., Arando, M., Barberà, M.J., Barthélemy, A., Belda-Ibáñez, J., Bertisch, B., Bil, J., Blanco, J.R., Block, K., Boesecke, C., Boura, M., Burgos, J., Cabo, J., Calabuig, E., Campbell, L., Cardoso, O., Claudia, W., Clumeck, N., Colucci, A., Corrao, S., Cuellar, S., Cunha, J., Daikos, G., Darling, K., Del Romero, J., Dellot, P., Domingo, P., Dronda, F., Ebeling, F., Engelhardt, A., Engler, B., Farrell, J., Fehr, J., Feijó, M., Fernández, E., Fernández García, E., Fernandez, T., Fortes, A.L., Fox, J., Garcia de Olalla, P., García, F., Gargalianos-Kakolyris, P., Germano, I., Gilleran, G., Gilson, R., Goepel, S., Gogos, H.A., Gómez Sirvent, J.L., Gountas, I., Gregg, A., Gutiérrez, F., Gutierrez, M.M., Hermans, I., Iribarren, J.A., Knobel, H., Koulai, L., Kourkounti, S., La Morté, C., LeCompte, T., Ledergerber, B., Leonidou, L., Ligero, M.C., Lindergard, G., Lino, S., Lopes, M.J., Lopez Lirola, A., Louhenapessy, M., Lourida, G., Luzi, A.M., Maltez, F., Manirankunda, L., Martín-Pérez, A., Martins, L., Masía, M., Mateu, M.G., Meireles, P., Mendes, A., Metallidis, S., Mguni, S., Milinkovic, A., Miró, J.M., Mohrmann, K., Montero, M., Mouhebati, T., Moutschen, M., Müller, M., Murphy, C., Nöstlinger, C., Ocaña, I., Okumu-Fransche, S., Onwuchekwa, G., Ospina, J.E., Otiko, D., Pacheco, P., Palacios, R., Paparizos, V., Papastamopoulos, V., Paredes, V., Patel, N., Pellicer, T., Peña, A., Petrosillo, N., Pinheiro, A., Poças, J., Portillo, A., Post, F., Prestileo, F., Prins, P., Protopapas, K., Psichogiou, M., Pulido, F., Rebollo, J., Ribeirinho, A., Río, I., Robau, M., Rockstroh, J.K., Rodrigues, E., Rodríguez, M., Sajani, C., Salavert, M., Salman, R., Sanz, N., Schuettfort, G., Schüttfort, G., Schwarze-Zander, C., Serrão, R., Silva, D., Silva, V., Silverio, P., Skoutelis, A., Staehelin, C., Stephan, C., Stretton, C., Styles, F., Sutre, A.F., Taylor, S., Teixeira, B., Thierfelder, C., Tsachouridou, O., Tudor, K., Valadas, E., van Frankenhuijsen, M., Vázquez, M., Velasco Arribas, M., Vera, M., Vinciana, P., Voudouri, N., Wasmuth, J.C., Wilkins, E., Young, L., Yurdakul, S., Zafra Espinosa, T., Zuilhof, W., and Zuure, F.
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Male ,0301 basic medicine ,Cross-sectional study ,HIV Infections ,migrants ,Logistic regression ,Health Services Accessibility ,Sexual and Gender Minorities ,0302 clinical medicine ,Pregnancy ,Health care ,Medicine ,030212 general & internal medicine ,10. No inequality ,Research Articles ,Reproductive health ,Transients and Migrants ,AIDS Serodiagnosis ,virus diseases ,3. Good health ,Europe ,Infectious Diseases ,Anti-Retroviral Agents ,behavior and behavior mechanisms ,population characteristics ,Bisexuality ,Female ,Viral load ,geographic locations ,Research Article ,Adult ,Sexual Behavior ,Migrants ,primary healthcare ,03 medical and health sciences ,Humans ,HIV serodiagnosis ,ddc:610 ,Heterosexuality ,Anti-Retroviral Agents/therapeutic use ,Cross-Sectional Studies ,Europe/epidemiology ,HIV Infections/diagnosis ,HIV Infections/drug therapy ,Logistic Models ,Primary Health Care ,Sexual Behavior/statistics & numerical data ,HIV ,health services accessibility ,business.industry ,Health services accessibility ,Public Health, Environmental and Occupational Health ,social sciences ,Treatment as prevention ,030112 virology ,Residence ,business ,Primary healthcare ,Demography - Abstract
INTRODUCTION: Migrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe. METHODS: A cross-sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV-positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign-born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men. RESULTS: A total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post-migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three-quarters of people on antiretrovirals had an HIV viral load
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- 2018
12. Promotion of rapid testing for HIV in primary care (RHIVA2): a cluster-randomised controlled trial.
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Leber W, McMullen H, Anderson J, Marlin N, Santos AC, Bremner S, Boomla K, Kerry S, Millett D, Mguni S, Creighton S, Figueroa J, Ashcroft R, Hart G, Delpech V, Brown A, Rooney G, Sampson M, Martineau A, Terris-Prestholt F, and Griffiths C
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- Adolescent, Adult, CD4 Lymphocyte Count, Early Diagnosis, Female, HIV Infections blood, Humans, London, Male, Middle Aged, Primary Health Care, Young Adult, HIV Infections diagnosis, Health Promotion
- Abstract
Background: Many people with HIV are undiagnosed. Early diagnosis saves lives and reduces onward transmission. We assessed whether an education programme promoting rapid HIV testing in general practice would lead to increased and earlier HIV diagnosis., Methods: In this cluster randomised controlled trial in Hackney (London, UK), general practices were randomly assigned (1:1) to offer either opt-out rapid HIV testing to newly registering adults or continue usual care. All practices were invited to take part. Practices were randomised by an independent clinical trials unit statistician with a minimisation program, maintaining allocation concealment. Neither patients nor investigators were masked to treatment allocation. The primary outcome was CD4 count at diagnosis. Secondary outcomes were rate of diagnosis, proportion with CD4 count less than 350 cells per μL, and proportion with CD4 count less than 200 cells per μL. This study is registered with ClinicalTrials.gov, number ISRCTN63473710., Findings: 40 of 45 (89%) general practices agreed to participate: 20 were assigned to the intervention group (44 971 newly registered adult patients) and 20 to the control group (38 464 newly registered adult patients), between April 19, 2010, and Aug 31, 2012. Intervention practices diagnosed 32 people with HIV versus 14 in control practices. Mean CD4 count at diagnosis was 356 cells per μL (SD 254) intervention practices versus 270 (SD 257) in control practices (adjusted difference of square root CD4 count 3·1, 95% CI -1·2 to 7·4; p=0·16);); in a pre-planned sensitivity analysis excluding patients diagnosed via antenatal care, the difference was 6·4 (95% CI, 1·2 to 11·6; p=0·017). Rate of HIV diagnosis was 0·30 (95% CI 0·11 to 0·85) per 10 000 patients per year in intervention practices versus 0·07 (0·02 to 0·20) in control practices (adjusted ratio of geometric means 4·51, 95% CI 1·27 to 16·05; p=0·021). 55% of patients in intervention practices versus 73% in control practices had CD4 count less than 350 cells per μL (risk ratio 0·75, 95% CI 0·53 to 1·07). 28% versus 46% had CD4 count less than 200 cells per μL (0·60, 0·32 to 1·13). All patients diagnosed by rapid testing were successfully transferred into specialist care. No adverse events occurred., Interpretation: Promotion of opt-out rapid testing in general practice led to increased rate of diagnosis, and might increase early detection, of HIV. We therefore recommend implementation of HIV screening in general practices in areas with high HIV prevalence., Funding: UK Department of Health, NHS City and Hackney., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
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- 2015
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