122 results on '"Phillips, A.N."'
Search Results
2. Changes in AIDS-defining illnesses in a London clinic, 1987 - 1998
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Mocroft, A., Sabin, C.A., Youle, M., Madge, S., Tyrer, M., Devereux, H., Deayton, J., Dykhoff, A., Lipman, M.C.I., Phillips, A.N., and Johnson, M.A.
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AIDS (Disease) -- Diagnosis ,Thrush (Mouth disease) -- Statistics ,Cytomegalovirus infections -- Statistics ,Kaposi's sarcoma -- Statistics ,Pneumocystis carinii pneumonia -- Statistics ,Mycobacterium avium complex -- Statistics ,AIDS dementia -- Statistics ,Wasting syndrome -- Statistics ,Health - Abstract
Some of the disorders usually used to define the presence of AIDS have declined in incidence over the 11 year period studied by the authors. esophageal candidiasis, cytomegalovirus (CMV), Kaposi's sarcoma (KS), Wasting syndrome, and Pneumocystis carinii pneumonia (PCP) have all declined dramatically, while Mycobacterium avium complex (MAC) and AIDS dementia have not
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- 1999
3. Associations of depression and anxiety symptoms with sexual behaviour in women and heterosexual men attending sexual health clinics: a cross-sectional study
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Coyle, R.M., Lampe, F.C., Miltz, A.R., Sewell, J., Anderson, J., Apea, V., Collins, S., Dhairyawan, R., Johnson, A.M., Lascar, M., Mann, S., O'Connell, R., Sherr, L., Speakman, A., Tang, A., Phillips, A.N., Rodger, A., and Group, AURAH Study
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Male ,clinical care ,Cross-sectional study ,Sexual Behavior ,Sexually Transmitted Diseases ,Ethnic group ,sexual health ,Dermatology ,Ambulatory Care Facilities ,State Medicine ,law.invention ,Young Adult ,03 medical and health sciences ,symbols.namesake ,Risk-Taking ,Sex Factors ,0302 clinical medicine ,Condom ,law ,Surveys and Questionnaires ,London ,Humans ,Medicine ,Behaviour ,030212 general & internal medicine ,Poisson regression ,Socioeconomic status ,Depression (differential diagnoses) ,Reproductive health ,Depressive Disorder ,030505 public health ,business.industry ,sexual behaviour ,Patient Acceptance of Health Care ,Anxiety Disorders ,Cross-Sectional Studies ,Infectious Diseases ,symbols ,Anxiety ,genitourinary medicine services ,Female ,medicine.symptom ,0305 other medical science ,business ,Clinical psychology - Abstract
ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics.MethodsAttitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-administered questionnaire study recruited from 20 GUM clinics in England, 2013–2014. This analysis included women and heterosexual men. The prevalence of depression and anxiety symptoms was assessed. Modified Poisson regression was used to produce adjusted prevalence ratios (aPR) for the association of t demographic, socioeconomic and lifestyle factors with depression and anxiety, adjusted for gender, age, ethnicity, education level and study region. Among individuals reporting sex in the past 3 months, associations of depression and anxiety with sexual risk behaviour and history were assessed separately by gender, adjusted for age, ethnicity, study region, education and relationship status.ResultsQuestionnaires were completed by 676 women and 470 heterosexual men. Depression symptoms were reported by 100 (14.8%) women and 33 men (7.0%). Anxiety symptoms were reported by 79 women (11.7%) and 21 men (4.5%). Among women reporting recent sex, those with depression symptoms were more likely to report condomless sex with a non-regular partner, aPR 1.38 (1.07–1.77) and recent condomless sex with two or more partners, 1.80 (1.25–2.59). Women with anxiety symptoms more likely to report recent condomless sex with two or more partners, 1.68 (1.13–2.50), low self-efficacy for condom use, 1.54 (1.02–2.31) and STI diagnosis in the last year 1.51 (1.04–2.20). Among heterosexual men reporting recent sex, depression and anxiety symptoms were associated with low self-efficacy with condom use, 2.32 (1.29–4.19) for depression and 2.23 (1.26–3.94) for anxiety, but not with measures of condomless sex.DiscussionThe associations between psychological symptoms and sexual risk behaviours highlight the importance of holistic assessment of need by both general and sexual health clinicians. We highlight the challenge in delivering holistic care associated with fragmentation of sexual health services.
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- 2019
4. Effectiveness of Transmitted Drug Resistance Testing before Initiation of Antiretroviral Therapy in HIV-Positive Individuals
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Lodi, S. Günthard, H.F. Gill, J. Phillips, A.N. Dunn, D. Vu, Q. Siemieniuk, R. Garcia, F. Logan, R. Jose, S. Bucher, H.C. Scherrer, A.U. Reiss, P. Van Sighem, A. Boender, T.S. Porter, K. Gilson, R. Paraskevis, D. Simeon, M. Vourli, G. Moreno, S. Jarrin, I. Sabin, C. Hernán, M.A.
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Background:For people living with HIV, major guidelines in high-income countries recommend testing for transmitted drug resistance (TDR) to guide the choice of first-line antiretroviral therapy (ART). However, individuals who fail a first-line regimen can now be switched to one of several effective regimens. Therefore, the virological and clinical benefit of TDR testing needs to be evaluated.Methods:We included individuals from the HIV-CAUSAL Collaboration who enrolled
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- 2019
5. Strengthening the scale-up and uptake of effective interventions for sex workers for population impact in Zimbabwe
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Cowan, F.M. (Frances M), Chabata, S.T. (Sungai T), Musemburi, S. (Sithembile), Fearon, E. (Elizabeth), Davey, C. (Calum), Ndori-Mharadze, T. (Tendayi), Bansi-Matharu, L. (Loveleen), Cambiano, V. (Valentina), Steen, R. (Richard), Busza, J. (Joanna), Yekeye, R. (Raymond), Mugurungi, O. (Owen), Hargreaves, J.R. (James R), Phillips, A.N. (Andrew N), Cowan, F.M. (Frances M), Chabata, S.T. (Sungai T), Musemburi, S. (Sithembile), Fearon, E. (Elizabeth), Davey, C. (Calum), Ndori-Mharadze, T. (Tendayi), Bansi-Matharu, L. (Loveleen), Cambiano, V. (Valentina), Steen, R. (Richard), Busza, J. (Joanna), Yekeye, R. (Raymond), Mugurungi, O. (Owen), Hargreaves, J.R. (James R), and Phillips, A.N. (Andrew N)
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Introduction: UNAIDS’ goal of ending AIDS by 2030 is unreachable without better targeting of testing, prevention and care. Female sex workers (FSW) in Zimbabwe are at high risk of HIV acquisition and transmission. Here, we report on collated programme and research data from Zimbabwe's national sex work programme. We also assess the potential for wider population impact of FSW programmes by modelling the impact on HIV incidence of eliminating transmission through FSW (i.e. calcu
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- 2019
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6. HIV Dynamics
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Phillips, A.N., primary
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- 1999
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7. Time to virological failure of 3 classes of antiretrovirals after initiation of highly active antiretroviral therapy: results from the EuroSIDA study group
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Mocroft, A., Ledergerber, B., Viard, J.P., Staszewski, S., Murphy, M., Chiesi, A., Horban, A., Hansen, A.-B.E., Phillips, A.N., and Lundgren, J.D.
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Communicable diseases -- Care and treatment ,Virology -- Research ,Highly active antiretroviral therapy -- Health aspects ,Highly active antiretroviral therapy -- Research ,Health - Published
- 2004
8. Impact of Kaposi‚s sarcoma on HIV disease progression
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Mocroft, A., Sabin, C., and Phillips, A.N.
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- 1999
9. Predictors of CD4 cell recovery following initiation of antiretroviral therapy among HIV-1 positive patients with well-estimated dates of seroconversion
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Stirrup, O.T. Copas, A.J. Phillips, A.N. Gill, M.J. Geskus, R.B. Touloumi, G. Young, J. Bucher, H.C. Babiker, A.G. Kelleher, T. Cooper, D. Grey, P. Finlayson, R. Bloch, M. Ramacciotti, T. Gelgor, L. Smith, D. Zangerle, R. Gill, J. Lutsar, I. Chêne, G. Dabis, F. Thiebaut, R. Costagliola, D. Guiguet, M. Vanhems, P. Chaix, M.-L. Ghosn, J. Meyer, L. Boufassa, F. Hamouda, O. Meixenberger, K. Bannert, N. Bartmeyer, B. Antoniadou, A. Chrysos, G. Daikos, G.L. Pantazis, N. Katsarou, O. Rezza, G. Dorrucci, M. Monforte, A. Luca, A. Prins, M. Geskus, R. Helm, J. Schuitemaker, H. Sannes, M. Brubakk, O. Kran, A.-M. Rosinska, M. Muga, R. Tor, J. Olalla, P. Cayla, J. Moreno, S. Monge, S. Amo, J. Romero, J. Pérez-Hoyos, S. Sönnerborg, A. Bucher, C. Günthard, H. Scherrer, A. Malyuta, R. Murphy, G. Porter, K. Johnson, A. Babiker, A. Pillay, D. Morrison, C. Salata, R. Mugerwa, R. Chipato, T. Price, M.A. Gilmour, J. Kamali, A. Karita, E. CASCADE Collaboration in EuroCoord
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Objectives: To investigate factors that predict speed of recovery and long-term CD4 cell count in HIV-1 seroconverters initiating combination antiretroviral therapy (cART), and to quantify the influence of very early treatment initiation. We make use of all pre-treatment CD4 counts, because analyses using only a single observation at initiation may be subject to biases. Methods: We used data from the CASCADE (Concerted Action on SeroConversion to AIDS and Death in Europe) multinational cohort collaboration of HIV-1 seroconverters. We analysed pre- and post-treatment data of patients with seroconversion dates estimated January 2003–March 2014 (n = 7600 for primary analysis) using a statistical model in which the characteristics of recovery in CD4 counts are determined by multiple predictive factors. Secondary analyses were performed incorporating uncertainty in the exact timing of seroconversion to allow more precise estimation of the benefit of very early treatment initiation. Results: ‘True’ CD4 count at cART initiation was the strongest predictor of CD4 count beyond 3 years on cART. Allowing for lack of complete certainty in the date of seroconversion, CD4 recovery was more rapid for patients in whom treatment was initiated within 4 months. For a given CD4 count, higher viral load (VL) at initiation was strongly associated with higher post-treatment CD4 recovery. For other patient and drug characteristics, associations with recovery were statistically significant but small in magnitude. Conclusions: CD4 count at cART initiation is the most important factor in predicting post-treatment recovery, but VL provides substantial additional information. If cART is initiated in the first 4 months following seroconversion, recovery of CD4 counts appears to be more rapid. © 2017 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association
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- 2018
10. Effect of immediate initiation of antiretroviral treatment on the risk of acquired HIV drug resistance
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Lodi, S. Günthard, H.F. Dunn, D. Garcia, F. Logan, R. Jose, S. Bucher, H.C. Scherrer, A.U. Schneider, M.-P. Egger, M. Glass, T.R. Reiss, P. Van Sighem, A. Boender, T.S. Phillips, A.N. Porter, K. Hawkins, D. Moreno, S. Monge, S. Paraskevis, D. Simeon, M. Vourli, G. Sabin, C. Hernán, M.A.
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Objective: We estimated and compared the risk of clinically identified acquired drug resistance under immediate initiation [the currently recommended antiretroviral therapy (ART) initiation strategy], initiation with CD4 + cell count less than 500 cells/μl and initiation with CD4 + cell count less than 350 cells/μl. Design: Cohort study based on routinely collected data from the HIV-CAUSAL collaboration. Methods: For each individual, baseline was the earliest time when all eligibility criteria (ART-naive, AIDS free, and others) were met after 1999. Acquired drug resistance was defined using the Stanford classification as resistance to any antiretroviral drug that was clinically identified at least 6 months after ART initiation. We used the parametric g-formula to adjust for time-varying (CD4 + cell count, HIV RNA, AIDS, ART regimen, and drug resistance testing) and baseline (calendar period, mode of acquisition, sex, age, geographical origin, ethnicity and cohort) characteristics. Results: In 50-981 eligible individuals, 10% had CD4 + cell count more than 500 cells/μl at baseline, and 63% initiated ART during follow-up. Of 2672 tests for acquired drug resistance, 794 found resistance. The estimated 7-year risk (95% confidence interval) of acquired drug resistance was 3.2% (2.8,3.5) for immediate initiation, 3.1% (2.7,3.3) for initiation with CD4 + cell count less than 500 cells/μl, and 2.8% (2.5,3.0) for initiation with CD4 + cell count less than 350 cells/μl. In analyses restricted to individuals with baseline in 2005-2015, the corresponding estimates were 1.9% (1.8, 2.5), 1.9% (1.7, 2.4), and 1.8% (1.7, 2.2). Conclusion: Our findings suggest that the risk of acquired drug resistance is very low, especially in recent calendar periods, and that immediate ART initiation only slightly increases the risk. It is unlikely that drug resistance will jeopardize the proven benefits of immediate ART initiation. © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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- 2018
11. HIV resistance testing and detected drug resistance in Europe
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Schultze, A., Phillips, A.N., Paredes, R., Battegay, M., Rockstroh, J.K., Machala, L., Tomazic, J., Girard, P.M., Januskevica, I., Gronborg-Laut, K., Lundgren, J.D., Cozzi-Lepri, A., Burger, D.M., Amsterdam institute for Infection and Immunity, Amsterdam Public Health, and Global Health
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Adult ,Male ,medicine.medical_specialty ,Genotype ,Anti-HIV Agents ,prevalence ,Immunology ,HIV Infections ,Drug resistance ,Logistic regression ,Odds ,Cohort Studies ,Internal medicine ,Drug Resistance, Viral ,medicine ,Immunology and Allergy ,Humans ,Treatment Failure ,Generalized estimating equation ,business.industry ,antiviral drug resistance ,HIV ,Odds ratio ,HIV Protease Inhibitors ,Middle Aged ,Viral Load ,Confidence interval ,CD4 Lymphocyte Count ,Europe ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Infectious Diseases ,Logistic Models ,Cohort ,Multivariate Analysis ,HIV-1 ,Reverse Transcriptase Inhibitors ,Female ,business ,logistic models ,Testing ,Regional differences ,Virological failure ,Cohort study - Abstract
OBJECTIVES: To describe regional differences and trends in resistance testing among individuals experiencing virological failure and the prevalence of detected resistance among those individuals who had a genotypic resistance test done following virological failure.DESIGN: Multinational cohort study.METHODS: Individuals in EuroSIDA with virological failure (>1 RNA measurement >500 on ART after >6 months on ART) after 1997 were included. Adjusted odds ratios (aORs) for resistance testing following virological failure and aORs for the detection of resistance among those who had a test were calculated using logistic regression with generalized estimating equations.RESULTS: Compared to 74.2% of ART-experienced individuals in 1997, only 5.1% showed evidence of virological failure in 2012. The odds of resistance testing declined after 2004 (global P CONCLUSIONS: Despite a concurrent decline in virological failure and testing, drug resistance was commonly detected. This suggests a selective approach to resistance testing. The regional differences identified indicate that policy aiming to minimize the emergence of resistance is of particular relevance in some European regions, notably in the countries in Eastern Europe.
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- 2015
12. Effect of Immediate Initiation of Antiretroviral Treatment in HIV-Positive Individuals Aged 50 Years or Older
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Lodi, S. Costagliola, D. Sabin, C. Del Amo, J. Logan, R. Abgrall, S. Reiss, P. Van Sighem, A. Jose, S. Blanco, J.-R. Hernando, V. Bucher, H.C. Kovari, H. Segura, F. Ambrosioni, J. Gogos, C.A. Pantazis, N. Dabis, F. Vandenhende, M.-A. Meyer, L. Seng, R. Gill, M.J. Krentz, H. Phillips, A.N. Porter, K. Grinsztejn, B. Pacheco, A.G. Muga, R. Tate, J. Justice, A. Hernán, M.A.
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Background: Clinical guidelines recommend immediate initiation of combined antiretroviral therapy for all HIV-positive individuals. However, those guidelines are based on trials of relatively young participants. Methods: We included HIV-positive antiretroviral therapy-naive, AIDS-free individuals aged 50-70 years after 2004 in the HIV-CAUSAL Collaboration. We used the parametric g-formula to estimate the 5-year risk of all-cause and non-AIDS mortality under (1) immediate initiation at baseline and initiation at CD4 count, (2)
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- 2017
13. Risk factors for stroke in middle aged British men
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Shaper, A.G., Phillips, A.N., Pocock, S.J., Walker, M., and Macfarlane, P.W.
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Stroke (Disease) -- Risk factors -- Health aspects ,Smoking -- Health aspects -- Risk factors ,Health ,Risk factors ,Health aspects - Abstract
Introduction According to a consensus statement on stroke, 'Every five minutes someone in the United Kingdom has a stroke. It is the cause of one in eight deaths and constitutes [...]
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- 1991
14. ABO blood group and ischaemic heart disease in British men
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Whincup, P.H., Cook, D.G., Phillips, A.N., and Shaper, A.G.
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Coronary heart disease -- Demographic aspects ,Blood groups -- Physiological aspects ,Coronary heart disease -- Risk factors ,Blood cholesterol -- Measurement ,Blood groups -- ABO system - Published
- 1990
15. Does rapid HIV disease progression prior to combination antiretroviral therapy hinder optimal CD4 + T-cell recovery once HIV-1 suppression is achieved?
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Jarrin, I. Pantazis, N. Dalmau, J. Phillips, A.N. Olson, A. Mussini, C. Boufassa, F. Costagliola, D. Porter, K. Blanco, J. Del Amo, J. Martinez-Picado, J. Chene, G. Sabin, C. Walker, S. Fisher, M. Kelleher, T. Cooper, D. Finlayson, R. Bloch, M. Ramacciotti, T. Gelgor, L. Smith, D. Zangerle, R. Gill, J. Lutsar, I. Dabis, F. Thiebaut, R. Guiguet, M. Vanhems, P. Chaix, M.-L. Ghosn, J. Meyer, L. Hamouda, O. Kucherer, C. Bartmeyer, B. Antoniadou, A. Chrysos, G. Daikos, G.L. Touloumi, G. Katsarou, O. Rezza, G. Dorrucci, M. Monforte, A.D. De Luca, A. Prins, M. Geskus, R. Van Der Helm, J. Schuitemaker, H. Sannes, M. Brubakk, O. Kran, A.-M.B. Rosinska, M. Muga, R. Tor, J. De Olalla, P.G. Cayla, J. Moreno, S. Monge, S. Del Romero, J. Perez-Hoyos, S. Sonnerborg, A. Bucher, H.C. Gunthard, H. Rickenbach, M. Malyuta, R. Murphy, G. Johnson, A. Babiker, A. Pillay, D. Morrison, C. Salata, R. Mugerwa, R. Chipato, T. Amornkul, P.N. Gilmour, J. Kamali, A. Karita, E. Burns, F. Giaquinto, C. Grarup, J. Kirk, O. Bailey, H. Anne, A.V. Panteleev, A. Thorne, C. Aboulker, J.-P. Albert, J. Asandi, S. De Wit, S. Reiss, P. Gatell, J. Karpov, I. Ledergerber, B. Lundgren, J. Møller, C. Rakhmanova, A. Rockstroh, J. Sandhu, M. Dedes, N. Fenton, K. Pizzuti, D. Vitoria, M. Faggion, S. Fradette, L. Frost, R. Cartier, A. Raben, D. Schwimmer, C. Scott, M.
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Objective: This article compares trends in CD4 + T-cell recovery and proportions achieving optimal restoration (≥500cells/μl) after viral suppression following combination antiretroviral therapy (cART) initiation between rapid and nonrapid progressors. Methods: We included HIV-1 seroconverters achieving viral suppression within 6 months of cART. Rapid progressors were individuals experiencing at least one CD4 + less than 200cells/μl within 12 months of seroconverters before cART. We used piecewise linear mixed models and logistic regression for optimal restoration. Results: Of 4024 individuals, 294 (7.3%) were classified as rapid progressors. At the same CD4 + T-cell count at cART start (baseline), rapid progressors experienced faster CD4 + T-cell increases than nonrapid progressors in first month [difference (95% confidence interval) in mean increase/month (square root scale): 1.82 (1.61; 2.04)], which reversed to slightly slower increases in months 1-18 [-0.05 (-0.06; -0.03)] and no significant differences in 18-60 months [-0.003 (-0.01; 0.01)]. Percentage achieving optimal restoration was significantly lower for rapid progressors than nonrapid progressors at months 12 (29.2 vs. 62.5%) and 36 (47.1 vs. 72.4%) but not at month 60 (70.4 vs. 71.8%). These differences disappeared after adjusting for baseline CD4 + T-cell count: odds ratio (95% confidence interval) 0.86 (0.61; 1.20), 0.90 (0.38; 2.17) and 1.56 (0.55; 4.46) at months 12, 36 and 60, respectively. Conclusion: Among people on suppressive antiretroviral therapy, rapid progressors experience faster initial increases of CD4 + T-cell counts than nonrapid progressors, but are less likely to achieve optimal restoration during the first 36 months after cART, mainly because of lower CD4 + T-cell counts at cART initiation. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
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- 2015
16. Increased risk of cardiovascular disease (CVD) with age in HIV-positive men: a comparison of the D:A:D CVD risk equation and general population CVD risk equations
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Petoumenos, K., Reiss, P., Ryom, L., Rickenbach, M., Sabin, C.A., El-Sadr, W., Monforte, A., Phillips, A.N., Wit, S. de, Kirk, O., Dabis, F., Pradier, C., Lundgren, J.D., Law, M.G., Warris, A., Koopmans †, P.P., Keuter, M., and Ven, A.J. van der
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lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,cardiovascular diseases - Abstract
Contains fulltext : 138900.pdf (Publisher’s version ) (Closed access) OBJECTIVES: The aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. METHODS: We analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D:A:D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. RESULTS: A total of 24 323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age(2) for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population. CONCLUSIONS: We found only limited evidence of accelerating increased risk of CVD with age in D:A:D compared with the general population. The absolute risk of CVD associated with HIV infection remains uncertain.
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- 2014
17. Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era
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Eaton, J.W., Bacaer, N., Bershteyn, A., Cambiano, V., Cori, A., Dorrington, R.E., Fraser, C., Gopalappa, C., Hontelez, J.A., Johnson, L.F., Klein, D.J., Phillips, A.N., Pretorius, C., Stover, J., Rehle, T.M., Hallett, T.B., Eaton, J.W., Bacaer, N., Bershteyn, A., Cambiano, V., Cori, A., Dorrington, R.E., Fraser, C., Gopalappa, C., Hontelez, J.A., Johnson, L.F., Klein, D.J., Phillips, A.N., Pretorius, C., Stover, J., Rehle, T.M., and Hallett, T.B.
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Contains fulltext : 154578.pdf (publisher's version ) (Open Access), BACKGROUND: Mathematical models are widely used to simulate the effects of interventions to control HIV and to project future epidemiological trends and resource needs. We aimed to validate past model projections against data from a large household survey done in South Africa in 2012. METHODS: We compared ten model projections of HIV prevalence, HIV incidence, and antiretroviral therapy (ART) coverage for South Africa with estimates from national household survey data from 2012. Model projections for 2012 were made before the publication of the 2012 household survey. We compared adult (age 15-49 years) HIV prevalence in 2012, the change in prevalence between 2008 and 2012, and prevalence, incidence, and ART coverage by sex and by age groups between model projections and the 2012 household survey. FINDINGS: All models projected lower prevalence estimates for 2012 than the survey estimate (18.8%), with eight models' central projections being below the survey 95% CI (17.5-20.3). Eight models projected that HIV prevalence would remain unchanged (n=5) or decline (n=3) between 2008 and 2012, whereas prevalence estimates from the household surveys increased from 16.9% in 2008 to 18.8% in 2012 (difference 1.9, 95% CI -0.1 to 3.9). Model projections accurately predicted the 1.6 percentage point prevalence decline (95% CI -0.3 to 3.5) in young adults aged 15-24 years, and the 2.2 percentage point (0.5 to 3.9) increase in those aged 50 years and older. Models accurately represented the number of adults on ART in 2012; six of ten models were within the survey 95% CI of 1.54-2.12 million. However, the differential ART coverage between women and men was not fully captured; all model projections of the sex ratio of women to men on ART were lower than the survey estimate of 2.22 (95% CI 1.73-2.71). INTERPRETATION: Projections for overall declines in HIV epidemics during the ART era might have been optimistic. Future treatment and HIV prevention needs might be greater than previousl
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- 2015
18. Death rates in HIV-positive antiretroviral-naive patients with CD4 count greater than 350 cells per mu L in Europe and North America: a pooled cohort observational study
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Lodwick, R.K., Sabin, C.A., Porter, K., Ledergerber, B., Sighem, A. van, Cozzi-Lepri, A., Khaykin, P., Mocroft, A., Jacobson, L., Wit, S. de, Obel, N., Castagna, A., Wasmuth, J.C., Gill, J., Klein, M.B., Gange, S., Riera, M., Mussini, C., Gutierrez, F., Touloumi, G., Carrieri, P., Guest, J.L., Brockmeyer, N.H., Phillips, A.N., and CD4 Count Antiretroviral Naive
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human-immunodeficiency-virus general-population infected adults mortality therapy aids individuals risk seroconversion diseases - Abstract
Background Whether people living with HIV who have not received antiretroviral therapy (ART) and have high CD4 cell counts have higher mortality than the general population is unknown. We aimed to examine this by analysis of pooled data from industrialised countries. Methods We merged data on demographics, CD4 cell counts, viral-load measurements, hepatitis C co-infection status, smoking status, date of death, and whether death was AIDS-related or not from 23 European and North American cohorts. We calculated standardised mortality ratios (SMRs) standardised by age, sex, and year, stratifying by risk group. Data were included for patients aged 20-59 years who had at least one CD4 count greater than 350 cells per mu L while ART naive. All pre-ART CD4 counts greater than 350 cells per mu L from January, 1990, to December, 2004, were included. We investigated mortality for four risk groups men who have sex with men, heterosexual people, injecting drug users, and those at other or unknown risk. The association between CD4 cell count and death rate was investigated by use of Poisson regression methods. Findings Data were analysed for 40 830 patients contributing 80 682 person-years of follow-up. Of 419 deaths, 401 were used in the SMR analysis: 100 men who have sex with men (SMR 1.30 , 95% CI 1.06-1 58); 68 heterosexual people (2.94, 2.28-3.73); 203 injecting drug users (9.37, 8.13-10.75); and 30 in the other or unknown risk category (4.57, 3.09-6.53). Compared with CD4 counts of 350-499 cells per mu L, death rate was lower in patients with counts of 500-699 cells per mu L (adjusted rate ratio 0-77, 95% CI 0.61-0.95) and counts of 700 cells per mu L (0.66, 0.52-0.85). Interpretation In HIV-infected ART-naive patients with high CD4 cell counts, death rates were raised compared with the general population. In men who have sex with men this was modest, suggesting that a substantial proportion of the increased risk in other groups is due to confounding by other factors. Even though the increased risk is small, new studies of potential benefits of ART in this group are merited.
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- 2010
19. The effect of combined antiretroviral therapy on the overall mortality of HIV-infected individuals
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Ray, M., Logan, R., Sterne, J.A.C., Hernandez-Diaz, S., Robins, J.M., Sabin, C., Bansi, L., Sighem, A. van, Wolf, F. de, Costagliola, D., Lanoy, E., Bucher, H.C., Wyl, V. von, Esteve, A., Casabona, J., Amo, J. del, Moreno, S., Justice, A., Gouler, J., Lodi, S., Phillips, A., Seng, R., Meyer, L., Perez-Hoyos, S., Olalla, P.G. de, Herman, M.A., Phillips, A.N., Gilson, R., Easterbrook, P., Fisher, M., Gazzard, B., Johnson, M., Walsh, J., Leen, C., Orkin, C., Anderson, J., Pillay, D., Delpech, V., Schwenk, A., Dunn, D., Gompels, M., Hill, T., Porter, K., Babiker, A., HIV-CAUSAL Collaboration, Wyler, Claire-Anne, Other departments, AII - Amsterdam institute for Infection and Immunity, Infectious diseases, Graduate School, APH - Amsterdam Public Health, General Internal Medicine, Global Health, Paediatric Infectious Diseases / Rheumatology / Immunology, and Medical Microbiology and Infection Prevention
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Cart ,Adult ,Male ,medicine.medical_specialty ,Time Factors ,Immunology ,Marginal structural model ,Antiretroviral Therapy ,HIV Infections ,Article ,Drug Administration Schedule ,Europe/epidemiology ,Zidovudine ,Pharmacotherapy ,Acquired immunodeficiency syndrome (AIDS) ,Drug Therapy ,Antiretroviral Therapy, Highly Active ,Internal medicine ,medicine ,Immunology and Allergy ,Humans ,Highly Active ,Prospective cohort study ,Proportional Hazards Models ,ddc:618 ,Proportional hazards model ,business.industry ,Poverty-related infectious diseases [N4i 3] ,virus diseases ,Antiretroviral Therapy, Highly Active/mortality ,Drug Therapy, Combination/mortality ,Middle Aged ,Viral Load ,medicine.disease ,United States/epidemiology ,United States ,CD4 Lymphocyte Count ,Europe ,Infectious Diseases ,HIV Infections/drug therapy/mortality ,Combination ,HIV-1 ,Drug Therapy, Combination ,Female ,business ,Viral load ,medicine.drug - Abstract
Contains fulltext : 88938.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To estimate the effect of combined antiretroviral therapy (cART) on mortality among HIV-infected individuals after appropriate adjustment for time-varying confounding by indication. DESIGN: A collaboration of 12 prospective cohort studies from Europe and the United States (the HIV-CAUSAL Collaboration) that includes 62 760 HIV-infected, therapy-naive individuals followed for an average of 3.3 years. Inverse probability weighting of marginal structural models was used to adjust for measured confounding by indication. RESULTS: Two thousand and thirty-nine individuals died during the follow-up. The mortality hazard ratio was 0.48 (95% confidence interval 0.41-0.57) for cART initiation versus no initiation. In analyses stratified by CD4 cell count at baseline, the corresponding hazard ratios were 0.29 (0.22-0.37) for less than 100 cells/microl, 0.33 (0.25-0.44) for 100 to less than 200 cells/microl, 0.38 (0.28-0.52) for 200 to less than 350 cells/microl, 0.55 (0.41-0.74) for 350 to less than 500 cells/microl, and 0.77 (0.58-1.01) for 500 cells/microl or more. The estimated hazard ratio varied with years since initiation of cART from 0.57 (0.49-0.67) for less than 1 year since initiation to 0.21 (0.14-0.31) for 5 years or more (P value for trend
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- 2010
20. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration
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Smith, C.J., Ryom, L., Weber, R., Morlat, P., Pradier, C., Reiss, P., Kowalska, J.D., Wit, S. de, Law, M., Sadr, W. el, Kirk, O., Friis-Moller, N., Monforte, A., Phillips, A.N., Sabin, C.A., Lundgren, J.D., Groot, R. de, Koopmans †, P.P., Keuter, M., Ven, A.J. van der, et al., Smith, C.J., Ryom, L., Weber, R., Morlat, P., Pradier, C., Reiss, P., Kowalska, J.D., Wit, S. de, Law, M., Sadr, W. el, Kirk, O., Friis-Moller, N., Monforte, A., Phillips, A.N., Sabin, C.A., Lundgren, J.D., Groot, R. de, Koopmans †, P.P., Keuter, M., Ven, A.J. van der, and et al.
- Abstract
Contains fulltext : 137128.pdf (publisher's version ) (Closed access), BACKGROUND: With the advent of effective antiretroviral treatment, the life expectancy for people with HIV is now approaching that seen in the general population. Consequently, the relative importance of other traditionally non-AIDS-related morbidities has increased. We investigated trends over time in all-cause mortality and for specific causes of death in people with HIV from 1999 to 2011. METHODS: Individuals from the Data collection on Adverse events of anti-HIV Drugs (D:A:D) study were followed up from March, 1999, until death, loss to follow-up, or Feb 1, 2011, whichever occurred first. The D:A:D study is a collaboration of 11 cohort studies following HIV-1-positive individuals receiving care at 212 clinics in Europe, USA, and Australia. All fatal events were centrally validated at the D:A:D coordinating centre using coding causes of death in HIV (CoDe) methodology. We calculated relative rates using Poisson regression. FINDINGS: 3909 of the 49,731 D:A:D study participants died during the 308,719 person-years of follow-up (crude incidence mortality rate, 12.7 per 1000 person-years [95% CI 12.3-13.1]). Leading underlying causes were: AIDS-related (1123 [29%] deaths), non-AIDS-defining cancers (590 [15%] deaths), liver disease (515 [13%] deaths), and cardiovascular disease (436 [11%] deaths). Rates of all-cause death per 1000 person-years decreased from 17.5 in 1999-2000 to 9.1 in 2009-11; we saw similar decreases in death rates per 1000 person-years over the same period for AIDS-related deaths (5.9 to 2.0), deaths from liver disease (2.7 to 0.9), and cardiovascular disease deaths (1.8 to 0.9). However, non-AIDS cancers increased slightly from 1.6 per 1000 person-years in 1999-2000 to 2.1 in 2009-11 (p=0.58). After adjustment for factors that changed over time, including CD4 cell count, we detected no decreases in AIDS-related death rates (relative rate for 2009-11 vs 1999-2000: 0.92 [0.70-1.22]). However, all-cause (0.72 [0.61-0.83]), liver disease (0.48 [0.32
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- 2014
21. A survey of ATRIPLA use in clinical practice as first-line therapy in HIV-positive persons in Europe
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Mocroft, A., Reiss, P., Rakhmanova, A., Banhegyi, D., Phillips, A.N., Wit, S. de, Ristola, M., Lundgren, J.D., Grarup, J., Kirk, O., Burger, D.M., et al., Mocroft, A., Reiss, P., Rakhmanova, A., Banhegyi, D., Phillips, A.N., Wit, S. de, Ristola, M., Lundgren, J.D., Grarup, J., Kirk, O., Burger, D.M., and et al.
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Item does not contain fulltext, ATRIPLA is licensed for use only in HIV-positive persons whose viral loads <50 for >/= 3 months. We investigated the use of ATRIPLA as first-line antiretroviral therapy (ART) in EuroSIDA using a web-based survey performed in Autumn 2012. 96/112 clinics (85.7 %) completed the survey. Recommendations when initiating first-line ART was TRUVADA plus efavirenz in 36 (37.5 %), ATRIPLA in 35 (36.5 %), a different first-line regimen in 12 clinics (12.5 %), and no recommendation in 7 clinics (7.3 %). ATRIPLA was commonest in Northern (15/21 clinics; 71.4 %), and least common in Eastern Europe (2/31 clinics; 6.5 %; p < 0.0001). Over one-third of the participating clinics in this survey were using ATRIPLA as first-line antiretroviral therapy, despite EMA recommendations.
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- 2014
22. Factors associated with D-Dimer levels in HIV-Infected individuals
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Apetrei, C., Borges, Á.H., O’Connor, J.L., Phillips, A.N., Baker, J.V., Vjecha, M.J., Losso, M.H., Klinker, H., Lopardo, G., Williams, I., Lundgren, J.D., John, M., Apetrei, C., Borges, Á.H., O’Connor, J.L., Phillips, A.N., Baker, J.V., Vjecha, M.J., Losso, M.H., Klinker, H., Lopardo, G., Williams, I., Lundgren, J.D., and John, M.
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Background Higher plasma D-dimer levels are strong predictors of mortality in HIV+ individuals. The factors associated with D-dimer levels during HIV infection, however, remain poorly understood. Methods In this cross-sectional study, participants in three randomized controlled trials with measured D-dimer levels were included (N = 9,848). Factors associated with D-dimer were identified by linear regression. Covariates investigated were: age, gender, race, body mass index, nadir and baseline CD4+ count, plasma HIV RNA levels, markers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6]), antiretroviral therapy (ART) use, ART regimens, co-morbidities (hepatitis B/C, diabetes mellitus, prior cardiovascular disease), smoking, renal function (estimated glomerular filtration rate [eGFR] and cystatin C) and cholesterol. Results Women from all age groups had higher D-dimer levels than men, though a steeper increase of D-dimer with age occurred in men. Hepatitis B/C co-infection was the only co-morbidity associated with higher D-dimer levels. In this subgroup, the degree of hepatic fibrosis, as demonstrated by higher hyaluronic acid levels, but not viral load of hepatitis viruses, was positively correlated with D-dimer. Other factors independently associated with higher D-dimer levels were black race, higher plasma HIV RNA levels, being off ART at baseline, and increased levels of CRP, IL-6 and cystatin C. In contrast, higher baseline CD4+ counts and higher high-density lipoprotein cholesterol were negatively correlated with D-dimer levels. Conclusions D-dimer levels increase with age in HIV+ men, but are already elevated in women at an early age due to reasons other than a higher burden of concomitant diseases. In hepatitis B/C co-infected individuals, hepatic fibrosis, but not hepatitis viral load, was associated with higher D-dimer levels.
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- 2014
23. Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in the D:A:D study: a multi-cohort collaboration
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Sabin, C.A., Worm, S.W., Weber, R., Reiss, P., El-Sadr, W., Dabis, F., Wit, S. de, Law, M., d'Arminio Montforte, A., Friis-Moller, N., Kirk, O., Pradier, C., Weller, I., Phillips, A.N., Lundgren, J.D., and Gyssens, I.C.J.
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Pathogenesis and modulation of inflammation [N4i 1] ,Microbial pathogenesis and host defense [UMCN 4.1] - Abstract
Item does not contain fulltext
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- 2008
24. Access to antiretroviral treatment, incidence of sustained therapy interruptions, and risk of clinical events according to sex: evidence from the I.Co.N.A. Study
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Murri, R., Cozzi Lepri, A., Phillips, A.N., Girardi, E., Nasti, G., Ferrara, S., Mura, M.S., Mussini, C., Petrelli, E., Arlotti, M., De Stefano, C., Vigano, P., Novati, R., Cargnel, A., d'Arminio Monforte, A., and Study Group, I.C.O.N.A.
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Adult ,Male ,medicine.medical_specialty ,HAART ,Time Factors ,Settore MED/17 - Malattie Infettive ,Adolescent ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Antiretroviral Therapy, Highly Active ,Epidemiology ,medicine ,Humans ,Pharmacology (medical) ,Risk factor ,Aged ,Acquired Immunodeficiency Syndrome ,business.industry ,Incidence (epidemiology) ,HIV ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Discontinuation ,CD4 Lymphocyte Count ,AIDS ,Infectious Diseases ,Female ,business ,Cohort study - Abstract
Objectives of the study were to assess the differences between sexes in the likelihood of starting antiretroviral therapy (ART), in rates of sustained discontinuation from highly active antiretroviral therapy (HAART), and in clinical progression. In a multicenter cohort study (I.Co.N.A. Study), 2323 men and 1335 women previously naive to antiretrovirals were enrolled. As of September 2002, 807 women and 1480 men started ART. The median time to starting ART was 28 weeks for women and 17 weeks for men (P = 0.0003 by log-rank test). This difference was no longer significant after adjusting for either HIV RNA (P = 0.21) or CD4 count (P = 0.28) at enrollment. Women tend to start HAART less frequently than mono/dual ART after adjusting for potential confounders (odds ratio = 0.78, 95% confidence interval [CI]: 0.60-1.01; P = 0.06). Women who started HAART were 1.4 times more likely than men (95% CI: 1.00-1.99; P = 0.05) to interrupt at least 1 drug because of toxicity. Twenty-one percent of women and 19% of men interrupted HAART altogether for more than 3 months (P = 0.3). Clinical progression was observed in 53 women (22.6%) and 137 men (23.4%; P = 0.56). Risk of developing a clinical event was found to be no different between women and men (relative hazard = 0.84, 95% CI: 0.56-1.26; P = 0.40).
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- 2003
25. Antiretroviral Therapy Cohort Collaboration : prognostic importance of initial response in HIV-1 infected patients starting potent antiretroviral therapy : analysis of prospective studies
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Chene, G., Sterne, J.A., May, M., Costagliola, D., Ledergerber, B., Phillips, A.N., Dabis, F., Lundgren, J., D'Arminio Monforte, A., de Wolf, F., Hogg, R., Reiss, P., Justice, A., Leport, C., Staszewski, S., Gill, J., Fatkenheuer, G., Egger, M.E., and Antiretroviral Therapy Cohort Collaboration
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Settore MED/17 - Malattie Infettive - Published
- 2003
26. Associations between immune depression and cardiovascular events in HIV infection
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Sabin, C.A., Ryom, L., De Wit, S., Mocroft, A., Phillips, A.N., Worm, S.W., Weber, R., d’Arminio Monforte, A., Reiss, P., Kamara, D., El-Sadr, W., Pradier, C., Dabis, F., Law, M., Lundgren, J., Nolan, D., Sabin, C.A., Ryom, L., De Wit, S., Mocroft, A., Phillips, A.N., Worm, S.W., Weber, R., d’Arminio Monforte, A., Reiss, P., Kamara, D., El-Sadr, W., Pradier, C., Dabis, F., Law, M., Lundgren, J., and Nolan, D.
- Abstract
Objective: To consider associations between the latest/nadir CD4+ cell count, and time spent with CD4+ cell count less than 200 cells/μl (duration of immune depression), and myocardial infarction (MI), coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) (CHD or stroke) in 33 301 HIV-positive individuals. Design: Longitudinal cohort study. Methods: Analyses were undertaken using Poisson regression. To investigate whether analyses of stroke were robust to the type of endpoint, we additionally included stroke-like events and rejected strokes into the stroke endpoint. Results: Participants experienced 716 MI, 1056 CHD, 303 stroke, and 1284 CVD events. Whereas there was no evidence of a higher MI/CHD risk in those with lower latest/nadir CD4+ cell counts after adjustment [current CD4+ <100 cells/μl: relative rate (95% confidence interval) 0.96 (0.62–1.50) for MI, 0.89 (0.30–2.36) for CHD; nadir CD4+ <100 cells/μl: 1.36 (0.57–3.23) for MI, 0.98 (0.45–2.16) for CHD], stroke and CVD rates were higher in those with a latest CD4+ cell count less than 100 cells/μl [2.26 (1.29–3.94) and 1.14 (0.84–1.56), respectively]. All events occurred less frequently in those who had not experienced immune depression, although evidence for a linear association with duration of immune depression was weak. The association between stroke risk and the latest CD4+ cell count strengthened as stroke-like and rejected strokes were included; conversely, associations with established stroke risk factors weakened. Conclusion: We do not find strong evidence that HIV-positive individuals with a low CD4+ cell count are more likely to experience MI/CHD. Although strokes appear to occur more commonly at low CD4+ cell counts, this may be partly explained by misclassification or other biases.
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- 2013
27. CD4 cell count and viral load-specific rates of AIDS, non-AIDS and deaths according to current antiretroviral use
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Mocroft, A., Phillips, A.N., Gatell, J., Horban, A., Ledergerber, B., Zilmer, K., Jevtovic, D., Maltez, F., Podlekareva, D., Lundgren, J.D., Burger, D.M., et al., Mocroft, A., Phillips, A.N., Gatell, J., Horban, A., Ledergerber, B., Zilmer, K., Jevtovic, D., Maltez, F., Podlekareva, D., Lundgren, J.D., Burger, D.M., and et al.
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Item does not contain fulltext, BACKGROUND: CD4 cell count and viral loads are used in clinical trials as surrogate endpoints for assessing efficacy of newly available antiretrovirals. If antiretrovirals act through other pathways or increase the risk of disease this would not be identified prior to licensing. The aim of this study was to investigate the CD4 cell count and viral load-specific rates of fatal and nonfatal AIDS and non-AIDS events according to current antiretrovirals. METHODS: Poisson regression was used to compare overall events (fatal or nonfatal AIDS, non-AIDS or death), AIDS events (fatal and nonfatal) or non-AIDS events (fatal or nonfatal) for specific nucleoside pairs and third drugs used with more than 1000 person-years of follow-up (PYFU) after 1 January 2001. RESULTS: Nine thousand, eight hundred and one patients contributed 42372.5 PYFU, during which 1203 (437 AIDS and 766 non-AIDS) events occurred. After adjustment, there was weak evidence of a difference in the overall events rates between nucleoside pairs (global P-value = 0.084), and third drugs (global P-value = 0.031). As compared to zidovudine/lamivudine, patients taking abacavir/lamivudine [adjusted incidence rate ratio (aIRR) 1.22; 95% CI 0.99-1.49] and abacavir and one other nucleoside [aIRR 1.51; 95% CI 1.14-2.02] had an increased incidence of overall events. Comparing the third drugs, those taking unboosted atazanavir had an increased incidence of overall events compared with those taking efavirenz (aIRR 1.46; 95% CI 1.09-1.95). CONCLUSION: There was little evidence of substantial differences between antiretrovirals in the incidence of clinical disease for a given CD4 cell count or viral load, suggesting there are unlikely to be major unidentified adverse effects of specific antiretrovirals.
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- 2013
28. Response to antiretroviral therapy among patients exposed to three classes of antiretrovirals:Results from the EuroSIDA study
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Mocroft, A., Phillips, A.N., Friis-Møller, N., Colebunders, R., Johnson, A.M., Hirschel, B., Saint Marc, T., Staub, T., Clotet, B., and Lundgren, J., for the EuroSIDA study group
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- 2002
29. HIV treatment as prevention: systematic comparison of mathematical models of the potential impact of antiretroviral therapy on HIV incidence in South Africa
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Eaton, J.W., Johnson, L.F., Salomon, J.A., Barnighausen, T., Bendavid, E., Bershteyn, A., Bloom, D.E., Cambiano, V., Fraser, C., Hontelez, J.A.C., Humair, S., Klein, D.J., Long, E.F., Phillips, A.N., Pretorius, C., Stover, J., Wenger, E.A., Williams, B.G., Hallett, T.B., Eaton, J.W., Johnson, L.F., Salomon, J.A., Barnighausen, T., Bendavid, E., Bershteyn, A., Bloom, D.E., Cambiano, V., Fraser, C., Hontelez, J.A.C., Humair, S., Klein, D.J., Long, E.F., Phillips, A.N., Pretorius, C., Stover, J., Wenger, E.A., Williams, B.G., and Hallett, T.B.
- Abstract
Contains fulltext : 108066.pdf (publisher's version ) (Open Access), BACKGROUND: Many mathematical models have investigated the impact of expanding access to antiretroviral therapy (ART) on new HIV infections. Comparing results and conclusions across models is challenging because models have addressed slightly different questions and have reported different outcome metrics. This study compares the predictions of several mathematical models simulating the same ART intervention programmes to determine the extent to which models agree about the epidemiological impact of expanded ART. METHODS AND FINDINGS: Twelve independent mathematical models evaluated a set of standardised ART intervention scenarios in South Africa and reported a common set of outputs. Intervention scenarios systematically varied the CD4 count threshold for treatment eligibility, access to treatment, and programme retention. For a scenario in which 80% of HIV-infected individuals start treatment on average 1 y after their CD4 count drops below 350 cells/microl and 85% remain on treatment after 3 y, the models projected that HIV incidence would be 35% to 54% lower 8 y after the introduction of ART, compared to a counterfactual scenario in which there is no ART. More variation existed in the estimated long-term (38 y) reductions in incidence. The impact of optimistic interventions including immediate ART initiation varied widely across models, maintaining substantial uncertainty about the theoretical prospect for elimination of HIV from the population using ART alone over the next four decades. The number of person-years of ART per infection averted over 8 y ranged between 5.8 and 18.7. Considering the actual scale-up of ART in South Africa, seven models estimated that current HIV incidence is 17% to 32% lower than it would have been in the absence of ART. Differences between model assumptions about CD4 decline and HIV transmissibility over the course of infection explained only a modest amount of the variation in model results. CONCLUSIONS: Mathematical models evaluati
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- 2012
30. Infections with Mycobacterium tuberculosis and Mycobacterium avium among HIV-infected patients after the introduction of highly active antiretroviral therapy
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Kirk, O., Gatell, J., Pedersen, C., Proenca, R., Brettle, R.P., Barton, S., Sudre, P., Phillips, A.N., and Lundgren, J.D.
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- 2000
31. HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies.
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Montforte, A., Abrams, D., Pradier, C., Weber, R., Reiss, P., Bonnet, F., Kirk, O., Law, M., Wit, S. de, Friis-Moller, N., Phillips, A.N., Sabin, C.A., Lundgren, J.D., Gyssens, I.C.J., et al., Montforte, A., Abrams, D., Pradier, C., Weber, R., Reiss, P., Bonnet, F., Kirk, O., Law, M., Wit, S. de, Friis-Moller, N., Phillips, A.N., Sabin, C.A., Lundgren, J.D., Gyssens, I.C.J., and et al.
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Item does not contain fulltext
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- 2008
32. Changes over time in risk factors for cardiovascular disease and use of lipid-lowering drugs in HIV-infected individuals and impact on myocardial infarction.
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Sabin, C.A., d'Arminio Montforte, A., Friis-Moller, N., Weber, R., El-Sadr, W., Reiss, P., Kirk, O., Mercie, P., Law, M.G., Wit, S. de, Pradier, C., Phillips, A.N., Lundgren, J.D., Sabin, C.A., d'Arminio Montforte, A., Friis-Moller, N., Weber, R., El-Sadr, W., Reiss, P., Kirk, O., Mercie, P., Law, M.G., Wit, S. de, Pradier, C., Phillips, A.N., and Lundgren, J.D.
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Item does not contain fulltext
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- 2008
33. Risk of discontinuation of nevirapine due to toxicities in antiretroviral-naive and -experienced HIV-infected patients with high and low CD4(+) T-cell counts (vol 12, pg 325, 2007)
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Mocroft, A., Staszewski, S., Weber, R., Gatell, J., Rockstroh, J., Gasiorowski, J., Panos, G., Monforte, A.D., Rakhmanova, A., Phillips, A.N., Lundgren, J.D., Mocroft, A., Staszewski, S., Weber, R., Gatell, J., Rockstroh, J., Gasiorowski, J., Panos, G., Monforte, A.D., Rakhmanova, A., Phillips, A.N., and Lundgren, J.D.
- Abstract
Udgivelsesdato: 2007
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- 2007
34. Predictors of CD4 count change over 8 months of follow up in HIV-1-infected patients with a CD4 count >= 300 cells/mu L who were assigned to 7.5 MIU interleukin
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Fox, Z., Antunes, F., Davey, R., Gazzard, B., Klimas, N., Labriola, A., Losso, M., Neaton, J.D., Phillips, A.N., Ruxrungtham, K., Staszewski, S., Weiss, L., Lundgren, J.D., Abrams, D.I., Cooper, D.A., Darbyshire, J.H., Duncan, W.R., Emery, S., Lane, H.C., Lehrman, S., Aguilar, L., Angel, E.B., Aquilia, S., Belloso, W., Benetucci, J., Bittar, V., Cahn, P., Casiro, A., Contarelli, J., Corral, J., Daciuk, L., David, D., Ferrari, I., Fridman, D., Galache, V., Guaragna, G., Ivalo, S., Laplume, H., Lanusse, I., Lasala, M.B., Lattes, R., Lasovsky, J., Lopardo, G., Lourtau, L., Lupo, S., Maranzana, A., Marson, C., Massera, L., Sanchez, M.D., Somenzini, C., Tocci, M., Algar, S., Anderson, J., Baker, D., Blavius, K., Bloch, M., Boyle, M., Bradford, D., Britton, P., Carrall, L., Carr, A., Chuah, J., Curry, M., D'Arcy-Evans, C., Dobson, P., Doong, N., Egan, C., Ferguson, W., Finlayson, R., French, M., Frater, A., Gold, J., Habel, P., Haig, K., Holland, R., Hyland, N., Hoy, J., Hudson, J., James, R., Leung, J., Lowe, K., MacRae, K., McMurchie, M., Medland, N., Miller, S., Murray, J., Newman, R., Orth, D., Patching, J., Primrose, R., Ree, H., Richardson, R., Rogers, G., Roney, J., Roth, N., Sarangapany, J., Shaw, D., Silberberg, C., Skett, J., Williams, L., Soo, T.M., Sowden, D., Street, A., Vale, R., Villella, C., Walker, A., Watson, A., Wendt, N., Wood, H., Youds, D., Aichelburg, A., Rieger, A., Vetter, N., Clumeck, N., Wit, S. De, Kabeya, K., O'Doherty, E., Amorim, C.D., Basso, C.R., Lewi, D.S., Pereira, L.C., Silva, M. da, Souza, T.N.L., Angel, J., Bouchard, P.R., Clark, F., Cohen, J., Dambreville, M., Ellis, M., Fiset, S., Foster, A., Fraser, C., Gagnon, S., Gilmour, J., Guenette, R., Haldane, H., Hawley-Foss, N., Hyndman, S., Johnston, L., Jubinville, N., Juneau, F., Kelleher, L., LaPointe, L., Latendre-Paquette, J., Lindemulder, A., Mashinter, L., Lefebvre, E., McFarland, N., Morisseau, C., O'Neill, R., Piche, A., Ralph, E., Rouleau, D., Routy, J.P., Sandre, R., Schmidt, S., Shafran, S., Smaill, F., Stromberg, D., Trepanier, J.M., Trottier, S., Veal, S., Walmsley, S., Weiss, K., Williams, K., Young, M., Zaleschuk, B., Zarowny, D., Baadegaard, B., Black, F., Boedker, K., Gerstoft, J., Jensen, L., Mathiesen, L., Nielsen, H., Pedersen, C., Petersen, D., Aboulker, J.P., Baakili, A., Bengrait, N., Bensalem, M., Berthe, H., Bloche, M., Bazin, C., Boue, F., Bouvet, E., Brancon, C., Capitant, C., Ceppi, C., Cheneau, C., Coutellier, A., Chennebault, J.M., Coquet, F., Truchis, P. De, Delavalle, A.M., Frixon-Marin, V., Gastaut, J.A., Delfraissy, F., Eliaszeicz, M., Gallais, H., Gataut, J.A., Gilquin, J., Gonzalez-Canali, G., Gaudebout, C., Goujard, C., Hoen, B., Honore, P., Jarousse, B., Lang, J.M., Lefebvre, B., Levy, Y., Loison, J., Maignan, A., Meynard, J.L., Michon, C., Mole, M., Marsal, L., Matheron, S., Mortier, E., Oksenhendler, E., Poirier, S., Picard-Dahan, C., Ravaux, I., Raffi, F., Raguin, G., Reynes, J., Rozenbaum, W., Salmon, D., Simon, A., Spiridon, G., Viard, J.P., Vidal, M., Zucman, D., Bergmann, F., Brockmeyer, N., Faetkenheuer, G., Fenske, S., Gey, D., Goebel, F.D., Goetsch, M., Hartmann, M., Klinker, H., Kremer, G., Mantzsch, K., Mauss, S., Rockstroh, J., Rotty, J., Rund, E., Schneider, K., Fox, Z., Antunes, F., Davey, R., Gazzard, B., Klimas, N., Labriola, A., Losso, M., Neaton, J.D., Phillips, A.N., Ruxrungtham, K., Staszewski, S., Weiss, L., Lundgren, J.D., Abrams, D.I., Cooper, D.A., Darbyshire, J.H., Duncan, W.R., Emery, S., Lane, H.C., Lehrman, S., Aguilar, L., Angel, E.B., Aquilia, S., Belloso, W., Benetucci, J., Bittar, V., Cahn, P., Casiro, A., Contarelli, J., Corral, J., Daciuk, L., David, D., Ferrari, I., Fridman, D., Galache, V., Guaragna, G., Ivalo, S., Laplume, H., Lanusse, I., Lasala, M.B., Lattes, R., Lasovsky, J., Lopardo, G., Lourtau, L., Lupo, S., Maranzana, A., Marson, C., Massera, L., Sanchez, M.D., Somenzini, C., Tocci, M., Algar, S., Anderson, J., Baker, D., Blavius, K., Bloch, M., Boyle, M., Bradford, D., Britton, P., Carrall, L., Carr, A., Chuah, J., Curry, M., D'Arcy-Evans, C., Dobson, P., Doong, N., Egan, C., Ferguson, W., Finlayson, R., French, M., Frater, A., Gold, J., Habel, P., Haig, K., Holland, R., Hyland, N., Hoy, J., Hudson, J., James, R., Leung, J., Lowe, K., MacRae, K., McMurchie, M., Medland, N., Miller, S., Murray, J., Newman, R., Orth, D., Patching, J., Primrose, R., Ree, H., Richardson, R., Rogers, G., Roney, J., Roth, N., Sarangapany, J., Shaw, D., Silberberg, C., Skett, J., Williams, L., Soo, T.M., Sowden, D., Street, A., Vale, R., Villella, C., Walker, A., Watson, A., Wendt, N., Wood, H., Youds, D., Aichelburg, A., Rieger, A., Vetter, N., Clumeck, N., Wit, S. De, Kabeya, K., O'Doherty, E., Amorim, C.D., Basso, C.R., Lewi, D.S., Pereira, L.C., Silva, M. da, Souza, T.N.L., Angel, J., Bouchard, P.R., Clark, F., Cohen, J., Dambreville, M., Ellis, M., Fiset, S., Foster, A., Fraser, C., Gagnon, S., Gilmour, J., Guenette, R., Haldane, H., Hawley-Foss, N., Hyndman, S., Johnston, L., Jubinville, N., Juneau, F., Kelleher, L., LaPointe, L., Latendre-Paquette, J., Lindemulder, A., Mashinter, L., Lefebvre, E., McFarland, N., Morisseau, C., O'Neill, R., Piche, A., Ralph, E., Rouleau, D., Routy, J.P., Sandre, R., Schmidt, S., Shafran, S., Smaill, F., Stromberg, D., Trepanier, J.M., Trottier, S., Veal, S., Walmsley, S., Weiss, K., Williams, K., Young, M., Zaleschuk, B., Zarowny, D., Baadegaard, B., Black, F., Boedker, K., Gerstoft, J., Jensen, L., Mathiesen, L., Nielsen, H., Pedersen, C., Petersen, D., Aboulker, J.P., Baakili, A., Bengrait, N., Bensalem, M., Berthe, H., Bloche, M., Bazin, C., Boue, F., Bouvet, E., Brancon, C., Capitant, C., Ceppi, C., Cheneau, C., Coutellier, A., Chennebault, J.M., Coquet, F., Truchis, P. De, Delavalle, A.M., Frixon-Marin, V., Gastaut, J.A., Delfraissy, F., Eliaszeicz, M., Gallais, H., Gataut, J.A., Gilquin, J., Gonzalez-Canali, G., Gaudebout, C., Goujard, C., Hoen, B., Honore, P., Jarousse, B., Lang, J.M., Lefebvre, B., Levy, Y., Loison, J., Maignan, A., Meynard, J.L., Michon, C., Mole, M., Marsal, L., Matheron, S., Mortier, E., Oksenhendler, E., Poirier, S., Picard-Dahan, C., Ravaux, I., Raffi, F., Raguin, G., Reynes, J., Rozenbaum, W., Salmon, D., Simon, A., Spiridon, G., Viard, J.P., Vidal, M., Zucman, D., Bergmann, F., Brockmeyer, N., Faetkenheuer, G., Fenske, S., Gey, D., Goebel, F.D., Goetsch, M., Hartmann, M., Klinker, H., Kremer, G., Mantzsch, K., Mauss, S., Rockstroh, J., Rotty, J., Rund, E., and Schneider, K.
- Abstract
Udgivelsesdato: 2007/3
- Published
- 2007
35. HIV in the UK 1980-2006: Reconstruction using a model of HIV infection and the effect of antiretroviral therapy
- Author
-
Phillips, A.N., Sabin, C., Pillay, D., Lundgren, J.D., Phillips, A.N., Sabin, C., Pillay, D., and Lundgren, J.D.
- Abstract
Udgivelsesdato: 2007/11
- Published
- 2007
36. Relating protease inhibitor resistance at time of virological failure with drug exposure
- Author
-
Van Luin, M., Bannister, W.P., Paredes, R., Phillips, A.N., Bruun, J., Van Lunzen, J., Kirk, O., Monforte, A. D'Arminio, Cozzi-Lepri, A., and Burger, D.M.
- Subjects
Protease inhibitors -- Patient outcomes ,Drug resistance -- Risk factors -- Development and progression ,HIV infection -- Drug therapy ,Health - Abstract
7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK, Background The absence of detectable HIV resistance after treatment failure may result from non‐adherence, especially for drugs such as ritonavir‐boosted PIs (PI/r) for which minimum adherence may be sufficient to [...]
- Published
- 2010
- Full Text
- View/download PDF
37. Reasons for Stopping Antiretrovirals Used in an Initial Highly Active Antiretroviral Regimen: Increased Incidence of Stopping due to Toxicity or Patient/Physician Choice in Patients with Hepatitis C Coinfection
- Author
-
Mocroft, A., primary, Phillips, A.N., additional, Soriano, V., additional, Rockstroh, J., additional, Blaxhult, A., additional, Katlama, C., additional, Boron-Kaczmarska, A., additional, Viksna, L., additional, Kirk, O., additional, and Lundgren, J.D., additional
- Published
- 2005
- Full Text
- View/download PDF
38. The effect of fungicide programmes based on epoxiconazole on the control and DMI sensitivity of Rhynchosporium secalis in winter barley
- Author
-
Cooke, L.R., primary, Locke, T., additional, Lockley, K.D., additional, Phillips, A.N., additional, Sadiq, M.D.S., additional, Coll, R., additional, Black, L., additional, Taggart, P.J., additional, and Mercer, P.C., additional
- Published
- 2004
- Full Text
- View/download PDF
39. Benzimidazole resistance in Rhynchosporium secalis and its effect on barley leaf blotch control in the UK
- Author
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Taggart, P.J., primary, Locke, T., additional, Phillips, A.N., additional, Pask, N., additional, Hollomon, D.W., additional, Kendall, S.J., additional, Cooke, L.R., additional, and Mercer, P.C., additional
- Published
- 1999
- Full Text
- View/download PDF
40. RAYMATH, A COMPUTER LANGUAGE FOR THE REDUCTION OF DATA FROM NEUTRON CROSS- SECTION EXPERIMENTS.
- Author
-
Harlow, M.V. Jr., primary, Ferrell, K.D., additional, Phillips, A.N., additional, and Wigglesworth, R.M., additional
- Published
- 1972
- Full Text
- View/download PDF
41. Determination of the EMP enhancement factor
- Author
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Benton, C.U., primary, Phillips, A.N., additional, Buchanan, R.W., additional, and Fowles, H.M., additional
- Published
- 1973
- Full Text
- View/download PDF
42. Changing patterns of mortality across Europe in patients infected with HIV-1
- Author
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Mocroft, A., Vella, S., Benfield, T.L., Chiesi, A., Miller, V., Gargalianos, P., Monforte, A. d'Arminio, Yust, I., Bruun, J.N., Phillips, A.N., and Lundgren, J.D.
- Subjects
HIV infection -- Drug therapy ,Antiviral agents -- Evaluation ,Drug therapy, Combination -- Evaluation - Published
- 1998
43. The Molecular Epidemiology of Human Immunodeficiency Virus Type 1 in Six Cities in Britain and Ireland
- Author
-
Brown, A.J.Leigh, primary, Lobidel, D, additional, Wade, C.M, additional, Rebus, S, additional, Phillips, A.N, additional, Brettle, R.P, additional, France, A.J, additional, Leen, C.S, additional, McMenamin, J, additional, McMillan, A, additional, Maw, R.D, additional, Mulcahy, F, additional, Robertson, J.R, additional, Sankar, K.N, additional, Scott, G, additional, Wyld, R, additional, and Peutherer, J.F, additional
- Published
- 1997
- Full Text
- View/download PDF
44. Clinical staging system for AIDS patients
- Author
-
Cozzi Lepri, A., primary, Pezzotti, P., additional, Phillips, A.N., additional, Petrucci, A., additional, and Rezza, G., additional
- Published
- 1995
- Full Text
- View/download PDF
45. Staging system for clinical AIDS patients
- Author
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Mocroft, A.J, primary, Phillips, A.N, additional, Elford, J, additional, Sabin, c.A, additional, Lipman, M, additional, Johnson, M.A, additional, Emery, V, additional, Lee, C.A, additional, Youle, M, additional, Morcineck, J, additional, and Janossy, G, additional
- Published
- 1995
- Full Text
- View/download PDF
46. Smoking as "independent" risk factor for suicide: illustration of an artifact from observational epidemiology?
- Author
-
Davey Smith, G., primary, Phillips, A.N., additional, and Neaton, J.D., additional
- Published
- 1992
- Full Text
- View/download PDF
47. CD4 cell count and initiation of antiretroviral therapy: trends in seven UK centres, 1997–2003.
- Author
-
Stöhr, W., Dunn, D.T., Porter, K., Hill, T., Gazzard, B., Walsh, J., Gilson, R., Easterbrook, P., Fisher, M., Johnson, M.A., Delpech, V.C., Phillips, A.N., and Sabin, C.A.
- Subjects
CD4 antigen ,VIRAL receptors ,THERAPEUTICS ,ETHNICITY ,CLINICAL medicine ,LOGISTIC regression analysis - Abstract
Objectives We examined whether the timing of initiation of antiretroviral therapy (ART) in routine clinical practice reflected treatment guidelines, which have evolved towards recommending starting therapy at lower CD4 cell counts. Methods We analysed longitudinal data on 10 820 patients enrolled in the UK Collaborative HIV Cohort (UK CHIC) Study, which includes seven large clinical centres in south-east England. CD4 cell and viral load measurements performed in the period between 1 January 1997 and 31 December 2003 were classified according to whether ART was subsequently initiated or deferred, to estimate the probability of ART initiation by CD4 count and viral load over time. The effect of nonclinical factors (age, sex, ethnicity, and exposure category) was analysed by logistic regression. Kaplan–Meier analysis was used to estimate the proportion of patients who had initiated ART by a particular CD4 count among ‘early’ presenters (initial CD4 cell count >500 cells/μL). Results There was a tendency to initiate ART at lower CD4 cell counts over time in the years 1997–2000, especially in the range 200–500 cells/μL, with little change thereafter. An estimated 34% of HIV-infected individuals having presented early initiated ART at a CD4 count <200 cells/μL. We also found an independent influence of viral load, which was particularly pronounced for CD4 <350 cells/μL. Use of injection drugs was the only nonclinical factor associated with initiation of ART at lower CD4 cell counts. Conclusions The initiation of ART in the clinics included in this analysis reflected evolving treatment guidelines. However, an unexpectedly high proportion of patients started ART at lower CD4 counts than recommended, which is only partly explained by late presentation. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
48. Eighth annual conference of the British HIV Association (BHIVA), 19–21 April 2002, University of York, York, UK.
- Author
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Paddam, L.A., Phillips, A.N., Lundgren, J.D., and Bhaskaran, K.
- Subjects
- *
HIV infections , *CONFERENCES & conventions - Abstract
Presents conferences on HIV infection, conducted by the British HIV Association in York, England. Status of patients who started highly active antiretroviral therapy; Changes in factors associated with HIV survival in Europe.
- Published
- 2002
- Full Text
- View/download PDF
49. Antiretroviral therapy CNS penetration and HIV-1–associated CNS disease(CME)
- Author
-
Garvey, L., Winston, A., Walsh, J., Post, F., Porter, K., Gazzard, B., Fisher, M., Leen, C., Pillay, D., Hill, T., Johnson, M., Gilson, R., Anderson, J., Easterbrook, P., Bansi, L., Orkin, C., Ainsworth, J., Palfreeman, A., Gompels, M., Phillips, A.N., and Sabin, C.A.
- Abstract
The impact of different antiretroviral agents on the risk of developing or surviving CNS disease remains unknown. The aim of this study was to investigate whether using antiretroviral regimens with higher CNS penetration effectiveness (CPE) scores was associated with reduced incidence of CNS disease and improved survival in the UK Collaborative HIV Cohort (CHIC) Study.
- Published
- 2011
- Full Text
- View/download PDF
50. Alcohol and ischaemic heart disease in middle aged British men.
- Author
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Shaper, A.G., Phillips, A.N., Pocock, S.J., and Walker, M.
- Subjects
- *
DISEASES in men , *ALCOHOL , *HEART diseases - Abstract
Examines alcohol and ischemic heart disease in middle aged British men. Incidence of ischemic heart disease events in men without heart disease; Use of logistic regression on calculating the adjusted percentage rates of ischemic heart disease; List of potential risk factors for ischemic heart disease.
- Published
- 1987
- Full Text
- View/download PDF
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