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4. Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy : not all AIDS-defining conditions are created equal

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Antiretroviral Therapy Cohort Collaboration Mocroft A, Sterne JA, Egger M, May M, Grabar S, Furrer H, Sabin C, Fatkenheuer G, Justice A, Reiss P, d'Arminio Monforte A, Gill J, Hogg R, Bonnet F, Kitahata M, Staszewski S, Casabona J, Harris R, Saag M, Chêne G, Costagliola D, Dabis F, D'Arminio Monforte A, de Wolf F, Ledergerber B, Mocroft A, Phillips A, Weller I, Sterne J, Abgrall S, Barin F, Bentata M, Billaud E, Boué F, Burty C, Cabié A, Cotte L, De Truchis P, Duval X, Duvivier C, Enel P, Fredouille Heripret L, Gasnault J, Gaud C, Gilquin J, Katlama C, Khuong MA, Lang JM, Lascaux AS, Launay O, Mahamat A, Mary Krause M, Matheron S, Meynard JL, Pavie J, Pialoux G, Pilorgé F, Poizot Martin I, Pradier C, Reynes J, Rouveix E, Simon A, Tattevin P, Tissot Dupont H, Viard JP, Viget N, Pariente Khayat A, Salomon V, Jacquemet N, Rivet A, Guiguet M, Kousignian I, Lanoy E, Lièvre L, Potard V, Selinger Leneman H, Bouvet E, Crickx B, Ecobichon JL, Leport C, Picard Dahan C, Yeni P, Tisne Dessus D, Weiss L, Salmon D, Sicard D, Auperin I, Roudière L, Fior R, Delfraissy JF, Goujard C, Jung C, Lesprit P, Desplanque N, Meyohas MC, Picard O, Cadranel J, Mayaud C, Bricaire F, Herson S, Clauvel JP, Decazes JM, Gerard L, Molina JM, Diemer M, Sellier P, Berthé H, Dupont C, Chandemerle C, Mortier E, Honoré P, Jeantils V, Tassi S, Mechali D, Taverne B, Gourdon F, Laurichesse H, Fresard A, Lucht F, Eglinger P, Faller JP, Bazin C, Verdon R, Boibieux A, Peyramond D, Livrozet JM, Touraine JL, Trepo C, Ravaux I, Delmont JP, Moreau J, Gastaut JA, Retornaz F, Soubeyrand J, Allegre T, Blanc PA, Galinier A, Ruiz JM, Lepeu G, Granet Brunello P, Esterni JP, Pelissier L, Cohen Valensi R, Nezri M, Chadapaud S, Laffeuillade A, May T, Rabaud C, Raffi F, Arvieux C, Michelet C, Borsa Lebas F, Caron F, Fraisse P, Rey D, Arlet Suau E, Cuzin L, Massip P, Thiercelin Legrand MF, Yasdanpanah Y, Pradinaud R, Sobesky M, Contant M, Montroni M, Scalise G, Braschi MC, Riva A, Tirelli U, Martellotta F, Pastore G, Ladisa N, Suter F, Arici C, Chiodo F, Colangeli V, Fiorini C, Carosi G, Cristini G, Torti C, Minardi C, Bertelli D, Quirino T, Manconi PE, Piano P, Cosco L, Scerbo A, Vecchiet J, D'Alessandro M, Santoro D, Pusterla L, Carnevale G, Lorenzotti S, Viganò P, Mena M, Ghinelli F, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Lo Caputo S, Grisorio B, Ferrara S, Grima P, Grima PF, Pagano G, Cassola G, Alessandrini A, Piscopo R, Toti M, Trezzi M, Soscia F, Tacconi L, Orani A, Perini P, Scasso A, Vincenti A, Chiodera F, Castelli P, Scalzini A, Palvarini L, Moroni M, Lazzarin A, Rizzardini G, Caggese L, Cicconi P, Galli A, Merli S, Pastecchia C, Moioli MC, Esposito R, Mussini C, Abrescia N, Chirianni A, Izzo CM, Piazza M, De Marco M, Viglietti R, Manzillo E, Colomba A, Abbadessa V, Prestileo T, Mancuso S, Ferrari C, Pizzaferri P, Filice G, Minoli L, Bruno R, Novati S, Baldelli F, Camanni G, Petrelli E, Cioppi A, Alberici F, Ruggieri A, Menichetti F, Martinelli C, De Stefano C, La Gala A, Ballardini G, Rizzo E, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Cauda R, Dianzani F, Ippolito G, Antinori A, Antonucci G, Ciardi M, Narciso P, Petrosillo N, Vullo V, De Luca A, Zaccarelli M, Acinapura R, De Longis P, Trotta MP, Noto P, Lichtner M, Capobianchi MR, Carletti F, Girardi E, Pezzotti P, Rezza G, Mura MS, Mannazzu M, Caramello P, Di Perri G, Orofino GC, Sciandra M, Grossi PA, Basilico C, Poggio A, Bottari G, Raise E, Ebo F, Pellizzer G, Buonfrate D, Resta F, Loso K, Cozzi Lepri A, Battegay M, Bernasconi E, Böni J, Bucher H, Bürgisser P, Cattacin S, Cavassini M, Dubs R, Elzi L, Erb P, Fischer M, Flepp M, Fontana A, Francioli P, Gorgievski M, Günthard H, Hirsch H, Hirschel B, Hösli I, Kahlert C, Kaiser L, Karrer U, Kind C, Klimkait T, Martinetti G, Martinez B, Müller N, Nadal D, Opravil M, Paccaud F, Pantaleo G, Rickenbach M, Rudin C, Schmid P, Schultze D, Schüpbach J, Speck R, Taffé P, Tarr P, Telenti A, Trkola A, Vernazza P, Weber R, Yerly S, Gras LA, van Sighem AI, Smit C, Bronsveld W, Hillebrand Haverkort ME, Prins JM, Branger J, Eeftinck Schattenkerk JK, Gisolf J, Godfried MH, Lange JM, Lettinga KD, van der Meer JT, Nellen FJ, van der Poll T, Ruys TA, Steingrover R, Vermeulen JN, Vrouenraets SM, van Vugt M, Wit FW, Kuijpers TW, Pajkrt D, Scherpbier HJ, van Eeden A, Brinkman K, van den Berk GE, Blok WL, Frissen PH, Roos JC, Schouten WE, Mulder JW, van Gorp EC, Wagenaar J, Veenstra J, Danner SA, Van Agtmael MA, Claessen FA, Perenboom RM, Rijkeboer A, van Vonderen MG, Richter C, van der Berg J, Vriesendorp R, Jeurissen FJ, Kauffmann RH, Pogány K, Bravenboer B, ten Napel CH, Kootstra GJ, Sprenger HG, van Assen S, van Leeuwen JT, Doedens R, Scholvinck EH, ten Kate RW, Soetekouw R, van Houte D, Polée MB, Kroon FP, van den Broek PJ, van Dissel JT, Schippers EF, Schreij G, van der Geest S, Lowe S, Verbon A, Koopmans PP, Van Crevel R, de Groot R, Keuter M, Post F, van der Ven AJ, Warris A, van der Ende ME, Gyssens IC, van der Feltz M, Nouwen JL, Rijnders BJ, de Vries TE, Driessen G, van der Flier M, Hartwig NG, Juttman JR, van Kasteren ME, Van de Heul C, Hoepelman IM, Schneider MM, Bonten MJ, Borleffs JC, Ellerbroek PM, Jaspers CA, Mudrikove T, Schurink CA, Gisolf EH, Geelen SP, Wolfs TF, Faber T, Tanis AA, Groeneveld PH, den Hollander JG, Duits AJ, Winkel K, Back NK, Bakker ME, Berkhout B, Jurriaans S, Zaaijer HL, Cuijpers T, Rietra PJ, Roozendaal KJ, Pauw W, van Zanten AP, Smits PH, von Blomberg BM, Savelkoul P, Pettersson A, Swanink CM, Franck PF, Lampe AS, Jansen CL, Hendriks R, Benne CA, Veenendaal D, Storm H, Weel J, van Zeijl JH, Kroes AC, Claas HC, Bruggeman CA, Goossens VJ, Galama JM, Melchers WJ, Poort YA, Doornum GJ, Niesters MG, Osterhaus AD, Schutten M, Buiting AG, Swaans CA, Boucher CA, Schuurman R, Boel E, Jansz AF, Veldkamp A, Beijnen JH, Huitema AD, Burger DM, Hugen PW, van Kan HJ, Losso M, Duran A, Vetter N, Karpov I, Vassilenko A, Mitsura VM, Suetnov O, Clumeck N, De Wit S, Poll B, Colebunders R, Kostov K, Begovac J, Machala L, Rozsypal H, Sedlacek D, Nielsen J, Lundgren J, Benfield T, Kirk O, Gerstoft J, Katzenstein T, Hansen AB, Skinhøj P, Pedersen C, Oestergaard L, Zilmer K, Ristola M, Girard PM, Vanhems P, Rockstroh J, Schmidt R, van Lunzen J, Degen O, Stellbrink HJ, Bogner J, Kosmidis J, Gargalianos P, Xylomenos G, Perdios J, Panos G, Filandras A, Karabatsaki E, Sambattakou H, Banhegyi D, Mulcahy F, Yust I, Turner D, Burke M, Pollack S, Hassoun G, Maayan S, Chiesi A, Mazeu I, Pristera R, Gabbuti A, Montesarchio E, Gargiulo M, Iacomi F, Vlassi C, Finazzi R, Galli M, Ridolfo A, Rozentale B, Aldins P, 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, Mularska E, Trocha H, Antunes F, Valadas E, Mansinho K, Maltez F, Duiculescu D, Rakhmanova A, Vinogradova E, Buzunova S, Jevtovic D, Mokrás M, Staneková D, González Lahoz J, Soriano V, Martin Carbonero L, Labarga P, Clotet B, Jou A, Conejero J, Tural C, Gatell JM, Miró JM, Domingo P, Gutierrez M, Mateo G, Sambeat MA, Karlsson A, Persson PO, Flamholc L, Boffi E, Kravchenko E, Chentsova N, Barton S, Johnson AM, Mercey D, Johnson MA, Murphy M, Weber J, Scullard G, Fisher M, Brettle R, Gatell J, Gazzard B, Friis Møller N, Bannister W, Ellefson M, Borch A, Podlekareva D, Holkmann Olsen C, Kjaer J, Peters L, Reekie J, Raffanti S, Dieterch D, Becker S, Scarsella A, Fusco G, Most B, Balu R, Rana R, Beckerman R, Ising T, Fusco J, Irek R, Johnson B, Hirani A, DeJesus E, Pierone G, Lackey P, Irek C, Johnson A, Burdick J, Leon S, Arch J, Helm EB, Carlebach A, Müller A, Haberl A, Nisius G, Lennemann T, Stephan C, Bickel M, Mösch M, Gute P, Locher L, Lutz T, Klauke S, Knecht G, Khaykin P, Doerr HW, Stürmer M, Babacan E, von Hentig N, Beylot J, Dupon M, Longy Boursier M, Pellegrin JL, Ragnaud JM, Salamon R, Thiébaut R, Lewden C, Lawson Ayayi S, Mercié P, Moreau JF, Morlat P, Bernard N, Lacoste D, Malvy D, Neau D, Blaizeau MJ, Decoin M, Delveaux S, Hannapier C, Labarrère S, Lavignolle Aurillac V, Uwamaliya Nziyumvira B, Palmer G, Touchard D, Balestre E, Alioum A, Jacqmin Gadda H, Bonarek M, Coadou B, Gellie P, Nouts C, Bocquentin F, Dutronc H, Lafarie S, Aslan A, Pistonne T, Thibaut P, Vatan R, Chambon D, De La Taille C, Cazorla C, Ocho A, Viallard JF, Caubet O, Cipriano C, Lazaro E, Couzigou P, Castera L, Fleury H, Lafon ME, Masquelier B, Pellegrin I, Breilh D, Blanco P, Loste P, Caunègre L, Bonnal F, Farbos S, Ferrand M, Ceccaldi J, Tchamgoué S, De Witte S, Buy E, Alexander C, Barrios R, Braitstein P, Brumme Z, Chan K, Cote H, Gataric N, Geller J, Guillemi S, Harrigan PR, Harris M, Joy R, Levy A, Montaner J, Montessori V, Palepu A, Phillips E, Phillips P, Press N, Tyndall M, Wood E, Yip B, Bhagani S, Breen R, Byrne P, Carroll A, Cuthbertson Z, Dunleavy A, Geretti AM, Heelan B, Johnson M, Kinloch de Loes S, Lipman M, Madge S, Marshall N, Nair D, Nebbia G, Prinz B, Shah S, Swader L, Tyrer M, Youle M, Chaloner C, Grabowska H, Holloway J, Puradiredja J, Ransom D, Tsintas R, Bansi L, Fox Z, Harris E, Hill T, Lampe F, Lodwick R, Smith C, Amoah E, Booth C, Clewley G, Garcia Diaz A, Gregory B, Janossy G, Labbett W, Thomas M, Read R, Krentz H, Beckthold B, Schmeisser N, Alquézar A, Esteve A, Podzamczer D, Murillas J, Romero A, Agustí C, Agüero F, Ferrer E, Riera M, Segura F, Navarro G, Force L, Vilaró J, Masabeu A, García I, Guadarrama M, Montoliu A, Ortega N, Lazzari E, Puchol E, Sanchez M, Blanco JL, Garcia Alcaide F, Martinez E, Mallolas J, López Dieguez M, García Goez JF, Sirera G, Romeu J, Negredo E, Miranda C, Capitan MC, Olmo M, Barragan P, Saumoy M, Bolao F, Cabellos C, Peña C, Sala M, Cervantes M, Jose Amengual M, Navarro M, Penelo E, Barrufet P, Raper JL, Mugavero MJ, Willig JH, Schumacher J, Chang PW, Westfall AO, Cloud G, Lin HY, Acosta EP, Colette Kempf M, Allison JJ, Pisu M., NAPPA, SALVATORE, Mocroft, A, Mancuso, S, Antiretroviral Therapy Cohort Collaboration Mocroft, A, Sterne, Ja, Egger, M, May, M, Grabar, S, Furrer, H, Sabin, C, Fatkenheuer, G, Justice, A, Reiss, P, d'Arminio Monforte, A, Gill, J, Hogg, R, Bonnet, F, Kitahata, M, Staszewski, S, Casabona, J, Harris, R, Saag, M, Chêne, G, Costagliola, D, Dabis, F, D'Arminio Monforte, A, de Wolf, F, Ledergerber, B, Phillips, A, Weller, I, Sterne, J, Abgrall, S, Barin, F, Bentata, M, Billaud, E, Boué, F, Burty, C, Cabié, A, Cotte, L, De Truchis, P, Duval, X, Duvivier, C, Enel, P, Fredouille Heripret, L, Gasnault, J, Gaud, C, Gilquin, J, Katlama, C, Khuong, Ma, Lang, Jm, Lascaux, A, Launay, O, Mahamat, A, Mary Krause, M, Matheron, S, Meynard, Jl, Pavie, J, Pialoux, G, Pilorgé, F, Poizot Martin, I, Pradier, C, Reynes, J, Rouveix, E, Simon, A, Tattevin, P, Tissot Dupont, H, Viard, Jp, Viget, N, Pariente Khayat, A, Salomon, V, Jacquemet, N, Rivet, A, Guiguet, M, Kousignian, I, Lanoy, E, Lièvre, L, Potard, V, Selinger Leneman, H, Bouvet, E, Crickx, B, Ecobichon, Jl, Leport, C, Picard Dahan, C, Yeni, P, Tisne Dessus, D, Weiss, L, Salmon, D, Sicard, D, Auperin, I, Roudière, L, Fior, R, Delfraissy, Jf, Goujard, C, Jung, C, Lesprit, P, Desplanque, N, Meyohas, Mc, Picard, O, Cadranel, J, Mayaud, C, Bricaire, F, Herson, S, Clauvel, Jp, Decazes, Jm, Gerard, L, Molina, Jm, Diemer, M, Sellier, P, Berthé, H, Dupont, C, Chandemerle, C, Mortier, E, Honoré, P, Jeantils, V, Tassi, S, Mechali, D, Taverne, B, Gourdon, F, Laurichesse, H, Fresard, A, Lucht, F, Eglinger, P, Faller, Jp, Bazin, C, Verdon, R, Boibieux, A, Peyramond, D, Livrozet, Jm, Touraine, Jl, Trepo, C, Ravaux, I, Delmont, Jp, Moreau, J, Gastaut, Ja, Retornaz, F, Soubeyrand, J, Allegre, T, Blanc, Pa, Galinier, A, Ruiz, Jm, Lepeu, G, Granet Brunello, P, Esterni, Jp, Pelissier, L, Cohen Valensi, R, Nezri, M, Chadapaud, S, Laffeuillade, A, May, T, Rabaud, C, Raffi, F, Arvieux, C, Michelet, C, Borsa Lebas, F, Caron, F, Fraisse, P, Rey, D, Arlet Suau, E, Cuzin, L, Massip, P, Thiercelin Legrand, Mf, Yasdanpanah, Y, Pradinaud, R, Sobesky, M, Contant, M, Montroni, M, Scalise, G, Braschi, Mc, Riva, A, Tirelli, U, Martellotta, F, Pastore, G, Ladisa, N, Suter, F, Arici, C, Chiodo, F, Colangeli, V, Fiorini, C, Carosi, G, Cristini, G, Torti, C, Minardi, C, Bertelli, D, Quirino, T, Manconi, Pe, Piano, P, Cosco, L, Scerbo, A, Vecchiet, J, D'Alessandro, M, Santoro, D, Pusterla, L, Carnevale, G, Lorenzotti, S, Viganò, P, Mena, M, Ghinelli, F, Sighinolfi, L, Leoncini, F, Mazzotta, F, Pozzi, M, Lo Caputo, S, Grisorio, B, Ferrara, S, Grima, P, Grima, Pf, Pagano, G, Cassola, G, Alessandrini, A, Piscopo, R, Toti, M, Trezzi, M, Soscia, F, Tacconi, L, Orani, A, Perini, P, Scasso, A, Vincenti, A, Chiodera, F, Castelli, P, Scalzini, A, Palvarini, L, Moroni, M, Lazzarin, A, Rizzardini, G, Caggese, L, Cicconi, P, Galli, A, Merli, S, Pastecchia, C, Moioli, Mc, Esposito, R, Mussini, C, Abrescia, N, Chirianni, A, Izzo, Cm, Piazza, M, De Marco, M, Viglietti, R, Manzillo, E, Nappa, Salvatore, Colomba, A, Abbadessa, V, Prestileo, T, Ferrari, C, Pizzaferri, P, Filice, G, Minoli, L, Bruno, R, Novati, S, Baldelli, F, Camanni, G, Petrelli, E, Cioppi, A, Alberici, F, Ruggieri, A, Menichetti, F, Martinelli, C, De Stefano, C, La Gala, A, Ballardini, G, Rizzo, E, Magnani, G, Ursitti, Ma, Arlotti, M, Ortolani, P, Cauda, R, Dianzani, F, Ippolito, G, Antinori, A, Antonucci, G, Ciardi, M, Narciso, P, Petrosillo, N, Vullo, V, De Luca, A, Zaccarelli, M, Acinapura, R, De Longis, P, Trotta, Mp, Noto, P, Lichtner, M, Capobianchi, Mr, Carletti, F, Girardi, E, Pezzotti, P, Rezza, G, Mura, M, Mannazzu, M, Caramello, P, Di Perri, G, Orofino, Gc, Sciandra, M, Grossi, Pa, Basilico, C, Poggio, A, Bottari, G, Raise, E, Ebo, F, Pellizzer, G, Buonfrate, D, Resta, F, Loso, K, Cozzi Lepri, A, Battegay, M, Bernasconi, E, Böni, J, Bucher, H, Bürgisser, P, Cattacin, S, Cavassini, M, Dubs, R, Elzi, L, Erb, P, Fischer, M, Flepp, M, Fontana, A, Francioli, P, Gorgievski, M, Günthard, H, Hirsch, H, Hirschel, B, Hösli, I, Kahlert, C, Kaiser, L, Karrer, U, Kind, C, Klimkait, T, Martinetti, G, Martinez, B, Müller, N, Nadal, D, Opravil, M, Paccaud, F, Pantaleo, G, Rickenbach, M, Rudin, C, Schmid, P, Schultze, D, Schüpbach, J, Speck, R, Taffé, P, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Weber, R, Yerly, S, Gras, La, van Sighem, Ai, Smit, C, Bronsveld, W, Hillebrand Haverkort, Me, Prins, Jm, Branger, J, Eeftinck Schattenkerk, Jk, Gisolf, J, Godfried, Mh, Lange, Jm, Lettinga, Kd, van der Meer, Jt, Nellen, Fj, van der Poll, T, Ruys, Ta, Steingrover, R, Vermeulen, Jn, Vrouenraets, Sm, van Vugt, M, Wit, Fw, Kuijpers, Tw, Pajkrt, D, Scherpbier, Hj, van Eeden, A, Brinkman, K, van den Berk, Ge, Blok, Wl, Frissen, Ph, Roos, Jc, Schouten, We, Mulder, Jw, van Gorp, Ec, Wagenaar, J, Veenstra, J, Danner, Sa, Van Agtmael, Ma, Claessen, Fa, Perenboom, Rm, Rijkeboer, A, van Vonderen, Mg, Richter, C, van der Berg, J, Vriesendorp, R, Jeurissen, Fj, Kauffmann, Rh, Pogány, K, Bravenboer, B, ten Napel, Ch, Kootstra, Gj, Sprenger, Hg, van Assen, S, van Leeuwen, Jt, Doedens, R, Scholvinck, Eh, ten Kate, Rw, Soetekouw, R, van Houte, D, Polée, Mb, Kroon, Fp, van den Broek, Pj, van Dissel, Jt, Schippers, Ef, Schreij, G, van der Geest, S, Lowe, S, Verbon, A, Koopmans, Pp, Van Crevel, R, de Groot, R, Keuter, M, Post, F, van der Ven, Aj, Warris, A, van der Ende, Me, Gyssens, Ic, van der Feltz, M, Nouwen, Jl, Rijnders, Bj, de Vries, Te, Driessen, G, van der Flier, M, Hartwig, Ng, Juttman, Jr, van Kasteren, Me, Van de Heul, C, Hoepelman, Im, Schneider, Mm, Bonten, Mj, Borleffs, Jc, Ellerbroek, Pm, Jaspers, Ca, Mudrikove, T, Schurink, Ca, Gisolf, Eh, Geelen, Sp, Wolfs, Tf, Faber, T, Tanis, Aa, Groeneveld, Ph, den Hollander, Jg, Duits, Aj, Winkel, K, Back, Nk, Bakker, Me, Berkhout, B, Jurriaans, S, Zaaijer, Hl, Cuijpers, T, Rietra, Pj, Roozendaal, Kj, Pauw, W, van Zanten, Ap, Smits, Ph, von Blomberg, Bm, Savelkoul, P, Pettersson, A, Swanink, Cm, Franck, Pf, Lampe, A, Jansen, Cl, Hendriks, R, Benne, Ca, Veenendaal, D, Storm, H, Weel, J, van Zeijl, Jh, Kroes, Ac, Claas, Hc, Bruggeman, Ca, Goossens, Vj, Galama, Jm, Melchers, Wj, Poort, Ya, Doornum, Gj, Niesters, Mg, Osterhaus, Ad, Schutten, M, Buiting, Ag, Swaans, Ca, Boucher, Ca, Schuurman, R, Boel, E, Jansz, Af, Veldkamp, A, Beijnen, Jh, Huitema, Ad, Burger, Dm, Hugen, Pw, van Kan, Hj, Losso, M, Duran, A, Vetter, N, Karpov, I, Vassilenko, A, Mitsura, Vm, Suetnov, O, Clumeck, N, De Wit, S, Poll, B, Colebunders, R, Kostov, K, Begovac, J, Machala, L, Rozsypal, H, Sedlacek, D, Nielsen, J, Lundgren, J, Benfield, T, Kirk, O, Gerstoft, J, Katzenstein, T, Hansen, Ab, Skinhøj, P, Pedersen, C, Oestergaard, L, Zilmer, K, Ristola, M, Girard, Pm, Vanhems, P, Rockstroh, J, Schmidt, R, van Lunzen, J, Degen, O, Stellbrink, Hj, Bogner, J, Kosmidis, J, Gargalianos, P, Xylomenos, G, Perdios, J, Panos, G, Filandras, A, Karabatsaki, E, Sambattakou, H, Banhegyi, D, Mulcahy, F, Yust, I, Turner, D, Burke, M, Pollack, S, Hassoun, G, Maayan, S, Chiesi, A, Mazeu, I, Pristera, R, Gabbuti, A, Montesarchio, E, Gargiulo, M, Iacomi, F, Vlassi, C, Finazzi, R, Galli, M, Ridolfo, A, Rozentale, B, Aldins, P, 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, Mularska, E, Trocha, H, Antunes, F, Valadas, E, Mansinho, K, Maltez, F, Duiculescu, D, Rakhmanova, A, Vinogradova, E, Buzunova, S, Jevtovic, D, Mokrás, M, Staneková, D, González Lahoz, J, Soriano, V, Martin Carbonero, L, Labarga, P, Clotet, B, Jou, A, Conejero, J, Tural, C, Gatell, Jm, Miró, Jm, Domingo, P, Gutierrez, M, Mateo, G, Sambeat, Ma, Karlsson, A, Persson, Po, Flamholc, L, Boffi, E, Kravchenko, E, Chentsova, N, Barton, S, Johnson, Am, Mercey, D, Johnson, Ma, Murphy, M, Weber, J, Scullard, G, Fisher, M, Brettle, R, Gatell, J, Gazzard, B, Friis Møller, N, Bannister, W, Ellefson, M, Borch, A, Podlekareva, D, Holkmann Olsen, C, Kjaer, J, Peters, L, Reekie, J, Raffanti, S, Dieterch, D, Becker, S, Scarsella, A, Fusco, G, Most, B, Balu, R, Rana, R, Beckerman, R, Ising, T, Fusco, J, Irek, R, Johnson, B, Hirani, A, Dejesus, E, Pierone, G, Lackey, P, Irek, C, Johnson, A, Burdick, J, Leon, S, Arch, J, Helm, Eb, Carlebach, A, Müller, A, Haberl, A, Nisius, G, Lennemann, T, Stephan, C, Bickel, M, Mösch, M, Gute, P, Locher, L, Lutz, T, Klauke, S, Knecht, G, Khaykin, P, Doerr, Hw, Stürmer, M, Babacan, E, von Hentig, N, Beylot, J, Dupon, M, Longy Boursier, M, Pellegrin, Jl, Ragnaud, Jm, Salamon, R, Thiébaut, R, Lewden, C, Lawson Ayayi, S, Mercié, P, Moreau, Jf, Morlat, P, Bernard, N, Lacoste, D, Malvy, D, Neau, D, Blaizeau, Mj, Decoin, M, Delveaux, S, Hannapier, C, Labarrère, S, Lavignolle Aurillac, V, Uwamaliya Nziyumvira, B, Palmer, G, Touchard, D, Balestre, E, Alioum, A, Jacqmin Gadda, H, Bonarek, M, Coadou, B, Gellie, P, Nouts, C, Bocquentin, F, Dutronc, H, Lafarie, S, Aslan, A, Pistonne, T, Thibaut, P, Vatan, R, Chambon, D, De La Taille, C, Cazorla, C, Ocho, A, Viallard, Jf, Caubet, O, Cipriano, C, Lazaro, E, Couzigou, P, Castera, L, Fleury, H, Lafon, Me, Masquelier, B, Pellegrin, I, Breilh, D, Blanco, P, Loste, P, Caunègre, L, Bonnal, F, Farbos, S, Ferrand, M, Ceccaldi, J, Tchamgoué, S, De Witte, S, Buy, E, Alexander, C, Barrios, R, Braitstein, P, Brumme, Z, Chan, K, Cote, H, Gataric, N, Geller, J, Guillemi, S, Harrigan, Pr, Harris, M, Joy, R, Levy, A, Montaner, J, Montessori, V, Palepu, A, Phillips, E, Phillips, P, Press, N, Tyndall, M, Wood, E, Yip, B, Bhagani, S, Breen, R, Byrne, P, Carroll, A, Cuthbertson, Z, Dunleavy, A, Geretti, Am, Heelan, B, Johnson, M, Kinloch de Loes, S, Lipman, M, Madge, S, Marshall, N, Nair, D, Nebbia, G, Prinz, B, Shah, S, Swader, L, Tyrer, M, Youle, M, Chaloner, C, Grabowska, H, Holloway, J, Puradiredja, J, Ransom, D, Tsintas, R, Bansi, L, Fox, Z, Harris, E, Hill, T, Lampe, F, Lodwick, R, Smith, C, Amoah, E, Booth, C, Clewley, G, Garcia Diaz, A, Gregory, B, Janossy, G, Labbett, W, Thomas, M, Read, R, Krentz, H, Beckthold, B, Schmeisser, N, Alquézar, A, Esteve, A, Podzamczer, D, Murillas, J, Romero, A, Agustí, C, Agüero, F, Ferrer, E, Riera, M, Segura, F, Navarro, G, Force, L, Vilaró, J, Masabeu, A, García, I, Guadarrama, M, Montoliu, A, Ortega, N, Lazzari, E, Puchol, E, Sanchez, M, Blanco, Jl, Garcia Alcaide, F, Martinez, E, Mallolas, J, López Dieguez, M, García Goez, Jf, Sirera, G, Romeu, J, Negredo, E, Miranda, C, Capitan, Mc, Olmo, M, Barragan, P, Saumoy, M, Bolao, F, Cabellos, C, Peña, C, Sala, M, Cervantes, M, Jose Amengual, M, Navarro, M, Penelo, E, Barrufet, P, Raper, Jl, Mugavero, Mj, Willig, Jh, Schumacher, J, Chang, Pw, Westfall, Ao, Cloud, G, Lin, Hy, Acosta, Ep, Colette Kempf, M, Allison, Jj, Pisu, M., Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Infectious diseases, Other departments, General Internal Medicine, Graduate School, Global Health, Paediatric Infectious Diseases / Rheumatology / Immunology, and Medical Microbiology and Infection Prevention

Subjects
Male, Infectious diseases and international health [NCEBP 13], Lymphoma, 030312 virology, Esophageal candidiasis, Cohort Studies, 0302 clinical medicine, Interquartile range, 030212 general & internal medicine, AIDS-Related, Lymphoma, AIDS-Related, 0303 health sciences, Mortality rate, Progressive multifocal leukoencephalopathy, Hazard ratio, Prognosis, 3. Good health, Pathogenesis and modulation of inflammation [N4i 1], Infectious Diseases, Combination, Drug Therapy, Combination, Female, Infection and autoimmunity [NCMLS 1], Human, Microbiology (medical), Adult, medicine.medical_specialty, Prognosi, Anti-HIV Agents, antiretroviral therapy, Infectious Disease, Article, AIDS-Related Opportunistic Infection, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Drug Therapy, Internal medicine, medicine, Humans, AIDS-defining event, Proportional Hazards Models, AIDS-Related Opportunistic Infections/diagnosis/ mortality, Acquired Immunodeficiency Syndrome/complications/diagnosis/drug, therapy/ mortality, Anti-HIV Agents/ therapeutic use, AIDS-Related/diagnosis/mortality, Acquired Immunodeficiency Syndrome, AIDS-Related Opportunistic Infections, business.industry, Proportional hazards model, Poverty-related infectious diseases [N4i 3], Anti-HIV Agent, medicine.disease, mortality, Confidence interval, Immunology, Proportional Hazards Model, Cohort Studie, business
Abstract

Contains fulltext : 80963.pdf (Publisher’s version ) (Open Access) BACKGROUND: The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)-defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. METHODS: We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of antiretroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in

Published
2009
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12. Adverse effects of antiretroviral therapy for HIV infection.

Author

Montessori V, Press N, Harris M, Akagi L, Montaner JSG, Montessori, Valentina, Press, Natasha, Harris, Marianne, Akagi, Linda, and Montaner, Julio S G

Abstract

Long-term remission of HIV-1 disease can be readily achieved by combinations of antiretroviral agents. The suppression of plasma viral loads to less than the limit of quantification of the most sensitive commercially available assays (i.e., less than 50 copies/mL) and the coincident improvement in CD4 T cell counts is associated with resolution of established opportunistic infections and a decrease in the risk of new opportunistic infections. However, prolonged treatment with combination regimens can be difficult to sustain because of problems with adherence and toxic effects. All antiretroviral drugs can have both short-term and long-term adverse events. The risk of specific side effects varies from drug to drug, from drug class to drug class, and from patient to patient. A better understanding of the adverse effects of antiretroviral agents is of interest not only for HIV specialists as they try to optimize therapy, but also for other physicians who care for HIV-positive patients. [ABSTRACT FROM AUTHOR]

Published
2004

13. The impact of zidovudine on dementia-free survival in a population of HIV-positive men and women on antiretroviral therapy.

Author

Cornelisse, Peter G. A., Montessori, Val, Yip, Benita, Craib, Kevin J. P., O'Shaughnessy, Michael V., Montaner, Julio S. G., Hogg, Robert S., Cornelisse, P G, Montessori, V, Yip, B, Craib, K J, O'Shaughnessy, M V, Montaner, J S, and Hogg, R S

Subjects
HIV-positive persons, AZIDOTHYMIDINE, ANTIRETROVIRAL agents, DEMENTIA, CD4 antigen, ANTI-HIV agents, AIDS dementia complex, COMPARATIVE studies, HIV infections, RESEARCH methodology, MEDICAL cooperation, PROGNOSIS, RESEARCH, EVALUATION research, DISEASE progression, CD4 lymphocyte count
Abstract

Our objective was to characterize the effect of zidovudine therapy on AIDS dementia complex (dementia) free survival among HIV-infected men and women in a population-based cohort with free access to antiretroviral therapy in the province of British Columbia. Time to diagnosis of dementia among individuals was examined on the basis of zidovudine duration, CD4+ cell count at first treatment, gender, and transmission group [men having sex with men (MSM), intravenous drug users (IDU), heterosexuals]. We restricted the analysis to subjects with CD4+ cells counts within 12 months prior to treatment start date. Among 641 participants eligible for analysis, median duration of follow-up was 3.6 years, under which 86 (9.3%) events of dementia occurred. Participants were less likely to develop dementia with: increased zidovudine exposure (OR=0.26, 95% CI: 0.14-0.49), at least 260 CD4+ cells/mm3 (median) (OR=0.52, 95% CI: 0.34-0.78), and MSM risk group (OR=0.57, 95% CI: 0.35-0.94). Those infected through heterosexual contact had an increased risk (RR=2.04, 95% CI: 1.02-4.07). Using Cox's proportional hazards model, controlling for CD4+ cell count at treatment start date, independent predictors of dementia-free survival were: duration of zidovudine (OR=0.28, 95% CI: 0.15-0.52) and MSM transmission group (OR=0.61, 95% CI: 0.37-1.00). In this observational treatment cohort, factors associated with dementia-free survival include duration of zidovudine (AZT) therapy and MSM transmission group. It is not clear from these data whether the AZT protective effect is exclusive to this agent or whether other therapies might offer a similar protective effect. [ABSTRACT FROM AUTHOR]

Published
2000
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14. Quality of Life in Patients Treated with First-Line Antiretroviral Therapy Containing Nevirapine And/Or Efavirenz

Author

van Leth, Frank, Conway, Brian, Laplumé, Hector, Martin, Des, Fisher, Martin, Jelaska, Ante, Wit, Ferdinand W, Lange, Joep MA, Laplumé, H, Lasala, MB, Losso, MH, Bogdanowicz, E, Lattes, R, Krolewiecki, A, Zala, C, Orcese, C, Terlizzi, S, Duran, A, Ebensrteijn, J, Bloch, M, Russell, O, Russell, DB, Roth, NR, Eu, B, Austin, D, Gowers, A, Quan, D, Demonty, J, Peleman, R, Vandercam, B, Vogelaers, D, van der Gucht, B, van Wanzeele, F, Moutschen, MM, Badaro, R, Grinsztejn, B, Schechter, M, Uip, D, Netto, EN, Coelho, SS, Badaró, F, Pilotto, JH, Schubach, A, Barros, ML, Leite, OHM, Kiffer, CRV, Wunsch, CT, Nunes, D, Catalani, A, de Cassia Alves, Lira R, Dossin, TJ, D'Alló de Oliveira, MT, Martini, S, Conway, B, de Wet, JJ, Montaner, JSG, Murphy, C, Woodfall, B, Sestak, P, Phillips, P, Montessori, V, Harris, M, Tesiorowski, A, Willoughby, B, Voigt, R, Farley, J, Reynolds, R, Devlaming, S, Livrozet, JM, Rozenbaum, W, Sereni, D, Valantin, MA, Lascoux, C, Milpied, B, Brunet, C, Billaud, E, Huart, A, Reliquet, V, Charonnat, MF, Sicot, M, Esnault, JL, Slama, L, Staszewski, S, Bickel, M, Lazanas, MK, Stavrianeas, N, Mangafas, N, Zagoreos, I, Kourkounti, S, Paparizos, V, Botsi, Ch, Clarke, S, Brannigan, E, Boyle, N, Chiriani, A, Leoncini, F, Montella, F, Francesco, L, Ambu, S, Farese, A, Gargiulo, M, Di Sora, F, Lavria, F, Folgori, F, Beniowski, M, Boron Kaczmarska, A, Halota, W, Prokopowicz, D, Bander, DB, Leszuzyszyn-Pynka, MLP, Wnuk, AW, Bakowska, E, Pulik, P, Flisiak, R, Wiercinska-Drapalo, A, Mularska, E, Witor, A, Antunes, F, Sarmento, RSE, Doroana, M, Horta, AA, Vasconcelos, O, Andrews, SM, Huisamen, CB, Johnson, D, Martin, O, Bekker, L-G, Maartens, G, Wilson, D, Visagie, CJ, David, NJ, Rattley, M, Nettleship, E, Martin, DJ, Keyser, V, Moraites, TM, Moorhouse, MA, Pitt, JA, Orrell, CJ, Bester, C, Parboosing, R, Moodley, P, Gathiram, V, Woolf, D, Bernasconi, E, Magenta, L, Cardiello, P, Kroon, E, Ungsedhapand, C, Fisher, M, Wilkins, EGL, Stockwell, E, Day, J, Daintith, RS, Perry, N, Timaeus, C, Intosh-Roffet, J Mc, Powell, A, Youle, M, Tyrer, M, Madge, S, Drinkwater, A, Cuthbertson, Z, Carroll, A, Becker, S, Katner, H, Rimland, D, Saag, MS, Thompson, M, Witt, M, Aguilar, MM, LaVoy, A, Illeman, M, Guerrero, M, Gatell, J, Belsey, E, Hirschel, B, Potarca, A, Cronenberg, M, Kreekel, L, Meester, R, Khodabaks, J, Botma, H-J, Esrhir, N, Farida, I, Feenstra, M, Jansen, K, Klotz, A, Mulder, M, Ruiter, G, Bass, CB, Pluymers, E, de Vlegelaer, E, Leeneman (VCL), R, Carlier, H, van Steenberge, E, and Hall, D

Abstract

Objective To assess whether differences in safety profiles between nevirapine (NVP) and efavirenz (EFV), as observed in the 2NN study, translated into differences in ‘health related quality of life’ (HRQoL).Design A sub-study of the 2NN study, with antiretro-viral-naive patients randomly allocated to NVP (once or twice daily), EFV or NVP+EFV, in addition to stavudine and lamivudine.Methods Comparing differences in changes of HRQoL over 48 weeks as measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire, using analysis of variance.Results The 2NN study enrolled 1216 patients. No validated questionnaires were available for 244 patients, and 55 patients had no HRQoL data at all, leaving 917 patients eligible for this sub-study. A total of 471 (51%) had HRQoL measurements both at baseline and week 48. The majority (69%) of patients without HRQoL measurements did, however, complete the study. The change in the physical health score (PHS) was 3.9 for NVP, 3.4 for EFV and 2.4 for NVP+EFV (P=0.712). For the mental health score (MHS) these values were 6.1, 7.0 and 3.9, respectively (P=0.098). A baseline plasma HIV-1 RNA concentration (pVL) =100 000 copies/ml and a decline in pVL (per log10) were independently associated with an increase of PHS. An increase of MHS was only associated with pVL decline. Patients experiencing an adverse event during follow-up had a comparable change in PHS but a significantly smaller change in MHS, compared with those without an adverse event.Conclusions First-line ART containing NVP and/or EFV leads to an improvement in HRQoL. The gain in HRQoL was similar for NVP and EFV, but slightly lower for the combination of these drugs.

Published
2004
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15. HIV Lipodystrophy Case Definition using Artificial Neural Network Modelling

Author

Ioannidis, John PA, Trikalinos, Thomas A, Law, Matthew, Carr, Andrew, Carr, A, Barr, D, Cooper, DA, Emery, S, Grinspoon, S, Ioannidis, J, Lewis, R, Law, M, Lichtenstein, K, Murray, J, Pizzuti, D, Powderly, WG, Rozenbaum, W, Schambelan, M, Puls, R, Emery, S, Moore, A, Miller, J, Carr, A, Belloso, WH, Ivalo, SA, Clara, LO, Barcan, LA, Stern, LD, Galich, AM, Perman, MI, Losso, M, Duran, A, Toibaro, J, Baker, D, Vale, R, McFarlane, R, MacLeod, H, Kidd, J, Genn, B, Carr, A, Fielden, R, Mallal, S, French, M, Cain, A, Skett, J, Maxwell, D, Mijch, A, Hoy, J, Pierce, A, McCormick, C, De Graaf, B, Falutz, J, Vatistas, J, Dion, L, Montaner, J, Harris, M, Phillips, P, Montessori, V, Valyi, M, Stewart, W, Walmsley, S, Casciaro, L, Lundgren, J, Andersen, O, Gronholdt, A, Beguinot, I, Mercié, P, Chêne, G, Reynes, J, Cotte, L, Rozenbaum, W, Nait-Ighil, L, Slama, L, Nguyen, TH, Rousselle, C, Viard, J-P, Roudière, L, Maignan, A, Burgard, M, Mauss, S, Schmutz, G, Scholten, S, Oka, S, Fraser, H, Ishihara, M, Itoh, K, Reiss, P, van der Valk, M, Leunissen, P, Nievaard, M, van EckSmit, B, Kujik, C can, Paton, N, Peperstraete, B, Karim, F, Khim, C Y, Ong, S, Gatell, J, Martinez, E, Milinkovic, A, Churchill, D, Timaeus, C, Maher, T, Perry, N, Bray, A, Moyle, G, Baldwin, C, Higgs, C, Reynolds, B, Carpenter, C, Bausserman, L, Fiore, T, DiSpigno, M, Cohen, C, Hellinger, J, Foy, K, Hubka, S, Riccio, B, El-Sadr, W, Raghavan, S, Chowdury, N, de Vries, B, Miller, S, Hammer, S, Crawford, M, Chang, S, Dobkin, J, Quagliarello, B, Gallagher, D, Punyanitya, M, Kessler, H, Tenorio, A, Kjos, S, Falloon, J, Lane, HC, Rock, D, Ehler, L, Lichtenstein, K, McClain, T, Murphy, R, Milne, P, Powderly, W, Aberg, J, Klebert, M, Conklin, M, Ward, D, Green, L, and Stearn, B

Abstract

Objective A case definition of HIV lipodystrophy has recently been developed from a combination of clinical, metabolic and imaging/body composition variables using logistic regression methods. We aimed to evaluate whether artificial neural networks could improve the diagnostic accuracy.Methods The database of the case-control Lipodystrophy Case Definition Study was split into 504 subjects (265 with and 239 without lipodystrophy) used for training and 284 independent subjects (152 with and 132 without lipodystrophy) used for validation. Back-propagation neural networks with one or two middle layers were trained and validated. Results were compared against logistic regression models using the same information.Results Neural networks using clinical variables only (41 items) achieved consistently superior performance than logistic regression in terms of specificity, overall accuracy and area under the ROC curve. Their average sensitivity and specificity were 72.4 and 71.2%, as compared with 73.0 and 62.9% for logistic regression, respectively (area under the ROC curve, 0.784 vs 0.748). The discriminating performance of the neural networks was largely unaffected when built excluding 13 parameters that patients may not have readily available. The average sensitivity and specificity of the neural networks remained the same when metabolic variables were also considered (total 60 items) without a clear advantage against logistic regression (overall accuracy 71.8%). The performance of networks considering also body composition variables was similar to that of logistic regression (overall accuracy 78.5% for both).Conclusions Neural networks may offer a means to improve the discriminating performance for HIV lipodystrophy, when only clinical data are available and a rapid approximate diagnostic decision is needed. In this context, information on metabolic parameters is apparently not helpful in improving the diagnosis of HIV lipodystrophy, unless imaging and body composition studies are also obtained.

Published
2003
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16. Incidence of tuberculosis among HIV-infected patients receiving highly active antiretroviral therapy in Europe and North America

Author

Costagliola, D., Dabis, F., Monforte, Ad, Wolf, F., Egger, M., Fatkenheuer, G., Gill, J., Hogg, R., Justice, A., Ledergerber, B., Lundgren, J., May, M., Phillips, A., Reiss, P., Sabin, C., Staszewski, S., Sterne, J., Weller, I., Beckthold, B., Yip, B., Dauer, B., Fusco, J., Grabar, S., Lanoy, E., Junghans, C., Lavignolle, V., Leth, F., Pereira, E., Pezzotti, P., Schmeisser, N., Billaud, E., Boue, F., Duval, X., Duvivier, C., Enel, P., Fournier, S., Gasnault, J., Gaud, C., Gilquin, J., Khuong, Ma, Lang, Jm, Mary-Krause, M., Matheron, S., Meyohas, Mc, Pialoux, G., Poizot-Martin, I., Pradier, C., Rouveix, E., Salmon-Ceron, D., Sobel, A., Tattevin, P., Tissot-Dupont, H., Yasdanpanah, Y., Aronica, E., Tirard-Fleury, V., Tortay, I., Abgrall, S., Guiguet, M., Leneman, H., Lievre, L., Potard, V., Saidi, S., Vilde, Jl, Leport, C., Yeni, P., Bouvet, E., Gaudebout, C., Crickx, B., Picard-Dahan, C., Weiss, L., Tisne-Dessus, D., Sicard, D., Salmon, D., Auperin, I., Viard, Jp, Roudiere, L., Delfraissy, Jf, Goujard, C., Lesprit, P., Jung, C., Meynard, Jl, Picard, O., Desplanque, N., Cadranel, J., Mayaud, C., Rozenbaum, W., Bricaire, F., Katlama, C., Herson, S., Simon, A., Decazes, Jm, Molina, Jm, Clauvel, Jp, Gerard, L., Widal, Ghlf, Sellier, P., Diemer, M., Dupont, C., Berthe, H., Saiag, P., Mortier, L., Mortier, E., Chandemerle, C., Truchis, P., Bentata, M., Honore, P., Tassi, S., Jeantils, V., Mechali, D., Taverne, B., Laurichesse, H., Gourdon, F., Lucht, F., Fresard, A., Faller, Jp, Eglinger, P., Bazin, C., Verdon, R., Peyramond, D., Boibieux, A., Touraine, Jl, Livrozet, Jm, Trepo, C., Cotte, L., Ravaux, I., Delmont, Jp, Moreau, J., Gastaut, Ja, Soubeyrand, J., Retornaz, F., Blanc, Pa, Allegre, T., Galinier, A., Ruiz, Jm, Lepeu, G., Granet-Brunello, P., Pelissier, L., Esterni, Jp, Nezri, M., Cohen-Valensi, R., Laffeuillade, A., Chadapaud, S., Reynes, J., May, T., Rabaud, C., Raffi, F., Pugliese, P., Michelet, C., Arvieux, C., Caron, F., Borsa-Lebas, F., Fraisse, P., Massip, P., Cuzin, L., Arlet-Suau, E., Legrand, Mft, Sobesky, M., Pradinaud, R., Guyon, F., Contant, M., Montroni, M., Scalise, G., Braschi, Mc, Aviano, Ar, Tirelli, U., Cinelli, R., Pastore, G., Ladisa, N., Minafra, G., Suter, F., Arici, C., Chiodo, F., Colangeli, V., Fiorini, C., Coronado, O., Carosi, G., Cadeo, Gp, Torti, C., Minardi, C., Bertelli, D., Rizzardini, G., Melzi, S., Manconi, Pe, Catanzaro, Pp, Cosco, L., Scerbo, A., Vecchiet, J., D Alessandro, M., Santoro, D., Pusterla, L., Carnevale, G., Citterio, P., Vigano, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Pozzi, M., Lo Caputo, S., Angarano, G., Grisorio, B., Saracino, A., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Cassola, G., Alessandrini, A., Piscopo, R., Toti, M., Chigiotti, S., Soscia, F., Tacconi, L., Orani, A., Perini, P., Scasso, A., Vincenti, A., Chiodera, F., Castelli, P., Scalzini, A., Palvarini, L., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, Gm, Caggese, L., Repetto, D., Galli, A., Merli, S., Pastecchia, C., Moioli, Mc, Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, Cm, Piazza, M., Marco, M., Viglietti, R., Manzillo, E., Nappa, S., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Ferrari, C., Pizzaferri, P., Filice, G., Minoli, L., Bruno, R., Novati, S., Baldelli, F., Tinca, M., Petrelli, E., Cioppi, A., Alberici, F., Ruggieri, A., Menichetti, F., Martinelli, C., Stefano, C., La Gala, A., Ballardini, G., Rizzo, E., Magnani, G., Ursitti, Ma, Arlotti, M., Ortolani, P., Cauda, R., Dianzani, F., Ippolito, G., Antinori, A., Antonucci, G., D Elia, S., Narciso, P., Petrosillo, N., Vullo, V., Luca, A., Bacarelli, A., Zaccarelli, M., Acinapura, R., Longis, P., Brandi, A., Trotta, Mp, Noto, P., Lichtner, M., Capobianchi, MR, Carletti, F., Girardi, E., Rezza, G., Mura, Ms, Mannazzu, M., Caramello, P., Di Perri, G., Soranzo, Ml, Orofino, Gc, Arnaudo, I., Bonasso, M., Grossi, Pa, Basilico, C., Poggio, A., Bottari, G., Raise, E., Ebo, F., Lalla, F., Tositti, G., Resta, F., Loso, K., Lepri, Ac, Battegay, M., Bernasconi, E., Boni, J., Bucher, H., Burgisser, P., Cattacin, S., Cavassini, M., Dubs, R., Elzi, L., Erb, P., Fantelli, K., Fischer, M., Flepp, M., Fontana, A., Francioli, P., Furrer, H., 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., Schmid, P., Schupbach, J., Speck, R., Telenti, A., Trkola, A., Vernazza, P., Weber, R., Yerly, S., Bronsveld, W., Hillebrand-Haverkort, Me, Prins, Jm, Bos, Jc, Schattenkerk, Jkme, Geerlings, Se, Godfried, Mh, Lange, Jma, Leth, Fc, Lowe, Sh, Meer, Jtm, Nellen, Fjb, Pogany, K., Poll, T., Ruys, Ta, Sankatsing, S., Steingrover, R., Twillert, G., Valk, M., Vonderen, Mga, Vrouenraets, Sme, Vugt, M., Wit, Fwmn, Kuijpers, Tw, Pajkrt, D., Scherpbier, Hj, Eeden, A., Ten Veen, Jh, Dam, Ps, Roos, Jc, Brinkman, K., Frissen, Phj, Weigel, Hm, Mulder, Jw, Gorp, Ecm, Meenhorst, Pl, Mairuhu, Ata, Ziekenhuis, S., Veenstra, J., Danner, Sa, Agtmael, Ma, Claessen, Fap, Perenboom, Rm, Rijkeboer, A., Vonderen, M., Richter, C., Berg, J., Leusen, R., Vriesendorp, R., Jeurissen, Fjf, Kauffmann, Rh, Koger, Elw, Bravenboer, B., Ten Napel, Chh, Kootstra, Gj, Sprenger, Hg, Miesen, Wmaj, Doedens, R., Scholvinck, Eh, Ten Kate, Rw, Houte, Dpf, Polee, M., Kroon, Fp, van den Broek, Dissel, Jt, Schippers, Ef, Schreij, G., Geest, Sv, Verbon, A., Koopmans, Pp, Keuter, M., Post, F., Ven, Ajam, Ende, Me, Gyssens, Ic, Feltz, M., Den Hollander, Jg, Marie, S., Nouwen, Jl, Rijnders, Bja, Vries, Tems, Driessen, G., Groot, R., Hartwig, N., Juttmann, Jr, Heul, C., Kasteren, Mee, Schneider, Mme, Bonten, Mjm, Borleffs, Jcc, Ellerbroek, Pm, Hoepelman, Im, Jaspers, Cajj, Schouten, I., Schurink, Cam, Geelen, Spm, Wolfs, Tfw, Blok, Wl, Tanis, Aa, Groeneveld, Php, Klinieken-Zwolle, I., Back, Nkt, Bakker, Meg, Berkhout, B., Jurriaans, S., Cuijpers, T., Rietra, Pjgm, Roozendaal, Kj, Pauw, W., Zanten, Ap, Blomberg, Bme, Savelkoul, P., Swanink, Cma, Franck, Pfh, Lampe, As, Hendriks, R., Schirm, J., Veenendaal, D., Storm, H., Weel, J., Zeijl, H., Kroes, Acm, Claas, Hcj, Bruggeman, Camva, Goossens, Vj, Galama, Jmd, Melchers, Wjg, Poort, Yag, Doornum, Gjj, Niesters, Mg, Osterhaus, Adme, Schutten, M., Buiting, Agm, Swaans, Cam, Boucher, Cab, Boel, E., Jansz, Af, Losso, M., Duran, A., Vetter, N., Karpov, I., Vassilenko, A., Clumeck, N., Wit, S., Poll, B., Colebunders, R., Machala, L., Rozsypal, H., Dalibor Sedlacek, Nielsen, J., Benfield, T., Kirk, O., Gerstoft, J., Katzenstein, T., Hansen, Abe, Skinhoj, P., Pedersen, C., Zilmer, K., Girard, Pm, Saint-Marc, T., Vanhems, P., Dietrich, M., Manegold, C., Lunzen, J., Stellbrink, Hj, Bickel, M., Goebel, Fd, Rockstroh, J., Schmidt, R., Kosmidis, J., Gargalianos, P., Sambatakou, H., Perdios, J., Panos, G., Filandras, A., Karabatsaki, E., Banhegyi, D., Mulcahy, F., Yust, I., Turner, D., Burke, M., Pollack, S., Hassoun, G., Sthoeger, Z., Maayan, S., Chiesi, A., Borghi, R., Pristera, R., Gabbuti, A., Montesarchio, E., Iacomi, F., Finazzi, R., Viksna, L., 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., Mularska, E., Trocha, H., Antunes, F., Valadas, E., Mansinho, K., Matez, F., Duiculescu, D., Babes, V., Streinu-Cercel, A., Vinogradova, E., Rakhmanova, A., Jevtovic, D., Mokras, M., Stanekova, D., Gonzalez-Lahoz, J., Sanchez-Conde, M., Garcia-Benayas, T., Martin-Carbonero, L., Soriano, V., Clotet, B., Jou, A., Conejero, J., Tural, C., Gatell, Jm, Miro, Jm, Blaxhult, A., Karlsson, A., Pehrson, P., Soravia-Dunand, V., Kravchenko, E., Chentsova, N., Barton, S., Johnson, Am, Mercey, D., Johnson, Ma, Mocroft, A., Murphy, M., Weber, J., Scullard, G., Fisher, M., Brettle, R., Loveday, C., Gatell, J., Johnson, A., Vella, S., Gjorup, I., Friis-Moeller, N., Cozzi-Lepri, A., Bannister, W., Mollerup, D., Podlevkareva, D., Olsen, Ch, Kjaer, J., Raffanti, S., Dieterch, D., Becker, S., Scarsella, A., Fusco, G., Most, B., Balu, R., Rana, R., Beckerman, R., Ising, T., Irek, R., Johnson, B., Hirani, A., Dejesus, E., Pierone, G., Lackey, P., Irek, C., Burdick, J., Leon, S., Arch, J., Helm, Eb, Carlebach, A., Muller, A., Haberl, A., Nisius, G., Lennemann, T., Rottmann, C., Wolf, T., Stephan, C., Mosch, M., Gute, P., Locher, L., Lutz, T., Klauke, S., Knecht, G., Doerr, Hw, Sturmer, M., Hentig, N., Jennings, B., Beylot, J., Chene, G., Dupon, M., Longy-Boursier, M., Pellegrin, Jl, Ragnaud, Jm, Salamon, R., Thiebaut, R., Lewden, C., Lawson-Ayayi, S., Mercie, P., Moreau, Jf, Moriat, P., Bernard, N., Lacoste, D., Malvy, D., Neau, D., Blaizeau, Mj, Decoin, M., Delveaux, S., Hannapier, C., Labarrere, S., Lavignolle-Aurillac, V., Uwamaliya-Nziyumvira, B., Palmer, G., Touchard, D., Balestre, E., Alioum, A., Jacqmin-Gadda, H., Morlat, P., Bonarek, M., Bonnet, F., Coadou, B., Gellie, P., Nouts, C., Bocquentin, F., Dutronc, H., Lafarie, S., Aslan, A., Pistonne, T., Thibaut, P., Vatan, R., Chambon, D., La Taille, C., Cazorla, C., Ocho, A., Castera, L., Fleury, H., Lafon, Me, Masquelier, B., Pellegrin, I., Breilh, D., Blanco, P., Loste, P., Caunegre, L., Bonnal, F., Farbos, S., Ferrand, M., Ceccaldi, J., Tchamgoue, S., Witte, S., Buy, E., Alexander, C., Barrios, R., Braitstein, P., Brumme, Z., Chan, K., Cote, H., Gataric, N., Geller, J., Guillemi, S., Harrigan, Harris, M., Joy, R., Levy, A., Montaner, J., Montessori, V., Palepu, A., Phillips, E., Phillips, P., Press, N., Tyndall, M., Wood, E., Ballinger, J., Bhagani, S., Breen, R., Byrne, P., Carroll, A., Cropley, I., Cuthbertson, Z., Drinkwater, T., Fernandez, T., Geretti, Am, Murphy, G., Ivens, D., Johnson, M., Kinloch-De Loes, S., Lipman, M., Madge, S., Prinz, B., Bell, Dr, Shah, S., Swaden, L., Tyrer, M., Youle, M., Chaloner, C., Gumley, H., Holloway, J., Puradiredja, D., Sweeney, J., Tsintas, R., Bansi, L., Fox, Z., Lampe, F., Smith, C., Amoah, E., Clewley, G., Dann, L., Gregory, B., Jani, I., Janossy, G., Kahan, M., Thomas, M., Gill, Mj, Read, R., Schmeisser, V., Voigt, K., Wasmuth, Jc, Wohrmann, A., and Antiretroviral Therapy Cohort Coll

17. Species distribution in human immunodeficiency virus-related mycobacterial infections: implications for selection of initial treatment

Author

Montessori, V., Phillips, P., Montaner, J., Haley, L., Craib, K., Bessuille, E., and Black, W.

Subjects
Mycobacterial infections -- Care and treatment, HIV infection -- Complications
Abstract

According to the authors' abstract of an article published in Clinical Infectious Diseases, "Management of mycobacterial infection is species specific; however, treatment is prompted by positive smears or cultures, often [...]

Published
1996

18. Atypical pyoderma gangrenosum mimicking an infectious process.

Author

To D, Wong A, and Montessori V

Abstract

We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

Published
2014
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19. Hepatitis C virus treatment rates and outcomes in HIV/hepatitis C virus co-infected individuals at an urban HIV clinic.

Author

Murray MC, Barrios R, Zhang W, Hull M, Montessori V, Hogg RS, and Montaner JS

Subjects
Adult, Alanine Transaminase blood, CD4 Lymphocyte Count, Comorbidity, Female, HIV Infections immunology, HIV Infections virology, Hemoglobins metabolism, Hepacivirus immunology, Hepacivirus isolation & purification, Hepatitis C immunology, Hepatitis C virology, Humans, Male, Middle Aged, Retrospective Studies, Substance Abuse, Intravenous epidemiology, Treatment Outcome, HIV Infections epidemiology, Hepacivirus drug effects, Hepatitis C drug therapy, Hepatitis C epidemiology, Urban Health Services statistics & numerical data
Abstract

Objectives: The factors associated with hepatitis C virus (HCV) treatment uptake and responses were assessed among HCV/HIV co-infected individuals referred for HCV therapy at an urban HIV clinic., Methods: Retrospective review of HIV/HCV patients enrolled in the HCV treatment program at the John Ruedy Immunodeficiency Clinic in Vancouver. The factors associated with treatment uptake were assessed using multivariate analysis., Results: A total of 134 HCV/HIV co-infected individuals were recalled for assessment for HCV therapy. Overall 64 (48%) initiated treatment, and of those treated 49 (76.6%) attained end treatment response, whereas 35 (57.8%) achieved sustained virological response (SVR). When evaluated by genotype, 53% (17/32) of those with genotype 1, and 65% (20/31) of those with genotype 2 or 3 infections attained SVR. In treated individuals, alanine aminotransferase dropped significantly after treatment (P<0.001). During treatment, CD4 counts dropped significantly (P<0.001) in all patients. The counts recovered to baseline in patients who achieved SVR, but remained lower in patients who failed the therapy (P=0.015). On multivariate analysis, history of injection drug use (odds ratio: 3.48; 95% confidence interval: 1.37-8.79; P=0.009) and low hemoglobin levels (odds ratio: 4.23; 95% confidence interval: 1.36-13.10; P=0.013) were associated with those who did not enter the treatment., Conclusion: Only half of treatment-eligible co-infected patients referred for the therapy initiated treatment. Of those referred for the therapy, history of injection drug use was associated with lower rates of treatment uptake. Treated HIV/HCV co-infected individuals benefitted from both decreased alanine aminotransferase (independent of SVR), and rates of SVR similar to those described in HCV monoinfected patients.

Published
2011
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20. Ethical and scientific issues surrounding solid organ transplantation in HIV-positive patients: Absence of evidence is not evidence of absence.

Author

Christie T, Jiwani B, Asrat G, Montessori V, Mathias R, and Montaner J

Abstract

End-stage liver disease is emerging as a leading cause of death among HIV-positive patients. Historically, an HIV diagnosis was a contraindication for a liver transplant; however, because of the efficacy of highly active antiretroviral therapy (HAART), HIV-positive patients have one-year, two-year, and three-year post-transplantation survival rates similar to that of HIV-negative patients. Based on this evidence, HIV-positive patients are now considered eligible for transplantation. However, newly emerging guidelines include the stipulation that HIV-positive patients must be on HAART to be placed on a waiting list for transplantation. The purpose of the present paper is to evaluate the scientific and ethical probity of requiring HIV-positive patients to be on HAART as a condition for being on a liver transplant waiting list. It is argued that the emphasis should be placed on the probability of post-transplantation HAART tolerance, and that concerns about pretransplantation HAART tolerance are of secondary importance.

Published
2006
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21. Effect of serostatus for hepatitis C virus on mortality among antiretrovirally naive HIV-positive patients.

Author

Braitstein P, Yip B, Montessori V, Moore D, Montaner JS, and Hogg RS

Subjects
Adult, Cross-Sectional Studies, Female, HIV Infections drug therapy, Hepacivirus pathogenicity, Humans, Male, Prognosis, Risk Factors, Serologic Tests, Viral Load, Anti-Retroviral Agents therapeutic use, HIV Infections complications, HIV Infections mortality, Hepatitis C complications, Hepatitis C mortality
Abstract

Background: We examined the effect of hepatitis C virus (HCV) seropositivity on risk of death among people receiving their first antiretroviral treatment (ART) for HIV infection., Methods: In British Columbia, the HIV/ AIDS Drug Treatment Program is the only source of free ART. Patients who initiated a triple-drug ART regimen between July 31, 1996, and July 31, 2000, were included if they were ART-naive and had baseline HCV serological data. Outcomes of interest for survival analysis were deaths from natural and HIV-related causes, with a data cutoff of June 30, 2003., Results: Of 1186 eligible subjects, 606 (51%) were HCV positive and 580, negative. Fewer HCV-positive people were male (78% v. 93%, p < 0.001) and had an AIDS diagnosis at baseline (11% v. 15%, p = 0.028). Their CD4 fraction was significantly higher at baseline (19% v. 16% of T lymphocytes, p < 0.001) but their absolute CD4 counts, log HIV viral load and the type of ART initiated were similar to those of HCV negative people. Of 163 deaths (from natural causes only) during the study period, 118 (19%) were in HCV positive and 45 (8%) in HCV negative patients (p < 0.001); of the 114 deaths attributed to HIV infection, these proportions were 79 (13%) versus 35 (6%; p < 0.001). After adjustment for potential confounders, HCV seropositivity remained predictive of death (adjusted hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.50- 3.21, p < 0.001), especially HIV-related death (adjusted HR 1.75, 95% CI 1.13- 2.72, p = 0.012)., Interpretation: In this population-based HIV treatment program, we found HCV seropositivity to be an independent predictor of mortality, especially death related to HIV infection.

Published
2005
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22. Hepatotoxicity of nucleoside reverse transcriptase inhibitors.

Author

Montessori V, Harris M, and Montaner JS

Subjects
Chemical and Drug Induced Liver Injury, HIV Infections drug therapy, Humans, Mitochondria, Liver drug effects, Anti-HIV Agents adverse effects, Liver drug effects, Reverse Transcriptase Inhibitors adverse effects
Abstract

Hepatotoxicity is an adverse effect of all available classes of antiretrovirals, including nucleoside reverse transcriptase inhibitors (NRTI). A syndrome of hepatic steatosis and lactic acidosis has been recognized as a rare, potentially fatal complication since the advent of NRTI monotherapy in the early 1990s. Today, NRTI remain the backbone of antiretroviral combination regimens, and, with the success of current treatment strategies, exposure to two or more of these agents may occur over a number of years. Hepatic steatosis and lactic acidosis are accordingly being observed more frequently, along with a more recently recognized syndrome of chronic hyperlactatemia. These as well as other adverse effects of NRTI are mediated by inhibition of human DNA polymerase gamma, resulting in mitochondrial dysfunction in the liver and other tissues. Early recognition and intervention are essential to avert serious outcomes.

Published
2003
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23. Factors other than the Duke criteria associated with infective endocarditis among injection drug users.

Author

Palepu A, Cheung SS, Montessori V, Woods R, and Thompson CR

Subjects
British Columbia, Endocarditis, Bacterial classification, Humans, Logistic Models, Endocarditis, Bacterial complications, Substance Abuse, Intravenous complications
Abstract

Background: Modified Duke criteria were applied to consecutive injection drug users (IDUs) who were admitted to an inner-city hospital with a clinical suspicion of infective endocarditis, and the presence of any other clinical variables that were predictive of the presence of infective endocarditis was determined., Methods: Clinical data on consecutive IDUs who were hospitalized over 15 months in Vancouver were collected. Data included the admission history, and findings on physical examination and on initial laboratory investigations. Each subject's course in hospital was followed until discharge or death during the index hospitalization. Follow-up data collected included culture results, the interpretation of the echocardiogram and the discharge diagnosis. The modified Duke criteria were used for the diagnosis of infective endocarditis (definite, possible or rejected). Multiple logistic regression was used to determine what clinical variables (exclusive of the Duke criteria) available within 48 hours of presentation were independent predictors of infective endocarditis., Results: One hundred IDUs were enrolled. Fifty-one were female, and 58 were HIV-positive. Twenty-three met the modified Duke criteria for definite infective endocarditis, and 25 had possible infective endocarditis. IDUs with definite infective endocarditis were more commonly noted to have evidence of vascular phenomena (arterial embolism, septic pulmonary infarction, mycotic aneurysm, intracranial hemorrhage or Janeway lesions) (6 [26%]) than those who had possible endocarditis (1 [4%]). Those with definite infective endocarditis more often had multiple opacities on chest radiography (56% v. < 12%), and fewer had an obvious source of infection (52% v. 72% and 81% of possible and rejected infective endocarditis, respectively). Among febrile IDUs, definite endocarditis was highly associated with having no obvious source of infection (odds ratio 3.1 [95% confidence interval 1.1-8.7]) compared with febrile IDUs with an obvious source of infection. In similarly compared groups, the presence of hematuria, proteinuria or pyuria was also predictive of definite endocarditis (odds ratio 2.9 [95% CI 1.1-8.6])., Conclusions: Among IDUs, the modified Duke criteria are useful for classifying cases with definite infective endocarditis and rejecting cases without infective endocarditis. The classification of possible infective endocarditis is suitable for this population.

Published
2002

24. Prevalence and response to antiretroviral therapy of non-B subtypes of HIV in antiretroviral-naive individuals in British Columbia.

Author

Alexander CS, Montessori V, Wynhoven B, Dong W, Chan K, O'Shaughnessy MV, Mo T, Piaseczny M, Montaner JS, and Harrigan PR

Subjects
Acquired Immunodeficiency Syndrome immunology, Acquired Immunodeficiency Syndrome virology, Adult, CD4 Lymphocyte Count, Drug Resistance, Viral genetics, Female, Humans, Male, Viral Load, Acquired Immunodeficiency Syndrome drug therapy, Anti-HIV Agents therapeutic use, HIV-1 classification
Abstract

In North America, the B subtype of the major group (M) of HIV-1 predominates. Phylogenetic analysis of HIV reverse transcriptase and protease sequences isolated from 479 therapy-naive patients, first seeking treatment in British Columbia between June 1997 and August 1998, revealed a prevalence of 4.4% non-B virus. A range of different subtypes was identified, including one subtype A, 11 C, two D, five CRF01&#95;AE, and one sample that could not be reliably subtyped. Baseline CD4 courts were significantly lower in individuals harbouring the non-B subtypes (P = 0.02), but baseline viral loads were similar (P = 0.80). In this study, individuals infected with non-B variants did not have a significantly different virological response to therapy after up to 18 months.

Published
2002

25. Erysipelothrix rhusiopathiae endocarditis and presumed osteomyelitis.

Author

Romney M, Cheung S, and Montessori V

Abstract

Erysipelothrix rhusiopathiae is known to cause infections in humans following exposure to decaying organic matter or animals colonized with the organism, such as swine and fish. Invasive infections with this organism are unusual and are manifested primarily as infective endocarditis. The present report is believed to be the first to report a case of E rhusiopathiae endocarditis and presumptive osteomyelitis. E rhusiopathiae appears to have intrinsic resistance to vancomycin. Because vancomycin is often used empirically for the treatment of endocarditis, rapid differentiation of E rhusiopathiae from other Gram-positive organisms is critical. In patients with endocarditis caused by a Gram-positive bacillus and epidemiological risk factors for E rhusiopathiae exposure, empirical treatment with vancomycin should be reconsidered.

Published
2001
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26. Respiratory failure associated with the lipodystrophy syndrome in an HIV-positive patient with compromised lung function.

Author

Press N, Montessori V, Bai TR, and Montaner J

Subjects
Adult, Antiretroviral Therapy, Highly Active adverse effects, Fatal Outcome, Humans, Male, HIV Infections drug therapy, HIV Protease Inhibitors adverse effects, Lipodystrophy chemically induced
Abstract

Protease inhibitors, used as treatment in human immunodeficiency virus (HIV) infection, are associated with a syndrome of peripheral lipodystrophy, central adiposity, hyperlipidemia and insulin resistance. An HIV-positive patient with chronic obstructive pulmonary disease is presented who developed the lipodystrophy syndrome that is associated with the use of protease inhibitors. It is postulated that the lipodystrophy syndrome further compromised his lung function, leading to respiratory failure. Patients who have pulmonary disease and are taking protease inhibitors require monitoring of clinical status and pulmonary function tests.

Published
2001
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27. Lipodystrophy-associated morphological, cholesterol and triglyceride abnormalities in a population-based HIV/AIDS treatment database.

Author

Heath KV, Hogg RS, Chan KJ, Harris M, Montessori V, O'Shaughnessy MV, and Montanera JS

Subjects
Acquired Immunodeficiency Syndrome complications, Acquired Immunodeficiency Syndrome drug therapy, Acquired Immunodeficiency Syndrome immunology, Acquired Immunodeficiency Syndrome metabolism, Adult, Canada epidemiology, Complementary Therapies, Databases, Factual, Female, HIV Infections drug therapy, HIV Infections immunology, HIV Infections metabolism, HIV Protease Inhibitors adverse effects, HIV Protease Inhibitors therapeutic use, Humans, Lipodystrophy epidemiology, Lipodystrophy metabolism, Male, Middle Aged, Prevalence, Reverse Transcriptase Inhibitors adverse effects, Reverse Transcriptase Inhibitors therapeutic use, Surveys and Questionnaires, Syndrome, Wasting Syndrome, Cholesterol metabolism, HIV Infections complications, Lipodystrophy etiology, Triglycerides metabolism
Abstract

Objective: To provide population-based estimates of the prevalence of lipodystrophy syndrome and constituent symptoms and to identify correlates of prevalent symptomology., Methods: Participants in a province-wide HIV/AIDS treatment programme reported morphological and metabolic abnormalities. Probable lipodystrophy was defined as self-report of at least one morphological abnormality or both high cholesterol and triglyceride levels. Explanatory variables investigated included: age; sex; ethnicity; transmission risk group; CD4 cell count; plasma viral load; AIDS diagnosis; duration of infection; alternative therapy use; past, current and duration of use of antiretroviral therapy (ART) by class and specific drug; total duration of ART; and current adherence. Stepwise logistic regression identified possible determinates of lipodystrophy., Results: Of 1035 participants, 50% appeared to have probable lipodystrophy, with 36% reporting peripheral wasting, 33% abdominal weight gain, 6% buffalo hump, and 10 and 12% increased triglyceride or cholesterol levels, respectively. In multivariate analysis, lipodystrophy was associated with older age (per year) (AOR 1.03; 95% CI 1.01, 1.04), the use of ingested alternative therapies (AOR 1.46; 95% CI 1.06, 2.01), having ever used protease inhibitors (PI) (AOR 2.63; 95% CI 1.89, 3.66), and duration of stavudine treatment (per year) (AOR 1.35; 95% CI 1.15, 1.58). In analysis limited to participants exposed to PI, after similar adjustment, the duration of lamivudine rather than stavudine treatment was associated with lipodystrophy (AOR 1.32; 95% CI 1.13, 1.53)., Conclusion: Increased risk of abnormalities is associated with the use of PI, and the duration of stavudine and lamivudine treatment after adjustment for personal characteristics, clinical disease stage, duration of infection and detailed treatment history.

Published
2001
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28. Multiple drug rescue therapy for HIV-infected individuals with prior virologic failure to multiple regimens.

Author

Montaner JS, Harrigan PR, Jahnke N, Raboud J, Castillo E, Hogg RS, Yip B, Harris M, Montessori V, and O'Shaughnessy MV

Subjects
Adult, Anti-HIV Agents pharmacology, Antiretroviral Therapy, Highly Active, Consumer Product Safety, Drug Resistance, Microbial, Female, HIV Infections virology, HIV Protease Inhibitors pharmacology, Humans, Male, Middle Aged, Predictive Value of Tests, RNA, Viral blood, Reverse Transcriptase Inhibitors pharmacology, Treatment Failure, Viral Load, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Protease Inhibitors therapeutic use, HIV-1 drug effects, HIV-1 genetics, Reverse Transcriptase Inhibitors therapeutic use
Abstract

Objectives: To characterize the antiviral response and tolerability of a multi-drug rescue therapy (MDRT) among heavily pretreated patients., Methods: Observational study conducted in a single, university-based tertiary referral clinic. Patients (n = 106) who failed several prior regimens started MDRT including at least five antiretroviral (ARV) drugs between August 1997 and June 1998. The most common starting regimen included three nucleoside reverse transcriptase inhibitors and two protease inhibitors, which was prescribed to 45 (42.5%) patients. Virologic response was defined as plasma viral load < 400 copies/ml on at least two consecutive visits., Results: Median prior ARV exposure was seven drugs over a median time of 43 months. Fifty-nine percent of the patients were phenotypically (VIRCO Antivirogram) resistant at baseline to seven or more ARV. Median plasma viral load change following initiation of MDRT was -1.04 log10 copies/ml over a median of 15 months. Using intention-to-treat analysis 40% of patients had plasma viral load values < 400 copies/ml between weeks 47 and 57 of follow-up. Twenty-six patients (25%) experienced severe laboratory abnormalities or subjective adverse drug effects and six of these participants discontinued therapy., Conclusion: MDRT induced a substantial antiviral response in this heavily pretreated group of patients despite extensive phenotypic resistance at baseline. Adverse effects were frequent but generally manageable. Our data suggest that relying exclusively on historical, clinical and laboratory evidence may not be sufficient to rule out a possible antiviral response when multiple drug regimens are used in this heavily pretreated patient population.

Published
2001
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29. Prophylaxis for infective endocarditis. Who needs it? How effective is it?

Author

Press N and Montessori V

Subjects
Animals, Endocarditis, Bacterial complications, Heart Diseases, Humans, Practice Guidelines as Topic, Prognosis, Risk Factors, Antibiotic Prophylaxis, Endocarditis, Bacterial prevention & control
Abstract

Objective: To review guidelines for using antibiotic prophylaxis to prevent infective endocarditis, and to present recent changes and controversies regarding these guidelines., Quality of Evidence: Data are from physiologic and in vitro studies, as well as studies of animal models, and from retrospective analyses of human endocarditis cases. Systematic reviews and guidelines are also examined. As no randomized clinical trials have examined prophylaxis for bacterial endocarditis, many recommendations presented are based on consensus guidelines., Main Message: Antibiotic prophylaxis to prevent bacterial endocarditis should be used in high- and moderate-risk patients with cardiac disease. It should be given before procedures in which bacteremias are likely with organisms that cause endocarditis, such as viridans streptococci. For most procedures, a single dose of amoxicillin (2 g by mouth 1 hour before the procedure) is sufficient to ensure adequate serum levels before and after the procedure., Conclusion: Infective endocarditis continues to have high rates of morbidity and mortality. Antibiotic prophylaxis, therefore, is important to combat this preventable disease. For high- and moderate-risk patients with cardiac disease, the cost-benefit ratio favours prophylaxis.

Published
2000

31. Primary lamivudine resistance in acute/early human immunodeficiency virus infection.

Author

Conway B, Montessori V, Rouleau D, Montaner JS, O'Shaughnessy MV, Fransen S, Shillington A, Weislow O, and Mayers DL

Subjects
Acute Disease, Adult, Anti-HIV Agents pharmacology, Anti-HIV Agents therapeutic use, Drug Resistance, Microbial genetics, Drug Therapy, Combination, Female, HIV-1 genetics, Humans, Lamivudine therapeutic use, Male, Reverse Transcriptase Inhibitors therapeutic use, Viral Load, HIV Infections drug therapy, HIV Infections virology, HIV-1 drug effects, Lamivudine pharmacology, Reverse Transcriptase Inhibitors pharmacology
Published
1999
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32. Urinary filariasis presenting as bladder pseudotumors.

Author

Gourlay WA, Chiu A, Montessori VC, and Dunn IJ

Subjects
Adult, Diagnosis, Differential, Humans, Male, Filariasis diagnosis, Urinary Bladder Neoplasms diagnosis, Urinary Tract Infections diagnosis
Published
1999

33. Epidemic keratoconjunctivitis outbreak at a tertiary referral eye care clinic.

Author

Montessori V, Scharf S, Holland S, Werker DH, Roberts FJ, and Bryce E

Subjects
Adenoviridae Infections diagnosis, Adult, Aged, Aged, 80 and over, British Columbia, Case-Control Studies, Cross Infection prevention & control, Cross Infection virology, Female, Humans, Incidence, Infection Control methods, Keratoconjunctivitis diagnosis, Keratoconjunctivitis virology, Male, Middle Aged, Odds Ratio, Ophthalmology statistics & numerical data, Outpatient Clinics, Hospital statistics & numerical data, Risk Factors, Adenoviridae Infections epidemiology, Cross Infection epidemiology, Disease Outbreaks statistics & numerical data, Keratoconjunctivitis epidemiology
Abstract

An outbreak of epidemic keratoconjunctivitis (EKC) occurred at a tertiary referral eye care clinic between late September and mid-November 1995. Before the outbreak, instruments were cleaned with 70% isopropyl alcohol and handwashing between patients was not routine. Infection control measures were implemented when the outbreak was recognized in mid-October. Control measures included triaging suspected cases to a separate waiting area, cohorting cases to a specific examining room, endorsing the use of gloves and handwashing during examinations of patients, and cleaning instruments with a buffered bleach solution. Thirty-six cases were diagnosed before the infection control measures were taken, and 3 cases were seen after the control measures were taken. Also, numerous secondary cases occurred in the community. No additional cases were diagnosed from DEcember to February 25, 1996. Acquisition of the infection was linked to visits to 4 of 20 physicians in the eye clinic with 61% of cases associated with visits to 1 of those 4 physicians. The use of diagnostic lenses applied directly to the eye was associated with infection (odds ratio = 2.83, 95% confidence interval = 0.79 to 10.4), although this did not reach statistical significance. The use of tonometers, ophthalmic solutions, or laser therapy was not associated with infection, and all environmental cultures were negative. This outbreak emphasizes the need for implementation of routine infection control guidelines to prevent nosocomial transmission of epidemic keratoconjunctivitis and stresses the need for appropriate disinfection of instruments.

Published
1998
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