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13 results on '"Lacor, P."'

1. The combination of 4-1BBL and CD40L strongly enhances the capacity of dendritic cells to stimulate HIV-specific T cell responses.

Author

De Keersmaecker B, Heirman C, Corthals J, Empsen C, van Grunsven LA, Allard SD, Pen J, Lacor P, Thielemans K, and Aerts JL

Subjects
Blotting, Western, CD40 Antigens immunology, Cell Proliferation, Enzyme-Linked Immunosorbent Assay, Flow Cytometry, HIV Seropositivity, Humans, Lymphocyte Activation, RNA, Messenger genetics, Reverse Transcriptase Polymerase Chain Reaction, T-Lymphocytes, Regulatory immunology, 4-1BB Ligand pharmacology, CD40 Ligand pharmacology, Dendritic Cells immunology, HIV immunology, HIV Infections immunology, T-Lymphocytes immunology
Abstract

One of the consequences of HIV infection is a progressive loss of T cell functions, resulting in decreased cytokine secretion and proliferation and an increased sensitivity to apoptosis. Therefore, successful therapeutic vaccination approaches should aim at restoring the functionality of existing HIV-specific T cells, as well as to efficiently induce potent, HIV-specific T cells from naïve T cells. In this study, we wanted to determine the stimulatory capacity of DCs coelectroporated with mRNA encoding for different costimulatory molecules of the TNFSF, together with HIV antigen-encoding mRNA. We show that DCs electroporated with 4-1BBL can enhance the proliferation, functionality, cytokine production, and survival of HIV-specific CD8(+) T cells. Furthermore, we are the first to show that a combination of 4-1BBL and CD40L overexpression on DCs dramatically enhances CD4(+) and CD8(+) T cell responses. Finally, we demonstrate that signaling through 4-1BB, but not through CD40, can alleviate the suppressive effect of Tregs on CD8(+) T cell proliferation. Thus, the combination of 4-1BBL and CD40L enhances HIV-specific CD8(+) T cell responses in a synergistic way, resulting in enhanced proliferation of CD4(+) and CD8(+) T cell subsets, an increased cytokine secretion, and a reduced sensitivity to Treg-mediated immune suppression.

Published
2011
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2. A public health value-based healthcare paradigm for HIV

Author

Vermeersch, Sebastian, Demeester, Rémy P., Ausselet, Nathalie, Callens, Steven, De Munter, Paul, Florence, Eric, Goffard, Jean-Christophe, Henrard, Sophie, Lacor, Patrick, Messiaen, Peter, Libois, Agnès, Seyler, Lucie, Uurlings, Françoise, Vandecasteele, Stefaan J., Van Wijngaerden, Eric, Yombi, Jean-Cyr, Annemans, Lieven, and De Wit, Stéphane

Published
2022
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3. A public health value-based healthcare paradigm for HIV

Author

Sebastian Vermeersch, Rémy P. Demeester, Nathalie Ausselet, Steven Callens, Paul De Munter, Eric Florence, Jean-Christophe Goffard, Sophie Henrard, Patrick Lacor, Peter Messiaen, Agnès Libois, Lucie Seyler, Françoise Uurlings, Stefaan J. Vandecasteele, Eric Van Wijngaerden, Jean-Cyr Yombi, Lieven Annemans, and Stéphane De Wit

Subjects
Value-based healthcare, HIV, Public health, Indicators, Frameworks, Public aspects of medicine, RA1-1270
Abstract

Abstract Background HIV patients face considerable acute and chronic healthcare needs and battling the HIV epidemic remains of the utmost importance. By focusing on health outcomes in relation to the cost of care, value-based healthcare (VBHC) proposes a strategy to optimize quality of care and cost-efficiency. Its implementation may provide an answer to the increasing pressure to optimize spending in healthcare while improving patient outcomes. This paper describes a pragmatic value-based healthcare framework for HIV care. Methods A value-based HIV healthcare framework was developed during a series of roundtable discussions bringing together 16 clinical stakeholder representatives from the Belgian HIV reference centers and 2 VBHC specialists. Each round of discussions was focused on a central question translating a concept or idea to the next level of practical implementation: 1) how can VBHC principles be translated into value-based HIV care drivers; 2) how can these value-based HIV care divers be translated into value-based care objectives and activities; and 3) how can value-based HIV care objectives and activities be translated into value-based care indicators. Value drivers were linked to concrete objectives and activities using a logical framework approach. Finally, specific, measurable, and acceptable structure, process and outcomes indicators were defined to complement the framework. Results Our framework identifies 4 core value areas where HIV care would benefit most from improvements: Prevention, improvement of the cascade of care, providing patient-centered HIV care and sustaining a state-of-the-art HIV disease management context. These 4 core value areas were translated into 12 actionable core value objectives. For each objective, example activities were proposed. Indicators are suggested for each level of the framework (outcome indicators for value areas and objectives, process indicators for suggested activities). Conclusions This framework approach outlines how to define a patient- and public health centered value-based HIV care paradigm. It proposes how to translate core value drivers to practical objectives and activities and suggests defining indicators that can be used to track and improve the framework’s implementation in practice.

Published
2022
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4. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe

Author

Moutschen, M., Hofstra, Laura Marije Arije, Sauvageot, Nicolas, Albert, Jan, Alexiev, Ivailo, Garcia, Federico, Struck, Daniel, Van, de Vijver, Åsjö, Birgitta, Beshkov, Danail, Coughlan, Suzie, Descamps, Diane, Griskevicius, Algirdas, Hamouda, Osamah, Horban, Andrzej, Van Kasteren, Marjo, Kolupajeva, Tatjana, Kostrikis, Leontios G., Liitsola, Kirsi, Linka, Marek, Mor, Orna, Nielsen, Claus, Otelea, Dan, Paraskevis, Dimitrios N., Paredes, Roger, Poljak, Mario, Puchhammer-Stöckl, Elisabeth, Sönnerborg, Anders, Staneková, Danica, Stanojevic, Maja, Van Laethem, Kristel, Zazzi, Maurizio, Zidovec Lepej, Snjezana, Boucher, Charles A. B., Schmit, Jean-Claude, Wensing, Annemarie M. J., Puchhammer-Stockl, E., Sarcletti, M., Schmied, B., Geit, M., Balluch, G., Vandamme, A. M., Vercauteren, J., Derdelinckx, I., Sasse, A., Bogaert, M., Ceunen, H., De Roo, A., De Wit, S., Echahidi, F., Fransen, K., Goffard, J. -C, Goubau, P., Goudeseune, E., Yombi, J. -C, Lacor, P., Liesnard, C., Pierard, D., Rens, R., Schrooten, Y., Vaira, D., Vandekerckhove, L. P. R., Van, den Heuvel, Van, Der Gucht, Van Ranst, M., Van Wijngaerden, E., Vandercam, B., Vekemans, M., Verhofstede, C., Clumeck, N., Van Laethem, K., Lepej, S. Z., Begovac, J., Demetriades, Ioannis, Kousiappa, Ioanna, Demetriou, Victoria L., Hezka, Johana, Linka, M., Maly, M., Machala, L., Nielsen, C., Jørgensen, L. B., Gerstoft, J., Mathiesen, L., Pedersen, C., Nielsen, H., Laursen, A., Kvinesdal, B., Liitsola, K., Ristola, M., Suni, J., Sutinen, J., Descamps, D., Assoumou, L., Castor, G., Grude, M., Flandre, P., Storto, A., Hamouda, O., Kücherer, C., Berg, T., Braun, P., Poggensee, G., Däumer, M., Eberle, J., Heiken, H., Kaiser, R., Knechten, H., Korn, K., Müller, H., Neifer, S., Schmidt, B., Walter, H., Gunsenheimer-Bartmeyer, B., Harrer, T., Hatzakis, Angelos E., Zavitsanou, Assimina, Vassilakis, A., Lazanas, Marios C., Chini, Maria C., Lioni, A., Sakka, V., Kourkounti, Sofia, Paparizos, Vassilios A., Antoniadou, Anastasia C., Papadopoulos, Antonios I., Poulakou, Garyphallia G., Katsarolis, I., Protopapas, K., Chryssos, Georgios, Drimis, Stylianos, Gargalianos, Panagiotis, Xylomenos, Georgios, Lourida, G., Psichogiou, Mina A., Daikos, George L., Sipsas, N. V., Kontos, Athanasios N., Gamaletsou, M. N., Koratzanis, Georgios, Sambatakou, H., Mariolis, H., Skoutelis, A., Papastamopoulos, V., Georgiou, O., Panagopoulos, Periklis, Maltezos, E., Coughlan, S., De Gascun, C., Byrne, C., Duffy, M., Bergin, C., Reidy, D., Farrell, G., Lambert, J., O'Connor, E., Rochford, A., Low, J., Coakely, P., O'Dea, S., Hall, W., Mor, O., Levi, I., Chemtob, D., Grossman, Z., Zazzi, M., de Luca, A., Balotta, Claudia, Riva, C., Mussini, C., Caramma, I., Capetti, A., Colombo, M. C., Rossi, C., Prati, F., Tramuto, F., Vitale, F., Ciccozzi, M., Angarano, G., Rezza, G., Kolupajeva, T., Vasins, O., Griskevicius, A., Lipnickiene, V., Schmit, J. C., Struck, D., Hemmer, R., Arendt, V., Michaux, C., Staub, T., Sequin-Devaux, C., Wensing, A. M. J., Boucher, C. A. B., van, de Vijver, van Kessel, A., van Bentum, P. H. M., Brinkman, K., Connell, B. J., van, der Ende, Hoepelman, I. M., van Kasteren, M., Kuipers, M., Langebeek, N., Richter, C., Santegoets, R. M. W. J., Schrijnders-Gudde, L., Schuurman, R., van, de Ven, Kran, A. -M B., Ormaasen, V., Aavitsland, P., Horban, A., Stanczak, J. J., Stanczak, G. P., Firlag-Burkacka, E., Wiercinska-Drapalo, A., Jablonowska, E., Maolepsza, E., Leszczyszyn-Pynka, M., Szata, W., Camacho, Ricardo J., Palma, C., Borges, F., Paixão, T., Duque, V., Araújo, F., Otelea, D., Paraschiv, S., Tudor, A. M., Cernat, R., Chiriac, C., Dumitrescu, F., Prisecariu, L. J., Stanojevic, M., Jevtovic, Dj, Salemovic, D., Stanekova, D., Habekova, M., Chabadová, Z., Drobkova, T., Bukovinova, P., Shunnar, A., Truska, P., Poljak, M., Lunar, M., Babic, Dunja Z., Tomazic, J., Vidmar, L., Vovko, T., Karner, P., Garcia, F., Paredes, R., Monge, S., Moreno, S., del Amo, J., Asensi, V., Sirvent, J. L., de Mendoza, C., Delgado, R., Gutiérrez, F., Berenguer, J., Garcia-Bujalance, S., Stella, Natalia C., de, los Santos, Blanco, J. R., Dalmau, D., Rivero, M., Segura, F., Elıás, Marıá Jesús Pérez, Alvarez, M., Chueca, N., Rodríguez-Martín, C., Vidal, C., Palomares, J. C., Viciana, I., Viciana, P., Cordoba, J., Aguilera, A., Domingo, P., Galindo, M. J., Miralles, C., del Pozo, M. A., Ribera, E., Iribarren, J. A., Ruiz, L., de, la Torre, Vidal, F., Clotet, B., Heidarian, A., Aperia-Peipke, K., Axelsson, M., Mild, M., Karlsson, A., Sönnerborg, A., Thalme, A., Navér, L., Bratt, G., Blaxhult, A., Gisslén, M., Svennerholm, B., Bergbrant, I., Björkman, Per, Säll, C., Mellgren, Å., Lindholm, A., Kuylenstierna, N., Montelius, R., Azimi, F., Johansson, B., Carlsson, M., Johansson, E., Ljungberg, B., Ekvall, H., Strand, A., Mäkitalo, S., Öberg, S., Holmblad, P., Höfer, M., Holmberg, H., Josefson, P., Ryding, U., Van Kessel, A., Clinical sciences, Microbiology and Infection Control, Supporting clinical sciences, Clinicum, Department of Medicine, Virology, Cohorte de Adultos de la Red de Investigación en SIDA, Spain., SPREAD Program, [Hofstra,LM, Sauvageot,N, Struck,D, Schmit,JC ] Luxembourg Institute of Health, Luxembourg. [Hofstra,LM, Wensing,AMJ] Department of Virology, University Medical Center Utrecht, The Netherlands. [Albert,J, Sönnerborg,A] Karolinska Institute, Solna. Karolinska University Hospital, Stockholm, Sweden. [Alexiev,I, Beshkov,D] National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria. [Garcia,F] Complejo Hospitalario Universitario de Granada. Instituto de Investigación IBS Granada, Spain. [Van de Vijver,DAMC, Boucher,CAB] Erasmus MC, University Medical Center, Rotterdam, The Netherlands. [Åsjö,B] University of Bergen, Norway. [Coughlan,S] University College Dublin, Ireland. [Descamps,D] AP-HP Groupe hospitalier Bichat-Claude Bernard. IAME INSERM UMR 1137. Université Paris Diderot Sorbonne Paris Cité, Paris, France. [Griskevicius,A] Lithuanian AIDS Center, Vilnius, Lithuania. [Hamouda,O] Robert Koch Institute, Berlin, Germany. [Horban,A] Hospital of Infectious Diseases, Warsaw, Poland. [Van Kasteren,M] St Elisabeth Hospital, Tilburg, The Netherlands. [Kolupajeva,T] Infectiology Center of Latvia, Riga. [Kostrikis,LG] University of Cyprus, Nicosia. [Liitsola,K] Department of Infectious Diseases, National Institute for Health and Welfare, Helsinki, Finland. [Linka,M] National Reference Laboratory for HIV/AIDS, National Institute of Public Health, Prague, Czech Republic. [Mor,O] National HIV Reference Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel. [Nielsen,C] Statens Serum Institut, Copenhagen, Denmark. [Otelea,D] National Institute for Infectious Diseases 'Prof. dr. Matei Bals', Bucharest, Romania. [Paraskevis,D] National Retrovirus Reference Center, University of Athens, Greece. [Paredes,R] IrsiCaixa Foundation, Badalona, Spain. [Poljak,M] Faculty of Medicine, Slovenian HIV/AIDS Reference Centre, University of Ljubljana, Slovenia. [Puchhammer-Stöckl,E] Medical University Vienna, Austria. [Staneková,D] Slovak Medical University, Bratislava, Slovakia. [Stanojevic,M] Faculty of Medicine, University of Belgrade, Serbia. [Van Laethem,K] Rega Institute for Medical Research, KU Leuven, Belgium. [Zazzi,M] University of Siena, Italy. [Zidovec Lepej,S] University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic', Zagreb, Croatia., This work was supported by a CORE grant of Fond National de la Recherche Luxembourg (grant number C12/BM/4011111–HIV molecular epidemiology in Europe). This work has been partially supported by the European Commission (fifth framework, grant number QLK2-CT-2001-01344, sixth framework, grant number LSHP-CT-2006-518211, DynaNets grant number 233847, seventh framework, CHAIN grant number 223131), Belgium: Belgian AIDS Reference Laboratory Fund, Belgian Fonds voor Wetenschappelijk Onderzoek (grant number G.0692.14), Cyprus: Cyprus Research Promotion Foundation (grant number Health/0104/22), Denmark: Danish AIDS Foundation, France: Agence Nationale de Recherches sur le SIDA et les Hepatites Virales, Germany: Ministry of Health (grant number 1502-686-18), Ministry of Education and Research (grant number 01KI501), Italy: Fifth National Program on HIV/AIDS, Instituto Superiore di Sanità (grant numbers 40F.56 and 20D.1.6), Luxembourg: Fondation Recherche sur le SiDA and Ministry of Health, Republic of Serbia: Ministry of Education and Science (grant number 175024), Slovakia: project 'Center of Excellence of Environmental Health,' ITMS number 26240120033, based on supporting operational research and development program financed from the European Regional Development Fund, and Sweden: Swedish Research Council and Swedish Civil Contingencies Agency., APH - Health Behaviors & Chronic Diseases, Graduate School, Hofstra, LM, Sauvageot, N, Albert, J, Alexiev, I, Garcia, F, Struck, D, Van de Vijver, DA, Åsjö, B, Beshkov, D, Coughlan, S, Descamps, D, Griskevicius, A, Hamouda, O, Horban, A, Van Kasteren, M, Kolupajeva, T, Kostrikis, LG, Liitsola, K, Linka, M, Mor, O, Nielsen, C, Otelea, D, Paraskevis, D, Paredes, R, Poljak, M, Puchhammer-Stöckl, E, Sönnerborg, A, Staneková, D, Stanojevic, M, Van Laethem, K, Zazzi, M, Lepej, SZ, Boucher, CA, Schmit, JC, Wensing, AM, SPREAD program investigators, including Vitale F and Tramuto, F, Vandamme, Annemie, Vercauteren, Jurgen, Schrooten, Yoeri, Van Ranst, Marc, Van Wijngaerden, Eric, Derdelinckx, Inge, Camacho, Ricardo Jorge, Kostrikis, Leontios G. [0000-0002-5340-7109], and Paraskevis, Dimitrios [0000-0001-6167-7152]

Subjects
Male, Human immunodeficiency virus 1, Etravirine, RNA directed DNA polymerase inhibitor, darunavir, HIV Infections, Settore MED/42 - Igiene Generale E Applicata, Disciplines and Occupations::Health Occupations::Medicine::Public Health [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Salud pública, genetics, Inhibidores de proteasas, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], atazanavir, media_common, transmission, Geographicals::Geographic Locations::Europe [Medical Subject Headings], 3. Good health, microbial sensitivity test, priority journal, Europe, HIV-1, antiretroviral therapy, drug resistance, HIV/AIDS, lamivudine, Reverse Transcriptase Inhibitors/pharmacology, anti human immunodeficiency virus agent, Drug, Microbiology (medical), medicine.medical_specialty, antiviral susceptibility, Phenomena and Processes::Genetic Phenomena::Genetic Variation::Mutation [Medical Subject Headings], media_common.quotation_subject, 030106 microbiology, HIV Infections/drug therapy, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antiviral Agents::Anti-Retroviral Agents::Reverse Transcriptase Inhibitors [Medical Subject Headings], Microbial Sensitivity Tests, RILPIVIRINE, Article, EFAVIRENZ, 03 medical and health sciences, transmitted drug resistance, SDG 3 - Good Health and Well-being, Humans, Transmission, human, Phenomena and Processes::Physiological Phenomena::Pharmacological Phenomena::Drug Resistance [Medical Subject Headings], REVERSE-TRANSCRIPTASE INHIBITORS, Rilpivirina, INTEGRASE, MUTATIONS, abacavir, major clinical study, Virology, Infecciones por VIH, Regimen, Antiretroviral therapy, Drug resistance, Medicine (all), Infectious Diseases, chemistry, Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Oxazines::Benzoxazines [Medical Subject Headings], Mutation, 0301 basic medicine, nevirapine, Communicable diseases, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Confidence Intervals [Medical Subject Headings], chemistry.chemical_compound, antiviral therapy, INFECTION, Medicine and Health Sciences, Prevalence, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires [Medical Subject Headings], Viral, Non-U.S. Gov't, Reverse-transcriptase inhibitor, antiretrovirus agent, Research Support, Non-U.S. Gov't, Human immunodeficiency virus infected patient, Middle Aged, virology, PREVALENCE, Encuestas y Cuestionarios, ANTIRETROVIRAL TREATMENT, HIV-1/drug effects, HIV Protease Inhibitors/pharmacology, Rilpivirine, Reverse Transcriptase Inhibitors, Diseases::Immune System Diseases::Immunologic Deficiency Syndromes::HIV Infections [Medical Subject Headings], Female, HIV drug resistance, medicine.drug, Adult, Human immunodeficiency virus proteinase inhibitor, Chemicals and Drugs::Organic Chemicals::Nitriles::Rilpivirine [Medical Subject Headings], Efavirenz, Anti-HIV Agents, Research Support, Resistencia a medicamentos, Settore MED/17 - MALATTIE INFETTIVE, antiviral resistance, Internal medicine, Anti-HIV Agents/pharmacology, Drug Resistance, Viral, Journal Article, medicine, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Enzyme Inhibitors::Protease Inhibitors [Medical Subject Headings], abacavir plus lamivudine, Europa (Continente), HIV Protease Inhibitors, emtricitabine, nonhuman, Intervalos de confianza, Mutación, business.industry, HIV, prediction, Inhibidores de la transcriptasa inversa, Human immunodeficiency virus 1 infection, tenofovir, INDIVIDUALS, Drug Resistance, Viral/genetics, Benzoxazinas, ETRAVIRINE, drug effects, 3121 General medicine, internal medicine and other clinical medicine, Prevalencia, business
Abstract

Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors., Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)–infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%–9.5%) in 2008–2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.

Published
2016

5. Late presentation to HIV testing is overestimated when based on the consensus definition

Author

Belgian Research AIDS & HIV consortium (BREACH), Sasse, A, Florence, E, Pharris, A, De Wit, S, Lacor, P, Van Beckhoven, D, Deblonde, J, Delforge, M-L, Fransen, K, Goffard, J-C, Legrand, J-C, Moutschen, M, Pierard, D, Ruelle, J, Vaira, D, Vandercam, B, Van Ranst, M, Van Wijngaerden, E, Vandekerckhove, L, Verhofstede, C, Clinical sciences, Microbiology and Infection Control, Internal Medicine, Supporting clinical sciences, Clinical Biology, and Department of Bio-engineering Sciences

Subjects
DYNAMICS, 0301 basic medicine, Male, Delayed Diagnosis, Human immunodeficiency virus (HIV), men who have sex with men, HIV Infections, medicine.disease_cause, Men who have sex with men, Late presentation, 0302 clinical medicine, Belgium, Risk Factors, INFECTION, Medicine, Pharmacology (medical), 030212 general & internal medicine, Pathologie maladies infectieuses, Health Policy, Sciences bio-médicales et agricoles, testing, AIDS, HIV Infections/diagnosis, consensus definition, Infectious Diseases, Late diagnosis, medicine.medical_specialty, Consensus, Short Communication, late diagnosis, Hiv testing, DIAGNOSIS, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), SEROCONVERSION, Humans, Homosexuality, Male, Belgium/epidemiology, late presentation, Health policy, business.industry, HIV, CARE, medicine.disease, 030112 virology, CD4 Lymphocyte Count, Homosexuality, Male/statistics & numerical data, Family medicine, Immunology, Late presenters, business, Delayed Diagnosis/statistics & numerical data
Abstract

In 2011, a consensus was reached defining "late presenters" (LPs) as individuals presenting for care with a CD4 count, SCOPUS: ar.j, FLWOA, info:eu-repo/semantics/published

Published
2015

6. Good continuum of HIV care in Belgium despite weaknesses in retention and linkage to care among migrants

Author

Van Beckhoven, D, Florence, E, Ruelle, J, Deblonde, J, Verhofstede, C, Callens, S, Vancutsem, E, Lacor, P, Demeester, R, Goffard, J-C, Sasse, A, Breach Study Group, Van Wijngaerden, Eric, Van Ranst, Marc, Faculty of Economic and Social Sciences and Solvay Business School, Clinical sciences, Microbiology and Infection Control, Internal Medicine, UCL - SSS/IREC/MBLG - Pôle de Microbiologie médicale, UCL - (SLuc) Service de microbiologie, UCL - SSS/IREC/SLUC - Pôle St.-Luc, and UCL - (SLuc) Service de médecine interne générale

Subjects
Male, Patient Acceptance of Health Care/statistics & numerical data, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Anti-Retroviral Agents/therapeutic use, Men who have sex with men, Drug Users, Medical microbiology, ANTIRETROVIRAL THERAPY, Belgium, INFECTION, Medicine and Health Sciences, Continuum of care, African Continental Ancestry Group, Transients and Migrants, education.field_of_study, Transmission (medicine), virus diseases, Sciences bio-médicales et agricoles, Continuity of Patient Care, Viral Load, HIV Infections/diagnosis, Infectious Diseases, Anti-Retroviral Agents, Cohort, Cascade, Female, Viral load, Research Article, Adult, medicine.medical_specialty, EUROPE, TRANSMISSION, Population, UNITED-STATES, Black People, Migrants, medicine, otorhinolaryngologic diseases, Humans, COHORT, education, Belgium/epidemiology, business.industry, HIV, Patient Acceptance of Health Care, PREVENTION, Health Surveys, Tropical medicine, Immunology, business, Demography
Abstract

The Belgian HIV epidemic is largely concentrated among men who have sex with men and Sub-Saharan Africans. We studied the continuum of HIV care of those diagnosed with HIV living in Belgium and its associated factors., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2015

7. Expansion of polyfunctional antigen-specific T-cells upon stimulation with mRNA electroporated dendritic cells in the presence of immunomodulatory drugs

Author

De Keersmaecker, Brenda, Allard, S., Lacor, P., Schots, R., Thielemans, Kris, Aerts, Joeri, and Laboratory of Molecullar and Cellular Therapy

Subjects
immunomodulatory drugs, lenalidomide, HIV, pomalidomide, dendritic cells
Abstract

Since its FDA approval, thalidomide/dexamethasone combination therapy has been successfully used in first-line multiple myeloma treatment. More active and less toxic thalidomide-derivatives such as lenalidomide and pomalidomide have been developed. Thalidomide and its derivatives exert direct anti-tumor effects but are also strong stimulators of NK-cell and polyclonal T-cell responses and are therefore referred to as immunomodulatory drugs (IMiDs). We hypothesize that the immunostimulatory properties of IMiDs could improve the efficacy of immunotherapies, such as dendritic cell-based vaccines. In this study, we therefore aim to investigate the effects of IMiDs on antigen-specific T-cell responses in vitro. Since it has been demonstrated that disease progression during HIV infection is not merely determined by the number of HIV-specific T cells, but rather by their quality, strategies to specifically enhance or induce high quality HIV-specific T-cell responses are necessary to develop effective HIV immune therapies. Therefore, we decided to evaluate the effects of lenalidomide and pomalidomide on HIV-specific T cells. We found that the presence of IMiDs during in vitro T-cell stimulation with dendritic cells electroporated with Gag or Nef encoding mRNA resulted in an increased HIV-specific CD8+ T-cell proliferation and cytokine (IFN-g, TNF-a and IL-2) production. Interestingly, the IMiDs particularly enhanced polyfunctional HIV-specific CD8+ T cells, which were previously shown to be associated with a better HIV disease control. Furthermore, CD8+ T cells responded to lower antigenic peptide concentrations and recognized a higher number of Gag epitopes upon addition of IMiDs. As opposed to the CD8+ T-cell proliferation, IMiDs reduced the proliferation of the HIV-specific CD4+ T cells while increasing the number of polyfunctional CD4+ T cells, be it to a lesser extent compared to the CD8+ T cells. These results provide new information about the effects of IMiDs on antigen-specific T cells and suggest that these drugs might increase the efficacy of immune therapies for infectious diseases and cancer.

Published
2012

8. A dendritic cell-based therapeutic vaccine against HIV-1

Author

Aerts, Joeri, De Keersmaecker, Brenda, Gruters, Rob A., Allard, S., Koetsveld, J., Corthals, Jurgen, Reedijk, M.l., Heirman, Carlo, Verschuren, E.j., Lacor, P., Van Der Ende, M.e., Thielemans, Kris, Osterhaus, Ab, Van Baalen, Carel A., and Laboratory of Molecullar and Cellular Therapy

Subjects
HIV, dendritic cells, immunotherapy, vaccination
Published
2010

11. HIV-1 sequence evolution after dendritic cell-based immune therapy

Author

De Goede, A.l., De Keersmaecker, Brenda, Schutten, M, Allard, S., Van Der Ende, M.e., Corthals, Jurgen, Osterhaus, Ab, Heirman, Carlo, Van Baalen, Carel A., Lacor, P., Boers, P.h.m., Thielemans, Kris, Gruters, Rob A., Aerts, Joeri, Physiology, Clinical sciences, Microbiology and Infection Control, Internal medicine - endocrinology, and Laboratory of Molecullar and Cellular Therapy

Subjects
virus evolution, sequence analysis, viruses, immune therapy, HIV-1, HIV, virus diseases, immune assays
Abstract

Background: Therapeutic vaccination of HIV infected patients is explored as an alternative to antiretroviral therapy (HAART). In a phase I/II clinical trial HIV infected participants were treated with autologous dendritic cells (DC) expressing the early HIV proteins Tat, Rev and Nef. We evaluated the effect of immune therapy on the cellular immune response and the impact on the viral genome by analysis of HIV genotype evolution. Methods: Seventeen asymptomatic HIV-1 infected patients on HAART therapy were treated with a DC-based vaccine. The vaccine consisted of autologous mature DC electroporated separately with mRNA expressing Tat, Rev and Nef and each formulation was administered at a distinct anatomical site. After four monthly vaccinations HAART treatment was interrupted. PBMC taken at 4 time points were used for stimulation with pools of overlapping Tat, Rev, Nef and Gag peptides and the number of IFN-g producing cells was analyzed using Elispot (peptide Elispot). Elispot was also performed using electroporated DC (DC Elispot) for in vitro re-stimulation. For sequence analysis, HIV RNA was extracted and partly amplified by RT-PCR. The open reading frames of the genes present in the vaccine (tat, rev and nef) and the control genes (vif, vpr and vpu) were analyzed. Variation in DNA and protein sequences from pre-HAART and (early) post vaccination was analyzed. HIV sequences spanning known and predicted epitopes of the relevant HLA alleles from each participant were analyzed in detail. Results: In 12 out of 16 patients screened with both peptide and DC Elispot, increased post-vaccination responses to vaccine-antigens were found. For 12/17 patients a complete set of both pre-HAART and post-vaccination sequences for the vaccine and control genes could be obtained. With one exception, variation in pre-HAART and post vaccination HIV sequences was limited, in all genes examined. Viral sequences spanning specific epitopes for the individual participants were examined in further detail. Although we could find evidence for viral evolution in these epitopes, this was not a common phenomenon. Conclusions: Immune therapy with autologous DC expressing Tat Rev and Nef was well-tolerated and did not have adverse effects. Increased cellular immunity against the immunogens was found with both assays. There was no significant correlation between the breadth and/or extent of the immune response after vaccination and the rate of virus evolution. Keywords: HIV-1, immune therapy, immune assays, sequence analysis, virus evolution Corresponding author: r.gruters@erasmusmc.nl

Published
2009

12. Late presentation to HIV testing is overestimated when based on the consensus definition.

Author

Sasse, A, Florence, E, Pharris, A, De Wit, S, Lacor, P, Van Beckhoven, D, Deblonde, J, Delforge, M‐L, Fransen, K, Goffard, J‐C, Legrand, J‐C, Moutschen, M, Piérard, D, Ruelle, J, Vaira, D, Vandercam, B, Van Ranst, M, Van Wijngaerden, E, Vandekerckhove, L, and Verhofstede, C

Subjects
DIAGNOSIS of HIV infections, HIV infection epidemiology, CONSENSUS (Social sciences), HIV infections, HIV-positive persons, PUBLIC health surveillance, AIDS serodiagnosis, CD4 lymphocyte count
Abstract

Objectives In 2011, a consensus was reached defining 'late presenters' ( LPs) as individuals presenting for care with a CD4 count < 350 cells/μL or with an AIDS-defining event, regardless of CD4 count. However, a transient low CD4 count is not uncommon in recent infections. The objective of this study was to investigate how measurements of late presentation change if the clinical stage at the time of diagnosis is taken into account. Methods Case surveillance data for newly diagnosed patients in Belgium in 1998-2012 were analysed, including CD4 count at diagnosis, the presence of AIDS-defining events, and recent infections (< 6 months) as reported by clinicians in the case of acute illness or a recent negative test. First, proportions of LPs were calculated according to the consensus definition. Secondly, LPs were reclassified as 'nonlate' if infections were reported as recent. Results A total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men ( MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition ( P < 0.001). The proportion of patients misclassified as LPs increased significantly over time: 5% in MSM in 1998 vs. 41% in 2012. Conclusions This study suggests that low CD4 counts in recent infections may lead to overestimation of late presentation when applying the consensus definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered. [ABSTRACT FROM AUTHOR]

Published
2016
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13. A public health value-based healthcare paradigm for HIV

Author

Paul De Munter, Jean-Christophe Goffard, Stefaan J. Vandecasteele, Eric Van Wijngaerden, Lucie Seyler, Françoise Uurlings, Peter Messiaen, Stéphane De Wit, Patrick Lacor, S. Callens, Eric Florence, Sophie Henrard, Rémy Demeester, Sebastian Vermeersch, Jean Cyr Yombi, Nathalie Ausselet, Lieven Annemans, Agnès Libois, Vermeersch, S., Demeester, RP, Ausselet, N, Callens, S, De Munter, P, Florence, E, Goffard, JC, Henrard, S, Lacor, P, MESSIAEN, Peter, Libois, A, Seyler, L, Uurlings, F, Vandecasteele, S.J., Van Wijngaerden, E, Yombi, JC, Annemans, L, De Wit, S, UZB Other, Clinical sciences, Microbiology and Infection Control, Internal Medicine, Public Health Sciences, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Pathologie infectieuse, UCL - SSS/IREC/SLUC - Pôle St.-Luc, and UCL - (SLuc) Service de médecine interne générale

Subjects
medicine.medical_specialty, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, infectious diseases, 1ST, Value-based healthcare, Nursing, Patient-Centered Care, medicine, Internal Medicine, Humans, Indicators, Public health, Science & Technology, Frameworks, MEDICINE, Health Policy, Research, Public Health, Environmental and Occupational Health, HIV, PERFORMANCE, Health Care Sciences & Services, Value based healthcare, HIV Infections/epidemiology, Business, Health Facilities, Public aspects of medicine, RA1-1270, PAY, Life Sciences & Biomedicine, Delivery of Health Care
Abstract

Background HIV patients face considerable acute and chronic healthcare needs and battling the HIV epidemic remains of the utmost importance. By focusing on health outcomes in relation to the cost of care, value-based healthcare (VBHC) proposes a strategy to optimize quality of care and cost-efficiency. Its implementation may provide an answer to the increasing pressure to optimize spending in healthcare while improving patient outcomes. This paper describes a pragmatic value-based healthcare framework for HIV care. Methods A value-based HIV healthcare framework was developed during a series of roundtable discussions bringing together 16 clinical stakeholder representatives from the Belgian HIV reference centers and 2 VBHC specialists. Each round of discussions was focused on a central question translating a concept or idea to the next level of practical implementation: 1) how can VBHC principles be translated into value-based HIV care drivers; 2) how can these value-based HIV care divers be translated into value-based care objectives and activities; and 3) how can value-based HIV care objectives and activities be translated into value-based care indicators. Value drivers were linked to concrete objectives and activities using a logical framework approach. Finally, specific, measurable, and acceptable structure, process and outcomes indicators were defined to complement the framework. Results Our framework identifies 4 core value areas where HIV care would benefit most from improvements: Prevention, improvement of the cascade of care, providing patient-centered HIV care and sustaining a state-of-the-art HIV disease management context. These 4 core value areas were translated into 12 actionable core value objectives. For each objective, example activities were proposed. Indicators are suggested for each level of the framework (outcome indicators for value areas and objectives, process indicators for suggested activities). Conclusions This framework approach outlines how to define a patient- and public health centered value-based HIV care paradigm. It proposes how to translate core value drivers to practical objectives and activities and suggests defining indicators that can be used to track and improve the framework’s implementation in practice.

Published
2022

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