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10. Trends in human immunodeficiency virus diagnoses among men who have sex with men in North America, Western Europe, and Australia, 2000–2014

Author

Chapin-Bardales, Johanna, Schmidt, Axel J., Guy, Rebecca J., Kaldor, John M., McGregor, Skye, Sasse, André, Archibald, Chris, Rank, Claudia, Casabona Barbarà, Jordi, Folch, Cinta, Vives, Núria, Cowan, Susan A., Cazein, Françoise, Velter, Annie, an der Heiden, Matthias, Gunsenheimer-Bartmeyer, Barbara, Marcus, Ulrich, Op de Coul, Eline L.M., van Sighem, Ard, Aldir, Isabel, Cortes Martins, Helena, Berglund, Torsten, Velicko, Inga, Gebhardt, Martin, Delpech, Valerie, Hughes, Gwenda, Nardone, Anthony, Hall, H. Irene, Johnson, Anna S., and Sullivan, Patrick S.

Published
2018
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11. Factors associated with the informal use of HIV pre-exposure prophylaxis in Germany: a cross-sectional study

Author

Koppe, Uwe, Marcus, Ulrich, Albrecht, Stefan, Jansen, Klaus, Jessen, Heiko, Gunsenheimer-Bartmeyer, Barbara, and Bremer, Viviane

Subjects
Prophylaxis, HIV infections -- Prevention, Emtricitabine, HIV -- Prevention, Sexually transmitted disease prevention, Health insurance, Health
Abstract

Introduction: Until September 2019, pre-exposure prophylaxis (PrEP) with tenofovir disoproxil/emtricitabine for HIV prevention was not covered by health insurance plans in Germany, and was only available through private prescriptions with self-pay or through informal non-prescription sources. The objective of this study was to investigate the proportion of informal PrEP use among PrEP users and to identify factors of public health relevance that might be associated with informal PrEP use. Methods: We conducted a cross-sectional study recruiting PrEP users independent of their PrEP source. Clients from anonymous community testing checkpoints, users of three dating apps for men who have sex with men residing in Germany and users of a PrEP community website, were recruited to complete a short anonymous online survey. Participants were recruited between 24 July and 3 September 2018. The results were analysed using univariable and multivariable logistic regressions. Results: We recruited 2005 participants currently using PrEP. The median age was 38 years, and 80.3% of the participants identified themselves as male (missing: 19.1%). Overall, 71.6% obtained PrEP through medical services with a private prescription or a clinical trial, and 17.4% obtained PrEP through informal sources (missing: 11.0%). The most common informal sources were ordering online from another country (8.8%), travel abroad (3.6%), and friends (2.5%). Factors associated with informa PrEP use were on demand/intermittent dosing (adjusted OR: 3.5, 95% CI 2.5 to 5.0) and not receiving medical tests during PrEP use (adjusted OR: 3.2, 95% CI 2.0 to 5.2). In addition, informal PrEP users who did not take PrEP daily had a strongly increased risk of starting PrEP without prior medical tests (adjusted stratum-specific OR = 31.7, 95% CI 4.6 to 219.5). Conclusions: Informal PrEP use was associated with a higher risk of not getting tested before and during PrEP use, which could lead to HIV infections resistant to tenofovir and emtricitabine if people with undiagnosed HIV use PrEP. Health insurance plans that cover PrEP and the accompanying routine tests could ensure adequate medical supervision of PrEP users and reduce barriers to PrEP use. Our findings strongly support the implementation of PrEP programmes in countries with similar patterns of informal PrEP use. Keywords: PrEP; men who have sex with men; testing; informal PrEP; non-daily use; affordability, 1 | INTRODUCTION Pre-exposure prophylaxis (PrEP), with tenofovir disoproxil/emtricitabine, has been proven to be highly effective in preventing HIV infections in men who have sex with men (MSM) and other [...]

Published
2019
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13. The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges

Author

European HIV Continuum of Care Working Group, Gourlay, Annabelle, Noori, Teymur, Pharris, Anastasia, Axelsson, Maria, Costagliola, Dominique, Cowan, Susan, Croxford, Sara, Monforte, Antonella d'Arminio, del Amo, Julia, Delpech, Valerie, Díaz, Asunción, Girardi, Enrico, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Jose, Sophie, Leierer, Gisela, Nikolopoulos, Georgios, Obel, Niels, de Coul, Eline Op, Paraskeva, Dimitra, Reiss, Peter, Sabin, Caroline, Sasse, André, Schmid, Daniela, Sonnerborg, Anders, Spina, Alexander, Suligoi, Barbara, Supervie, Virginie, Touloumi, Giota, Van Beckhoven, Dominique, van Sighem, Ard, Vourli, Georgia, Zangerle, Robert, and Porter, Kholoud

Published
2017

14. New HIV diagnoses among adults aged 50 years or older in 31 European countries, 2004–15: an analysis of surveillance data

Author

Schmid, Daniela, Sasse, André, Van Beckhoven, Dominique, Varleva, Tonka, Nemeth Blazic, Tatjana, Hadjihannas, Linos, Koliou, Maria, Maly, Marek, Cowan, Susan, Rüütel, Kristi, Liitsola, Kirsi, Salminen, Mika, Cazein, Françoise, Pillonel, Josiane, Lot, Florence, Gunsenheimer-Bartmeyer, Barbara, Patrinos, Stavros, Paraskeva, Dimitra, Dudas, Maria, Briem, Haraldur, Sigmundsdottir, Gudrun, Igoe, Derval, O'Donnell, Kate, O'Flanagan, Darina, Suligoi, Barbara, Konova, Šarlote, Erne, Sabine, Caplinskiene, Irma, Fischer, Aurélie, Maistre Melillo, Jackie, Melillo, Tanya, Op de Coul, Eline, Blystad, Hans, Rosinska, Magdalena, Aldir, Isabel, Gomes Dias, Helena, Mardarescu, Mariana, Truska, Peter, Klavs, Irena, Díaz, Asunción, Axelsson, Maria, Delpech, Valerie, Tavoschi, Lara, Gomes Dias, Joana, and Pharris, Anastasia

Published
2017
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15. Long-term virological suppression on first-line efavirenz + tenofovir + emtricitabine/lamivudine for HIV-1

Author

Stirrup, Oliver, Sterne, Jonathan, Dunn, David T., Grabmeier-Pfistershammer, Katharina, Papastamopoulos, Vasileios, Vandenhende, Marie-Anne, Wit, Ferdinand, Porter, Kholoud, Gunsenheimer-Bartmeyer, Barbara, Jarrin, Inma, Garcia, Federico, Fätkenheuer, Gerd, Obel, Niels, Schultze, Anna, Antinori, Andrea, Ceccherini-Silberstein, Francesca, Mussini, Cristina, Chêne, Geneviève, Neesgaard, Bastian, Castagna, Antonella, Kouyos, Roger, De Wit, Stéphane, Sönnerborg, Anders, Sabin, Caroline, Merino, Dolores, Barger, Diana, and Phillips, Andrew

Published
2019
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16. Are European HIV cohort data within EuroCoord representative of the diagnosed HIV population?

Author

Vourli, Georgia, Pharris, Anastasia, Cazein, Francoise, Costagliola, Dominique, Dabis, Francois, Del Amo, Julia, Delpech, Valerie, Díaz, Asuncion, Girardi, Enrico, Gourlay, Annabelle, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Nikolopoulos, Georgios, Porter, Kholoud, Rosińska, Magdalena, Sabin, Caroline, Suligoi, Barbara, Supervie, Virginie, Wit, Ferdinand, and Touloumi, Giota

Published
2018
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17. Are European HIV cohort data within EuroCoord representative of the diagnosed HIV population?

Author

Vourli, Georgia, Pharris, Anastasia, Cazein, Francoise, Costagliola, Dominique, Dabis, Francois, Del Amo, Julia, Delpech, Valerie, Díaz, Asuncion, Girardi, Enrico, Gourlay, Annabelle, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Nikolopoulos, Georgios, Porter, Kholoud, Rosińska, Magdalena, Sabin, Caroline, Suligoi, Barbara, Supervie, Virginie, Wit, Ferdinand, and Touloumi, Giota

Published
2019
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20. AIDS in the era of antiretroviral therapy: Changes in incidence rates and predictors of AIDS among people living with HIV under clinical care in Germany, a cohort study 1999–2018.

Author

Pantke, Annemarie, Kollan, Christian, Gunsenheimer‐Bartmeyer, Barbara, Jensen, Björn‐Erik Ole, Stephan, Christoph, Degen, Olaf, Schürmann, Dirk, Kurth, Tobias, Bremer, Viviane, and Koppe, Uwe

Subjects
HIV infection transmission, AIDS risk factors, HIV infections, DISEASE progression, PUBLIC health surveillance, CONFIDENCE intervals, VIRAL load, AGE distribution, ANTIRETROVIRAL agents, RISK assessment, INFECTIOUS disease transmission, CD4 lymphocyte count, DESCRIPTIVE statistics, PREDICTION models, AIDS-related opportunistic infections, AIDS, SECONDARY analysis, PROPORTIONAL hazards models
Abstract

Objectives: This study examined the incidence rates and predictive utility of established prognostic factors for the progression to AIDS among people living with HIV under clinical care. Methods: We used data from two observational cohorts of people living with HIV in Germany between 1999 and 2018. The outcome measure was the first AIDS‐defining event that occurred during follow‐up. Incidence rates (IRs) per 1000 person‐years (PY) were calculated by years of follow‐up and calendar periods. We used Cox models in our prediction analyses, including CD4 count, viral load, and age at baseline to estimate the predictive performance. Additionally, we included transmission mode to examine its predictive utility. Results: A total of 23 299 people living with HIV were included in the analyses. Of these, 1832 developed a first AIDS event during follow‐up, constituting an overall rate of 14.6/1000 PY (95% confidence interval [CI] 13.9–15.2). IRs were highest in the first year of follow‐up (45.6/1000 PY, 95% CI 42.6–48.8) and then declined continuously. IRs were highest among people living with HIV who enrolled between 1999 and 2003 (36.1/1000 PY, 95% CI 32.6–40.0). A low CD4 count, high viral load, and older age at baseline increased the likelihood of progressing to AIDS. Adding transmission mode to the models did not improve the predictive performance. Conclusions: The rates of a first AIDS event among people living with HIV have continuously declined in Germany. Health outcomes depend on a person's CD4 count, viral load, and age but not on transmission mode. To further reduce the number of AIDS cases, the focus should be on groups more likely to present in progressed stages of their HIV infection. [ABSTRACT FROM AUTHOR]

Published
2023
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23. A highly virulent variant of HIV-1 circulating in the Netherlands

Author

Wymant, Chris, Bezemer, Daniela, Blanquart, François, Ferretti, Luca, Gall, Astrid, Hall, Matthew, Golubchik, Tanya, Bakker, Margreet, Ong, Swee Hoe, Zhao, Lele, Bonsall, David, de Cesare, Mariateresa, MacIntyre-Cockett, George, Abeler-Dörner, Lucie, Albert, Jan, Bannert, Norbert, Fellay, Jacques, Grabowski, M Kate, Gunsenheimer-Bartmeyer, Barbara, Günthard, Huldrych F, Kivelä, Pia, Kouyos, Roger D, Laeyendecker, Oliver, Meyer, Laurence, Porter, Kholoud, Ristola, Matti, van Sighem, Ard, Berkhout, Ben, Kellam, Paul, Cornelissen, Marion, Reiss, Peter, Fraser, Christophe, Aubert, V, Battegay, M, Bernasconi, E, Böni, J, Braun, D L, Bucher, H C, Burton-Jeangros, C, Calmy, A, Cavassini, M, Dollenmaier, G, Egger, M, Elzi, L, Fehr, J, Fellay, J, Furrer, H, Fux, C A, Gorgievski, M, Günthard, H, Haerry, D, Hasse, B, Hirsch, H H, Hoffmann, M, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kouyos, R, Kovari, H, Ledergerber, B, Martinetti, G, de Tejada, B Martinez, Marzolini, C, Metzner, K, Müller, N, Nadal, D, Nicca, D, Pantaleo, G, Rauch, A, Regenass, S, Rudin, C, Schöni-Affolter, F, Schmid, P, Speck, R, Stöckle, M, Tarr, P, Trkola, A, Vernazza, P, Weber, R, Yerly, S, van der Valk, M, Geerlings, S E, Goorhuis, A, Hovius, J W, Lempkes, B, Nellen, F J B, van der Poll, T, Prins, J M, Reiss, P, van Vugt, M, Wiersinga, W J, Wit, F W M N, van Duinen, M, van Eden, J, Hazenberg, A, van Hes, A M H, Pijnappel, F J J, Smalhout, S Y, Weijsenfeld, A M, Jurriaans, S, Back, N K T, Zaaijer, H L, Berkhout, B, Cornelissen, M T E, Schinkel, C J, Wolthers, K C, Peters, E J G, van Agtmael, M A, Autar, R S, Bomers, M, Sigaloff, K C E, Heitmuller, M, Laan, L M, Ang, C W, van Houdt, R, Jonges, M, Kuijpers, T W, Pajkrt, D, Scherpbier, H J, de Boer, C, van der Plas, A, van den Berge, M, Stegeman, A, Baas, S, Hage de Looff, L, Buiting, A, Reuwer, A, Veenemans, J, Wintermans, B, Pronk, M J H, Ammerlaan, H S M, van den Bersselaar, D N J, de Munnik, E S, Deiman, B, Jansz, A R, Scharnhorst, V, Tjhie, J, Wegdam, M C A, van Eeden, A, Nellen, J, Brokking, W, Elsenburg, L J M, Nobel, H, van Kasteren, M E E, Berrevoets, M A H, Brouwer, A E, Adams, A, van Erve, R, de Kruijf-van de Wiel, B A F M, Keelan-Phaf, S, van der Ven, B, Buiting, A G M, Murck, J L, de Vries-Sluijs, T E M S, Bax, H I, van Gorp, E C M, de Jong-Peltenburg, N C, de Mendonç A Melo, M, van Nood, E, Nouwen, J L, Rijnders, B J A, Rokx, C, Schurink, C A M, Slobbe, L, Verbon, A, Bassant, N, van Beek, J E A, Vriesde, M, van Zonneveld, L M, de Groot, J, Boucher, C A B, Koopmans, M P G, van Kampen, J J A, Fraaij, P L A, van Rossum, A M C, Vermont, C L, van der Knaap, L C, Visser, E, Branger, J, Douma, R A, Cents-Bosma, A S, Duijf-van de Ven, C J H M, Schippers, E F, van Nieuwkoop, C, van Ijperen, J M, Geilings, J, van der Hut, G, van Burgel, N D, Leyten, E M S, Gelinck, L B S, Mollema, F, Davids-Veldhuis, S, Tearno, C, Wildenbeest, G S, Heikens, E, Groeneveld, P H P, Bouwhuis, J W, Lammers, A J J, Kraan, S, van Hulzen, A G W, Kruiper, M S M, van der Bliek, G L, Bor, P C J, Debast, S B, Wagenvoort, G H J, Kroon, F P, de Boer, M G J, Jolink, H, Lambregts, M M C, Roukens, A H E, Scheper, H, Dorama, W, van Holten, N, Claas, E C J, Wessels, E, den Hollander, J G, El Moussaoui, R, Pogany, K, Smit, J V, Struik-Kalkman, D, van Niekerk, T, Pontesilli, O, Lowe, S H, Oude Lashof, A M L, Posthouwer, D, van Wolfswinkel, M E, Ackens, R P, Burgers, K, Schippers, J, Weijenberg-Maes, B, van Loo, I H M, Havenith, T R A, van Vonderen, M G A, Kampschreur, L M, Faber, S, Steeman-Bouma, R, Al Moujahid, A, Kootstra, G J, Delsing, C E, van der Burg-van de Plas, M, Scheiberlich, L, Kortmann, W, van Twillert, G, Renckens, R, Ruiter-Pronk, D, van Truijen-Oud, F A, Cohen Stuart, J W T, Jansen, E R, Hoogewerf, M, Rozemeijer, W, van der Reijden, W A, Sinnige, J C, Brinkman, K, van den Berk, G E L, Blok, W L, Lettinga, K D, de Regt, M, Schouten, W E M, Stalenhoef, J E, Veenstra, J, Vrouenraets, S M E, Blaauw, H, Geerders, G F, Kleene, M J, Kok, M, Knapen, M, van der Meché, I B, Mulder-Seeleman, E, Toonen, A J M, Wijnands, S, Wttewaal, E, Kwa, D, van Crevel, R, van Aerde, K, Dofferhoff, A S M, Henriet, S S V, Ter Hofstede, H J M, Hoogerwerf, J, Keuter, M, Richel, O, Albers, M, Grintjes-Huisman, K J T, de Haan, M, Marneef, M, Strik-Albers, R, Rahamat-Langendoen, J, Stelma, F F, Burger, D, Gisolf, E H, Hassing, R J, Claassen, M, Ter Beest, G, van Bentum, P H M, Langebeek, N, Tiemessen, R, Swanink, C M A, van Lelyveld, S F L, Soetekouw, R, van der Prijt, L M M, van der Swaluw, J, Bermon, N, Jansen, R, Herpers, B L, Veenendaal, D, Verhagen, D W M, Lauw, F N, van Broekhuizen, M C, van Wijk, M, Bierman, W F W, Bakker, M, Kleinnijenhuis, J, Kloeze, E, Middel, A, Postma, D F, Schölvinck, E H, Stienstra, Y, Verhage, A R, Wouthuyzen-Bakker, M, Boonstra, A, de Groot-de Jonge, H, van der Meulen, P A, de Weerd, D A, Niesters, H G M, van Leer-Buter, C C, Knoester, M, Hoepelman, A I M, Arends, J E, Barth, R E, Bruns, A H W, Ellerbroek, P M, Mudrikova, T, Oosterheert, J J, Schadd, E M, van Welzen, B J, Aarsman, K, Griffioen-van Santen, B M G, de Kroon, I, van Berkel, M, van Rooijen, C S A M, Schuurman, R, Verduyn-Lunel, F, Wensing, A M J, Bont, L J, Geelen, S P M, Loeffen, Y G T, Wolfs, T F W, Nauta, N, Rooijakkers, E O W, Holtsema, H, Voigt, R, van de Wetering, D, Alberto, A, van der Meer, I, Rosingh, A, Halaby, T, Zaheri, S, Boyd, A C, Bezemer, D O, van Sighem, A I, Smit, C, Hillebregt, M, de Jong, A, Woudstra, T, Bergsma, D, Meijering, R, van de Sande, L, Rutkens, T, van der Vliet, S, de Groot, L, van den Akker, M, Bakker, Y, El Berkaoui, A, Bezemer, M, Brétin, N, Djoechro, E, Groters, M, Kruijne, E, Lelivelt, K J, Lodewijk, C, Lucas, E, Munjishvili, L, Paling, F, Peeck, B, Ree, C, Regtop, R, Ruijs, Y, Schoorl, M, Schnörr, P, Scheigrond, A, Tuijn, E, Veenenberg, L, Visser, K M, Witte, E C, Van Frankenhuijsen, Maartje, Allegre, Thierry, Makhloufi, Djamila, Livrozet, Jean-Michel, Chiarello, Pierre, Godinot, Mathieu, Brunel-Dalmas, Florence, Gibert, Sylvie, Trepo, Christian, Peyramond, Dominique, Miailhes, Patrick, Koffi, Joseph, Thoirain, Valérie, Brochier, Corinne, Baudry, Thomas, Pailhes, Sylvie, Lafeuillade, Alain, Philip, Gisèle, Hittinger, Gilles, Assi, Assi, Lambry, Véronique, Rosenthal, Eric, Naqvi, Alissa, Dunais, Brigitte, Cua, Eric, Pradier, Christian, Durant, Jacques, Joulie, Aline, Quinsat, Denis, Tempesta, Serge, Ravaux, Isabelle, Martin, Isabelle Poizot, Faucher, Olivia, Cloarec, Nicolas, Champagne, Hélène, Pichancourt, Gilles, Morlat, Philippe, Pistone, Thierry, Bonnet, Fabrice, Mercie, Patrick, Faure, Isabelle, Hessamfar, Mojgan, Malvy, Denis, Lacoste, Denis, Pertusa, Marie-Carmen, Vandenhende, Marie-Anne, Bernard, Noëlle, Paccalin, François, Martell, Cédric, Roger-Schmelz, Julien, Receveur, Marie-Catherine, Duffau, Pierre, Dondia, Denis, Ribeiro, Emmanuel, Caltado, Sabrina, Neau, Didier, Dupont, Michel, Dutronc, Hervé, Dauchy, Frédéric, Cazanave, Charles, Vareil, Marc-Olivier, Wirth, Gaétane, Le Puil, Séverine, Pellegrin, Jean-Luc, Raymond, Isabelle, Viallard, Jean-François, Chaigne de Lalande, Severin, Garipuy, Daniel, Delobel, Pierre, Obadia, Martine, Cuzin, Lise, Alvarez, Muriel, Biezunski, Noemie, Porte, Lydie, Massip, Patrice, Debard, Alexa, Balsarin, Florence, Lagarrigue, Myriam, Prevoteau du Clary, François, Aquilina, Christian, Reynes, Jacques, Baillat, Vincent, Merle, Corinne, Lemoing, Vincent, Atoui, Nadine, Makinson, Alain, Jacquet, Jean Marc, Psomas, Christina, Tramoni, Christine, Aumaitre, Hugues, Saada, Mathieu, Medus, Marie, Malet, Martine, Eden, Aurélia, Neuville, Ségolène, Ferreyra, Milagros, Sotto, Albert, Barbuat, Claudine, Rouanet, Isabelle, Leureillard, Didier, Mauboussin, Jean-Marc, Lechiche, Catherine, Donsesco, Régine, Cabie, André, Abel, Sylvie, Pierre-Francois, Sandrine, Batala, Anne-Sophie, Cerland, Christophe, Rangom, Camille, Theresine, Nadine, Hoen, Bruno, Lamaury, Isabelle, Fabre, Isabelle, Schepers, Kinda, Curlier, Elodie, Ouissa, Rachida, Gaud, Catherine, Ricaud, Carole, Rodet, Roland, Wartel, Guillaume, Sautron, Carmele, Beck-Wirth, Geneviève, Michel, Catherine, Beck, Charles, Halna, Jean-Michel, Kowalczyk, Jakub, Benomar, Meryem, Drobacheff-Thiebaut, Christine, Chirouze, Catherine, Faucher, Jean-François, Parcelier, François, Foltzer, Adeline, Haffner-Mauvais, Cécile, Hustache Mathieu, Mathieu, Proust, Aurélie, Piroth, Lionel, Chavanet, Pascal, Duong, Michel, Buisson, Marielle, Waldner, Anne, Mahy, Sophie, Gohier, Sandrine, Croisier, Delphine, May, Thierry, Delestan, Mikael, Andre, Marie, Zadeh, Mahsa Mohseni, Martinot, Martin, Rosolen, Béatrice, Pachart, Anne, Martha, Benoît, Jeunet, Noëlle, Rey, David, Cheneau, Christine, Partisani, Maria, Priester, Michèle, Bernard-Henry, Claudine, Batard, Marie-Laure, Fischer, Patricia, Berger, Jean-Luc, Kmiec, Isabelle, Robineau, Olivier, Huleux, Thomas, Ajana, Faïza, Alcaraz, Isabelle, Allienne, Christophe, Baclet, Véronique, Meybeck, Agnès, Valette, Michel, Viget, Nathalie, Aissi, Emmanuelle, Biekre, Raphael, Cornavin, Pauline, Merrien, Dominique, Seghezzi, Jean-Christophe, Machado, Moise, Diab, Georges, Raffi, François, Bonnet, Bénédicte, Allavena, Clotilde, Grossi, Olivier, Reliquet, Véronique, Billaud, Eric, Brunet, Cecile, Bouchez, Sabelline, Morineau-Le Houssine, Pascale, Sauser, Fabienne, Boutoille, David, Besnier, Michel, Hue, Hervé, Hall, Nolwenn, Brosseau, Delphine, Souala, Faouzi, Michelet, Christian, Tattevin, Pierre, Arvieux, Cédric, Revest, Matthieu, Leroy, Helene, Chapplain, Jean-Marc, Dupont, Matthieu, Fily, Fabien, Patra-Delo, Solène, Lefeuvre, Céline, Bernard, Louis, Bastides, Frédéric, Nau, Pascale, Verdon, Renaud, de la Blanchardiere, Arnaud, Martin, Anne, Feret, Philippe, Geffray, Loïk, Daniel, Corinne, Rohan, Jennifer, Fialaire, Pascale, Chennebault, Jean Marie, Rabier, Valérie, Abgueguen, Pierre, Rehaiem, Sami, Luycx, Odile, Niault, Mathilde, Moreau, Philippe, Poinsignon, Yves, Goussef, Marie, Mouton-Rioux, Virginie, Houlbert, Dominique, Alvarez-Huve, Sandrine, Barbe, Frédérique, Haret, Sophie, Perre, Philippe, Leantez-Nainville, Sophie, Esnault, Jean-Luc, Guimard, Thomas, Suaud, Isabelle, Girard, Jean-Jacques, Simonet, Véronique, Debab, Yasmine, Schmit, Jean-Luc, Jacomet, Christine, Weinberck, Pierre, Genet, Claire, Pinet, Pauline, Ducroix, Sophie, Durox, Hélène, Denes, Éric, Abraham, Bruno, Gourdon, Florence, Antoniotti, Odile, Molina, Jean-Michel, Ferret, Samuel, Lascoux-Combe, Caroline, Lafaurie, Matthieu, Colin de Verdiere, Nathalie, Ponscarme, Diane, De Castro, Nathalie, Aslan, Alexandre, Rozenbaum, Willy, Pintado, Claire, Clavel, François, Taulera, Olivier, Gatey, Caroline, Munier, Anne-Lise, Gazaigne, Sandrine, Penot, Pauline, Conort, Guillaume, Lerolle, Nathalie, Leplatois, Anne, Balausine, Stéphanie, Delgado, Jeannine, Timsit, Julie, Tabet, Magda, Gerard, Laurence, Girard, Pierre-Marie, Picard, Odile, Tredup, Jürgen, Bollens, Diane, Valin, Nadia, Campa, Pauline, Bottero, Julie, Lefebvre, Benedicte, Tourneur, Muriel, Fonquernie, Laurent, Wemmert, Charlotte, Lagneau, Jean-Luc, Yazdanpanah, Yazdan, Phung, Bao, Pinto, Adriana, Vallois, Dorothée, Cabras, Ornella, Louni, Françoise, Pialoux, Gilles, Lyavanc, Thomas, Berrebi, Valérie, Chas, Julie, Lenagat, Sophie, Rami, Agathe, Diemer, Myriam, Parrinello, Maguy, Depond, Audrey, Salmon, Dominique, Guillevin, Loïc, Tahi, Tassadit, Belarbi, Linda, Loulergue, Pierre, Zak Dit Zbar, Olivier, Launay, Odile, Silbermann, Benjamin, Leport, Catherine, Alagna, Laura, Pietri, Marie-Pierre, Simon, Anne, Bonmarchand, Manuela, Amirat, Naouel, Pichon, François, Kirstetter, Myriam, Katlama, Christine, Valantin, Marc Antoine, Tubiana, Roland, Caby, Fabienne, Schneider, Luminita, Ktorza, Nadine, Calin, Ruxandra, Merlet, Audrey, Ben Abdallah, Saadia, Weiss, Laurence, Buisson, Martin, Batisse, Dominique, Karmochine, Marina, Pavie, Juliette, Minozzi, Catherine, Jayle, Didier, Castel, Philippe, Derouineau, Jean, Kousignan, Pascale, Eliazevitch, Murielle, Pierre, Isabelle, Collias, Lio, Viard, Jean-Paul, Gilquin, Jacques, Sobel, Alain, Slama, Laurence, Ghosn, Jade, Hadacek, Blanka, Thu-Huyn, Nugyen, Nait-Ighil, Lella, Cros, Agnes, Maignan, Aline, Duvivier, Claudine, Consigny, Paul Henri, Lanternier, Fanny, Shoai-Tehrani, Michka, Touam, Fatima, Jerbi, Saadia, Bodard, Loïc, Jung, Corinne, Goujard, Cécile, Quertainmont, Yann, Duracinsky, Martin, Segeral, Olivier, Blanc, Arnaud, Peretti, Delphine, Cheret, Antoine, Chantalat, Christelle, Dulucq, Marie Josée, Levy, Yves, Lelievre, Jean Daniel, Lascaux, Anne Sophie, Dumont, Cécile, Boue, François, Chambrin, Véronique, Abgrall, Sophie, Kansau, Imad, Raho-Moussa, Mariem, De Truchis, Pierre, Dinh, Aurélien, Davido, Benjamin, Marigot, Dhiba, Berthe, Huguette, Devidas, Alain, Chevojon, Pierre, Chabrol, Amélie, Agher, Nouara, Lemercier, Yvon, Chaix, Fabrice, Turpault, Isabelle, Bouchaud, Olivier, Honore, Patricia, Rouveix, Elisabeth, Reimann, Evelyne, Belan, Alix Greder, Godin Collet, Claire, Souak, Safia, Mortier, Emmanuel, Bloch, Martine, Simonpoli, Anne-Marie, Manceron, Véronique, Cahitte, Isabelle, Hiraux, Emmanuel, Lafon, Erik, Cordonnier, François, Zeng, Ai-Feng, Zucman, David, Majerholc, Catherine, Bornarel, Dominique, Uludag, Agnès, Gellen-Dautremer, Justine, Lefort, Agnès, Bazin, Christine, Daneluzzi, Vincent, Gerbe, Juliette, Jeantils, Vincent, Coupard, Mélissa, Patey, Olivier, Bantsimba, Jonas, Delllion, Sophie, Paz, Pauline Caraux, Cazenave, Benoit, Richier, Laurent, Garrait, Valérie, Delacroix, Isabelle, Elharrar, Brigitte, Vittecoq, Daniel, Bolliot, Claudine, Lepretre, Annie, Genet, Philippe, Masse, Virginie, Perrone, Véronique, Boussard, Jean-Luc, Chardon, Patricia, Froguel, Eric, Simon, Philippe, Tassi, Sylvie, Avettand Fenoel, Véronique, Barin, Francis, Bourgeois, Christine, Cardon, Fanny, Chaix, Marie-Laure, Delfraissy, Jean François, Essat, Asma, Fischer, Hugues, Lecuroux, Camille, Petrov-Sanchez, Ventzislava, Rouzioux, Christine, Saez-Cirion, Asier, Seng, Rémonie, Kuldanek, Kristin, Mullaney, Scott, Young, Carmel, Zucchetti, Antonella, Bevan, Margaret-Ann, McKernan, Sinead, Wandolo, Emily, Richardson, Celia, Youssef, Elaney, Green, Pippa, Faulkner, Sue, Faville, Rebecca, Herman, Sandra, Care, Christine, Blackman, Helen, Bellenger, Katharine, Fairbrother, Keith, Phillips, Andrew, Babiker, Abdel, Delpech, Valerie, Fidler, S, Clarke, Mindy, Fox, Julie, Gilson, R, Goldberg, David, Hawkins, David, Johnson, Anne, Johnson, Margaret, McLean, Ken, Nastouli, Eleni, Post, Frank, Kennedy, N, Pritchard, J, Andrady, U, Rajda, N, Donnelly, C, McKernan, S, Drake, S, Gilleran, G, White, D, Ross, J, Harding, J, Faville, R, Sweeney, J, Flegg, P, Toomer, S, Wilding, H, Woodward, R, Dean, G, Richardson, C, Perry, N, Gompels, M, Jennings, L, Bansaal, D, Browing, M, Connolly, L, Stanley, B, Estreich, S, Magdy, A, O'Mahony, C, Fraser, P, Jebakumar, S P R, David, L, Mette, R, Summerfield, H, Evans, M, White, C, Robertson, R, Lean, C, Morris, S, Winter, A, Faulkner, S, Goorney, B, Howard, L, Fairley, I, Stemp, C, Short, L, Gomez, M, Young, F, Roberts, M, Green, S, Sivakumar, K, Minton, J, Siminoni, A, Calderwood, J, Greenhough, D, DeSouza, C, Muthern, Lisa, Orkin, C, Murphy, S, Truvedi, M, McLean, K, Hawkins, D, Higgs, C, Moyes, A, Antonucci, S, McCormack, S, Lynn, W, Bevan, M, Fox, J, Teague, A, Anderson, J, Mguni, S, Post, F, Campbell, L, Mazhude, C, Russell, H, Carrick, G, Ainsworth, J, Waters, A, Byrne, P, Johnson, M, Kuldanek, K, Mullaney, S, Lawlor, V, Melville, R, Sukthankar, A, Thorpe, S, Murphy, C, Wilkins, E, Ahmad, S, Green, P, Tayal, S, Ong, E, Meaden, J, Riddell, L, Loay, D, Peacock, K, Blackman, H, Harindra, V, Saeed, A M, Allen, S, Natarajan, U, Williams, O, Lacey, H, Care, C, Bowman, C, Herman, S, Devendra, S V, Wither, J, Bridgwood, A, Singh, G, Bushby, S, Kellock, D, Young, S, Rooney, G, Snart, B, Currie, J, Fitzgerald, M, Arumainayyagam, J, Chandramani, S, Rajamanoharan, S, Robinson, T, Taylor, B, Brewer, C, Mayr, Christoph, Schmidt, Wolfgang, Speidel, Andrea, Strohbach, Frank, Arastéh, Keikawus, Cordes, Christiane, Stündel, Manfred, Claus, Jörg, Baumgarten, Axel, Carganico, Andreas, Ingiliz, Patrick, Dupke, Stephan, Freiwald, Matthias, Rausch, Michael, Moll, Arend, Schleehauf, Dorothea, Hintsche, Bettina, Klausen, Gerd, Jessen, Heiko, Jessen, Arne, Köppe, Siegfried, Kreckel, Peter, Schranz, Dietmar, Fischer, Klaus, Schulbin, Hubert, Speer, Miriam, Glaunsinger, Tobias, Wicke, Thomas, Bieniek, Bernhard, Hillenbrand, Heribert, Schlote, Frank, Lauenroth-Mai, Elke, Schuler, Christoph, Schürmann, Dirk, Wesselmann, Hans, Brockmeyer, Norbert, Gehring, Peter, Schmalöer, Dirk, Hower, Martin, Spornraft-Ragaller, Petra, Häussinger, Dieter, Reuter, Stefan, Esser, Stefan, Markus, Rudolf, Kreft, Burkhard, Berzow, Dirk, Christl, Andreas, Meyer, Andreas, Plettenberg, Andreas, Stoehr, Albrecht, Graefe, Katrin, Lorenzen, Thore, Adam, Axel, Schewe, Knut, Weitner, Lutwin, Fenske, Stefan, Hansen, Stefan, Stellbrink, Hans-Jürgen, Wiemer, Dorothea, Hertling, Sandra, Schmidt, Reinhold, Arbter, Peter, Claus, Bernd, Galle, Peter, Jäger, Hans, Jä Gel-Guedes, Eva, Postel, Nils, Fröschl, Monika, Spinner, Christoph, Bogner, Johannes, Salzberger, Bernd, Schölmerich, Jürgen, Audebert, Franz, Marquardt, Ties, Schaffert, Andreas, Schnaitmann, Eiko, Trein, Andreas, Frietsch, Bernhard, Müller, Marcus, Ulmer, Albrecht, Detering-Hübner, Barbara, Kern, Peter, Schubert, Franz, Dehn, Günther, Schreiber, Maria, Güler, Cengiz, Schmidt, Daniel, Meixenberger, Karolin, Medical Microbiology & Infectious Diseases, Internal Medicine, Virology, Pediatrics, Medical Microbiology and Infection Prevention, AII - Infectious diseases, Global Health, Infectious diseases, APH - Aging & Later Life, Centre interdisciplinaire de recherche en biologie (CIRB), Labex MemoLife, École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Internal medicine, VU University medical center, Surgery, AMS - Rehabilitation & Development, APH - Quality of Care, Psychiatry, Pediatric surgery, Neurology, Public and occupational health, APH - Mental Health, Pathology, Cardiology, ACS - Heart failure & arrhythmias, Anesthesiology, IOO, Rehabilitation medicine, Obstetrics and gynaecology, General practice, Gastroenterology and hepatology, Pulmonary medicine, ACS - Pulmonary hypertension & thrombosis, Medical oncology laboratory, Hematology, Epidemiology and Data Science, Physiology, Microbes in Health and Disease (MHD), University of Oxford, Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), European Bioinformatics Institute [Hinxton] (EMBL-EBI), EMBL Heidelberg, Amsterdam UMC - Amsterdam University Medical Center, The Wellcome Trust Sanger Institute [Cambridge], Karolinska Institutet [Stockholm], Robert Koch Institute [Berlin] (RKI), Ecole Polytechnique Fédérale de Lausanne (EPFL), Johns Hopkins University (JHU), Universität Zürich [Zürich] = University of Zurich (UZH), Helsinki University Hospital [Helsinki, Finlande], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, University College of London [London] (UCL), Kymab Ltd, Cambridge, England, Institut Pasteur [Paris] (IP), This study was funded by ERC Advanced Grant PBDR-339251 and a Li Ka Shing Foundation grant, both awarded to C.F. The ATHENA Cohort is managed by Stichting HIV Monitoring and supported by a grant from the Dutch Ministry of Health, Welfare and Sport through the Centre for Infectious Disease Control of the National Institute for Public Health and the Environment., We thank K. Fransen and G. Vanham for help with the Belgian data, O. Ratmann for help in identifying the Dutch clusters, K. Kusejko for testing for additional VB individuals in the SHCS, B. Foley for help with genome sharing, B. Dearlove and L. Thomson for help with software, and J. Herbeck and three other reviewers for helpful suggestions., Contributors and affiliations are listed in the supplementary materials., Department of Medicine, University of Helsinki, Infektiosairauksien yksikkö, HUS Inflammation Center, and Clinicum

Subjects
Adult, Male, HIV-1/genetics, Genotype, Anti-HIV Agents, Evolution, [SDV]Life Sciences [q-bio], lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], HIV Infections/drug therapy, selection, HIV Infections, Genome, Viral, heritability, epidemic, human-immunodeficiency-virus, Evolution, Molecular, SDG 3 - Good Health and Well-being, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Viral, Phylogeny, Netherlands, Multidisciplinary, Genome, model, Virulence, transmission, Molecular, setpoint viral load, reverse-transcriptase, dynamics, Viral Load, CD4 Lymphocyte Count, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], 3121 General medicine, internal medicine and other clinical medicine, Anti-HIV Agents/therapeutic use, Mutation, HIV-1, Female, progression
Abstract

Comment in Does HIV-1 virulence matter in the ART era? Lewitus E, Rolland M. Med (N Y). 2022 Apr 8;3(4):217-219. doi: 10.1016/j.medj.2022.03.003. PMID: 35590149; International audience; We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log 10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV—CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences—is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.

Published
2022
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24. Phylogenetic estimation of the viral fitness landscape of HIV-1 set-point viral load

Author

Zhao, Lele, Wymant, Chris, Blanquart, François, Golubchik, Tanya, Gall, Astrid, Bakker, Margreet, Bezemer, Daniela, Hall, Matthew, Hoe Ong, Swee, Albert, Jan, Bannert, Norbert, Fellay, Jacques, Grabowski, M. Kate, Gunsenheimer-Bartmeyer, Barbara, Günthard, Huldrych F., Kivelä, Pia, Kouyos, Roger D., Laeyendecker, Oliver, Meyer, Laurence, Porter, Kholoud, van Sighem, Ard, van der Valk, Marc, Berkhout, Ben, Kellam, Paul, Cornelissen, Marion, Reiss, Peter, Fraser, Christophe, Ferretti, Luca, on behalf of the BEEHIVE Collaboration, Blanquart, François, University of Oxford, Centre interdisciplinaire de recherche en biologie (CIRB), Labex MemoLife, École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), European Molecular Biology Laboratory (EMBL), Amsterdam UMC - Amsterdam University Medical Center, Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), The Wellcome Trust Sanger Institute [Cambridge], Karolinska Institutet [Stockholm], Robert Koch Institute [Berlin] (RKI), Johns Hopkins University (JHU), University hospital of Zurich [Zurich], Helsinki University Hospital [Finland] (HUS), National Institutes of Health [Bethesda] (NIH), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, University College of London [London] (UCL), Kymab Ltd, Cambridge, England, Medical Microbiology and Infection Prevention, Infectious diseases, AII - Infectious diseases, APH - Digital Health, APH - Personalized Medicine, APH - Global Health, Global Health, APH - Aging & Later Life, University of Zurich, Ferretti, Luca, HUS Internal Medicine and Rehabilitation, Department of Medicine, University of Helsinki, and Infektiosairauksien yksikkö

Subjects
11832 Microbiology and virology, between-host evolution, diagnosis, tansmission fitness, [SDV]Life Sciences [q-bio], 2404 Microbiology, antiretroviral therapy, 610 Medicine & health, heritability, Microbiology, initiation, 10234 Clinic for Infectious Diseases, virulence, [SDV] Life Sciences [q-bio], Virology, 2406 Virology, HIV-1, rna, ddc:610, 3111 Biomedicine, set-point viral load, 610 Medizin und Gesundheit, prognostic markers, time
Abstract

Set-point viral load (SPVL), a common measure of human immunodeficiency virus (HIV)-1 virulence, is partially determined by viral genotype. Epidemiological evidence suggests that this viral property has been under stabilising selection, with a typical optimum for the virus between 104 and 105 copies of viral RNA per ml. Here we aimed to detect transmission fitness differences between viruses from individuals with different SPVLs directly from phylogenetic trees inferred from whole-genome sequences. We used the local branching index (LBI) as a proxy for transmission fitness. We found that LBI is more sensitive to differences in infectiousness than to differences in the duration of the infectious state. By analysing subtype-B samples from the Bridging the Evolution and Epidemiology of HIV in Europe project, we inferred a significant positive relationship between SPVL and LBI up to approximately 105 copies/ml, with some evidence for a peak around this value of SPVL. This is evidence of selection against low values of SPVL in HIV-1 subtype-B strains, likely related to lower infectiousness, and perhaps a peak in the transmission fitness in the expected range of SPVL. The less prominent signatures of selection against higher SPVL could be explained by an inherent limit of the method or the deployment of antiretroviral therapy.

Published
2022
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25. Correction to: Treatment modifcation after starting cART in people living with HIV: retrospective analysis of the German ClinSurv HIV Cohort 2005–2017

Author

Stecher, Melanie, Schommers, Philipp Frederik, Kollan, Christian, Stoll, Matthias, Kuhlendahl, Frieder-Johan, Stellbrink, Hans‑Jürgen, Wasmuth, Jan‑Christian, Stephan, Christoph, Hamacher, Laura, Lehmann, Clara, Boesecke, Christoph, Bogner, Johannes, Esser, Stefan, Fritzsche, Carlos, Haberl, Annette, Schürmann, Dirk, Degen, Olaf, Horst, Heinz August, Hoffmann, Christian, Jensen, Björn-Erik Ole, Schwarze-Zander, Carolynne, Platten, Martin, Fätkenheuer, Gerd, Schmidt, Daniel, Gunsenheimer-Bartmeyer, Barbara, Vehreschild, Jörg Janne, and ClinSurv Study Group

Subjects
ddc:610
Abstract

Correction to: Infection (2020) 48:723–733 https://doi.org/10.1007/s15010-020-01469-6. The original version of this article unfortunately contained a mistake. In this article the authors Dirk Schürmann at affiliation Charité, University Medicine, Berlin, Olaf Degen at affiliation University Clinic Hamburg Eppendorf, Hamburg and Heinz-August Horst at affiliation University Hospital Schleswig–Holstein, Kiel, Germany were missing from the author list. The original article has been corrected.

Published
2021

26. Progress towards the 90-90-90 HIV targets in 11 EU countries

Author

Vourli, Georgia, Noori, Teymur, Porter, Kholoud, Begovac, Josip, Delpech, Valerie, Girardi, Enrico, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Obel, Niels, Van Sighem, Ard, Sönnerborg, Anders, Supervie, Virginie, Zangerle, Robert, and Touloumi, Giota

Subjects
Antiretroviral treatment (ART), HIV, care, EU
Abstract

Despite the availability of highly effective antiretroviral treatment (ART), delayed diagnosis and ART initiation, and poor retention in care remain barriers to reducing HIV incidence. We aimed to estimate progress towards the UNAIDS 90- 90-90 targets by constructing the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. Using surveillance and cohort data from Austria, Croatia, Denmark, Germany, Greece, France, Italy, the Netherlands, Spain, Sweden and the United Kingdom, a CoC was constructed with four stages: i) number of people living with HIV (PLHIV) ; ii) proportion of PLHIV ever diagnosed ; iii) proportion of diagnosed who initiated ART ; iv) proportion of treated who achieved viral suppression (≤200 copies/mL) at their last visit (July 2015- December 2016). The 11 countries represent 73% of EU population and 85% of PLHIV in the region. The estimated number of PLHIV in the participating countries at the end of 2016 was 702, 848, corresponding to 0.19% adult prevalence. Overall, we estimated that 87% of PLHIV were diagnosed ; 92% of those diagnosed had initiated ART ; and 91% of those on ART were virally suppressed. Therefore, among all PLHIV 73% were virally suppressed. The corresponding figures for men having sex with men (MSM) were: 86%, 93%, 93% (and among all PLHIV 74%) ; for people who inject drugs (PWID): 91%, 88%, 84% (67%) ; for heterosexuals: 86%, 92%, 91% (72%) ; for men: 87%, 92%, 91% (73%) and for women: 89%, 92%, 89% (73%). Substantial variation across countries was observed. The EU is near to reaching the 90-90-90 UNAIDS targets, and achieved the UNAIDS final target of 73% of all PLHIV with viral suppression. This finding represents a significant progress compared to 2013, where 60% of all PLHIV were virally suppressed. However, differences between countries and key populations persisted in 2016. To improve outcomes along the CoCs, annual numbers of newly- acquired HIV infections and time intervals spent between stages need to be reduced. Furthermore, strengthening of testing programs and stronger treatment and adherence support, along with HIV prevention measures, are needed to achieve HIV epidemic control and, ultimately, AIDS elimination by 2030.

Published
2020

27. Decreasing prevalence and stagnating incidence of Hepatitis C‐co‐infection among a cohort of HIV‐1‐positive patients, with a majority of men who have sex with men, in Germany, 1996–2019.

Author

Krings, Amrei, Schmidt, Daniel, Meixenberger, Karolin, Bannert, Norbert, Münstermann, Dieter, Tiemann, Carsten, Kollan, Christian, and Gunsenheimer‐Bartmeyer, Barbara

Subjects
MEN who have sex with men, GONORRHEA, AIDS, HEPATITIS C virus, VIRAL hepatitis, HEPATITIS
Abstract

Co‐infection with Hepatitis C virus (HCV) among HIV‐positive patients leads to accelerated progression of liver disease and AIDS. Due to increased HCV prevalence and incidence, co‐infection requires monitoring trends among HIV‐positive individuals. This will help target prevention strategies and support to reach the global goals of eliminating viral hepatitis as a public health threat. In this analysis HCV prevalence and incidence were determined for the years 1996–2019 from yearly blood samples and questionnaire details among HIV‐1‐positive patients, with a majority of men who have sex with men, belonging to a nationwide, multicentre observational, prospective cohort study. The results show that HCV prevalence for acute/chronic and resolved infection increased until 2014 to 12%. Since then, prevalence of acute/chronic HCV infection rapidly decreased and prevalence of resolved infections showed a steady increase. HCV incidence was highest in 2010 and lowest in 2017; however, no significant change in HCV incidence could be seen over the years. Therefore, the introduction of directly‐acting antiviral agents for HCV treatment notably decreased prevalence and potentially incidence of acute/chronic HCV infection. Nevertheless, prevalence and incidence of HCV among these HIV‐1‐positive study participants remain high compared with the general population and justify the need for continuous HCV prevention and treatment efforts among HIV‐positive individuals. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Similar Sexual Behaviour yet Different Outcomes: Comparing Trans and Gender Diverse and Cis PrEP Users in Germany Based on the Outcomes of the PrApp Study.

Author

Appenroth, Max Nicolai, Marcus, Ulrich, Albrecht, Stefan, Jansen, Klaus, Gunsenheimer-Bartmeyer, Barbara, Bremer, Viviane, and Koppe, Uwe

Subjects
HUMAN sexuality, PRE-exposure prophylaxis, GENDER, CONDOM use, ODDS ratio
Abstract

Little knowledge about pre-exposure prophylaxis (PrEP) use in trans and gender diverse (TGD) communities in Germany exists. The PrApp Study collected data on PrEP use and sexual behaviour among PrEP users in Germany. Descriptive methods and logistic regression were used to describe PrEP use among TGD and cis persons. A total of 4350 PrEP users in Germany were included, with 65 (1.5%) identified as TGD. Compared to cis participants, TGD participants were younger (median age 29 vs. 37 years) and more likely to have a lower income (adjusted odds ratio (aOR) = 4.4; 95% confidence interval (CI) = 2.4–8.2) and be born outside Germany (aOR = 2.5; 95% CI = 1.3–4.5). On-demand PrEP use was higher in TGD participants (aOR = 1.9; 95% CI = 1.0–3.5) and numerically more TGD obtained PrEP from informal sources (aOR = 1.8; 95% CI = 0.9–3.5). Testing behaviour, condom use, and number of sexual partners were comparable between both groups. Socioeconomic disparities may constitute structural barriers for TGD people to access PrEP, leading to more informal and on-demand use. PrEP providers need to reduce access barriers for TGD PrEP users and provide information on safe PrEP use for this population. [ABSTRACT FROM AUTHOR]

Published
2022
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31. Are European HIV cohort data within EuroCoord representative of the diagnosed HIV population?

Author

Nikolopoulos, Georgios, Vourli, Georgia, Pharris, Anastasia, Cazein, Francoise, Costagliola, Dominique, Dabis, Francois, Del Amo, Julia, Delpech, Valerie, Díaz, Asuncion, Girardi, Enrico, Gourlay, Annabelle, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Porter, Kholoud, Rosińska, Magdalena, Sabin, Caroline, Suligoi, Barbara, Supervie, Virginie, Wit, Ferdinand, Touloumi, Giota, National and Kapodistrian University of Athens (NKUA), European Centre for Disease Prevention and Control (ECDC), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Instituto de Salud Carlos III [Madrid] (ISC), Public Health England [London], Istituto Nazionale di Malattie Infettive 'Lazzaro Spallanzani' (INMI), University College of London [London] (UCL), London School of Hygiene and Tropical Medicine (LSHTM), Robert Koch Institute [Berlin] (RKI), Open University of Cyprus, Istituto Superiore di Sanita [Rome], Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), Nikolopoulos, Georgios [0000-0002-3307-0246], Rosińska, Magdalena [0000-0002-6256-7809], and Vourli, Georgia [0000-0002-9727-2808]

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Adolescent, representativeness, Immunology, Population, MEDLINE, cohorts, HIV Infections, Sampling Studies, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Immunology and Allergy, Medicine, 030212 general & internal medicine, Young adult, education, Aged, education.field_of_study, business.industry, Transmission (medicine), Public health, HIV, Middle Aged, 3. Good health, Europe, Epidemiology and Social: Concise Communications, 030104 developmental biology, Infectious Diseases, Epidemiological Monitoring, Cohort, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, surveillance, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography, Cohort study
Abstract

Supplemental Digital Content is available in the text, Objective: HIV cohorts are an important source of clinical data for informing public health policies and programmes. However, the generalizability of cohort findings to the wider population of people diagnosed with HIV in each country remains unclear. In this work, we assessed the representativeness of six large national HIV cohorts within Europe. Design and methods: Individual-level cohort data were provided from national cohorts in France, Germany, Greece, Italy, Spain and the United Kingdom. Analysis focused on new HIV diagnoses reported to The European Surveillance System (TESSy) during three time periods (2000–2004, 2005–2009 and 2010–2013), to allow for temporal changes. Cohort and TESSy records were matched and compared by age, sex, transmission mode, region of origin and CD4+ cell count at diagnosis. The probability of being included in each cohort given demographic characteristics was estimated and used to generate weights inversely proportional to the probability of being included. Results: Participating cohorts were generally representative of the national HIV-diagnosed population submitted to TESSy. However, people who inject drugs, those born in a country other than that reporting the data, those with low CD4+ cell counts at diagnosis, and those more than 55 years were generally underrepresented in the cohorts examined. Conclusion: These European cohorts capture a representative sample of the HIV-diagnosed populations in each country; however some groups may be underrepresented.

Published
2019
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32. Effect of incident hepatitis C infection on CD4 count and HIV RNA trajectories based on a multinational HIV seroconversion cohort

Author

van Santen, Daniela K, van der Helm, Jannie J, Touloumi, Giota, Pantazis, Nikos, Muga, Roberto, Gunsenheimer-Bartmeyer, Barbara, Gill, M John, Sanders, Eduard, Kelleher, Anthony, Zangerle, Robert, Porter, Kholoud, Prins, Maria, and Geskus, Ronald B

Subjects
virus diseases
Abstract

Most studies on hepatitis C virus (HCV)/HIV co-infection do not account for the order and duration of these two infections. We aimed to assess the effect of incident HCV infection, and its timing relative to HIV seroconversion (HIVsc) in HIV-positive men who have sex with men (MSM) on their subsequent CD4 T-cell count (CD4) and HIV-RNA viral load (VL) trajectories.

Published
2018

33. Easy and accurate reconstruction of whole HIV genomes from short-read sequence data with shiver

Author

BEEHIVE Collaboration, Wymant, Chris, Blanquart, Francois, Golubchik, Tanya, Gall, Astrid, Bakker, Margreet, Bezemer, Daniela, Croucher, Nicholas J., Hall, Matthew, Hillebregt, Mariska, Ong, Swee Hoe, Ratmann, Oliver, Albert, Jan, Bannert, Norbert, Fellay, Jacques, Fransen, Katrien, Gourlay, Annabelle, Grabowski, M. Kate, Gunsenheimer-Bartmeyer, Barbara, Gunthard, Huldrych F., Kivelä, Pia, Kouyos, Roger, Laeyendecker, Oliver, Liitsola, Kirsi, Meyer, Laurence, Porter, Kholoud, Ristola, Matti, van Sighem, Ard, Berkhout, Ben, Cornelissen, Marion, Kellam, Paul, Reiss, Peter, Fraser, Christophe, Institute for Particle Physics Phenomenology (IPPP), Durham University, Centre interdisciplinaire de recherche en biologie (CIRB), Labex MemoLife, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), Evolution and Ecology Research Center, University of New South Wales [Sydney] (UNSW), Department of Infectious Disease Epidemiology [London] (DIDE), Imperial College London, Ecole Polytechnique Fédérale de Lausanne (EPFL), University College of London [London] (UCL), Universität Zürich [Zürich] = University of Zurich (UZH), Department of Infectious Diseases and Hospital Epidemiology [Zurich], University hospital of Zurich [Zurich], Department of Medicine, The Johns Hopkins University School of Medicine-Division of Infectious Diseases, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Center for Infection and Immunity Amsterdam (CINIMA), Wellcome Trust Genome Campus, Structures et propriétés d'architectures moléculaire (SPRAM - UMR 5819), Institut Nanosciences et Cryogénie (INAC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Big Data Institute, University of Oxford, École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), University of Cambridge [UK] (CAM), Laboratory of Experimental Virology - Department of Medical Microbiology [Amsterdam, The Netherlands], Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA)-University of Amsterdam [Amsterdam] (UvA)-Center for Infection and Immunity Amsterdam - CINIMA [Amsterdam, The Netherlands], The Wellcome Trust Sanger Institute [Cambridge], Karolinska Institutet [Stockholm], Robert Koch Institute [Berlin] (RKI), Johns Hopkins University (JHU), Helsinki University Hospital [Finland] (HUS), Division of Intramural Research [Bethesda, MD, USA] (Cardiovascular Branch), National Institutes of Health [Bethesda] (NIH)-National Heart, Lung, and Blood Institute [Bethesda] (NHLBI), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Saclay, THe BEEHIVE Collaboration, European Project: 339251,EC:FP7:ERC,ERC-2013-ADG,BEEHIVE(2014), AII - Infectious diseases, Medical Microbiology, APH - Aging & Later Life, Infectious diseases, Global Health, Clinicum, Infektiosairauksien yksikkö, HUS Inflammation Center, HUS Internal Medicine and Rehabilitation, and Bill & Melinda Gates Foundation

Subjects
0301 basic medicine, PROTEASE, Computer science, Sequence assembly, RECOMBINATION, Computational biology, Microbiology, Genome, DNA sequencing, diversity, Set (abstract data type), 03 medical and health sciences, Virology, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], ddc:610, mapping, TYPE-1, ComputingMilieux_MISCELLANEOUS, Sequence (medicine), Contig, IDENTIFICATION, [SDV.BID.EVO]Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE], BEEHIVE Collaboration, HIV, INSERTIONS, food and beverages, bioinformatics, TRANSFORM, GENE, Resources, 3. Good health, Identification (information), ALIGNMENT, 030104 developmental biology, 3121 General medicine, internal medicine and other clinical medicine, HUMAN-IMMUNODEFICIENCY-VIRUS, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, genome assembly, next-generation sequencing, 3111 Biomedicine, 610 Medizin und Gesundheit, INHIBITORS, Reference genome
Abstract

International audience; Studying the evolution of viruses and their molecular epidemiology relies on accurate viral sequence data, so that small differences between similar viruses can be meaningfully interpreted. Despite its higher throughput and more detailed minority variant data, next-generation sequencing has yet to be widely adopted for HIV. The difficulty of accurately reconstructing the consensus sequence of a quasispecies from reads (short fragments of DNA) in the presence of large betweenand within-host diversity, including frequent indels, may have presented a barrier. In particular, mapping (aligning) reads to a reference sequence leads to biased loss of information; this bias can distort epidemiological and evolutionary conclusions. De novo assembly avoids this bias by aligning the reads to themselves, producing a set of sequences called contigs. However contigs provide only a partial summary of the reads, misassembly may result in their having an incorrect structure, and no information is available at parts of the genome where contigs could not be assembled. To address these problems we developed the tool shiver to pre-process reads for quality and contamination, then map them to a reference tailored to the sample using corrected contigs supplemented with the user’s choice of existing reference sequences. Run with two commands per sample, it can easily be used for large heterogeneous data sets. We used shiver to reconstruct the consensus sequence and minority variant information from paired-end short-read whole-genome data produced with the Illumina platform, for sixty-five existing publicly available samples and fifty new samples. We show the systematic superiority of mapping to shiver’s constructed reference compared with mapping the same reads to the closest of 3,249 real references: median values of 13 bases called differently and more accurately, 0 bases called differently and less accurately, and 205 bases of missing sequence recovered. We also successfully applied shiver to whole-genome samples of Hepatitis C Virus and Respiratory Syncytial Virus. shiver is publicly available from https://github.com/ChrisHIV/shiver.

Published
2018
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34. Needs for an Integration of Specific Data Sources and Items -- First Insights of a National Survey Within the German Center for Infection Research.

Author

JAKOB, Carolin E. M., STECHER, Melanie, FUHRMANN, Sandra, WINGEN-HEIMANN, Sebastian, HEINEN, Stephanie, ANTON, Gabriele, BEHNKE, Michael, BEHRENDS, Uta, BOEKER, Martin, CASTELL, Stefanie, DEMSKI, Hans, DIEFENBACH, Maximilian, FALGENHAUER, Jane C., FRITZENWANKER, Moritz, GASTMEIER, Petra, GERHARD, Markus, GLÖCKNER, Stephan, GOLUBOVIC, Mira, GUNSENHEIMER BARTMEYER, Barbara, and INGENERF, Josef

Abstract

State-subsidized programs develop medical data integration centers in Germany. To get infection disease (ID) researchers involved in the process of data sharing, common interests and minimum data requirements were prioritized. In 06/2019 we have initiated the German Infectious Disease Data Exchange (iDEx) project. We have developed and performed an online survey to determine prioritization of requests for data integration and exchange in ID research. The survey was designed with three sub-surveys, including a ranking of 15 data categories and 184 specific data items and a query of available 51 data collecting systems. A total of 84 researchers from 17 fields of ID research participated in the survey (predominant research fields: gastrointestinal infections n=11, healthcare-associated and antibiotic-resistant infections n=10, hepatitis n=10). 48 % (40/84) of participants had experience as medical doctor. The three top ranked data categories were microbiology and parasitology, experimental data, and medication (53%, 52%, and 47% of maximal points, respectively). The most relevant data items for these categories were bloodstream infections, availability of biomaterial, and medication (88%, 87%, and 94% of maximal points, respectively). The ranking of requests of data integration and exchange is diverse and depends on the chosen measure. However, there is need to promote discipline-related digitalization and data exchange. [ABSTRACT FROM AUTHOR]

Published
2021
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35. The human immunodeficiency virus continuum of care in European Union Countries in 2013: Data and Challenges

Author

Gourlay, Annabelle, Noori, T., Pharris, Anastasia, Avdicova, Maria, Costagliola, Dominique, Cowan, Susan, Croxford, Sara, Monforte, A. D'arminio, Amo, Julia del, Delpech, Valerie, Diaz, Alejandro, Girardi, Enrico, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Jose, Sophie, Leierer, Gisela, Nikolopoulos, Georgios K., Obel, N., Coul, E. Op De, Paraskeva, D., Reiss, P., Sabin, C., Sasse, A., Schmid, D., Sonnerborg, A., Spina, A., Suligoi, B., Supervie, V., Touloumi, G., Beckhoven, D. Van, Sighem, A. Van, Vourli, G., Zangerle, R., Porter, K., Nikolopoulos, Georgios K.[0000-0002-3307-0246], University College of London [London] (UCL), European Centre for Disease Prevention and Control (ECDC), Public Health Agency of Sweden, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Statens Serum Institut [Copenhagen], Public Health England [London], Università degli Studi di Milano = University of Milan (UNIMI), Instituto de Salud Carlos III [Madrid] (ISC), National Institute for Infectious Diseases 'Lazzaro Spallanzani', Robert Koch Institute [Berlin] (RKI), Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), University of Cyprus [Nicosia] (UCY), Hellenic Center for Disease Control and Prevention, Rigshospitalet [Copenhagen], Copenhagen University Hospital, National Institute for Public Health and the Environment [Bilthoven] (RIVM), Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), Institut Scientifique de Santé Publique [Belgique] - Scientific Institute of Public Health [Belgium] (WIV-ISP), Réseau International des Instituts Pasteur (RIIP), Austrian Agency for Health and Food Safety (AGES), Karolinska Institutet [Stockholm], Karolinska University Hospital [Stockholm], Istituto Superiore di Sanita [Rome], University of Athens Medical School [Athens], National and Kapodistrian University of Athens (NKUA), Universität Innsbruck [Innsbruck], European HIV Continuum of Care Working Group, HAL-SU, Gestionnaire, European Centre for Disease Prevention and Control, AII - Infectious diseases, APH - Aging & Later Life, Global Health, and Amsterdam institute for Infection and Immunity

Subjects
Male, 0301 basic medicine, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Cohort Studies, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Prevalence, Continuum of care, Mass Screening, 030212 general & internal medicine, media_common, Hiv infection, Surveillance, Continuity of Patient Care, cohort analysis, Antiretroviral therapy, 3. Good health, [SDV] Life Sciences [q-bio], HIV Infections/diagnosis, Infectious Diseases, antiretroviral therapy, Cohort, Disease Eradication/legislation & jurisprudence, surveillance, Female, Cohort analysis, Cohort study, Microbiology (medical), United Nations, Anti-HIV Agents, Hiv testing, World Health Organization, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Major Article, HIV/isolation & purification, medicine, Humans, media_common.cataloged_instance, European Union, Disease Eradication, European union, business.industry, HIV, HIV infection, continuum of care, medicine.disease, 030112 virology, Virology, Anti-HIV Agents/therapeutic use, Disease prevention, business, Demography
Abstract

Summary Definitions for a 4-stage continuum of HIV care were standardized and applied to HIV surveillance and national cohort data in 11 European Union countries. These countries are nearing the UNAIDS 90-90-90 target, although reducing the proportion undiagnosed remains challenging., Background. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a “90-90-90” target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. Methods. Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. Results. In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%–0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. Conclusions. European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge.

Published
2017
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36. Verbundprojekt: TTU 04.901 - The development and implementation of the HIV observational data base HIOBs in the DZIF-TTU-HIV clinical sites (Robert Koch Institut) : Teilprojekte: TTU 04.901 - The development and implementation of the HIV observational data base HIOBs in the DZIF-TTU-HIV clinical sites (Robert Koch Institut)

Author

Gunsenheimer-Bartmeyer, Barbara

Subjects
Medizinische Dokumentation, Immunkrankheiten, Methoden und Techniken der Medizin, HIV, Medicine
Published
2017
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37. Human Immunodeficiency Virus Continuum of Care in 11 European Union Countries at the End of 2016 Overall and by Key Population: Have We Made Progress?

Author

Vourli, Georgia, Noori, Teymur, Pharris, Anastasia, Porter, Kholoud, Axelsson, Maria, Begovac, Josip, Cazein, Francoise, Costagliola, Dominique, Cowan, Susan, Croxford, Sara, Monforte, Antonella d'Arminio, Delpech, Valerie, Díaz, Asunción, Girardi, Enrico, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Leierer, Gisela, Lot, Florence, Nunez, Olivier, and Obel, Niels

Subjects
DIAGNOSIS of HIV infections, HIV prevention, COMPARATIVE studies, CONTINUUM of care, HIV infections, HIV-positive persons, MEN, HEALTH outcome assessment, PUBLIC health surveillance, VIRAL load, ANTIRETROVIRAL agents, MEN who have sex with men, DESCRIPTIVE statistics
Abstract

Background High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control. [ABSTRACT FROM AUTHOR]

Published
2020
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38. Trends in HIV surveillance data in the EU/EEA, 2005 to 2014: New HIV diagnoses still increasing in men who have sex with men

Author

Pharris, Anastasia, Quinten, C., Tavoschi, L., Spiteri, G., Amato-Gauci, A. J., Schmid, D., Sasse, A., Beckhoven, D. Van, Varleva, T., Blazic, Tatjana Nemeth, Koliou, M., Hadjihannas, L., Maly, M., Cowan, Susan, Rüütel, K., Liitsola, K., Salminen, M., Cazein, F., Pillonel, J., Lot, F., Gunsenheimer-Bartmeyer, Barbara, Nikolopoulos, Georgios K., Paraskeva, D., Dudas, M., Briem, H., Sigmundsdottir, G., Igoe, D., O’Donnell, K., O’Flanagan, D., Suligoi, B., Konova, S., Erne, S., Caplinskiene, I., Jean-Schmit, C., Melillo, J. M., Melillo, T., Coul, E. Op De, Blystad, H., Rosinska, M., Diniz, A., Mardarescu, Mariana, Truska, P., Klavs, I., Diez, M., Avdicova, Maria, Delpech, Valerie, and Nikolopoulos, Georgios K.[0000-0002-3307-0246]

Subjects
Male, Delayed Diagnosis, Epidemiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Men who have sex with men, Risk Factors, Diagnosis, Medical diagnosis, media_common, human immunodeficiency virus, Transmission (medicine), Human immunodeficiency virus, AIDS Serodiagnosis, Homosexuality, Emigration and Immigration, Early diagnosis, Cell count, Virus diagnosis, AIDS, Europe, Population Surveillance, Public Health, Human, Adult, medicine.medical_specialty, Virus transmission, Cd4+ t lymphocyte, Acquired immunodeficiency syndrome (AIDS), Virology, medicine, media_common.cataloged_instance, Humans, European Union, European union, Homosexuality, Male, Hiv surveillance, HIV, acquired immunodeficiency syndrome, CD4 Lymphocyte Count, Public Health, Environmental and Occupational Health, business.industry, Prevention, Environmental and Occupational Health, medicine.disease, Immunology, business, Demography
Abstract

Human immunodeficiency virus (HIV) transmission remains significant in Europe. Rates of acquired immunodeficiency syndrome (AIDS) have declined, but not in all countries. New HIV diagnoses have increased among native and foreign-born men who have sex with men. Median CD4 + T-cell count at diagnosis has increased, but not in all groups, and late diagnosis remains common. HIV infection and AIDS can be eliminated in Europe with resolute prevention measures, early diagnosis and access to effective treatment. © 2015, European Centre for Disease Prevention and Control (ECDC). All rights reserved. 20 47

Published
2015

41. Prevalence and persistence of transmitted drug resistance mutations in the German HIV-1 Seroconverter Study Cohort.

Author

Machnowska, Patrycja, Meixenberger, Karolin, Schmidt, Daniel, Jessen, Heiko, Hillenbrand, Heribert, Gunsenheimer-Bartmeyer, Barbara, Hamouda, Osamah, Kücherer, Claudia, Bannert, Norbert, and null, null

Subjects
DISEASE prevalence, DRUG resistance, HIV-positive persons, HIGHLY active antiretroviral therapy, REVERSE transcriptase
Abstract

The prevalence of transmitted drug resistance (TDR) in antiretroviral therapy (ART)-naïve individuals remains stable in most developed countries despite a decrease in the prevalence of acquired drug resistance. This suggests that persistence and further transmission of HIV-1 that encodes transmitted drug resistance mutations (TDRMs) is occurring in ART-naïve individuals. In this study, we analysed the prevalence and persistence of TDRMs in the protease and reverse transcriptase-sequences of ART-naïve patients within the German HIV-1 Seroconverter Study Cohort who were infected between 1996 and 2017. The prevalence of TDRMs and baseline susceptibility to antiretroviral drugs were assessed using the Stanford HIVdb list and algorithm. Mean survival times of TDRMs were calculated by Kaplan-Meier analysis. The overall prevalence of TDR was 17.2% (95% CI 15.7–18.6, N = 466/2715). Transmitted NNRTI resistance was observed most frequently with 7.8% (95% CI 6.8–8.8), followed by NRTI resistance (5.0%, 95% CI 4.2–5.9) and PI resistance (2.8%, 95% CI 2.2–3.4). Total TDR (OR = 0.89, p = 0.034) and transmitted NRTI resistance (OR = 0.65, p = 0.000) decreased between 1996 and 2017 but has remained stable during the last decade. Viral susceptibility to NNRTIs (6.5%-6.9% for individual drugs) was mainly reduced, while <3% of the recommended NRTIs and PIs were affected. The longest mean survival times were calculated for the NNRTI mutations K103N (5.3 years, 95% CI 4.2–5.6) and E138A/G/K (8.0 years, 95% CI 5.8–10.2 / 7.9 years, 95% CI 5.4–10.3 / 6.7 years, 95% CI 6.7–6.7) and for the NRTI mutation M41L (6.4 years, 95% CI 6.0–6.7).The long persistence of single TDRMs indicates that onward transmission from ART-naïve individuals is the main cause for TDR in Germany. Transmitted NNRTI resistance was the most frequent TDR, showing simultaneously the highest impact on baseline ART susceptibility and on TDRMs with prolonged persistence. These results give cause for concern regarding the use of NNRTI in first-line regimens. [ABSTRACT FROM AUTHOR]

Published
2019
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42. Characterisation of long-term non-progression of HIV-1 infection after seroconversion: a cohort study

Author

van der Helm, Jannie J. Geskus, Ronald Lodi, Sara Meyer, Laurence Schuitemaker, Hanneke Gunsenheimer-Bartmeyer, Barbara and Monforte, Antonella d'Arminio Olson, Ashley Touloumi, Giota and Sabin, Caroline Porter, Kholoud Prins, Maria CASCADE Collaboration EuroCoord

Abstract

Background Some individuals remain AIDS-free with a high and stable CD4 cell count without antiretroviral therapy (ART) for many years. We estimated long-term progression-free survival after HIV seroconversion and aimed to identify factors associated with loss of long-term non-progression (LTNP) status. Methods For this cohort study, we used data for individuals with well-estimated dates of HIV-1 seroconversion from the CASCADE Collaboration a network of 28 HIV seroconverter cohort studies in Europe, Australia, Canada, and sub-Saharan Africa. The first cohort began enrolling patients in 1979, and for this analysis we used data pooled in May 1, 2011. We defined non-progression as being HIV-positive without AIDS, ART-naive, and with CD4 counts of 500 cells per mu L or higher. We defined LTNP as non-progression during the first 10 years after seroconversion. We used longitudinal methods to characterise LTNP. Findings Of the 4979 HIV seroconverters in our dataset, 3708 (75%) were men. Median time to progression was 2.07 years (95% CI 1.96-2.17), giving estimated progression-free survivals of 18.4% (17.2-19.6) 5 years, 4.0% (3.6-4.5) 10 years, and 1.4% (0.9-1.5) 15 years after seroconversion. The rate of progression did not change beyond 10 years after seroconversion (0.28 [95% CI 0.26-0.31] per person-year at 10 years after seroconversion, 0.24 [0.19-0.29] per person-year at 15 years, and 0.18 [0.10-0.33] per person-year at 20 years). At 10 years since HIV seroconversion, 283 individuals had LTNP, of whom 202 subsequently lost this status (median time to loss of status 2.49 years [2.05-2.92]). In univariable analyses, loss of LTNP status was associated with CD4 cell count at 10 years after seroconversion (p

Published
2014

43. Viral genetic variation accounts for a third of variability in HIV-1 set-point viral load in Europe.

Author

Blanquart, François, Wymant, Chris, Cornelissen, Marion, Gall, Astrid, Bakker, Margreet, Bezemer, Daniela, Hall, Matthew, Hillebregt, Mariska, Ong, Swee Hoe, Albert, Jan, Bannert, Norbert, Fellay, Jacques, Fransen, Katrien, Gourlay, Annabelle J., Grabowski, M. Kate, Gunsenheimer-Bartmeyer, Barbara, Günthard, Huldrych F., Kivelä, Pia, Kouyos, Roger, and Laeyendecker, Oliver

Subjects
VIRAL genetics, HIV, BIOLOGICAL evolution, GENETICS, VIRAL transmission, RNA viruses
Abstract

HIV-1 set-point viral load—the approximately stable value of viraemia in the first years of chronic infection—is a strong predictor of clinical outcome and is highly variable across infected individuals. To better understand HIV-1 pathogenesis and the evolution of the viral population, we must quantify the heritability of set-point viral load, which is the fraction of variation in this phenotype attributable to viral genetic variation. However, current estimates of heritability vary widely, from 6% to 59%. Here we used a dataset of 2,028 seroconverters infected between 1985 and 2013 from 5 European countries (Belgium, Switzerland, France, the Netherlands and the United Kingdom) and estimated the heritability of set-point viral load at 31% (CI 15%–43%). Specifically, heritability was measured using models of character evolution describing how viral load evolves on the phylogeny of whole-genome viral sequences. In contrast to previous studies, (i) we measured viral loads using standardized assays on a sample collected in a strict time window of 6 to 24 months after infection, from which the viral genome was also sequenced; (ii) we compared 2 models of character evolution, the classical “Brownian motion” model and another model (“Ornstein–Uhlenbeck”) that includes stabilising selection on viral load; (iii) we controlled for covariates, including age and sex, which may inflate estimates of heritability; and (iv) we developed a goodness of fit test based on the correlation of viral loads in cherries of the phylogenetic tree, showing that both models of character evolution fit the data well. An overall heritability of 31% (CI 15%–43%) is consistent with other studies based on regression of viral load in donor–recipient pairs. Thus, about a third of variation in HIV-1 virulence is attributable to viral genetic variation. [ABSTRACT FROM AUTHOR]

Published
2017
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44. CD4-cell counts and presence of AIDS in HIV-positive patients entering specialized care---a comparison of migrant groups in the German ClinSurv HIV Cohort Study, 1999-2013.

Author

Zeitlmann, Nadine, Gunsenheimer-Bartmeyer, Barbara, Santos-Hövener, Claudia, Kollan, Christian, and an der Heiden, Matthias

Subjects
*ANTIRETROVIRAL agents, *HIV infections, *HEALTH of immigrants, *AIDS, *AIDS patients
Abstract

Background: Although early presentation to HIV-care is essential to ensure timely initiation of antiretroviral therapy, recent studies have shown that especially migrants present to HIV-care at a later stage of HIV-infection. Currently, thirty percent of all newly diagnosed HIV cases in Germany originate from abroad. So far it is unknown, which specific migrant groups in Germany are particularly at risk for late presentation to HIV-care. Methods: We used data from the Clinical Surveillance of HIV Disease (ClinSurv) cohort, a multi-centre observational cohort (01/01/1999 and 31/07/2013) and included treatment-naïve patients with valid information on country of origin and date of enrolment. Migrants were patients with country of origin outside Germany. We compared time trends for percentage of AIDS (CDC Stage C) and mean CD4-count at enrolment between migrants from Western Europe (WE), Central Europe (CE), Eastern Europe (EE), Sub-Saharan Africa (SSA), South East Asia (SEA) and non-migrants using multivariable regressions. Male non-migrants with mean age of 38-years constituted the reference group. Results: In total, 10,211 patients fulfilled the inclusion criteria, of which 2784 were migrants (SSA: 42%, CE: 17%, WE: 11%, EE: 10%, SEA: 9%). The percentage of patients with AIDS at enrolment was higher in SSA (Odds Ratio (OR)SSA: 1.44, 95%- confidence interval (95%-CI):1.12-1.84) and SEA-migrants (ORSEA:2.16, 95%-CI:1.43-3.27). In addition, female SEA-migrants, were more likely to present with AIDS than their male counterparts (OR:2.22, 95%-CI:1.18-4.17). Mean CD4-count at enrolment was lower for SSA- (Mean CD4-count ratio (IRR):0.72; 95%-CI:0.64-0.82) and SEA-migrants (IRR:0.62, 95%-CI:0.49-0. 78). Over time, it increased in non-migrants and CE-migrants (by 1 and 3%/year, respectively), whereas no increase was seen for SEA and SSA. Conclusions: SSA and SEA-migrants in Germany present to HIV-care at a later stage of HIV infection than non-migrants. Additionally, previous research found a higher risk for late HIV-testing for migrants. Collecting information about the arrival date of migrants in Germany in the HIV notification system would help to understand to which extent these problems could be tackled in Germany. Moreover, participatory approaches for HIV-testing and care as well as research regarding knowledge, behaviour and attitudes towards these topics for SSA and SEA migrants should be expanded. [ABSTRACT FROM AUTHOR]

Published
2016
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46. High Prevalence and High Incidence of Coinfection with Hepatitis B, Hepatitis C, and Syphilis and Low Rate of Effective Vaccination against Hepatitis B in HIV-Positive Men Who Have Sex with Men with Known Date of HIV Seroconversion in Germany.

Author

Jansen, Klaus, Thamm, Michael, Bock, Claus-Thomas, Scheufele, Ramona, Kücherer, Claudia, Muenstermann, Dieter, Hagedorn, Hans-Jochen, Jessen, Heiko, Dupke, Stephan, Hamouda, Osamah, Gunsenheimer-Bartmeyer, Barbara, Meixenberger, Karolin, and null, null

Subjects
MIXED infections, HEPATITIS B, MEN who have sex with men, HEPATITIS C, SEROCONVERSION, DISEASE progression, SYPHILIS
Abstract

Objectives: Men who have sex with men (MSM) are at higher risk for coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis than the general population. HIV infection and these coinfections accelerate disease progression reciprocally. This study evaluated the prevalence and incidence of these coinfections in HIV1-positive MSM in Germany. Materials and Methods: As part of a nationwide, multicenter, prospective cohort study of HIV-infected MSM, plasma samples collected yearly were screened for HBsAg and antibodies to HBc, HBs, HCV, and syphilis. Samples with indications of active HBV or HCV infection were confirmed by polymerase chain reaction. Prevalence and incidence of each infection and incidence rates per study participant were calculated, and incidences over 4-year time intervals compared. Results: This study screened 5,445 samples from 1,843 MSM. Median age at HIV seroconversion was 33 years. Prevalences of active, cleared, and occult HBV, and of active/cleared HCV were 1.7%, 27.1%, 0.2%, and 8.2%, respectively, and 47.5% had been effectively vaccinated against HBV. Prevalence of antibodies to Treponema pallidum and of triple or quadruple sexually transmitted infections (STIs) were 39.6% and 18.9%, respectively. Prevalence of STI, cleared HBV, HBV vaccination, and history of syphilis differed significantly among age groups. Incidences of HBV, HCV, and syphilis were 2.51, 1.54, and 4.06 per 100 person-years, respectively. Incidences of HCV and syphilis increased over time. HCV incidence was significantly higher in MSM coinfected with syphilis and living in Berlin, and syphilis incidence was significantly higher for MSM living in Berlin. Discussion: Despite extensive HBV vaccination campaigns, fewer than 50% of screened MSM were effectively vaccinated, with a high proportion of HIV-positive MSM coinfected with HBV. High rates of STI coinfections in HIV-positive MSM and increasing incidences emphasize the need for better tailored campaigns for HBV vaccination and STI prevention. [ABSTRACT FROM AUTHOR]

Published
2015
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47. Tuberculosis among people living with HIV/AIDS in the German ClinSurv HIV Cohort: long-term incidence and risk factors.

Author

Karo, Basel, Haas, Walter, Kollan, Christian, Gunsenheimer-Bartmeyer, Barbara, Hamouda, Osamah, and Fiebig, Lena

Subjects
TUBERCULOSIS, HIV-positive persons, HIGHLY active antiretroviral therapy, ANTIRETROVIRAL agents, SURVIVAL analysis (Biometry)
Abstract

Background Tuberculosis (TB) still presents a leading cause of morbidity and mortality among people living with HIV/AIDS (PLWHA), including those on antiretroviral therapy. In this study, we aimed to determine the long-term incidence density rate (IDR) of TB and risk factors among PLWHA in relation to combination antiretroviral therapy (cART)-status. Methods Data of PLWHA enrolled from 2001 through 2011 in the German ClinSurv HIV Cohort were investigated using survival analysis and Cox regression. Results TB was diagnosed in 233/11,693 PLWHA either at enrollment (N = 62) or during follow-up (N = 171). The TB IDR during follow-up was 0.37 cases per 100 person-years (PY) overall [95%CI, 0.32-0.43], and was higher among patients who never started cART and among patients originating from Sub-Saharan Africa (1.23 and 1.20 per 100PY, respectively). In two multivariable analyses, both patients (I) who never started cART and (II) those on cART shared the same risk factors for TB, namely: originating from Sub-Saharan Africa compared to Germany (I, hazard ratio (HR); [95%CI]) 4.05; [1.87-8.78] and II, HR 5.15 [2.76-9.60], CD4+ cell count <200 cells/μl (I, HR 8.22 [4.36-15.51] and II, HR 1.90 [1.14-3.15]) and viral load >5 log10 copies/ml (I, HR 2.51 [1.33-4.75] and II, HR 1.77 [1.11-2.82]). Gender, age or HIV-transmission risk group were not independently associated with TB. Conclusion In the German ClinSurv HIV cohort, patients originating from Sub-Saharan Africa, with low CD4+ cell count or high viral load at enrollment were at increased risk of TB even after cART initiation. As patients might be latently infected with Mycobacterium tuberculosis complex, early screening for latent TB infection and implementing isoniazid preventive therapy in line with available recommendations is crucial. [ABSTRACT FROM AUTHOR]

Published
2014
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48. HIV-Prevalence in Tuberculosis Patients in Germany, 2002-2009: An Estimation Based on HIV and Tuberculosis Surveillance Data.

Author

Fiebig, Lena, Kollan, Christian, Hauer, Barbara, Gunsenheimer-Bartmeyer, Barbara, an der Heiden, Matthias, Hamouda, Osamah, and Haas, Walter

Subjects
CHRYSANTHEMUMS, SPECIES, HABITATS, MORPHOLOGY, PLOIDY, POLYPLOIDY
Abstract

Tuberculosis (TB) and HIV comorbidity is a major challenge in TB prevention and control but difficult to assess in Germany as in other countries, where data confidentiality precludes notifying the HIV status of TB patients. We aimed to estimate the HIV-prevalence in TB patients in Germany, 2002-2009, and to characterize the HIV/TB patients demographically. Data from the long-term observational open multicentre cohort ClinSurv HIV were used to identify incident TB in HIV-positive individuals. We assessed the cohort's coverage for the nationwide HIV-positive population by contrasting ClinSurv HIV patients under antiretroviral therapy (ART) with national HIV patient numbers derived from ART prescriptions (data by Insight Health; available for 2006-2009). The HIV-prevalence in TB patients was calculated as the number of HIV/TB cases projected for Germany over all culture-positive TB notifications. From 2002 to 2009, 298 of 15,531 HIV-positive patients enrolled in the ClinSurv HIV cohort were diagnosed with TB. A 21% cohort coverage was determined. The annual estimates of the HIV-prevalence in TB patients were on average 4.5% and ranged from 3.5% (95%CI 2.3-5.1%) in 2007 to 6.6% (95%CI 5.0-8.5%) in 2005. The most recent estimate for 2009 was 4.0% (95%CI 2.6-5.9%). The 298 HIV/TB patients were characterized by a male-to-female ratio of 2.1, by a median age of 38 years at TB diagnosis, and by 59% of the patients having a foreign origin, mainly from Subsahara Africa. We provide, to our knowledge, the first estimate of the HIV- prevalence in TB patients for Germany by joint evaluation of anonymous HIV and TB surveillance data sources. The identified level of HIV in TB patients approximates available surveillance data from neighbouring countries and indicates a non-negligible HIV/TB burden in Germany. Our estimation approach is valuable for epidemiological monitoring of HIV/TB within the current legal frameworks. [ABSTRACT FROM AUTHOR]

Published
2012
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49. Correction: Viral genetic variation accounts for a third of variability in HIV-1 set-point viral load in Europe.

Author

Blanquart, François, Wymant, Chris, Cornelissen, Marion, Gall, Astrid, Bakker, Margreet, Bezemer, Daniela, Hall, Matthew, Hillebregt, Mariska, Ong, Swee Hoe, Albert, Jan, Bannert, Norbert, Fellay, Jacques, Fransen, Katrien, Gourlay, Annabelle J., Grabowski, M. Kate, Gunsenheimer-Bartmeyer, Barbara, Günthard, Huldrych F., Kivelä, Pia, Kouyos, Roger, and Laeyendecker, Oliver

Subjects
VIRAL genetics, HIV
Abstract

A correction is presented for the article "Viral genetic variation accounts for a third of variability in HIV-1 set-point viral load in Europe."

Published
2017
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50. Tuberculosis among people living with HIV/AIDS in the German ClinSurv HIV Cohort: long-term incidence and risk factors

Author

Karo, Basel, Haas, Walter, Kollan, Christian, Gunsenheimer-Bartmeyer, Barbara, Hamouda, Osamah, Fiebig, Lena, Kühne, A., Arastéh, K., Bergmann, F., Warncke, M., Brockmeyer, N., Mühlbächer, N., Rockstroh, J., Wasmuth, J., Hass, S., Jensen, B., Rollmann, L., Esser, Stefan, Schenk-Westkamp, P., Plettenberg, A., Kuhlendahl, F., Adam, A., Weitner, L., Schewe, K., Goey, H., Fenske, S., Buhk, T., Stellbrink, H.-J., Hoffmann, C., van~Lunzen, J., Wassmus, K., Stoll, M., Gerschmann, S., Hoeper, K., Horst, H. A., Trautmann, S., Fätkenheuer, G., Gillor, D., Schommers, P., Bogner, J., Sonntag, B., Salzberger, B., and Fritzsche, C.

Subjects
Adult, Male, medicine.medical_specialty, Tuberculosis, Epidemiology, Medizin, HIV Infections, Immigration, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Isoniazid preventive therapy, Internal medicine, Germany, medicine, Humans, business.industry, Coinfection, Incidence (epidemiology), Incidence, Hazard ratio, Middle Aged, medicine.disease, Survival Analysis, Antiretroviral therapy, Industrialized country, Infectious Diseases, Cohort, Immunology, HIV/AIDS, Female, business, Viral load, Research Article
Abstract

Background Tuberculosis (TB) still presents a leading cause of morbidity and mortality among people living with HIV/AIDS (PLWHA), including those on antiretroviral therapy. In this study, we aimed to determine the long-term incidence density rate (IDR) of TB and risk factors among PLWHA in relation to combination antiretroviral therapy (cART)-status. Methods Data of PLWHA enrolled from 2001 through 2011 in the German ClinSurv HIV Cohort were investigated using survival analysis and Cox regression. Results TB was diagnosed in 233/11,693 PLWHA either at enrollment (N = 62) or during follow-up (N = 171). The TB IDR during follow-up was 0.37 cases per 100 person-years (PY) overall [95% CI, 0.32-0.43], and was higher among patients who never started cART and among patients originating from Sub-Saharan Africa (1.23 and 1.20 per 100PY, respectively). In two multivariable analyses, both patients (I) who never started cART and (II) those on cART shared the same risk factors for TB, namely: originating from Sub-Saharan Africa compared to Germany (I, hazard ratio (HR); [95% CI]) 4.05; [1.87-8.78] and II, HR 5.15 [2.76-9.60], CD4+ cell count 5 log10 copies/ml (I, HR 2.51 [1.33-4.75] and II, HR 1.77 [1.11-2.82]). Gender, age or HIV-transmission risk group were not independently associated with TB. Conclusion In the German ClinSurv HIV cohort, patients originating from Sub-Saharan Africa, with low CD4+ cell count or high viral load at enrollment were at increased risk of TB even after cART initiation. As patients might be latently infected with Mycobacterium tuberculosis complex, early screening for latent TB infection and implementing isoniazid preventive therapy in line with available recommendations is crucial.

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