517 results on '"Thorne, Claire"'
Search Results
2. Setting the research agenda: involving parents in research on children who are HIV‐free
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Bukasa, Laurette L., Namiba, Angelina, Brown, Matilda, Ndu'Ngu, Estelle, Nangwale, Mercy, Letting, Gillian, Chirwa, Patricia, Thorne, Claire, and Tariq, Shema
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Maternal-fetal exchange -- Health aspects ,Clinical trials -- Management ,HIV infection -- Prevention ,Company business management ,Health - Abstract
: Introduction: There is growing interest in health, developmental and survival outcomes of children who are born HIV‐free to women living with HIV (children born HIV‐free). To date, the research agenda has been largely determined by researchers, funders and policy makers, with limited involvement of parents, who are key stakeholders. Researchers at UCL Great Ormond Street Institute of Child Health in partnership with community‐based organisation 4M Network of Mentor Mothers conducted two workshops with parents in March 2022 to establish research priorities for children born HIV‐free, and key considerations for methodological approaches both to research and engagement with the affected communities. Discussion: When exploring research on children born HIV‐free, we consider the following: what aspects of current research are aligned with women and parents’ priorities, what is missing and what approaches would be preferred. A holistic approach to research on children born HIV‐free should be prioritised, focussing on a breadth of outcomes and how they intersect. Secondary use of existing data sources should be maximised to facilitate this, with a view of monitoring the long‐term effects of fetal antiretroviral drug exposure alongside other key health and developmental outcomes. Involving and engaging with parents, and children where possible, must be at the heart of research design to maximise relevance and impact of findings for the affected communities. Potential barriers to engaging with individuals who were children born HIV‐free include parental disclosure and individuals not identifying as a child born HIV‐free to a mother living with HIV. Stigma‐free language must be incorporated into the vocabulary of researchers and other stakeholders, avoiding reference to exposure; we propose the term “children born HIV‐free.” Conclusions: Mothers and parents living with HIV should be involved in research about their children born HIV‐free and are key in identifying research priorities so that findings may translate into an impact on their children's health and wellbeing. Meaningful involvement of women living with HIV through trusted community partners is an effective mechanism by which to elicit views on research about their children., INTRODUCTION Successes in preventing vertical transmission (VT) have led to substantially fewer children being born with HIV [1]. In parallel, the number of children who are born HIV‐free to women [...]
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- 2023
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3. Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis
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Jesson, Julie, Crichton, Siobhan, Quartagno, Matteo, Yotebieng, Marcel, Abrams, Elaine J., Chokephaibulkit, Kulkanya, Le Coeur, Sophie, Ake-Assi, Marie-Helene, Patel, Kunjal, Pinto, Jorge, Paul, Mary, Vreeman, Rachel, Davies, Mary-Ann, Ben-Farhat, Jihane, Van-Dyke, Russell, Judd, Ali, Mofenson, Lynne, Vicari, Marissa, Seage, George, III, Bekker, Linda-Gail, Essajee, Shaffiq, Gibb, Diana, Penazzato, Martina, Collins, Intira Jeannie, Wools-Kaloustian, Kara, Slogrove, Amy, Powis, Kate, Williams, Paige, Matshaba, Mogomotsi, Thahane, Lineo, Nyasulu, Phoebe, Lukhele, Bhekumusa, Mwita, Lumumba, Kekitiinwa-Rukyalekere, Adeodata, Wanless, Sebastian, Goetghebuer, Tessa, Thorne, Claire, Warszawski, Josiane, Galli, Luisa, van-Rossum, Annemarie M.C., Giaquinto, Carlo, Marczynska, Magdalena, Marques, Laura, Prata, Filipa, Ene, Luminita, Okhonskaya, Lyuba, Navarro, Marisa, Frick, Antoinette, Naver, Lars, Kahlert, Christian, Volokha, Alla, Chappel, Elizabeth, Pape, Jean William, Rouzier, Vanessa, Marcelin, Adias, Succi, Regina, Sohn, Annette H., Kariminia, Azar, Edmonds, Andrew, Lelo, Patricia, Lyamuya, Rita, Ogalo, Edith Apondi, Odhiambo, Francesca Akoth, Haas, Andreas D., Bolton, Carolyn, Muhairwe, Josephine, Tweya, Hannock, Sylla, Mariam, D'Almeida, Marceline, Renner, Lorna, J.Abzug, Mark, Oleske, James, Purswani, Murli, Teasdale, Chloe, Nuwagaba-Biribonwoha, Harriet, Goodall, Ruth, and Leroy, Valeriane
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Adolescent development -- Health aspects ,Perinatal infection -- Statistics -- International aspects -- Complications and side effects ,Growth -- Health aspects ,CD4 lymphocytes -- Health aspects ,Pediatric research ,HIV infection -- Statistics -- International aspects -- Complications and side effects ,Health - Abstract
Introduction: Adolescents living with HIV are subject to multiple co-morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) globalproject. Methods: Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10-17 years, were included. Growth was measured using height-for-age Z-scores (HAZ, stunting if Results: A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two-thirds lived in East and Southern Africa, and median age at ART initiation ranged from 7 years in sub-Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia-Pacific; 19% overall had CD4 counts Conclusions: Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood. Keywords: adolescent; CD4; cohort studies; growth; HIV; perinatally acquired Additional information may be found under the Supporting Information tab of this article., 1 | INTRODUCTION In 2019, an estimated 1.7 million adolescents aged 10-19 years were living with HIV worldwide, with 90% of them in sub-Saharan Africa, and 8% in Asia and [...]
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- 2022
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4. Where are the children in national hepatitis C policies? A global review of national strategic plans and guidelines
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Malik, Farihah, Bailey, Heather, Chan, Polin, Collins, Intira Jeannie, Mozalevskis, Antons, Thorne, Claire, and Easterbrook, Philippa
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- 2021
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5. A public health approach for deciding policy on infant feeding and mother–infant contact in the context of COVID-19
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Rollins, Nigel, Minckas, Nicole, Jehan, Fyezah, Lodha, Rakesh, Raiten, Daniel, Thorne, Claire, Van de Perre, Philippe, Ververs, Mija, Walker, Neff, Bahl, Rajiv, and Victora, Cesar G
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- 2021
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6. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study
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Judd, Ali, Zangerle, Robert, Touloumi, Giota, Warszawski, Josiane, Meyer, Laurence, Dabis, François, Krause, Murielle Mary, Ghosn, Jade, Leport, Catherine, Wittkop, Linda, Reiss, Peter, Wit, Ferdinand, Prins, Maria, Bucher, Heiner, Gibb, Diana, Fätkenheuer, Gerd, Julia, Del Amo, Obel, Niels, Thorne, Claire, Mocroft, Amanda, Kirk, Ole, Stephan, Christoph, Pérez-Hoyos, Santiago, Hamouda, Osamah, Bartmeyer, Barbara, Chkhartishvili, Nikoloz, Noguera-Julian, Antoni, Antinori, Andrea, Monforte, Antonella d’Arminio, Brockmeyer, Norbert, Prieto, Luis, Conejo, Pablo Rojo, Soriano-Arandes, Antoni, Battegay, Manuel, Kouyos, Roger, Mussini, Cristina, Tookey, Pat, Casabona, Jordi, Miró, Jose M, Castagna, Antonella, Konopnick, Deborah, Goetghebuer, Tessa, Sönnerborg, Anders, Quiros-Roldan, Eugenia, Sabin, Caroline, Teira, Ramon, Garrido, Myriam, Haerry, David, de Wit, Stéphane, Costagliola, Dominique, d’Arminio-Monforte, Antonella, del Amo, Julia, Raben, Dorthe, Chêne, Geneviève, Rojo, Conejo Pablo, Barger, Diana, Schwimmer, Christine, Termote, Monique, Campbell, Maria, Frederiksen, Casper M, Friis-Møller, Nina, Kjaer, Jesper, Brandt, Rikke Salbøl, Berenguer, Juan, Bohlius, Julia, Bouteloup, Vincent, Cozzi-Lepri, Alessandro, Davies, Mary-Anne, Dorrucci, Maria, Dunn, David, Egger, Matthias, Furrer, Hansjakob, Grabar, Sophie, Guiguet, Marguerite, Lambotte, Olivier, Leroy, Valériane, Lodi, Sara, Matheron, Sophie, Miro, Jose M, Monge, Susana, Nakagawa, Fumiyo, Paredes, Roger, Phillips, Andrew, Puoti, Massimo, Rohner, Eliane, and Schomaker, Michael
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Biomedical and Clinical Sciences ,Clinical Sciences ,Sexually Transmitted Infections ,Rare Diseases ,Emerging Infectious Diseases ,Infectious Diseases ,HIV/AIDS ,Infection ,Adolescent ,Adult ,Anti-Retroviral Agents ,CD4 Lymphocyte Count ,Cohort Studies ,Female ,HIV Infections ,HIV-1 ,Humans ,Male ,Middle Aged ,Risk Factors ,Sarcoma ,Kaposi ,Viral Load ,Young Adult ,AIDS-defining Cancer Project Working Group for IeDEA and COHERE in EuroCoord ,HIV ,Kaposi sarcoma ,antiretroviral therapy ,cohort study ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundWe compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America.MethodsWe included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs).ResultsWe included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were
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- 2017
7. Antenatal Seroprevalence of Zika and Chikungunya Viruses, Kingston Metropolitan Area, Jamaica, 2017-2019
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Anzinger, Joshua J., Mears, Chadwic D., Ades, A.E., Francis, Keisha, Phillips, Yakima, Leys, Ynolde E., Spyer, Moira J., Brown, David, Filippis, Ana M. Bispo de, Nastouli, Eleni, Byrne, Thomas, Bailey, Heather, Palmer, Paulette, Bryan, Lenroy, Webster-Kerr, Karen, Giaquinto, Carlo, Thorne, Claire, and Christie, Celia D.C.
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Kingston, Jamaica (City) -- Health aspects ,Chikungunya fever -- Statistics -- Risk factors ,Pregnant women -- Statistics -- Health aspects ,Health - Abstract
The recent introductions of chikungunya virus (CHIKV) and Zika virus (ZIKV) in the Americas led to widespread epidemics with substantial health and economic effects. Small island developing states in the [...]
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- 2022
8. Neonatal deaths among infants born to women living with HIV in the UK and Ireland
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Yan, Helen, Peters, Helen, and Thorne, Claire
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- 2022
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9. Surveillance of ARV safety in pregnancy and breastfeeding: towards a new framework
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Renaud, Françoise, Mofenson, Lynne M., Bakker, Charlotte, Dolk, Helen, Leroy, Valeriane, Namiba, Angelina, Sahin, Leyla, Shapiro, Roger, Slogrove, Amy, Thorne, Claire, Vicari, Marissa, Low?Beer, Daniel, and Doherty, Meg
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Safety regulations -- Evaluation ,Birth defects -- Prevention ,Breast feeding -- Health aspects ,Antiviral agents -- Testing -- Complications and side effects ,Sentinel health events -- Methods -- Standards ,Clinical trials -- Methods -- Standards ,Data entry -- Methods -- Standards ,Pharmaceutical research -- Standards ,Pregnant women -- Drug therapy ,HIV infection -- Drug therapy ,Health - Abstract
: Introduction: As new antiretrovirals (ARVs), including long‐acting ARVs for treatment and prevention, are approved and introduced, surveillance during pregnancy must become the safety net for evaluating birth outcomes, especially those that are rare and require large numbers of observations. Historically, drug pharmacovigilance in pregnancy has been limited and fragmented between different data sources, resulting in inadequate data to assess risk. The International Maternal Pediatric Adolescent AIDS Clinical Trials Network and World Health Organization convened a Workshop which reviewed strengths and weaknesses of existing programs and discussed an improved framework to integrate existing safety data sources and promote harmonization and digitalization. Discussion: This paper highlights that although robust sources of safety data and surveillance programs exist, key challenges remain, including unknown denominators, reporting bias, under‐reporting (e.g. in voluntary registries), few data sources from resource‐limited settings (most are in North America and Europe), incomplete or inaccurate data (e.g. within routine medical records). However, recent experiences (e.g. with safety signals) and current innovations (e.g. electronic record use in resource‐limited settings and defining adverse outcomes) provide momentum and building blocks for a new framework for active surveillance of ARV safety in pregnancy. A public health approach should be taken using data from existing sources, including registries of pregnancy ARV exposure and birth defects; observational surveillance and cohort studies; clinical trials; and real‐world databases. Key facilitators are harmonization and standardization of outcomes, sharing of materials and tools, and data linkages between programs. Other key facilitators include the development of guidance to estimate sample size and duration of surveillance, ensuring strategic geographic diversity, bringing partners together to share information and engaging the community of women living with HIV. Conclusions: Looking ahead, critical steps to safely introduce new ARVs include (1) adopting harmonized standards for measuring adverse maternal, birth and infant outcomes; (2) establishing surveillance centres of excellence in areas with high HIV prevalence with harmonized data collection and optimized electronic health records linking maternal/infant data; and (3) creating targets and evaluation goals for reporting progress on implementation and quality of surveillance in pregnancy. The platform will be leveraged to ensure that appropriate contributions and strategic actions by relevant stakeholders are implemented., INTRODUCTION Data on new antiretroviral (ARV) drugs in pregnancy are often delayed until years after initial approval [1, 2]. Additionally, the most vulnerable period for adverse foetal effects is in [...]
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- 2022
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10. The cascade of care for children and adolescents with HIV in the UK and Ireland, 2010 to 2016
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Chappell, Elizabeth, Lyall, Hermione, Riordan, Andrew, Thorne, Claire, Foster, Caroline, Butler, Karina, Prime, Katia, Bamford, Alasdair, Peters, Helen, Judd, Ali, and Collins, Intira J.
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Gilead Sciences Inc. ,Highly active antiretroviral therapy -- Comparative analysis ,Children -- Comparative analysis ,Child care -- Comparative analysis ,HIV -- Comparative analysis ,Pediatrics -- Comparative analysis ,Antiretroviral agents -- Comparative analysis ,Biological products industry -- Comparative analysis ,Health - Abstract
Introduction: The UNAIDS 90-90-90 targets for the cascade of care are widely used to monitor the success of HIV care programmes but there are few studies in children. We assessed the cascade for children and adolescents living with HIV in the national Collaborative HIV Paediatric Study (CHIPS) in the UK and Ireland. Methods: Utilizing longitudinal data from CHIPS we compared the cascade of care for 2010, 2013 and 2016. Among children diagnosed with HIV and not known to be lost to follow-up at the start of each calendar year, we summarized the proportion in active paediatric care during that year (defined as having >1 clinic visit, CD4 or viral load measurement, or change to antiretroviral therapy (ART) regimen), and of these, the proportion on ART at last visit in that year. Among those on ART, the proportion with viral suppression ( Results: Of children in paediatric HIV care at the start of 2010, 2013 and 2016 (n = 1249, 1157, 905 respectively), the proportion in active care during that calendar year was high throughout at 97 to 99%. Of those in active care, the proportion on ART increased from 79% to 85% and 92% respectively (p < 0.001). Among those on ART, the proportion with viral suppression and good immune status was stable at 83% to 86% and 85% to 88%, respectively, across the years. Among children in care in 2016, those aged >15 years were less likely to be virally suppressed (79% vs. 91%, p < 0.001) or to have good immune status (78% vs. 94%, p < 0.001) compared to younger children; there were no differences by place of birth or sex. Conclusions: Children and adolescents in the UK and Ireland national cohort had high retention in care. The proportion on ART increased significantly over time although there was no change in viral suppression or good immune status. Poorer outcomes among adolescents highlight the need for targeted support for this population. Keywords: HIV care continuum; paediatric; adolescents; cohort studies; UK and Ireland; retention in care, 1 | INTRODUCTION The HIV cascade of care is a model which outlines the steps from HIV infection that individuals must pass through to achieve viral suppression, with intermediate stages [...]
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- 2019
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11. Characterisation and Calibration of ZEPLIN III - A Dark Matter Detector
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Thorne, Claire and Sumner, Timothy
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520 - Abstract
The ZEPLIN III liquid xenon dark matter detector is designed to potentially discover the WIMP - a supersymmetric galactic dark matter candidate. This thesis presents experimental results of the ZEPLIN III commissioning studies, in preparation for the first and second underground science runs. Data acquired on the surface, at the Imperial College London laboratories, were used to characterise the instrument's response in terms of light yield (LY) and single photoelectron (SPE) spectra. A zero-field LY was measured as 7.42±0.37phe/keV and 18.12±0.91 phe/keV in dedicated single- and dual-phase high yieldconfigurations, respectively, consistent with Monte Carlo simulations. Mean SPEmeasured pulse areas ranged from 41.78±1.55 Vps to 52.37±1.59 Vps, dependingon the method employed. A 3-D position reconstruction was verified and, significantly,no evidence of a potentially-contaminating background -population wasobserved. This study directly lead to critical development of the DAQ software andhardware configuration. The PMT array was confirmed as responsive and, crucially,the particle discrimination principle was demonstrated. Zero-field LYs of (4.6-4.7)±0.5 phe/keV were recovered from the centre of the chamber, exceeding simulationpredictions. With-field (3.01 kV/cm in the liquid) LYs of (1.2-1.8) ±0.3 phe/keVfrom the liquid scintillation (S1) and an electroluminescence yield (S2) of (98-140)±35 phe/keV from the gas phase were also determined. ZEPLIN III was deployed in the Boulby Underground Laboratory, UK and demonstratedsuccessful operation at high field (up to 3.79 kV/cm in the liquid), in situ. An alternative Poisson method for obtaining single photoelectron distributions wasdeveloped by the ZEPLIN collaboration. The origin of long- events in surfacedata was investigated and ultimately resolved as an artefact of early versions ofthe data reduction software. An S1 zero-field LY of 4.72±0.10 phe/keV, obtainedwith a 57Co external source, was recovered for the centre of the chamber. The instrument's energy resolution was evaluated and a novel parameterisation approach,developed by the author, yielded σ=1.08±0.06p E(keV) with a dominant stochastic term. A 'flat-fielding' method was established, proving to minimise the resolution significantly, yielding 8.6% and 7.3% for S1 and S2, respectively, in the fiducialised anti-correlated energy channel. This flat-fielding recipe, along with construction of the light collection correction matrices, formed the basis of the final procedures subsequently applied to first science run data-sets.
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- 2009
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12. Ethnic group differences in rates of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19 related hospital admissions in young children by SARS-CoV-2- variant: national birth cohort study
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Fariyo Abdullahi, Hardelid, Pia, Nguyen, Vincent, Thorne, Claire, and Wijlaars, Linda
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The objective is to describe the rates of SARS-CoV-2 testing, PCR confirmed infections and COVID-19 related hospital admissions in children under 5 by ethnic group during the wild-type, alpha, delta and omicron variant waves.
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- 2023
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13. Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand
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Crichton, Siobhan, Belfrage, Erik, Collins, Intira Jeannie, Doerholt, Katja, Judd, Ali, Le Coeur, Sophie, Spoulou, Vana, Scherpbier, Henriette, Smit, Colette, Goetghebuer, Tessa, Gibb, Diana M., Noguera-Julian, Antoni, Navarro, Maria Luisa, Ramos, Jose Tomas, Galli, Luisa, Giaquinto, Carlo, Thorne, Claire, Ansone, Santa, Marczynska, Magdalena, Okhonskaia, Liubov, Tejada, Begoña Martinez de, Jourdain, Gonzague, Decker, Luc, Ene, Luminita, and Goodall, Ruth
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- 2019
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14. Gestational diabetes in women living with HIV in the UK and Ireland: insights from population‐based surveillance data
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Bukasa, Laurette L., primary, Cortina‐Borja, Mario, additional, Peters, Helen, additional, Taylor, Graham P., additional, and Thorne, Claire, additional
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- 2023
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15. Characteristics, treatment and care of pregnant women living with hepatitis B in England: findings from a national audit
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Bailey, Heather, primary, Nastouli, Eleni, additional, Webb, Sharon, additional, Peckham, Catherine, additional, and Thorne, Claire, additional
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- 2023
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16. Genetic analysis of blood molecular phenotypes reveals common properties in the regulatory networks affecting complex traits
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Brown, Andrew A., Fernandez-Tajes, Juan J., Hong, Mun gwan, Brorsson, Caroline A., Koivula, Robert W., Davtian, David, Dupuis, Théo, Sartori, Ambra, Michalettou, Theodora Dafni, Forgie, Ian M., Adam, Jonathan, Allin, Kristine H., Caiazzo, Robert, Cederberg, Henna, De Masi, Federico, Elders, Petra J.M., Giordano, Giuseppe N., Haid, Mark, Hansen, Torben, Hansen, Tue H., Hattersley, Andrew T., Heggie, Alison J., Howald, Cédric, Jones, Angus G., Kokkola, Tarja, Laakso, Markku, Mahajan, Anubha, Mari, Andrea, McDonald, Timothy J., McEvoy, Donna, Mourby, Miranda, Musholt, Petra B., Nilsson, Birgitte, Pattou, Francois, Penet, Deborah, Raverdy, Violeta, Ridderstråle, Martin, Romano, Luciana, Rutters, Femke, Sharma, Sapna, Teare, Harriet, ‘t Hart, Leen, Tsirigos, Konstantinos D., Vangipurapu, Jagadish, Vestergaard, Henrik, Brunak, Søren, Franks, Paul W., Frost, Gary, Grallert, Harald, Jablonka, Bernd, McCarthy, Mark I., Pavo, Imre, Pedersen, Oluf, Ruetten, Hartmut, Walker, Mark, Adragni, Kofi, Allesøe, Rosa Lundbye L., Artati, Anna A., Arumugam, Manimozhiyan, Atabaki-Pasdar, Naeimeh, Baltauss, Tania, Banasik, Karina, Barnett, Anna L., Baum, Patrick, Bell, Jimmy D., Beulens, Joline W., Bianzano, Susanna B., Bizzotto, Roberto, Bonnefond, Amelie, Cabrelli, Louise, Dale, Matilda, Dawed, Adem Y., de Preville, Nathalie, Dekkers, Koen F., Deshmukh, Harshal A., Dings, Christiane, Donnelly, Louise, Dutta, Avirup, Ehrhardt, Beate, Engelbrechtsen, Line, Eriksen, Rebeca, Fan, Yong, Ferrer, Jorge, Fitipaldi, Hugo, Forman, Annemette, Fritsche, Andreas, Froguel, Philippe, Gassenhuber, Johann, Gough, Stephen, Graefe-Mody, Ulrike, Grempler, Rolf, Groeneveld, Lenka, Groop, Leif, Gudmundsdóttir, Valborg, Gupta, Ramneek, Hennige, Anita M.H., Hill, Anita V., Holl, Reinhard W., Hudson, Michelle, Jacobsen, Ulrik Plesner, Jennison, Christopher, Johansen, Joachim, Jonsson, Anna, Karaderi, Tugce, Kaye, Jane, Kennedy, Gwen, Klintenberg, Maria, Kuulasmaa, Teemu, Lehr, Thorsten, Loftus, Heather, Lundgaard, Agnete Troen T., Mazzoni, Gianluca, McRobert, Nicky, McVittie, Ian, Nice, Rachel, Nicolay, Claudia, Nijpels, Giel, Palmer, Colin N., Pedersen, Helle K., Perry, Mandy H., Pomares-Millan, Hugo, Prehn, Cornelia P., Ramisch, Anna, Rasmussen, Simon, Robertson, Neil, Rodriquez, Marianne, Sackett, Peter, Scherer, Nina, Shah, Nisha, Sihinevich, Iryna, Slieker, Roderick C., Sondertoft, Nadja B., Steckel-Hamann, Birgit, Thomas, Melissa K., Thomas, Cecilia Engel E., Thomas, Elizabeth Louise L., Thorand, Barbara, Thorne, Claire E., Tillner, Joachim, Tura, Andrea, Uhlen, Mathias, van Leeuwen, Nienke, van Oort, Sabine, Verkindt, Helene, Vogt, Josef, Wad Sackett, Peter W., Wesolowska-Andersen, Agata, Whitcher, Brandon, White, Margaret W., Adamski, Jerzy, Schwenk, Jochen M., Pearson, Ewan R., Dermitzakis, Emmanouil T., Viñuela, Ana, Brown, Andrew A., Fernandez-Tajes, Juan J., Hong, Mun gwan, Brorsson, Caroline A., Koivula, Robert W., Davtian, David, Dupuis, Théo, Sartori, Ambra, Michalettou, Theodora Dafni, Forgie, Ian M., Adam, Jonathan, Allin, Kristine H., Caiazzo, Robert, Cederberg, Henna, De Masi, Federico, Elders, Petra J.M., Giordano, Giuseppe N., Haid, Mark, Hansen, Torben, Hansen, Tue H., Hattersley, Andrew T., Heggie, Alison J., Howald, Cédric, Jones, Angus G., Kokkola, Tarja, Laakso, Markku, Mahajan, Anubha, Mari, Andrea, McDonald, Timothy J., McEvoy, Donna, Mourby, Miranda, Musholt, Petra B., Nilsson, Birgitte, Pattou, Francois, Penet, Deborah, Raverdy, Violeta, Ridderstråle, Martin, Romano, Luciana, Rutters, Femke, Sharma, Sapna, Teare, Harriet, ‘t Hart, Leen, Tsirigos, Konstantinos D., Vangipurapu, Jagadish, Vestergaard, Henrik, Brunak, Søren, Franks, Paul W., Frost, Gary, Grallert, Harald, Jablonka, Bernd, McCarthy, Mark I., Pavo, Imre, Pedersen, Oluf, Ruetten, Hartmut, Walker, Mark, Adragni, Kofi, Allesøe, Rosa Lundbye L., Artati, Anna A., Arumugam, Manimozhiyan, Atabaki-Pasdar, Naeimeh, Baltauss, Tania, Banasik, Karina, Barnett, Anna L., Baum, Patrick, Bell, Jimmy D., Beulens, Joline W., Bianzano, Susanna B., Bizzotto, Roberto, Bonnefond, Amelie, Cabrelli, Louise, Dale, Matilda, Dawed, Adem Y., de Preville, Nathalie, Dekkers, Koen F., Deshmukh, Harshal A., Dings, Christiane, Donnelly, Louise, Dutta, Avirup, Ehrhardt, Beate, Engelbrechtsen, Line, Eriksen, Rebeca, Fan, Yong, Ferrer, Jorge, Fitipaldi, Hugo, Forman, Annemette, Fritsche, Andreas, Froguel, Philippe, Gassenhuber, Johann, Gough, Stephen, Graefe-Mody, Ulrike, Grempler, Rolf, Groeneveld, Lenka, Groop, Leif, Gudmundsdóttir, Valborg, Gupta, Ramneek, Hennige, Anita M.H., Hill, Anita V., Holl, Reinhard W., Hudson, Michelle, Jacobsen, Ulrik Plesner, Jennison, Christopher, Johansen, Joachim, Jonsson, Anna, Karaderi, Tugce, Kaye, Jane, Kennedy, Gwen, Klintenberg, Maria, Kuulasmaa, Teemu, Lehr, Thorsten, Loftus, Heather, Lundgaard, Agnete Troen T., Mazzoni, Gianluca, McRobert, Nicky, McVittie, Ian, Nice, Rachel, Nicolay, Claudia, Nijpels, Giel, Palmer, Colin N., Pedersen, Helle K., Perry, Mandy H., Pomares-Millan, Hugo, Prehn, Cornelia P., Ramisch, Anna, Rasmussen, Simon, Robertson, Neil, Rodriquez, Marianne, Sackett, Peter, Scherer, Nina, Shah, Nisha, Sihinevich, Iryna, Slieker, Roderick C., Sondertoft, Nadja B., Steckel-Hamann, Birgit, Thomas, Melissa K., Thomas, Cecilia Engel E., Thomas, Elizabeth Louise L., Thorand, Barbara, Thorne, Claire E., Tillner, Joachim, Tura, Andrea, Uhlen, Mathias, van Leeuwen, Nienke, van Oort, Sabine, Verkindt, Helene, Vogt, Josef, Wad Sackett, Peter W., Wesolowska-Andersen, Agata, Whitcher, Brandon, White, Margaret W., Adamski, Jerzy, Schwenk, Jochen M., Pearson, Ewan R., Dermitzakis, Emmanouil T., and Viñuela, Ana
- Abstract
We evaluate the shared genetic regulation of mRNA molecules, proteins and metabolites derived from whole blood from 3029 human donors. We find abundant allelic heterogeneity, where multiple variants regulate a particular molecular phenotype, and pleiotropy, where a single variant associates with multiple molecular phenotypes over multiple genomic regions. The highest proportion of share genetic regulation is detected between gene expression and proteins (66.6%), with a further median shared genetic associations across 49 different tissues of 78.3% and 62.4% between plasma proteins and gene expression. We represent the genetic and molecular associations in networks including 2828 known GWAS variants, showing that GWAS variants are more often connected to gene expression in trans than other molecular phenotypes in the network. Our work provides a roadmap to understanding molecular networks and deriving the underlying mechanism of action of GWAS variants using different molecular phenotypes in an accessible tissue.
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- 2023
17. HIV-1 infected women and their children in Europe : an epidemiological study of health and social care
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Thorne, Claire Nicola
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610 ,Medicine - Abstract
This thesis aims to describe the characteristics of HIV-infected women and their children in Europe and to investigate their clinical and psycho-social care. Socio-demographic, clinical and immunological characteristics of 2131 HIV-infected pregnant women, enrolled between 1985 and July 1997 in an on-going multi-centre prospective study, the European Collaborative Study (ECS) are described: two-thirds had a history of injecting drug use (IDU) and heterosexual acquisition of HIV infection had increased significantly over time. Five years after delivery, 14% of mothers will have died and 18% progressed to AIDS. Results from two surveys of 55 centres in 1994 and 1997 to identify obstetric policies for HIV-infected women showed that zidovudine use to reduce vertical transmission has increased significantly since 1994. Of the 1123 children enrolled in the ECS by September 1996, 70% had always been cared for by their parent(s) in the first four years of life, but by age eight, an estimated 60% will have lived in alternative care. Maternal IDU, clinical status and single parenthood were the main reasons necessitating alternative care. The hospitalisation experience of 1189 children is presented, showing that infected children were four times more likely to be admitted to hospital than uninfected children of the same age. The final part of the thesis presents the results of two surveys carried out in 1996/7. A survey of service-providers in 15 paediatric HIV centres was carried out to document the provision and organisation of clinical and psycho-social services for HIV-affected families. Service provision was similar, despite national differences in medical and social infrastructure. A survey of 182 parents and carers of children affected by HIV attending the same centres showed that satisfaction with services varied by centre and according to respondent characteristics. The thesis concludes with a discussion of the implications for service development and future research.
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- 1997
18. Discovery of drug–omics associations in type 2 diabetes with generative deep-learning models
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Allesøe, Rosa Lundbye, Lundgaard, Agnete Troen, Hernández Medina, Ricardo, Aguayo-Orozco, Alejandro, Johansen, Joachim, Nissen, Jakob Nybo, Brorsson, Caroline, Mazzoni, Gianluca, Niu, Lili, Biel, Jorge Hernansanz, Brasas, Valentas, Webel, Henry, Benros, Michael Eriksen, Pedersen, Anders Gorm, Chmura, Piotr Jaroslaw, Jacobsen, Ulrik Plesner, Mari, Andrea, Koivula, Robert, Mahajan, Anubha, Vinuela, Ana, Tajes, Juan Fernandez, Sharma, Sapna, Haid, Mark, Hong, Mun-Gwan, Musholt, Petra B., de Masi, Federico, Vogt, Josef, Pedersen, Helle Krogh, Gudmundsdottir, Valborg, Jones, Angus, Kennedy, Gwen, Bell, Jimmy, Thomas, E. Louise, Frost, Gary, Thomsen, Henrik, Hansen, Elizaveta, Hansen, Tue Haldor, Vestergaard, Henrik, Muilwijk, Mirthe, Blom, Marieke T., ‘t Hart, Leen M., Pattou, Francois, Raverdy, Violeta, Brage, Soren, Kokkola, Tarja, Heggie, Alison, McEvoy, Donna, Mourby, Miranda, Kaye, Jane, Hattersley, Andrew, McDonald, Timothy, Ridderstråle, Martin, Walker, Mark, Forgie, Ian, Giordano, Giuseppe N., Pavo, Imre, Ruetten, Hartmut, Pedersen, Oluf, Hansen, Torben, Dermitzakis, Emmanouil, Franks, Paul W., Schwenk, Jochen M., Adamski, Jerzy, McCarthy, Mark I., Pearson, Ewan, Banasik, Karina, Rasmussen, Simon, Brunak, S. ren, Froguel, Philippe, Thomas, Cecilia Engel, Haussler, Ragna, Beulens, Joline, Rutters, Femke, Nijpels, Giel, van Oort, Sabine, Groeneveld, Lenka, Elders, Petra, Giorgino, Toni, Rodriquez, Marianne, Nice, Rachel, Perry, Mandy, Bianzano, Susanna, Graefe-Mody, Ulrike, Hennige, Anita, Grempler, Rolf, Baum, Patrick, Stærfeldt, Hans-Henrik, Shah, Nisha, Teare, Harriet, Ehrhardt, Beate, Tillner, Joachim, Dings, Christiane, Lehr, Thorsten, Scherer, Nina, Sihinevich, Iryna, Cabrelli, Louise, Loftus, Heather, Bizzotto, Roberto, Tura, Andrea, Dekkers, Koen, van Leeuwen, Nienke, Groop, Leif, Slieker, Roderick, Ramisch, Anna, Jennison, Christopher, McVittie, Ian, Frau, Francesca, Steckel-Hamann, Birgit, Adragni, Kofi, Thomas, Melissa, Pasdar, Naeimeh Atabaki, Fitipaldi, Hugo, Kurbasic, Azra, Mutie, Pascal, Pomares-Millan, Hugo, Bonnefond, Amelie, Canouil, Mickael, Caiazzo, Robert, Verkindt, Helene, Holl, Reinhard, Kuulasmaa, Teemu, Deshmukh, Harshal, Cederberg, Henna, Laakso, Markku, Vangipurapu, Jagadish, Dale, Matilda, Thorand, Barbara, Nicolay, Claudia, Fritsche, Andreas, Hill, Anita, Hudson, Michelle, Thorne, Claire, Allin, Kristine, Arumugam, Manimozhiyan, Jonsson, Anna, Engelbrechtsen, Line, Forman, Annemette, Dutta, Avirup, Sondertoft, Nadja, Fan, Yong, Gough, Stephen, Robertson, Neil, McRobert, Nicky, Wesolowska-Andersen, Agata, Brown, Andrew, Davtian, David, Dawed, Adem, Donnelly, Louise, Palmer, Colin, White, Margaret, Ferrer, Jorge, Whitcher, Brandon, Artati, Anna, Prehn, Cornelia, Adam, Jonathan, Grallert, Harald, Gupta, Ramneek, Sackett, Peter Wad, Nilsson, Birgitte, Tsirigos, Konstantinos, Eriksen, Rebeca, Jablonka, Bernd, Uhlen, Mathias, Gassenhuber, Johann, Baltauss, Tania, de Preville, Nathalie, Klintenberg, Maria, Abdalla, Moustafa, Lundgaard, Agnete Troen [0000-0001-7447-6560], Hernández Medina, Ricardo [0000-0001-6373-2362], Johansen, Joachim [0000-0001-7052-1870], Niu, Lili [0000-0003-4571-4368], Biel, Jorge Hernansanz [0000-0002-3125-2951], Benros, Michael Eriksen [0000-0003-4939-9465], Pedersen, Anders Gorm [0000-0001-9650-8965], Jacobsen, Ulrik Plesner [0000-0001-9181-6854], Koivula, Robert [0000-0002-1646-4163], Vinuela, Ana [0000-0003-3771-8537], Haid, Mark [0000-0001-6118-1333], Hong, Mun-Gwan [0000-0001-8603-8293], Kennedy, Gwen [0000-0002-9856-3236], Thomas, E Louise [0000-0003-4235-4694], Frost, Gary [0000-0003-0529-6325], Hansen, Tue Haldor [0000-0001-5948-8993], Kaye, Jane [0000-0002-7311-4725], Hattersley, Andrew [0000-0001-5620-473X], Ridderstråle, Martin [0000-0002-3270-9167], Pedersen, Oluf [0000-0002-3321-3972], Hansen, Torben [0000-0001-8748-3831], Schwenk, Jochen M [0000-0001-8141-8449], Rasmussen, Simon [0000-0001-6323-9041], Brunak, Søren [0000-0003-0316-5866], Apollo - University of Cambridge Repository, Epidemiology and Data Science, ACS - Diabetes & metabolism, APH - Health Behaviors & Chronic Diseases, General practice, ACS - Heart failure & arrhythmias, APH - Aging & Later Life, Graduate School, and APH - Methodology
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Biomedical Engineering ,Type 2 diabetes ,Bioengineering ,Applied Microbiology and Biotechnology ,Deep Learning ,SDG 3 - Good Health and Well-being ,Diabetes Mellitus, Type 2 ,Machine learning ,Molecular Medicine ,Humans ,Data integration ,IMI DIRECT Consortium ,Systems biology ,Algorithms ,Biotechnology - Abstract
The application of multiple omics technologies in biomedical cohorts has the potential to reveal patient-level disease characteristics and individualized response to treatment. However, the scale and heterogeneous nature of multi-modal data makes integration and inference a non-trivial task. We developed a deep-learning-based framework, multi-omics variational autoencoders (MOVE), to integrate such data and applied it to a cohort of 789 people with newly diagnosed type 2 diabetes with deep multi-omics phenotyping from the DIRECT consortium. Using in silico perturbations, we identified drug–omics associations across the multi-modal datasets for the 20 most prevalent drugs given to people with type 2 diabetes with substantially higher sensitivity than univariate statistical tests. From these, we among others, identified novel associations between metformin and the gut microbiota as well as opposite molecular responses for the two statins, simvastatin and atorvastatin. We used the associations to quantify drug–drug similarities, assess the degree of polypharmacy and conclude that drug effects are distributed across the multi-omics modalities.
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- 2023
19. Overall Vertical Transmission of Hepatitis C Virus, Transmission Net of Clearance, and Timing of Transmission
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Anthony E Ades, Fabiana Gordon, Karen Scott, Intira J Collins, Thorne Claire, Lucy Pembrey, Elizabeth Chappell, Eugènia Mariné-Barjoan, Karina Butler, Giuseppe Indolfi, Diana M Gibb, and Ali Judd
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Microbiology (medical) ,Infectious Diseases - Abstract
Background It is widely accepted that the risk of hepatitis C virus (HCV) vertical transmission (VT) is 5%–6% in monoinfected women, and that 25%–40% of HCV infection clears spontaneously within 5 years. However, there is no consensus on how VT rates should be estimated, and there is a lack of information on VT rates “net” of clearance. Methods We reanalyzed data on 1749 children in 3 prospective cohorts to obtain coherent estimates of overall VT rate and VT rates net of clearance at different ages. Clearance rates were used to impute the proportion of uninfected children who had been infected and then cleared before testing negative. The proportion of transmission early in utero, late in utero, and at delivery was estimated from data on the proportion of HCV RNA positive within 3 days of birth, and differences between elective cesarean and nonelective cesarean deliveries. Results Overall VT rates were 7.2% (95% credible interval [CrI], 5.6%–8.9%) in mothers who were human immunodeficiency virus (HIV) negative and 12.1% (95% CrI, 8.6%–16.8%) in HIV-coinfected women. The corresponding rates net of clearance at 5 years were 2.4% (95% CrI, 1.1%–4.1%), and 4.1% (95% CrI, 1.7%–7.3%). We estimated that 24.8% (95% CrI, 12.1%–40.8%) of infections occur early in utero, 66.0% (95% CrI, 42.5%–83.3%) later in utero, and 9.3% (95% CrI, 0.5%–30.6%) during delivery. Conclusions Overall VT rates are about 24% higher than previously assumed, but the risk of infection persisting beyond age 5 years is about 38% lower. The results can inform design of trials of interventions to prevent or treat pediatric HCV infection, and strategies to manage children exposed in utero.
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- 2022
20. Stillbirth in Women Living With HIV Delivering in the United Kingdom and Ireland: 2007–2015
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Favarato, Graziella, Townsend, Claire L., Peters, Helen, Sconza, Rebecca, Bailey, Heather, Cortina-Borja, Mario, Tookey, Pat, and Thorne, Claire
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- 2019
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21. Pregnancy and Neonatal Outcomes Following Prenatal Exposure to Dolutegravir
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Vannappagari, Vani and Thorne, Claire
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- 2019
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22. The challenge of the laboratory diagnosis in a confirmed congenital Zika virus syndrome in utero: A case report
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Sulleiro, Elena, Frick, Marie Antoinette, Rodó, Carlota, Espasa, Mateu, Thorne, Claire, Espiau, María, Martín-Nalda, Andrea, Suy, Anna, Giaquinto, Carlo, Melendo, Susana, Rando, Ariadna, Alarcón, Ana, Martinón-Torres, Federico, Pumarola, Tomás, Soler-Palacín, Pere, and Soriano-Arandes, Antoni
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- 2019
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23. Brief Report: Surveillance of Congenital Anomalies After Exposure to Raltegravir or Elvitegravir During Pregnancy in the United Kingdom and Ireland, 2008–2018
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Rasi, Virginia, Cortina-Borja, Mario, Peters, Helen, Sconza, Rebecca, and Thorne, Claire
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- 2019
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24. Estimating the number of livebirths to Hepatitis C seropositive women in England in 2013 and 2018 using Bayesian modelling
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Dema, Emily, primary, Stander, Julian, additional, Cortina-Borja, Mario, additional, Thorne, Claire, additional, and Bailey, Heather, additional
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- 2022
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25. Risk factors for stunting in children who are HIV‐exposed and uninfected after Option B+ implementation in Malawi
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Toledo, Gabriela, primary, Landes, Megan, additional, van Lettow, Monique, additional, Tippett Barr, Beth A., additional, Bailey, Heather, additional, Crichton, Siobhan, additional, Msungama, Wezi, additional, and Thorne, Claire, additional
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- 2022
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26. Outcomes of second‐line antiretroviral therapy among children living with HIV: a global cohort analysis
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Patel, Kunjal, Smith, Colette, Collins, Intira Jeannie, Goodall, Ruth, Abrams, Elaine J., Sohn, Annette H., Mohamed, Thahira J., Van Dyke, Russell B., Rojo, Pablo, Wools?Kaloustian, Kara, Pinto, Jorge, Edmonds, Andrew, Marete, Irene, Paul, Mary, Nuwaqaba?Biribonwoha, Harriet, Leroy, Valériane, Davies, Mary?Ann, Vreeman, Rachel, Maxwell, Nicky, Timmerman, Venessa, Duff, Charlotte, Mofenson, Lynne, Bekker, Linda?Gail, Vicari, Marissa, Essajee, Shaffiq, Penazzato, Martina, Slogrove, Amy, Williams, Paige, Crichton, Siobhan, Seage, George, Thahane, Lineo, Kazembe, Peter N., Lukhele, Bhekumusa, Mwita, Lumumba, Kekitiinwa?Rukyalekere, Adeodata, Wanless, Sebastian, Matshaba, Mogomotsi S., Goetghebuer, Tessa, Thorne, Claire, Warszawski, Josiane, Galli, Luisa, Geelen, Sybil, Gibb, Diana M., Giaquinto, Carlo, Marczynska, Magdalena, Marques, Laura, Prata, Filipa, Ene, Luminita, Okhonskaia, Liubov, Noguera?Julian, Antoni, Naver, Lars, Rudin, Christoph, Jourdain, Gonzague, Judd, Ali, Volokha, Alla, Rouzier, Vanessa, Succi, Regina, Kariminia, Azar, Yotebieng, Marcel, Lelo, Patricia, Lyamuya, Rita, Oyaro, Patrick, Boulle, Andrew, Malisita, Kennedy, Fatti, Geoffrey, Haas, Andreas D., Desmonde, Sophie, Dicko, Fatoumata, Abzug, Mark J., Purswani, Murli, Van Dyke, Russell, Chadwick, Ellen, Abrams, Elaine, Teasdale, Chloe, and Nuwagaba, Harriet
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HIV infection in children -- Statistics -- Drug therapy -- Patient outcomes ,Highly active antiretroviral therapy -- Patient outcomes -- Statistics ,Pediatric research ,Health - Abstract
: Introduction: Limited data describe outcomes on second‐line antiretroviral therapy (ART) among children globally. Our objective was to contribute data on outcomes among children living with HIV after initiation of second‐line ART in the context of routine care within a large global cohort collaboration. Methods: Patient‐level data from 1993 through 2015 from 11 paediatric HIV cohorts were pooled. Characteristics at switch and through two years of follow‐up were summarized for children who switched to second‐line ART after starting a standard first‐line regimen in North America, Latin America, Europe, Asia, Southern Africa (South Africa & Botswana) and the rest of sub‐Saharan Africa (SSA). Cumulative incidences of mortality and loss to follow‐up (LTFU) were estimated using a competing risks framework. Results: Of the 85,389 children on first‐line ART, 3,555 (4%) switched to second‐line after a median of 2.8 years on ART (IQR: 1.6, 4.7); 69% were from Southern Africa or SSA and 86% of second‐line regimens were protease inhibitor‐based. At switch, median age was 8.4 years and 50% had a prior AIDS diagnosis. Median follow‐up after switch to second‐line ranged from 1.8 years in SSA to 5.3 years in North America. Median CD4 counts at switch to second‐line ranged from 235 cells/mm[sup.3] in SSA to 828 cells/mm[sup.3] in North America. Improvements in CD4 counts were observed over two years of follow‐up, particularly in regions with lower CD4 counts at second‐line switch. Improvements in weight‐for‐age z‐scores were not observed during follow‐up. Cumulative incidence of LTFU at two years was Conclusions: Children switched to second‐line ART experience CD4 count increases as well as low to moderate rates of LTFU and mortality within two years after switch. Severe immune deficiency at time of switch in some settings suggests need for improved recognition and management of treatment failure in children., Introduction In 2018, there were an estimated 1.7 million children living with HIV globally and 160,000 new paediatric infections [1]. With the recommendation for immediate antiretroviral therapy (ART) [2], substantial [...]
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- 2020
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27. Neurological Short-Term Outcomes of a Cohort of Children Born to Zika Virus-Infected Mothers in Barcelona
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Romaní, Natàlia, primary, Pieras, Maria, additional, Frick, Marie Antoinette, additional, Sulleiro, Elena, additional, Rodó, Carlota, additional, Silgado, Aroa, additional, Suy, Anna, additional, Espiau, Maria, additional, Thorne, Claire, additional, Giaquinto, Carlo, additional, Felipe-Rucián, Ana, additional, Soler-Palacín, Pere, additional, and Soriano-Arandes, Antoni, additional
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- 2022
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28. What do women living with HIV think about research on children born HIV-free in the UK?
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Bukasa, Laurette, primary, Namiba, Angelina, additional, Tariq, Shema, additional, Brown, Matilda, additional, Ndungu, Estelle, additional, Nangwale, Mercy, additional, Letting, Gillian, additional, Chirwa, Patricia, additional, and Thorne, Claire, additional
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- 2022
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29. Protease inhibitors and preterm delivery: another piece in the puzzle
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Favarato, Graziella, Townsend, Claire L., Bailey, Heather, Peters, Helen, Tookey, Pat A., Taylor, Graham P., and Thorne, Claire
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- 2018
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30. Viraemia before, during and after pregnancy in HIV‐infected women on antiretroviral therapy in rural KwaZulu‐Natal, South Africa, 2010–2015
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Chetty, Terusha, Newell, Marie‐Louise, Thorne, Claire, and Coutsoudis, Anna
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- 2018
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31. No Difference in Growth Outcomes up to 24 Months of Age by Duration of Exposure to Maternal Antiretroviral Therapy Among Children Who Are HIV-Exposed and Uninfected in Malawi
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Toledo, Gabriela, primary, Landes, Megan, additional, van Lettow, Monique, additional, Tippett Barr, Beth A., additional, Bailey, Heather, additional, Thorne, Claire, additional, and Crichton, Siobhan, additional
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- 2022
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32. Standardized Definitions of In Utero Human Immunodeficiency Virus and Antiretroviral Drug Exposure Among Children
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Slogrove, Amy A.L., Burmen, Barbara, Davies, Mary Ann, Edmonds, Andrew, Abrams, Elaine E.J., Chadwick, Ellen E.G., Goetghebuer, Tessa, Mofenson, Lynne L.M., Paul, Mary Elizabeth, Thorne, Claire, Williams, Paige P.L., Vicari, Marissa, Powis, Kathleen K.M., Slogrove, Amy A.L., Burmen, Barbara, Davies, Mary Ann, Edmonds, Andrew, Abrams, Elaine E.J., Chadwick, Ellen E.G., Goetghebuer, Tessa, Mofenson, Lynne L.M., Paul, Mary Elizabeth, Thorne, Claire, Williams, Paige P.L., Vicari, Marissa, and Powis, Kathleen K.M.
- Abstract
In countries with high human immunodeficiency virus (HIV) prevalence, up to 30% of pregnant women are living with HIV, with fetal exposure to both HIV and antiretroviral therapy during pregnancy. In addition, pregnant women without HIV but at high risk of HIV acquisition are increasingly receiving HIV preexposure antiretroviral prophylaxis (PrEP). Investments are being made to establish and follow cohorts of children to evaluate the long-term effects of in utero HIV and antiretroviral exposure. Agreement on a key set of definitions for relevant exposures and outcomes is important both for interpreting individual study results and for comparisons across cohorts. Harmonized definitions of in utero HIV and antiretroviral drug (maternal treatment or PrEP) exposure will also facilitate improved classification of these exposures in future observational studies and clinical trials. The proposed definitions offer a uniform approach to facilitate the consistent description and estimation of effects of HIV and antiretroviral exposures on key child health outcomes., SCOPUS: ar.j, info:eu-repo/semantics/published
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- 2022
33. Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand
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European Pregnancy, Lyons, Alex, Thompson, Lindsay, Chappell, Elizabeth, Ene, Luminita, Galli, Luisa, Goetghebuer, Tessa, Jourdain, Gonzague, Noguera-Julian, Antoni, Kahlert, Christian C.R., Königs, Christoph, Kosalaraksa, Pope, Lumbiganon, Pagakrong, Marczynska, Magdalena, Marques, Laura L.C., Navarro, Marissa, Naver, Lars, Okhonskaia, Liubov, Prata, Filipa, Puthanakit, Thanyawee, Ramos, José Tomás, Samarina, Anna, Thorne, Claire, Voronin, Evgeny, Turkova, Anna, Giaquinto, Carlo, Judd, Ali, Collins, Intira Jeannie, European Pregnancy, Lyons, Alex, Thompson, Lindsay, Chappell, Elizabeth, Ene, Luminita, Galli, Luisa, Goetghebuer, Tessa, Jourdain, Gonzague, Noguera-Julian, Antoni, Kahlert, Christian C.R., Königs, Christoph, Kosalaraksa, Pope, Lumbiganon, Pagakrong, Marczynska, Magdalena, Marques, Laura L.C., Navarro, Marissa, Naver, Lars, Okhonskaia, Liubov, Prata, Filipa, Puthanakit, Thanyawee, Ramos, José Tomás, Samarina, Anna, Thorne, Claire, Voronin, Evgeny, Turkova, Anna, Giaquinto, Carlo, Judd, Ali, and Collins, Intira Jeannie
- Abstract
BACKGROUND: Etravirine (ETR) is approved as a component of second or third-line antiretroviral treatment (ART) for children living with HIV. We assessed the outcomes of ETR-based ART in children in routine care in Europe and Thailand. METHODS: Data on children aged <18 years at ETR start were pooled from 17 observational cohorts. Characteristics at ETR start, immunological and virological outcomes at 12 months, discontinuations, adverse events (AEs) and serious adverse events (SAEs) were described. Follow-up was censored at ETR discontinuation, death or last visit. RESULTS: 177 children ever received ETR. At ETR start, median [IQR] age was 15 [12,16] years, CD4 count 480 [287, 713] cells/mm3, 70% had exposure to ≥3 ART classes and 20% had viral load (VL) <50 copies/mL. 95% received ETR in combination with ≥1 potent drug class, mostly protease inhibitor-based regimens. Median time on ETR was 24 [7, 48] months. Amongst those on ETR at 12 months (n=141), 69% had VL<50 copies/mL. Median CD4 increase since ETR start (n=83) was 147 [16, 267] cells/mm3. Overall, 81 (46%) discontinued ETR by last follow-up. Median time to discontinuation was 23 [8, 47] months. Common reasons for discontinuation were treatment simplification (19%), treatment failure (16%) and toxicity (12%). Eight children (5%) had AEs causally associated with ETR, all dermatological/hypersensitivity reactions. Two were SAEs, both Stevens-Johnson Syndrome in children on regimens containing ETR and darunavir and were causally related to either drugs; both resolved following ART discontinuation. CONCLUSION: Children receiving ETR were predominantly highly treatment-experienced, over two-thirds were virally suppressed at 12 months., SCOPUS: ar.j, info:eu-repo/semantics/published
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- 2022
34. Pregnancy incidence and outcomes in women with perinatal HIV infection
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Byrne, Laura, Sconza, Rebecca, Foster, Caroline, Tookey, Pat A., Cortina-Borja, Mario, and Thorne, Claire
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- 2017
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35. Optimizing responses to drug safety signals in pregnancy: the example of dolutegravir and neural tube defects
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Mofenson, Lynne M., Pozniak, Anton L., Wambui, Jacque, Raizes, Elliot, Ciaranello, Andrea, Clayden, Polly, Ehrenkranz, Peter, Fakoya, Ade, Hill, Andrew, Khoo, Saye, Mahaka, Imelda, Modi, Surbhi, Moore, Cynthia, Phillips, Andrew, Siberry, George, Sikwese, Kenly, Thorne, Claire, Watts, Heather D., Doherty, Meg, and Ford, Nathan P.
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Antiviral agents -- Complications and side effects ,Pregnant women -- Drug therapy ,Health risk assessment -- Evaluation ,HIV infection -- Drug therapy ,Health - Abstract
: Introduction: The unexpected identification of a neural tube defect (NTD) safety signal with preconception dolutegravir (DTG) exposure in the Botswana Tsepamo birth outcomes study brought into sharp focus the need for reliable data on use of new antiretrovirals in pregnancy, improved pharmacovigilance systems to evaluate safety of new drugs being introduced into populations including women of reproductive potential, and balanced risk‐benefit messaging when a safety signal is identified. Discussion: The Tsepamo study NTD safety signal and accompanying regulatory responses led to uncertainty about the most appropriate approach to DTG use among women of reproductive potential, affecting global DTG roll‐out plans, and limiting DTG use in adolescent girls and women. It also revealed a tension between a public health approach to antiretroviral treatment (ART) and individual choice, and highlighted difficulties interpreting and messaging an unexpected safety signal with uncertainty about risk. This difficulty was compounded by the lack of high‐quality data on pregnancy outcomes from women receiving ART outside the Tsepamo surveillance sites and countries other than Botswana, resulting in a prolonged period of uncertainty while data on additional exposures are evaluated to refute or confirm the initial safety signal. We discuss principles for evaluating and introducing new drugs in the general population that would ensure collection of appropriate data to inform drug safety in adolescent girls and women of reproductive potential and minimize confusion about drug use in this population when a safety signal is identified. Conclusions: The response to a signal suggesting a possible safety risk for a drug used in pregnancy or among women who may become pregnant needs to be rapid and comprehensive. It requires the existence of appropriately designed surveillance systems with broad population coverage; data analyses that examine risk‐benefit trade‐offs in a variety of contexts; guidance to transform this risk‐benefit balance into effective and agreed‐upon policy; involvement of the affected community and other key stakeholders; and a communication plan for all levels of knowledge and complexity. Implementation of this proposed framework for responding to safety signals is needed to ensure that any drug used in pregnancy can be rapidly and appropriately evaluated should a serious safety alert arise., Abbreviations Introduction While there is an urgency to bring newer and more potent antiretroviral drugs developed in resource‐rich settings to resource‐limited settings as quickly as possible, evaluation of the safety [...]
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- 2019
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36. Treatment and monitoring of children and adolescents with hepatitis C in Russia: Results from a multi-centre survey on policy and practice
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Malik, Farihah, primary, Chulanov, Vladimir, additional, Pimenov, Nikolay, additional, Fomicheva, Anastasia, additional, Lundin, Rebecca, additional, Levina, Nataliia, additional, Thorne, Claire, additional, Turkova, Anna, additional, and Indolfi, Giuseppe, additional
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- 2022
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37. Prevalence of sexually transmitted infections in HIV-1 infected pregnant women in Europe
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Landes, Megan, Thorne, Claire, Barlow, Patricia, Fiore, Simona, Malyuta, Ruslan, Martinelli, Pasquale, Posokhova, Svetlana, Savasi, Valeria, Semenenko, Igor, Stelmah, Andrej, Tibaldi, Cecilia, and Newell, Marie-Louise
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- 2007
38. 74. Maternal Dolutegravir (DTG) Use During Pregnancy and Birth Outcomes: The Antiretroviral Pregnancy Registry (APR)
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Vannappagari, Vani, primary, Albano, Jessica, additional, Ragone, Leigh, additional, Cook, Taylor, additional, Scheuerle, Angela, additional, Short, William R, additional, Thorne, Claire, additional, Beckerman, Karen P, additional, Chaktoura, Nahida, additional, and Mofenson, Lynne, additional
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- 2021
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39. Risk factors for stunting in children who are HIV‐exposed and uninfected after Option B+ implementation in Malawi.
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Toledo, Gabriela, Landes, Megan, van Lettow, Monique, Tippett Barr, Beth A., Bailey, Heather, Crichton, Siobhan, Msungama, Wezi, and Thorne, Claire
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HIV infections ,CONFIDENCE intervals ,ANTHROPOMETRY ,MULTIPLE regression analysis ,MULTIVARIATE analysis ,INTERVIEWING ,RISK assessment ,DESCRIPTIVE statistics ,RESEARCH funding ,ODDS ratio ,VIROLOGY ,DATA analysis software ,GROWTH disorders ,VERTICAL transmission (Communicable diseases) ,PROBABILITY theory ,DISEASE risk factors ,EVALUATION ,CHILDREN - Abstract
Evidence suggests children HIV‐exposed and uninfected (CHEU) experience poor growth. We analysed child anthropometrics and explored factors associated with stunting among Malawian CHEU. Mothers with HIV and their infants HIV‐exposed were enroled in a nationally representative prospective cohort within the National Evaluation of Malawi's Prevention of Mother‐to‐Child HIV Transmission Programme after Option B+ implementation (2014–2018). Anthropometry was measured at enrolment (age 1–6 months), visit 1 (approximately 12 months), and visit 2 (approximately 24 months). Weight‐for‐age (WAZ) and length‐for‐age (LAZ) z‐scores were calculated using World Health Organization Growth Standards; underweight and stunting were defined as WAZ and LAZ more than 2 standard deviations below the reference median. Multivariable logistic regression restricted to CHEU aged 24 months (±3 months) was used to identify factors associated with stunting. Among 1211 CHEU, 562/1211 attended visit 2, of which 529 were aged 24 months (±3 months) and were included. At age 24 months, 40.4% of CHEU were stunted and/or underweight, respectively. In multi‐variable analysis, adjusting for child age and sex, the odds of stunting were higher among CHEU with infectious disease diagnosis compared to those with no diagnosis (adjusted odds ratio = 3.35 [95% confidence interval: 1.82–6.17]), which was modified by co‐trimoxazole prophylaxis (p = 0.028). Infant low birthweight was associated with an increased odds of stunting; optimal feeding and maternal employment were correlated with reduced odds. This is one of the first studies examining CHEU growth since Option B+. Interventions to improve linear growth among CHEU should address their multi‐faceted health risks, alongside maternal ART prescription, and follow‐up of mother‐child pairs. Key messages: Understanding the health risks of children HIV‐exposed and uninfected (CHEU) and the impact on their growth is of paramount importance for optimizing their health.This is one of the first studies examining correlates of CHEU growth since the implementation of Option B+ and uses a random subsample of a nationally representative cohort of women with HIV and CHEU in Malawi.Factors associated with stunting included infant low birthweight, optimal feeding, co‐trimoxazole prophylaxis, and maternal employment.Interventions targeting modifiable risk factors, alongside maternal antiretroviral therapy, and improved nutritional follow‐up of CHEU will contribute to improving CHEU growth in Malawi. [ABSTRACT FROM AUTHOR]
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- 2023
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40. Characteristics, treatment and care of pregnant women living with hepatitis B in England: findings from a national audit.
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Bailey, Heather, Nastouli, Eleni, Webb, Sharon, Peckham, Catherine, and Thorne, Claire
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Around 0.4% of pregnant women in England have chronic hepatitis B virus (HBV) infection and need services to prevent vertical transmission. In this national audit, sociodemographic, clinical and laboratory information was requested from all maternity units in England for hepatitis B surface antigen-positive women initiating antenatal care in 2014. We describe these women's characteristics and indicators of access to/uptake of healthcare. Of 2542 pregnancies in 2538 women, median maternal age was 31 [IQR 27, 35] years, 94% (1986/2109) were non-UK born (25% (228/923) having arrived into the UK <2 years previously) and 32% (794/2473) had ⩾2 previous live births. In 39%, English levels were basic/less than basic. Antenatal care was initiated at median 11.3 [IQR 9.6, 14] gestation weeks, and 'late' (⩾20 weeks) in 10% (251/2491). In 70% (1783/2533) of pregnancies, HBV had been previously diagnosed and 11.8% (288/2450) had ⩾1 marker of higher infectivity. Missed specialist appointments were reported in 18% (426/2339). Late antenatal care and/or missed specialist appointments were more common in pregnancies among women lacking basic English, arriving in the UK ⩽2 years previously, newly HBV diagnosed, aged <25 years and/or with ⩾2 previous live births. We show overlapping groups of pregnant women with chronic HBV vulnerable to delayed or incomplete care. [ABSTRACT FROM AUTHOR]
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- 2022
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41. The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy
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Huntington, Susie, Thorne, Claire, Newell, Marie-Louise, Anderson, Jane, Taylor, Graham P., Pillay, Deenan, Hill, Teresa, Tookey, Pat A., and Sabin, Caroline
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- 2015
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42. Neonatal deaths among infants born to women living with HIV in the UK and Ireland
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Yan, Helen, primary, Peters, Helen, additional, and Thorne, Claire, additional
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- 2021
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43. It ain’t what you do, it’s the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants
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Chappell, Elizabeth, primary, Thorne, Claire, additional, Collins, Intira Jeannie, additional, Baisley, Kathy, additional, Yapa, H. Manisha, additional, Gareta, Dickman, additional, Bärnighausen, Till, additional, Herbst, Kobus, additional, and Judd, Ali, additional
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- 2021
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44. The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis
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Slogrove, Amy L., Schomaker, Michael, Davies, Mary-Ann, Williams, Paige, Balkan, Suna, Ben-Farhat, Jihane, Calles, Nancy, Chokephaibulkit, Kulkanya, Duff, Charlotte, Eboua, Tanoh François, Kekitiinwa-Rukyalekere, Adeodata, Maxwell, Nicola, Pinto, Jorge, Seage, George, Teasdale, Chloe A., Wanless, Sebastian, Warszawski, Josiane, Wools-Kaloustian, Kara, Yotebieng, Marcel, Timmerman, Venessa, Collins, Intira J., Goodall, Ruth, Smith, Colette, Patel, Kunjal, Paul, Mary, Gibb, Diana, Vreeman, Rachel, Abrams, Elaine J., Hazra, Rohan, Van Dyke, Russell, Bekker, Linda-Gail, Mofenson, Lynne, Vicari, Marissa, Essajee, Shaffiq, Penazzato, Martina, Anabwani, Gabriel, Q. Mohapi, Edith, N. Kazembe, Peter, Hlatshwayo, Makhosazana, Lumumba, Mwita, Goetghebuer, Tessa, Thorne, Claire, Galli, Luisa, van Rossum, Annemarie, Giaquinto, Carlo, Marczynska, Magdalena, Marques, Laura, Prata, Filipa, Ene, Luminita, Okhonskaia, Liubov, Rojo, Pablo, Fortuny, Claudia, Naver, Lars, Rudin, Christoph, Le Coeur, Sophie, Volokha, Alla, Rouzier, Vanessa, Succi, Regina, Sohn, Annette, Kariminia, Azar, Edmonds, Andrew, Lelo, Patricia, Ayaya, Samuel, Ongwen, Patricia, Jefferys, Laura F., Phiri, Sam, Mubiana-Mbewe, Mwangelwa, Sawry, Shobna, Renner, Lorna, Sylla, Mariam, Abzug, Mark J., Levin, Myron, Oleske, James, Chernoff, Miriam, Traite, Shirley, Purswani, Murli, Chadwick, Ellen G., Judd, Ali, and Leroy, Valériane
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Pediatric HIV infections -- Care and treatment -- Patient outcomes -- Statistics ,Medical research ,Adolescent medicine -- Research ,Epidemiology -- Research ,Biological sciences - Abstract
Background Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in 'real-life' settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. Methods and findings Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5-5.2) years for the total cohort and 6.4 (3.6-8.0) years in Europe, 3.7 (2.0-5.4) years in North America, 2.5 (1.2-4.4) years in South and Southeast Asia, 5.0 (2.7-7.5) years in South America and the Caribbean, and 2.1 (0.9-3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3-2.1) years in North America to 7.1 (5.3-8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4-2.6) years in North America to 7.9 (6.0-9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%-2.8%), 15.6% (15.1%-16.0%), and 11.3% (10.9%-11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%-1.1%]) and highest in South America and the Caribbean (4.4% [3.1%-6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%-6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%-13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria. Conclusion To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses., Author(s): The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration, Amy L. Slogrove 1, Michael Schomaker 1, Mary-Ann Davies 1, Paige Williams 2, Suna Balkan 3, [...]
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- 2018
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45. Long-term trends in mortality and AIDS-defining events after combination ART initiation among children and adolescents with perinatal HIV infection in 17 middle- and high-income countries in Europe and Thailand: A cohort study
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Judd, Ali, Chappell, Elizabeth, Turkova, Anna, Le Coeur, Sophie, Noguera-Julian, Antoni, Goetghebuer, Tessa, Doerholt, Katja, Galli, Luisa, Pajkrt, Dasja, Marques, Laura, Collins, Intira J., Gibb, Diana M., González Tome, Maria Isabel, Navarro, Marisa, Warszawski, Josiane, Königs, Christoph, Spoulou, Vana, Prata, Filipa, Chiappini, Elena, Naver, Lars, Giaquinto, Carlo, Thorne, Claire, Marczynska, Magdalena, Okhonskaia, Liubov, Posfay-Barbe, Klara, Ounchanum, Pradthana, Techakunakorn, Pornchai, Kiseleva, Galina, Malyuta, Ruslan, Volokha, Alla, Ene, Luminita, and Goodall, Ruth
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Mortality -- Analysis -- Eastern Europe -- Thailand -- United Kingdom -- Russia -- Ukraine ,Highly active antiretroviral therapy -- Usage ,HIV infections -- Health aspects ,Children -- Health aspects ,AIDS (Disease) -- Development and progression -- Risk factors ,Youth -- Health aspects ,Antiretroviral agents -- Dosage and administration ,Biological sciences - Abstract
Background Published estimates of mortality and progression to AIDS as children with HIV approach adulthood are limited. We describe rates and risk factors for death and AIDS-defining events in children and adolescents after initiation of combination antiretroviral therapy (cART) in 17 middle- and high-income countries, including some in Western and Central Europe (W&CE), Eastern Europe (Russia and Ukraine), and Thailand. Methods and findings Children with perinatal HIV aged 6 months of cART) death and progression to AIDS were assessed. Of 3,526 children included, 32% were from the United Kingdom or Ireland, 30% from elsewhere in W&CE, 18% from Russia or Ukraine, and 20% from Thailand. At cART initiation, median age was 5.2 (IQR 1.4-9.3) years; 35% of children aged Conclusions In our study, 3,526 children and adolescents with perinatal HIV infection initiated antiretroviral therapy (ART) in countries in Europe and Thailand. We observed that over 40% of deaths occurred [less than or equal to]6 months after cART initiation. Greater early mortality risk in infants, as compared to older children, and in Russia, Ukraine, or Thailand as compared to W&CE, raises concern. Current severe immune suppression, being underweight, and unsuppressed viral load were associated with a higher risk of death at >6 months after initiation of cART., Author(s): The European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) study group in EuroCoord, Ali Judd 1,*, Elizabeth Chappell 1, Anna Turkova 1, Sophie Le Coeur 2,3, Antoni Noguera-Julian 4, [...]
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- 2018
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46. Pregnancy is associated with elevation of liver enzymes in HIV-positive women on antiretroviral therapy
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Huntington, Susie, Thorne, Claire, Newell, Marie-Louise, Anderson, Jane, Taylor, Graham P., Pillay, Deenan, Hill, Teresa, Tookey, Pat A., and Sabin, Caroline
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- 2015
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47. Impact of expanded access to combination antiretroviral therapy in pregnancy: results from a cohort study in Ukraine/ Impact de l'acces elargi au traitement par association d'antiretroviraux pendant la grossesse: resultats d'une etude de cohorte en Ukraine
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Bailey, Heather, Townsend, Claire L., Semenenko, Igor, Malyuta, Ruslan, Cortina-Borja, Mario, and Thorne, Claire
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Antiviral agents -- Analysis ,Pregnant women -- Analysis ,Health ,World Health Organization - Abstract
Objective To investigate the scale-up of antenatal combination antiretroviral therapy (cART) in Ukraine since this became part of the national policy for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV). Methods Data on 3535 HIV-positive pregnant women who were enrolled into the Ukraine European Collaborative Study in 2008-2010 were analysed. Factors associated with receipt of zidovudine monotherapy (AZTm)--rather than cART--and rates of mother-to-child transmission (MTCT) of HIV were investigated. Findings cART coverage increased significantly, from 22% of deliveries in 2008 to 61% of those in 2010. After adjusting for possible confounders, initiation of antenatal AZTm--rather than cART--was associated with cohabiting (versus being married; adjusted prevalence ratio, aPR: 1.09; 95% confidence interval, CI: 1.02-1.16), at least two previous live births (versus none; aPR: 1.22; 95% CI: 1.11-1.35) and a diagnosis of HIV infection during the first or second trimester (versus before pregnancy; aPR: 1.11; 95% CI: 1.03-1.20). The overall MTCT rate was 4.1% (95% CI: 3.4-4.9); 42% (49/116) of the transmissions were from the 8% (n = 238) of women without antenatal ART. Compared with AZTm, cART was associated with a 70% greater reduction in the risk of MTCT (adjusted odds ratio: 0.30; 95% CI: 0.16-0.56). Conclusion Between 2008 and 2010, access to antenatal cART improved substantially in Ukraine, but implementation of the World Health Organization's Option-B policy was slow. For MTCT to be eliminated in Ukraine, improvements in the retention of women in HIV care and further roll-out of Option B are urgently needed. Objective Etudier le renforcement du traitement prenatal par association d'antiretroviraux (TPAA) en Ukraine puisqu'il fait partie integrante de la politique nationale pour la prevention de la transmission mere-enfant (PTME) du virus de l'immunodeficience humaine (VIH). Methodes Une analyse a ete menee sur les donnees de 3535 femmes enceintes seropositives qui ont ete inscrites dans l'etude collaborative europeenne pour l'Ukraine en 2008-2010. Une etude a aussi ete realisee sur les facteurs associes a un traitement a la zidovudine en monotherapie (TZM), plutot qu'a un TPAA, et sur le taux de transmission de la mere a l'enfant (TME) du VIH. Resultats La part du TPAA a considerablement augmente, passant de 22% des traitements en 2008 a 61% en 2010. Apres ajustement pour les facteurs confondants possibles, le TZM prenatal, plutot que le TPAA, a ete associe au cas de cohabitation (par rapport au mariage; ratio de prevalence ajuste, RPa: 1,09; intervalle de confiance (IC) a 95%: 1,02 a 1,16), a au moins deux naissances anterieures (par rapport a aucune; RPa: 1,22; IC a 95%: 1,11 a 1,35) et a un diagnostic d'infection au VIH au cours du premier ou du deuxieme trimestre (par rapport a avant la grossesse; RPa: 1,11; IC a 95%: 1,03 a 1,20). Le taux de TME global etait de 4,1% (IC a 95%: 3,4 a 4,9), 42% (49/116) des transmissions provenaient des 8% (n = 238) de femmes n'ayant pas recu de TPAA. Par rapport au TZM, le TPAA a ete associe a une reduction superieure a 70% du risque de transmission mere-enfant (rapport des cotes ajuste, RCa: 0,3; IC a 95%: 0,16 a 0,56). Conclusion Entre 2008 et 2010, l'acces au TPAA s'est nettement ameliore en Ukraine, mais la mise en oeuvre de l'option B de la politique de l'Organisation mondiale de la Sante a ete lente. Pour que la TME soit eliminee en Ukraine, l'amelioration de la retention des femmes dans les services de soins du VIH et la poursuite du deploiement de l'option B sont des points urgents a regler. Objetivo Investigar la generalizacion del tratamiento antirretroviral combinado prenatal en Ucrania desde que entro a formar parte de la politica nacional de prevencion de la transmision de madre a hijo del virus de la inmunodeficiencia humana (VIH). Metodos Se analizaron los datos de 3535 mujeres embarazadas seropositivas incluidas en el Estudio Colaborativo Europeo Ucraniano entre 2008 y 2010. Se investigaron los factores asociados a la recepcion de una monoterapia con zidovudina--y no el tratamiento antirretroviral combinado prenatal--y las tasas de transmision de madre a hijo del VIH. Resultados La cobertura del tratamiento antirretroviral combinado prenatal aumento significativamente, del 22% de partos en 2008 al 61% de los de 2010. Tras ajustarla por los posibles factores de confusion, el inicio de la monoterapia con zidovudina--y no el tratamiento antirretroviral combinado prenatal--estuvo asociado con la cohabitacion (frente a los matrimonios; razon de prevalencia ajustada: 1,09; intervalo de confianza 95%: 1,02-1,16), al menos dos nacimientos vivos anteriores (frente a ninguno; razon de prevalencia ajustada: 1,22; intervalo de confianza 95%: 1,11-1,35) y un diagnostico de infeccion por VIH durante el primer o segundo trimestre (frente a antes del embarazo, razon de prevalencia ajustada: 1,11; intervalo de confianza 95%: 1,03-1,20). La tasa total de transmision de madre a hijo fue del 4,1% (intervalo de confianza 95% 3,4-4,9); el 42% (49/116) de las transmisiones fueron del 8% (n = 238) de las mujeres que no recibieron antirretrovirales prenatales. En comparacion con la monoterapia con zidovudina, el tratamiento antirretroviral combinado prenatal estuvo asociado con una reduccion un 70% mayor del riesgo de transmision (razon de posibilidades ajustada: 0,30; intervalo de confianza 95%: 0,16-0,56). Conclusion Entre 2008 y 2010, el acceso al tratamiento antirretroviral combinado prenatal mejoro sustancialmente en Ucrania, pero la implementacion del enfoque en la opcion B de la Organizacion Mundial de la Salud se revelo lenta. Para eliminar la transmision de madre a hijo en Ucrania, se necesitan con urgencia mejoras en la retencion de las mujeres en la atencion al VIH y un mayor despliegue de la opcion B., Introduction Among the countries of Europe, Ukraine has the highest prevalence of adult infection with human immunodeficiency virus (HIV) (1.6%) and the highest rate of mortality attributable to acquired immunodeficiency [...]
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- 2013
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48. The Impact of Peripheral Artery Disease (PAD) on Lower Limb Kinematics in Type 2 Diabetes Mellitus
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Thorne, Claire Saliba, primary, Bartolo, Erica, additional, Gatt, Alfred, additional, and Formosa, Cynthia, additional
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- 2021
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49. Neurological development of children who are HIV‐exposed and uninfected
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Toledo, Gabriela, primary, Côté, Hélène C F, additional, Adler, Catherine, additional, Thorne, Claire, additional, and Goetghebuer, Tessa, additional
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- 2021
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50. No need for secondary Pneumocystis jirovecii pneumonia prophylaxis in adult people living with HIV from Europe on ART with suppressed viraemia and a CD4 cell count greater than 100 cells/µL
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Atkinson, Andrew, Miro, Jose M., Mocroft, Amanda, Reiss, Peter, Kirk, Ole, Morlat, Philippe, Ghosn, Jade, Stephan, Christoph, Mussini, Cristina, Antoniadou, Anastasia, Doerholt, K., Girardi, Enrico, De Wit, Stephane, Kraus, David, Zwahlen, Marcel, Furrer, Hansjakob, Antoniadou, A., Castagna, A., Fätkenheuer, G., Raben, Dorthe, Teira, R., Zangerle, R., Judd, Ali, Zangerle, Robert, Touloumi, Giota, Warszawski, Josiane, Meyer, Laurence, Dabis, François, Krause, Murielle Mary, Leport, Catherine, Wittkop, Linda, Wit, Ferdinand, Prins, Maria, Bucher, Heiner, Gibb, Diana, Fätkenheuer, Gerd, Del Amo, Julia, Obel, Niels, Thorne, Claire, Pérez-Hoyos, Santiago, Hamouda, Osamah, Bartmeyer, Barbara, Chkhartishvili, Nikoloz, Noguera-Julian, Antoni, Antinori, Andrea, d’Arminio Monforte, Antonella, Atkinson, Andrew, Miro, Jose M., Mocroft, Amanda, Reiss, Peter, Kirk, Ole, Morlat, Philippe, Ghosn, Jade, Stephan, Christoph, Mussini, Cristina, Antoniadou, Anastasia, Doerholt, K., Girardi, Enrico, De Wit, Stephane, Kraus, David, Zwahlen, Marcel, Furrer, Hansjakob, Antoniadou, A., Castagna, A., Fätkenheuer, G., Raben, Dorthe, Teira, R., Zangerle, R., Judd, Ali, Zangerle, Robert, Touloumi, Giota, Warszawski, Josiane, Meyer, Laurence, Dabis, François, Krause, Murielle Mary, Leport, Catherine, Wittkop, Linda, Wit, Ferdinand, Prins, Maria, Bucher, Heiner, Gibb, Diana, Fätkenheuer, Gerd, Del Amo, Julia, Obel, Niels, Thorne, Claire, Pérez-Hoyos, Santiago, Hamouda, Osamah, Bartmeyer, Barbara, Chkhartishvili, Nikoloz, Noguera-Julian, Antoni, Antinori, Andrea, and d’Arminio Monforte, Antonella
- Abstract
Introduction: Since the beginning of the HIV epidemic in resource-rich countries, Pneumocystis jirovecii pneumonia (PjP) is one of the most frequent opportunistic AIDS-defining infections. The Collaboration of Observational HIV Epidemiological Research Europe (COHERE) has shown that primary Pneumocystis jirovecii Pneumonia (PjP) prophylaxis can be safely withdrawn in patients with CD4 counts of 100 to 200 cells/µL if plasma HIV-RNA is suppressed on combination antiretroviral therapy. Whether this holds true for secondary prophylaxis is not known, and this has proved difficult to determine due to the much lower population at risk. Methods: We estimated the incidence of secondary PjP by including patient data collected from 1998 to 2015 from the COHERE cohort collaboration according to time-updated CD4 counts, HIV-RNA and use of PjP prophylaxis in persons >16 years of age. We fitted a Poisson generalized additive model in which the smoothed effect of CD4 was modelled by a restricted cubic spline, and HIV-RNA was stratified as low (<400), medium (400 to 10,000) or high (>10,000copies/mL). Results: There were 373 recurrences of PjP during 74,295 person-years (py) in 10,476 patients. The PjP incidence in the different plasma HIV-RNA strata differed significantly and was lowest in the low stratum. For patients off prophylaxis with CD4 counts between 100 and 200 cells/µL and HIV-RNA below 400 copies/mL, the incidence of recurrent PjP was 3.9 (95% CI: 2.0 to 5.8) per 1000 py, not significantly different from patients on prophylaxis in the same stratum (1.9, 95% CI: 0.1 to 3.7). Conclusions: HIV viraemia importantly affects the risk of recurrent PjP. In virologically suppressed patients on ART with CD4 counts of 100 to 200/µL, the incidence of PjP off prophylaxis is below 10/1000 py. Secondary PjP prophylaxis may be safely withheld in such patients. While European guidelines recommend discontinuing secondary PjP prophylaxis only if CD4 counts rise above 200 cells
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- 2021
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