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102. Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study

Author

Nikolaichuk, Myroslava, Mocroft, Amanda, Wandeler, Gilles, Szlavik, János, Gottfredsson, Magnus, Reikvam, Dag Henrik, Svedhem, Veronica, Elinav, Hila, Laguno, Montserrat, Mansinho, Kamal, Devitt, Emma, Chkhartishvili, Nikoloz, Behrens, Georg, Bogner, Johannes, Viard, Jean-Paul, Winston, Alan, Benfield, Thomas, Leen, Clifford, Fursa, Olga, Rockstroh, Jürgen, and Peters, Lars

Subjects
co-infection, HCV, HIV, contraindications, 610 Medicine & health, 610 Medizin und Gesundheit, DAA
Abstract

OBJECTIVES Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study. METHODS At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications ('red shading' in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs. RESULTS Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3-8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40-7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08-0.65) for 2015-2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55). CONCLUSION In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interactions with DAA across Europe. Participants who received a contraindicated DAA and ARV combination still had a high rate of SVR12.

Published
2022
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108. Impact of HIV-1 Reverse Transcriptase Polymorphism F214L on Virological Response to Thymidine Analogue-Based Regimens in Antiretroviral Therapy (ART)-Naive and ART-Experienced Patients

Author

EuroSIDA Study Group, Ceccherini-Silberstein, Francesca, Cozzi-Lepri, Alessandro, Ruiz, Lidia, Mocroft, Amanda, Phillips, Andrew N., Olsen, Christian Holkmann, Gatell, Jose M., Günthard, Huldrych F., Reiss, Peter, Perno, Carlo Federico, Clotet, Bonaventura, and Lundgren, Jens D.

Published
2007
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110. The association between hepatitis B virus infection and nonliver malignancies in persons living with HIV: results from the EuroSIDA study

Author

Mocroft, Amanda, Miro, Jose M., Wandeler, Gilles, Llibre, Josep M., Boyd, Anders, van Bremen, Kathrin, Beniowski, Marek, Mikhalik, Julia, Cavassini, Matthias, Maltez, Fernando, Duvivier, Claudine, Uberti Foppa, Caterina, Knysz, Brygida, Bakowska, Elzbieta, Kuzovatova, Elena, Domingo, Pere, Zagalo, Alexandra, Viard, Jean Paul, Degen, Olaf, Milinkovic, Ana, Benfield, Thomas, Peters, Lars, Harxhi, A., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Machala, L., Sedlacek, D., Kronborg, G., Gerstoft, J., Katzenstein, T., Pedersen, C., Johansen, I. S., Ostergaard, L., Wiese, L., Moller, N. F., Nielsen, L. N., Zilmer, K., Smidt, J., Aho, I., Lacombe, K., Pradier, C., Fontas, E., Rockstroh, J., Behrens, G., Hoffmann, C., Stellbrink, H. J., Stefan, C., Bogner, J., Fätkenheuer, G., Chkhartishvili, N., Sambatakou, H., Adamis, G., Paissios, N., Szlávik, J., Gottfredsson, M., Devitt, E., Tau, L., Turner, D., Burke, M., Shahar, E., Wattad, L. M., Elinav, H., Haouzi, M., Elbirt, D., D’Arminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Dragas, S., Stevanovic, M., vd Valk, M., Trajanovska, J., Reikvam, D. H., Maeland, A., Bruun, J., Szetela, B., Inglot, M., Flisiak, R., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Mularska, E., Jablonowska, E., Kamerys, J., Wojcik, K., Mozer-Lisewska, I., Rozplochowski, B., Mansinho, K., Radoi, R., Oprea, C., Gusev, D., Trofimova, T., Khromova, I., Borodulina, E., Ranin, J., Tomazic, J., Miró, J. M., Laguno, M., Martinez, E., Garcia, F., Blanco, J. L., Martinez-Rebollar, M., Mallolas, J., Callau, P., Rojas, J., Inciarta, A., Moreno, S., del Campo, S., Clotet, B., Jou, A., Paredes, R., Puig, J., Santos, J. R., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Svedhem, V., Thalme, A., Sönnerborg, A., Brännström, J., Flamholc, L., Kusejko, K., Braun, D., Calmy, A., Furrer, H., Battegay, M., Schmid, P., Kuznetsova, A., Sluzhynska, M., Johnson, M. A., Simons, E., Edwards, S., Phillips, A., Orkin, C., Winston, A., Clarke, A., Leen, C., Lundgren, J., Rasmussen, L. D., Kowalska, J. D., Guaraldi, G., Larsen, J. F., Bojesen, A., Neesgaard, B., Jaschinski, N., Fursa, O., Sather, M., Raben, D., Hansen, E. V., Kristensen, D., Fischer, A. H., Jensen, S. K., Elsing, T. W., Reekie, J., Cozzi-Lepri, A., Amele, S., Pelchen-Matthews, A., Roen, A., Tusch, E. S., Bannister, W., Mocroft, A., Miro, J. M., Wandeler, G., Llibre, J. M., Boyd, A., van Bremen, K., Beniowski, M., Mikhalik, J., Cavassini, M., Maltez, F., Duvivier, C., Uberti Foppa, C., Knysz, B., Bakowska, E., Kuzovatova, E., Domingo, P., Zagalo, A., Viard, J. -P., Degen, O., Milinkovic, A., Benfield, T., Peters, L., Harxhi, A., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Machala, L., Sedlacek, D., Kronborg, G., Gerstoft, J., Katzenstein, T., Pedersen, C., Johansen, I. S., Ostergaard, L., Wiese, L., Moller, N. F., Nielsen, L. N., Zilmer, K., Smidt, J., Aho, I., Lacombe, K., Pradier, C., Fontas, E., Rockstroh, J., Behrens, G., Hoffmann, C., Stellbrink, H. J., Stefan, C., Bogner, J., Fatkenheuer, G., Chkhartishvili, N., Sambatakou, H., Adamis, G., Paissios, N., Szlavik, J., Gottfredsson, M., Devitt, E., Tau, L., Turner, D., Burke, M., Shahar, E., Wattad, L. M., Elinav, H., Haouzi, M., Elbirt, D., D'Arminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Dragas, S., Stevanovic, M., vd Valk, M., Trajanovska, J., Reikvam, D. H., Maeland, A., Bruun, J., Szetela, B., Inglot, M., Flisiak, R., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Mularska, E., Jablonowska, E., Kamerys, J., Wojcik, K., Mozer-Lisewska, I., Rozplochowski, B., Mansinho, K., Radoi, R., Oprea, C., Gusev, D., Trofimova, T., Khromova, I., Borodulina, E., Ranin, J., Tomazic, J., Laguno, M., Martinez, E., Garcia, F., Blanco, J. L., Martinez-Rebollar, M., Mallolas, J., Callau, P., Rojas, J., Inciarta, A., Moreno, S., del Campo, S., Clotet, B., Jou, A., Paredes, R., Puig, J., Santos, J. R., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Svedhem, V., Thalme, A., Sonnerborg, A., Brannstrom, J., Flamholc, L., Kusejko, K., Braun, D., Calmy, A., Furrer, H., Battegay, M., Schmid, P., Kuznetsova, A., Sluzhynska, M., Johnson, A. M., Simons, E., Edwards, S., Phillips, A., Johnson, M. A., Orkin, C., Winston, A., Clarke, A., Leen, C., Lundgren, J., Rasmussen, L. D., Kowalska, J. D., Guaraldi, G., Larsen, J. F., Bojesen, A., Neesgaard, B., Jaschinski, N., Fursa, O., Sather, M., Raben, D., Hansen, E. V., Kristensen, D., Fischer, A. H., Jensen, S. K., Elsing, T. W., Reekie, J., Cozzi-Lepri, A., Amele, S., Pelchen-Matthews, A., Roen, A., Tusch, E. S., Bannister, W., and Infectious diseases

Subjects
Hepatitis B virus, Hepatitis B Surface Antigens, Health Policy, virus diseases, HIV Infections, Hepatitis B, digestive system diseases, HBV DNA, hepatitis B, nonliver cancer, Infectious Diseases, Hepatitis B, Chronic, Neoplasms, DNA, Viral, Humans, Pharmacology (medical), 610 Medicine & health
Abstract

Objectives: The aim of this study was to assess the impact of hepatitis B virus (HBV) infection on non-liver malignancies in people living with HIV (PLWH). Methods: All persons aged ≥18 years with known hepatitis B virus (HBV) surface antigen (HBsAg) status after the latest of 1January 2001 and enrolment in the EuroSIDA cohort (baseline) were included in the study; persons were categorized as HBV positive or negative using the latest HBsAg test and followed to their first diagnosis of nonliver malignancy or their last visit. Results: Of 17485 PLWH included in the study, 1269 (7.2%) were HBV positive at baseline. During 151766 person-years of follow-up (PYFU), there were 1298 nonliver malignancies, 1199 in those currently HBV negative [incidence rate (IR)8.42/1000 PYFU; 95% confidence interval (CI) 7.94–8.90/1000 PYFU] and 99 in those HBV positive (IR10.54/1000 PYFU; 95% CI8.47–12.62/1000 PYFU). After adjustment for baseline confounders, there was a significantly increased incidence of nonliver malignancies in HBV-positive versus HBV-negative individuals [adjusted incidence rate ratio (aIRR)1.23; 95% CI 1.00–1.51]. Compared to HBV-negative individuals, HBsAg-positive/HBV-DNA-positive individuals had significantly increased incidences of nonliver malignancies (aIRR 1.37; 95% CI 1.00–1.89) and NHL (aIRR 2.57; 95% CI 1.16–5.68). There was no significant association between HBV and lung or anal cancer. Conclusions: We found increased rates of nonliver malignancies in HBsAg-positive participants, the increases being most pronounced in those who were HBV DNA positive and for NHL. If confirmed, these results may have implications for increased cancer screening in HIV-positive subjects with chronic HBV infection.

Published
2021

111. Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality-a multicentre prospective cohort study

Author

Kraef, Christian, Bentzon, Adrian, Panteleev, Alexander, Skrahina, Alena, Bolokadze, Natalie, Tetradov, Simona, Podlasin, Regina, Karpov, Igor, Borodulina, Elena, Denisova, Elena, Azina, Inga, Lundgren, Jens, Johansen, Isik Somuncu, Mocroft, Amanda, Podlekareva, Daria, Kirk, Ole, Vassilenko, A., Klimuk, D., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Mitsura, V., Kozorez, E., Tumash, O., Suetnov, O., Paduto, D., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, Nino, Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Kancauskiene, Z., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Grezesczuk, A., Bura, M., Knysz, B., Inglot, M., Garlicki, A., Loster, J., uiculescu, D.D., Rakhmanova, A., Panteleev, O., Yakovlev, A., Kozlov, A., Tyukalova, A., Vlasova, Y., rofimov, T.T., Kyselyova, G., Obel, N., Gerstoft, J., Kronborg, G., Payen, M.C., abeya, K.K., Necsoi, C., Dabis, F., Tsaranazy, A., Cazanave, C., Furrer, H., Sagette, M., Rickenbach, M., Sculier, D., Calmy, A., Cavassini, Matthias, Bruno, A., Bernasconi, E., Hoffmann, M., Vernazza, P., Fehr, J., Weber, R., Miller, R., Vora, N., Cooke, G., Mullaney, S., Wilkins, E., George, V., Collini, P., Dockrell, D., Post, F., Campbell, L., Brum, R., Mabonga, E., Saigal, P., Kegg, S., Ainsworth, J., Waters, A., Dhar, J., Ellis, K., Girardi, E., Rianda, A., Galati, V., Pinnetti, C., Tommasi, C., Lapadula, G., Di Biagio, A., Parisini, A., Carbonara, S., Angarano, G., Purgatorio, M., Matteelli, A., Apostoli, A., Miro, J.M., Manzardo, C., Ligero, C., Gonzalez, J., Martinez-Martinez, J.A., Sanchez, F., Knobel Freud, Hernando, Salvadó, M., Lopez-Colomes, J.L., Martínez-Lacasa, X., Cuchí, E., Falcó, Vicenç, Curran, Adrian, Tortola, M.T., Ocaña Rivera, Immaculada, Vidal, R., Sambeat, M.A., Pomar, Virginia, Coll, P., Pozamczer, D., Saumoy, M., Alcaide, Fernando, Caylà, Joan A, Moreno Camacho, Asunción, Millet, Joan-Pau, Orcau, Àngels, Fina, L., Romero, A., Roldan, L.L., Iribarren, J.A., Ibarguren, M., Moreno, S., González, A., Miralles, P., Aldámiz-Echevarría, T., Losso, M., Toibaro, J., Gambardella, L., Moreno Macias, L., Warley, E., Tavella, S., Garcia Messina, O., Gear, O., Laplume, H., Marson, C., Contarelia, J., Michaan, M., Scapellato, P., Bartoletti, B., Palmero, D., Elias, C., Cortes, C., Crabtree, B., Mosqueda Gomez, J.L., Villanueva, J.A., Gonzalez Hernandez, L.A., Badial, F., Kraef, C, Bentzon, A, Panteleev, A, Skrahina, A, Bolokadze, N, Tetradov, S, Podlasin, R, Karpov, I, Borodulina, E, Denisova, E, Azina, I, Lundgren, J, Johansen, I, Mocroft, A, Podlekareva, D, Kirk, O, Vassilenko, A, Klimuk, D, Kondratenko, O, Zalutskaya, A, Bondarenko, V, Mitsura, V, Kozorez, E, Tumash, O, Suetnov, O, Paduto, D, Iljina, V, Kummik, T, Mshvidobadze, K, Lanchava, N, Goginashvili, L, Mikiashvili, L, Bablishvili, N, Rozentale, B, Zeltina, I, Janushkevich, I, Caplinskiene, I, Caplinskas, S, Kancauskiene, Z, Wiercinska-Drapalo, A, Thompson, M, Kozlowska, J, Grezesczuk, A, Bura, M, Knysz, B, Inglot, M, Garlicki, A, Loster, J, Uiculescu, D, Rakhmanova, A, Panteleev, O, Yakovlev, A, Kozlov, A, Tyukalova, A, Vlasova, Y, Rofimov, T, Kyselyova, G, Obel, N, Gerstoft, J, Kronborg, G, Payen, M, Abeya, K, Necsoi, C, Dabis, F, Tsaranazy, A, Cazanave, C, Furrer, H, Sagette, M, Rickenbach, M, Sculier, D, Calmy, A, Cavassini, M, Bruno, A, Bernasconi, E, Hoffmann, M, Vernazza, P, Fehr, J, Weber, R, Miller, R, Vora, N, Cooke, G, Mullaney, S, Wilkins, E, George, V, Collini, P, Dockrell, D, Post, F, Campbell, L, Brum, R, Mabonga, E, Saigal, P, Kegg, S, Ainsworth, J, Waters, A, Dhar, J, Ellis, K, Girardi, E, Rianda, A, Galati, V, Pinnetti, C, Tommasi, C, Lapadula, G, Di Biagio, A, Parisini, A, Carbonara, S, Angarano, G, Purgatorio, M, Matteelli, A, Apostoli, A, Miro, J, Manzardo, C, Ligero, C, Gonzalez, J, Martinez-Martinez, J, Sanchez, F, Knobel, H, Salvado, M, Lopez-Colomes, J, Martinez-Lacasa, X, Cuchi, E, Falco, V, Curran, A, Tortola, M, Ocana, I, Vidal, R, Sambeat, M, Pomar, V, Coll, P, Pozamczer, D, Saumoy, M, Alcaide, F, Cayla, J, Moreno, A, Millet, J, Orcau, A, Fina, L, Romero, A, Roldan, L, Iribarren, J, Ibarguren, M, Moreno, S, Gonzalez, A, Miralles, P, Aldamiz-Echevarria, T, Losso, M, Toibaro, J, Gambardella, L, Moreno Macias, L, Warley, E, Tavella, S, Garcia Messina, O, Gear, O, Laplume, H, Marson, C, Contarelia, J, Michaan, M, Scapellato, P, Bartoletti, B, Palmero, D, Elias, C, Cortes, C, Crabtree, B, Mosqueda Gomez, J, Villanueva, J, Gonzalez Hernandez, L, and Badial, F

Subjects
medicine.medical_specialty, Tuberculosis, Delayed Diagnosis, Aged, Europe, Eastern, Humans, Middle Aged, Prospective Studies, HIV Infections, Tuberculosi, Epidemiology, Tuberculosis/diagnosis, HIV Infections/complications, Infectious and parasitic diseases, RC109-216, Eastern Europe, Eastern, Logistic regression, Europa de l'Est, Medical microbiology, Weight loss, Internal medicine, medicine, VIH (Virus), HIV Infection, Europe, Eastern/epidemiology, Prospective cohort study, Epidemiologia, business.industry, Proportional hazards model, Transmission (medicine), HIV (Viruses), Research, Hazard ratio, Delayed Diagnosi, medicine.disease, Europe, Prospective Studie, Infectious Diseases, medicine.symptom, business, Human
Abstract

Background Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. Conclusion Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

Published
2021

114. Long-term effectiveness of unboosted atazanavir plus abacavir/lamivudine in subjects with virological suppression: A prospective cohort study

Author

Llibre, Josep M., Cozzi-Lepri, Alessandro, Pedersen, Court, Ristola, Matti, Losso, Marcelo, Mocroft, Amanda, Mitsura, Viktar, Falconer, Karolin, Maltez, Fernando, Beniowski, Marek, Vullo, Vincenzo, Hassoun, Gamal, Kuzovatova, Elena, Szlavik, János, Kuznetsova, Anastasiia, Stellbrink, Hans-Jürgen, Duvivier, Claudine, Edwards, Simon, Laut, Kamilla, and Paredes, Roger

Published
2016
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118. Antiretroviral resistance at virological failure in the NEAT 001/ANRS 143 trial: raltegravir plus darunavir/ritonavir or tenofovir/emtricitabine plus darunavir/ritonavir as first-line ART

Author

Lambert-Niclot, S., George, E. C., Pozniak, A., White, E., Schwimmer, C., Jessen, H., Johnson, M., Dunn, D., Perno, C. F., Clotet, B., Plettenberg, A., Blaxhult, A., Palmisano, L., Wittkop, L., Calvez, V., Marcelin, A. G., Raffi, F., Dedes, Nikos, Chêne, Geneviève, Richert, Laura, Allavena, Clotilde, Raffi, François, Autran, Brigitte, Antinori, Andrea, Bucciardini, Raff aella, Vella, Stefano, Horban, Andrzej, Arribas, Jose, Babiker, Abdel G., Boffito, Marta, Pillay, Deenan, Pozniak, Anton, Franquet, Xavier, Schwarze, Siegfried, Grarup, Jesper, Chêne, Geneviève, Fischer, Aurélie, Richert, Laura, Wallet, Cédrick, Raffi, François, Diallo, Alpha, Molina, Jean-Michel, Saillard, Juliette, Moecklinghoff, Christiane, Stellbrink, Hans-Jürgen, Vella, Stefano, Van Leeuwen, Remko, Gatell, Jose, Sandstrom, Eric, Flepp, Markus, Babiker, Abdel G, Ewings, Fiona, George, Elizabeth C., Hudson, Fleur, Pozniak, Anton, Pearce, Gillian, Quercia, Romina, Rogatto, Felipe, Leavitt, Randi, Nguyen, Bach-Yen, Goebel, Frank, Marcotullio, Simone, Babiker, Abdel G., Ewings, Fiona, George, Elizabeth C., Hudson, Fleur, Kaur, Navrup, Sasieni, Peter, Spencer-Drake, Christina, Peto, Tim, Miller, Veronica, Allavena, Clotilde, Raffi, François, Vella, Stefano, Pozniak, Anton, Arnault, Fabien, Boucherie, Céline, Fischer, Aurélie, Jean, Delphine, Paniego, Observer Virginie, Paraina, Felasoa, Richert, Laura, Rouch, Elodie, Schwimmer, Christine, Soussi, Malika, Taieb, Audrey, Termote, Monique, Touzeau, Guillaume, Wallet, Cédrick, Babiker, Abdel G., Cursley, Adam, Dodds, Wendy, Ewings, Fiona, George, Elizabeth C., Hoppe, Anne, Hudson, Fleur, Kummeling, Ischa, Pacciarini, Filippo, Paton, Nick, Russell, Charlotte, Taylor, Kay, Ward, Denise, Aagaard, Bitten, Eid, Marius, Gey, Daniela, Jensen, Birgitte Gram, Grarup, Jesper, Jakobsen, Marie-Louise, Jansson, Per O., Jensen, Karoline, Joensen, Zillah Maria, Larsen, Ellen Moseholm, Pahl, Christiane, Pearson, Mary, Nielsen, Birgit Riis, Reilev, Søren Stentoft, Christ, Ilse, Lathouwers, Desiree, Manting, Corry, Van Leeuwen, Remko, Diallo, Alpha, Mendy, Bienvenu Yves, Metro, Annie, Saillard, Juliette, Couffin-Cadiergues, Sandrine, Knellwolf, Anne-Laure, Palmisiano, Lucia, Aznar, Esther, Barea, Cristina, Cotarelo, Manuel, Esteban, Herminia, Girbau, Iciar, Moyano, Beatriz, Ramirez, Miriam, Saiz, Carmen, Sanchez, Isabel, Yllescas, Maria, Binelli, Andrea, Colasanti, Valentina, Massella, Maurizio, Palmisiano, Lucia, Anagnostou, Olga, Gioukari, Vicky, Touloumi, Giota, Schmied, Brigitte, Rieger, Armin, Vetter, Norbert, De Wit, Stephane, Florence, Eric, Vandekerckhove, Linos, Gerstoft, Jan, Mathiesen, Lars, Katlama, Christine, Cabie, Andre, Cheret, Antoine, Dupon, Michel, Ghosn, Jade, Girard, Pierre-Marie, Goujard, Cécile, Lévy, Yves, Molina, Jean-Michel, Morlat, Philippe, Neau, Didier, Obadia, Martine, Perre, Philippe, Piroth, Lionel, Reynes, Jacques, Tattevin, Pierre, Raffi, François, Ragnaud, Jean Marie, Weiss, Laurence, Yazdan, Yazdanpanah, Yeni, Patrick, Zucman, David, Behrens, Georg, Esser, Stefan, Fätkenheuer, Gerd, Hoffmann, Christian, Jessen, Heiko, Rockstroh, Jürgen, Schmidt, Reinhold, Stephan, Christoph, Unger, Stefan, Hatzakis, Angelos, Daikos, George L., Papadopoulos, Antonios, Skoutelis, Athamasios, Banhegyi, Denes, Mallon, Paddy, Mulcahy, Fiona, Antinori, Andrea, Andreoni, Massimo, Bonora, Stefano, Castelli, Francesco, Monforte, Antonella DʼArminio, Di Perri, Giovanni, Galli, Massimo, Lazzarin, Adriano, Mazzotta, Francesco, Carlo, Torti, Vullo, Vincenzo, Prins, Jan, Richter, Clemens, Verhagen, Dominique, Van Eeden, Arne, Horban, Andrzej, Doroana, Manuela, Antunes, Francisco, Maltez, Fernando, Sarmento-Castro, Rui, Garcia, Juan Gonzalez, Aldeguer, José López, Clotet, Bonaventura, Domingo, Pere, Gatell, Jose M., Knobel, Hernando, Marquez, Manuel, Miralles, Martin Pilar, Portilla, Joaquin, Soriano, Vicente, Tellez, Maria-Jesus, Thalme, Anders, Blaxhult, Anders, Gisslen, Magnus, Winston, Alan, Fox, Julie, Gompels, Mark, Herieka, Elbushra, Johnson, Margaret, Leen, Clifford, Pozniak, Anton, Teague, Alastair, Williams, Ian, Boyd, Mark Alastair, Grarup, Jesper, Jansson, Per O., Møller, Nina Friis, Larsen, Ellen Frøsig Moseholm, Morlat, Philippe, Piroth, Lionel, Le Moing, Vincent, Wit, Ferdinand W. N. M., Kowalska, Justyna, Berenguer, Juan, Moreno, Santiago, Müller, Nicolas J., Török, Estée, Post, Frank, Angus, Brian, Calvez, Vincent, Boucher, Charles, Collins, Simon, Dunn, David, Lambert, Sidonie, Marcelin, Anne-Geneviève, Perno, Carlo Federico, Pillay, Deenan, White, Ellen, Boffito, Marta, Ammassari, Adriana, Antinori, Andrea, Stoehr, Wolgang, Autran, Brigitte, Schmidt, Reinhold Ernst, Odermarsky, Michal, Smith, Colette, Thiébaut, Rodolphe, Arribas, Jose, De La Serna, Jose Ignacio Bernardino, Castagna, Antonella, De Wit, Stephane, Franquet, Xavier, Furrer, Hans-Jackob, Katlama, Christine, Mocroft, Amanda, Reiss, Peter, Bucciardini, Raffaella, Dedes, Nikos, Fragola, Vincenzo, George, Elizabeth C., Lauriola, Marco, Murri, Rita, Nieuwkerk, Pythia, Spire, Bruno, Volny-Anne, Alain, West, Brian, Amieva, Hélène, Antinori, Andrea, Llibre Codina, Josep Maria, Richert, Laura, Stoehr, Wolgang, Winston, Alan, Castelli, Francesco, Braggion, Marco, and Focà, Emanuele

Published
2016
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119. The role of HIV/hepatitis B virus/hepatitis C virus RNA+ triple infection in end-stage liver disease and all-cause mortality in Europe.

Author

Mocroft, Amanda, Geressu, Adam, Beguelin, Charles, Llibre, Josep M., Lazarus, Jeffrey V., Tomazic, Janez, Smidt, Jelena, Parczewski, Milosz, Brännström, Johanna, Sedlacek, Dalibor, Degen, Olaf, van der Valk, Marc, Paduta, Dzmitry, Flamholc, Leo, Schmid, Patrick, Orkin, Chloe, Nielsen, Lars N., Hoffmann, Christian, Beniowski, Marek, and Oprea, Cristiana

Published
2023
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121. Clinical outcomes of two-drug regimens vs. three-drug regimens in antiretroviral treatment-experienced people living with HIV

Author

Greenberg, Lauren, Ryom, Lene, Neesgaard, Bastian, Wandeler, Gilles, Staub, Therese, Gisinger, Martin, Skoll, Michael, Günthard, Huldrych F, Scherrer, Alexandra, Mussini, Cristina, Smith, Colette, Johnson, Margaret, De Wit, Stéphane, Necsoi, Coca, Pradier, Christian, Wit, Ferdinand, Lehmann, Clara, d’Arminio Monforte, Antonella, Miró, Jose M, Castagna, Antonella, Spagnuolo, Vincenzo, Sönnerborg, Anders, Law, Matthew, Hutchinson, Jolie, Chkhartishvili, Nikoloz, Bolokadze, Natalia, Wasmuth, Jan-Christian, Stephan, Christoph, Vannappagari, Vani, Rogatto, Felipe, Llibre, Josep M, Duvivier, Claudine, Hoy, Jennifer, Bloch, Mark, Bucher, Heiner C, Calmy, Alexandra, Volny Anne, Alain, Pelchen-Matthews, Annegret, Lundgren, Jens D, Peters, Lars, Bansi-Matharu, Loveleen, Mocroft, Amanda, Greenberg, Lauren, Ryom, Lene, Neesgaard, Bastian, Wandeler, Gille, Staub, Therese, Gisinger, Martin, Skoll, Michael, Günthard, Huldrych F, Scherrer, Alexandra, Mussini, Cristina, Smith, Colette, Johnson, Margaret, De Wit, Stéphane, Necsoi, Coca, Pradier, Christian, Wit, Ferdinand, Lehmann, Clara, d'Arminio Monforte, Antonella, Miró, Jose M, Castagna, Antonella, Spagnuolo, Vincenzo, Sönnerborg, Ander, Law, Matthew, Hutchinson, Jolie, Chkhartishvili, Nikoloz, Bolokadze, Natalia, Wasmuth, Jan-Christian, Stephan, Christoph, Vannappagari, Vani, Rogatto, Felipe, Llibre, Josep M, Duvivier, Claudine, Hoy, Jennifer, Bloch, Mark, Bucher, Heiner C, Calmy, Alexandra, Volny Anne, Alain, Pelchen-Matthews, Annegret, Lundgren, Jens D, Peters, Lar, Bansi-Matharu, Loveleen, and Mocroft, Amanda

Subjects
antiretroviral treatment, two-drug regimens, HIV, 610 Medicine & health, dual therapy, clinical outcomes
Abstract

Background: Limited data exist comparing clinical outcomes of two-drug regimens (2DRs) and three-drug regimens (3DRs) in people living with HIV. Methods: Antiretroviral treatment-experienced individuals in RESPOND switching to a new 2DR or 3DR from 1/1/12-1/10/18 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular disease, end-stage liver and renal disease, death) was compared between regimens using Poisson regression. Results: Of 9791 individuals included, 1088 (11.1%) started 2DRs and 8703 (88.9%) 3DRs. The most common 2DRs were dolutegravir plus lamivudine (22.8%) and raltegravir plus boosted darunavir (19.8%); the most common 3DR was dolutegravir plus 2 nucleoside reverse transcriptase inhibitors (46.9%). Individuals on 2DRs were older (median 52.6 years [interquartile range 46.7-59.0] vs 47.7 [39.7-54.3]), and a higher proportion had ≥1 comorbidity (81.6% vs 73.9%).There were 619 events during 27,159 person-years of follow-up (PYFU): 540 (incidence rate [IR] 22.5/1000 PYFU [95% CI 20.7-24.5]) on 3DRs, 79 (30.9/1000 PYFU [24.8-38.5]) on 2DRs. The most common events were death (7.5/1000 PYFU [95% CI 6.5-8.6]) and non-AIDS cancer (5.8/1000 PYFU [4.9-6.8]). After adjustment for baseline demographic and clinical characteristics, there was a similar incidence of events on both regimen types (2DRs vs 3DRs IR ratio: 0.92 [0.72-1.19]; p=0.53). Conclusions: This is the first large, international cohort assessing clinical outcomes on 2DRs. After accounting for baseline characteristics, there was a similar incidence of events on 2DRs and 3DRs. 2DRs appear to be a viable treatment option with regard to clinical outcomes; further research on resistance barriers and long-term durability of 2DRs is needed.

Published
2020

123. Reply

Author

Lundgren, Jens D., Mocroft, Amanda, Gatell, Jose M., and Phillips, Andrew N.

Published
2002

125. 23. Development and Validation of a Risk Score for Post-transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients

Author

dos Santos, Quenia, primary, Wareham, Neval E, additional, Mocroft, Amanda, additional, Rasmussen, Allan, additional, Gustafsson, Finn, additional, Perch, Michael, additional, Sørensen, Søren Schwartz, additional, Manuel, Oriol, additional, Mueller, Nicolas, additional, Lundgren, Jens, additional, and Reekie, Joanne, additional

Published
2021
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126. The hepatitis C cascade of care in HIV/hepatitis C virus coinfected individuals in Europe: regional and intra-regional differences

Author

Fursa, Olga, primary, Mocroft, Amanda, additional, Lazarus, Jeffrey V., additional, Amele, Sarah, additional, Lundgren, Jens, additional, Matulionyte, Raimonda, additional, Rasmussen, Line D., additional, Rockstroh, Jürgen K., additional, Parczewski, Milosz, additional, Jilich, David, additional, Moreno, Santiago, additional, Vassilenko, Anna, additional, Lacombe, Karine, additional, Wandeler, Gilles, additional, Borodulina, Elena, additional, Brännström, Johanna, additional, Wiese, Lothar, additional, Orkin, Chloe, additional, Behrens, Georg M.N., additional, Mansinho, Kamal, additional, Portu, Jose Joaquin, additional, and Peters, Lars, additional

Published
2021
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133. Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults

Author

Marzolini, Catia, Sabin, Caroline, Raffi, François, Siccardi, Marco, Mussini, Cristina, Launay, Odile, Burger, David, Roca, Bernardino, Fehr, Jan, Bonora, Stefano, Mocroft, Amanda, Obel, Niels, Dauchy, Frederic-Antoine, Zangerle, Robert, Gogos, Charalambos, Gianotti, Nicola, Ammassari, Adriana, Torti, Carlo, Ghosn, Jade, Chêne, Genevieve, Grarup, Jesper, and Battegay, Manuel

Published
2015
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134. Risk for Non–AIDS-Defining and AIDS-Defining Cancer of Early Versus Delayed Initiation of Antiretroviral Therapy

Author

Chammartin, Frédérique, primary, Lodi, Sara, additional, Logan, Roger, additional, Ryom, Lene, additional, Mocroft, Amanda, additional, Kirk, Ole, additional, d’Arminio Monforte, Antonella, additional, Reiss, Peter, additional, Phillips, Andrew, additional, El-Sadr, Wafaa, additional, Hatleberg, Camilla I., additional, Pradier, Christian, additional, Bonnet, Fabrice, additional, Law, Matthew, additional, De Wit, Stéphane, additional, Sabin, Caroline, additional, Lundgren, Jens D., additional, and Bucher, Heiner C., additional

Published
2021
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136. Effectiveness and safety of IFN-free DAA HCV therapy in HIV/HCV co-infected persons: Results from a pan-European study

Author

Amele, Sarah, Peters, Lars, Rodger, Alison, Lundgren, Jens, Rockstroh, Jϋrgen, Matulionyte, Raimonda, Leen, Clifford, Jabłonowska, Elzbieta, Østergaard, Lars, Bhagani, Sanjay, Sarcletti, Mario, Clarke, Amanda, Falconer, Karolin, Wandeler, Gilles, Domingo, Pere, Maltez, Fernando, Zaccarelli, Mauro, Chkhartisvili, Nikoloz, Szlavik, Janos, Stephan, Christoph, Fonquernie, Laurent, Aho, Inka, and Mocroft, Amanda

Subjects
360 Social problems & social services, virus diseases, 610 Medicine & health
Abstract

OBJECTIVES: To investigate the effectiveness, safety and reasons for premature discontinuation of direct-acting antivirals (DAAs) in a diverse population of HIV/HCV co-infected individuals in Europe.METHODS: All HIV/HCV co-infected individuals in the EuroSIDA study that started interferon (IFN) free DAA treatment between 1/6/2014 and 1/3/2018 with ≥12 weeks of follow-up after treatment stop were included in this analysis. Sustained virological response (SVR) was defined as a negative HCV-RNA result ≥12 weeks after stopping treatment (SVR12). Logistic regression was used to explore factors associated with SVR12.RESULTS: 1042 individuals started IFN-free DAA treatment after 1/6/2014 and were included, 862 (82.2%) had a known response to treatment, 789 (91.5%, 95% CI 89.7-93.4) of which achieved SVR12. There were no differences in SVR12 across regions of Europe (p=0.84). After adjustment, the odds of achieving SVR12 was lower in individuals that received sofosbuvir/simeprevir +/- RBV (aOR 0.21 (95% CI 0.08-0.53) or ombitasvir/paritaprevir/dasabuvir +/- RBV (aOR 0.46 (95% CI 0.22-1.00) compared to sofosbuvir/ledipasvir +/- RBV. 43 (4.6%) individuals had one or more components of their HCV regimen stopped early, most commonly due to toxicity (n=14); of these 14, 11 were treated with ribavirin. Increased bilirubin was the most common grade 3 or 4 laboratory adverse event (n=15.3%) and was related to treatment with atazanavir and ribavirin.CONCLUSIONS: Our findings from real-world data on HIV/HCV co-infected individuals across Europe show DAA treatment is well tolerated, and that high rates of SVR12 can be achieved in all regions of Europe.

Published
2021

137. Risk for non-AIDS-defining and AIDS-defining cancer of early versus delayed initiation of antiretroviral therapy

Author

Chammartin, Frédérique, Lodi, Sara, Logan, Roger, Ryom, Lene, Mocroft, Amanda, Kirk, Ole, d’Arminio Monforte, Antonella, Reiss, Peter, Phillips, Andrew, El-Sadr, Wafaa, Hatleberg, Camilla I., Pradier, Christian, Bonnet, Fabrice, Law, Matthew, De Wit, Stéphane, Sabin, Caroline, Lundgren, Jens D., and Bucher, Heiner C.

Subjects
adult, anti-HIV agents, CD4 lymphocyte count, female, HIV infections, humans, incidence, male, middle aged, neoplasms, prospective studies, risk factors, time-to-treatment, viral load
Abstract

ackground: Immediate initiation of antiretroviral therapy (ART) regardless of CD4 cell count reduces risk for AIDS and non-AIDS-related events in asymptomatic, HIV-positive persons and is the standard of care. However, most HIV-positive persons initiate ART when their CD4 count decreases below 500 × 109 cells/L. Consequences of delayed ART on risk for non-AIDS-defining and AIDS-defining cancer, one of the most common reasons for death in HIV, are unclear. Objective: To estimate the long-term risk difference for cancer with the immediate ART strategy. Design: Multinational prospective cohort study. Setting: The D:A:D (Data collection on Adverse events of anti-HIV Drugs) study, which included HIV-positive persons from Europe, Australia, and the United States. Participants: 8318 HIV-positive persons with at least 1 measurement each of CD4 cell count and viral load while ART-naive (study period, 2006 to 2016). Measurements: The parametric g-formula was used, with adjustment for baseline and time- dependent confounders (CD4 cell count and viral load), to assess the 10-year risk for non-AIDS- defining and AIDS-defining cancer of immediate versus deferred (at CD4 counts < 350 and < 500 × 109 cells/L) ART initiation strategies. Results: During 64 021 person-years of follow-up, 231 cases of non-AIDS-defining cancer and 272 of AIDS- defining cancer occurred among HIV-positive persons with a median age of 36 years (interquartile range, 29 to 43 years). With immediate ART, the 10-year risk for non-AIDS- defining cancer was 2.97% (95% CI, 2.37% to 3.50%) and that for AIDS-defining cancer was 2.50% (CI, 2.37% to 3.38%). Compared with immediate ART initiation, the 10-year absolute risk differences when deferring ART to CD4 counts less than 500 × 109 cells/L and less than 350 × 109 cells/L were 0.12 percentage point (CI, -0.01 to 0.26 percentage point) and 0.29 percentage point (CI, -0.03 to 0.73 percentage point), respectively, for non-AIDS-defining cancer and 0.32 percentage point (CI, 0.21 to 0.44 percentage point) and 1.00 percentage point (CI, 0.67 to 1.44 percentage points), respectively, for AIDS-defining cancer. Limitation: Potential residual confounding due to observational study design. Conclusion: In this young cohort, effects of immediate ART on 10-year risk for cancer were small, and further supportive data are needed for non-AIDS-defining cancer. Primary Funding Source: Highly Active Antiretroviral Therapy Oversight Committee.

Published
2021

138. Hypersensitivity reactions, hepatotoxicity, and other discontinuations in persons receiving integrase strand transfer inhibitors:results from the EuroSIDA study

Author

Pelchen-Matthews, Annegret, Larsen, Jakob Friis, Shepherd, Leah, Begovac, Josip, Pedersen, Karen, De Wit, Stéphane, Horban, Andrzej, Jablonowska, Elzbieta, Johnson, Margaret, Khromova, Irina, Losso, Marcelo H., Nielsen, Lars N., Ridolfo, Anna Lisa, Schmied, Brigitte, Stephan, Christoph, Yust, Israel, Curtis, Lloyd, Vannappagari, Vani, Ragone, Leigh, Roen, Ashley, Raben, Dorthe, Kirk, Ole, Peters, Lars, and Mocroft, Amanda

Subjects
integrase strand transfer inhibitors, hepatotoxicity, Human immunodeficiency virus, serious adverse events, antiretroviral therapy, hypersensitivity reaction, dolutegravir
Abstract

Background: Hypersensitivity reaction (HSR) and hepatotoxicity are rare, but potentially serious side-effects of antiretroviral use. Objective: To investigate discontinuations due to HSR, hepatotoxicity or other reasons among users of dolutegravir (DTG) vs. raltegravir (RAL) or elvitegravir (EVG) in the EuroSIDA cohort. Methods: We compared individuals ≥18 years and starting combination antiretroviral therapy (ART, ≥3 drugs) with DTG vs. RAL or EVG, with or without abacavir (ABC), between January 16, 2014 and January 23, 2019. Discontinuations due to serious adverse events (SAEs) were independently reviewed. Results: Altogether 4366 individuals started 5116 ART regimens including DTG, RAL, or EVG, contributing 9180 person-years of follow-up (PYFU), with median follow-up 1.6 (interquartile range 0.7–2.8) years per treatment episode. Of these, 3074 (60.1%) used DTG (1738 with ABC, 1336 without) and 2042 (39.9%) RAL or EVG (286 with ABC, 1756 without). 1261 (24.6%) INSTI episodes were discontinued, 649 of the DTG-containing regimens (discontinuation rate 115, 95% CI 106–124/1000 PYFU) and 612 RAL or EVG-containing regimens (173, CI 160–188/1000 PYFU). After independent review, there were five HSR discontinuations, two for DTG (one with and one without ABC, discontinuation rate 0.35, CI 0.04–1.28/1000 PYFU), and three for RAL or EVG without ABC (0.85, CI 0.18–2.48/1000 PYFU). There was one hepatotoxicity discontinuation on DTG with ABC (discontinuation rate 0.18, CI 0.00–0.99/1000 PYFU). Conclusion: During 5 years of observations in the EuroSIDA cohort independently reviewed discontinuations due to HSR or hepatotoxicity were very rare, indicating a low rate of SAEs.

Published
2021

139. Additional file 1 of Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

Author

Kraef, Christian, Bentzon, Adrian, Panteleev, Alexander, Skrahina, Alena, Bolokadze, Natalie, Tetradov, Simona, Podlasin, Regina, Karpov, Igor, Borodulina, Elena, Denisova, Elena, Azina, Inga, Lundgren, Jens, Johansen, Isik Somuncu, Mocroft, Amanda, Podlekareva, Daria, and Kirk, Ole

Abstract

Additional file 1: Table S1. Cox-regression model for survival in Eastern Europe, crude and adjusted hazard ratios for follow-up 0–2 months. Table S2. Cox-regression model for survival in Eastern Europe, crude and adjusted hazard ratios for follow-up 2–24 months. Figure S1. Kaplan–Meier survival estimates by diagnostic delay (≤ 3 months versus > 3 months)

Published
2021
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140. Withholding Primary Pneumocystis Pneumonia Prophylaxis in Virologically Suppressed Patients With Human Immunodeficiency Virus: An Emulation of a Pragmatic Trial in COHERE

Author

Atkinson, Andrew Zwahlen, Marcel Barger, Diana Monforte, Antonella d'Arminio De Wit, Stephane Ghosn, Jade Girardi, Enrico Svedhem, Veronica Morlat, Philippe Mussini, Cristina and Noguera-Julian, Antoni Stephan, Christoph Touloumi, Giota and Kirk, Ole Mocroft, Amanda Reiss, Peter Miro, Jose M. and Carpenter, James R. Furrer, Hansjakob Collaboration Observational HIV Ep

Abstract

Background. Using data from the COHERE collaboration, we investigated whether primary prophylaxis for pneumocystis pneumonia (PcP) might be withheld in all patients on antiretroviral therapy (ART) with suppressed plasma human immunodeficiency virus (HIV) RNA (200 cells/mu L for >3 months or (2) when the patient was virologically suppressed (2 consecutive HIV RNA

Published
2021

141. HCV reinfection after HCV therapy among HIV/HCV���coinfected individuals in Europe

Author

Amele, Sarah, Sandri, Anastasia Karachalia, Rodger, Alison, Vandekerckhove, Linos, Benfield, Thomas, Milinkovic, Ana, Duvivier, Claudine, Stellbrink, Hans���J��rgen, Sambatakou, Helen, Chkhartishvili, Nikoloz, Caldeira, Luis, Laguno, Monserrat, Domingo, Pere, Wandeler, Gilles, Gisinger, Martin, Kuzovatova, Elena, Dragovic, Gordana, Knysz, Brygida, Matulionyte, Raimonda, Rockstroh, J��rgen Kurt, Lundgren, Jens Dilling, Mocroft, Amanda, and Peters, Lars

Subjects
610 Medicine & health
Published
2021
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142. Independent Associations of Tumor Necrosis Factor-Alpha and Interleukin-1 Beta With Radiographic Emphysema in People Living With HIV

Author

Thudium, Rebekka F., Ringheim, Hedda, Ronit, Andreas, Hoel, Hedda, Benfield, Thomas, Mocroft, Amanda, Gerstoft, Jan, Trøseid, Marius, Borges, Álvaro H., Ostrowski, Sisse R., Vestbo, Jørgen, Nielsen, Susanne D., Thudium, Rebekka F., Ringheim, Hedda, Ronit, Andreas, Hoel, Hedda, Benfield, Thomas, Mocroft, Amanda, Gerstoft, Jan, Trøseid, Marius, Borges, Álvaro H., Ostrowski, Sisse R., Vestbo, Jørgen, and Nielsen, Susanne D.

Abstract

Background: People living with HIV (PLWH) have increased systemic inflammation, and inflammation has been suggested to contribute to the pathogenesis of emphysema. We investigated whether elevated cytokine concentrations (interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), IL-2, IL-4, IL-6, IL-10, IL-17A, tumor necrosis factor-alpha (TNFα), interferon-gamma (IFNγ), soluble CD14 (sCD14) and sCD163 were independently associated with radiographic emphysema in PLWH. Methods: We included PLWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) Study without hepatitis B and C co-infection and with a plasma sample and a chest computed tomography scan available. Emphysema plus trace emphysema was defined as the percentage of low attenuation area under −950 Houndsfield Unit (%LAA-950) using a cut-off at 5%. Cytokine concentrations were measured by ELISA or Luminex immunoassays. An elevated cytokine concentration was defined as above the 75th percentile. Results: Of 783 PLWH, 147 (18.8%) had emphysema. PLWH were predominantly male (86.0%) and 743 (94.9%) had undetectable viral replication. PLWH with emphysema had higher concentrations of TNFα (median (IQR): 8.2 (6.4-9.8) versus 7.1 (5.7-8.6) pg/ml, p<0.001), IL-1β (0.21 (0.1-0.4) versus 0.17 (0.1-0.3) pg/ml, p=0.004) and IL-6 (3.6 (2.6-4.9) versus 3.1 (2.0-4.3) pg/ml, p=0.023) than PLWH without. In a logistic regression model adjusted for age, sex, ethnicity, smoking status, BMI and CD4 nadir, elevated TNFα (adjusted odds ratio (aOR): 1.78 [95%CI: 1.14-2.76], p=0.011) and IL-1β (aOR: 1.81 [95%CI: 1.16-2.81], p=0.009) were independently associated with emphysema. The association between IL-1β and emphysema was modified by smoking (p-interaction=0.020) with a more pronounced association in never-smokers (aOR: 4.53 [95%CI: 2.05-9.98], p<0.001). Conclusion: Two markers of systemic inflammation, TNFα and IL-1β, were independently associated with emphysema in PLWH and may contribute to the pathogenesis

Published
2021

143. The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus:The D:A:D Study

Author

Ryom, Lene, Lundgren, Jens D, Reiss, Peter, Ross, Mike, Kirk, Ole, Fux, Christophe A, Morlat, Phillipe, Fontas, Eric, Smith, Colette, De Wit, Stephane, D’arminio Monforte, Antonella, El Sadr, Wafaa, Hatleberg, Camilla, Phillips, Andrew, Sabin, Caroline, Law, Matthew, Mocroft, Amanda, Ryom, Lene, Lundgren, Jens D, Reiss, Peter, Ross, Mike, Kirk, Ole, Fux, Christophe A, Morlat, Phillipe, Fontas, Eric, Smith, Colette, De Wit, Stephane, D’arminio Monforte, Antonella, El Sadr, Wafaa, Hatleberg, Camilla, Phillips, Andrew, Sabin, Caroline, Law, Matthew, and Mocroft, Amanda

Published
2021

144. Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents

Author

Byonanebye, Dathan M., Polizzotto, Mark N., Begovac, Josip, Grabmeier-Pfistershammer, Katharina, Abela, Irene, Castagna, Antonella, De Wit, Stephane, Mussini, Cristina, Vehreschild, Joerg J., Monforte, Antonella d'A, Wit, Ferdinand W. N. M., Pradier, Christian, Chkhartishvili, Nikoloz, Sonnerborg, Anders, Hoy, Jennifer, Lundgren, Jens, Neesgaard, Bastian, Bansi-matharu, Loveleen, Greenberg, Lauren, Llibre, Josep M., Vannappagari, Vani, Gallant, Joel, Necsoi, Coca, Cichon, Piotr, Reiss, Peter, Aho, Inka, Tsertsvadze, Tengiz, Mennozzi, Marianna, Rauch, Andri, Muccini, Camilla, Law, Matthew, Mocroft, Amanda, Ryom, Lene, Petoumenos, Kathy, Byonanebye, Dathan M., Polizzotto, Mark N., Begovac, Josip, Grabmeier-Pfistershammer, Katharina, Abela, Irene, Castagna, Antonella, De Wit, Stephane, Mussini, Cristina, Vehreschild, Joerg J., Monforte, Antonella d'A, Wit, Ferdinand W. N. M., Pradier, Christian, Chkhartishvili, Nikoloz, Sonnerborg, Anders, Hoy, Jennifer, Lundgren, Jens, Neesgaard, Bastian, Bansi-matharu, Loveleen, Greenberg, Lauren, Llibre, Josep M., Vannappagari, Vani, Gallant, Joel, Necsoi, Coca, Cichon, Piotr, Reiss, Peter, Aho, Inka, Tsertsvadze, Tengiz, Mennozzi, Marianna, Rauch, Andri, Muccini, Camilla, Law, Matthew, Mocroft, Amanda, Ryom, Lene, and Petoumenos, Kathy

Abstract

Objective: To compare the incidence of dyslipidemia in people with HIV receiving integrase inhibitors (INSTI) versus boosted protease inhibitors (PI/b) and nonnucleoside reverse transcriptase inhibitors (NNRTI) within RESPOND consortium of prospective cohorts. Methods: Participants were eligible if they were at least 18 years, without dyslipidemia and initiated or switched to a three-drug antiretroviral therapy (ART)-regimen consisting of either INSTI, NNRTI, or PI/b for the first time, between 1 January 2012 and 31 December 2018. Dyslipidemia was defined as random total cholesterol more than 240 mg/dl, HDL less than 35 mg/dl, triglyceride more than 200 mg/dl, or initiation of lipid-lowering therapy. Poisson regression was used to determine the adjusted incidence rate ratios. Follow-up was censored after 3 years or upon ART-regimen discontinuation or last lipid measurement or 31 December 2019, whichever occurred first. Results: Overall, 4577 people with HIV were eligible (INSTI = 66.9%, PI/b = 12.5%, and NNRTI = 20.6%), 1938 (42.3%) of whom were ART-naive. During 1.7 (interquartile range, 0.6-3.0) median years of follow-up, 1460 participants developed dyslipidemia [incidence rate: 191.6 per 1000 person-years, 95% confidence interval (CI) 182.0-201.7]. Participants taking INSTI had a lower incidence of dyslipidemia compared with those on PI/b (adjusted incidence rate ratio 0.71; CI 0.59-0.85), but higher rate compared with those on NNRTI (1.35; CI 1.15-1.58). Compared with dolutegravir, the incidence of dyslipidemia was higher with elvitegravir/cobicistat (1.20; CI 1.00-1.43) and raltegravir (1.24; CI 1.02-1.51), but lower with rilpivirine (0.77; CI 0.63-0.94). Conclusion: In this large consortium of heterogeneous cohorts, dyslipidemia was less common with INSTI than with PI/b. Compared with dolutegravir, dyslipidemia was more common with elvitegravir/cobicistat and raltegravir, but less common with rilpivirine.

Published
2021

145. Withholding primary pneumocystis pneumonia prophylaxis in virologically suppressed patients with human immunodeficiency virus: an emulation of a pragmatic trial in COHERE

Author

Opportunistic Infections Project Working Group of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord, Atkinson, Andrew, Zwahlen, Marcel, Barger, Diana, d’Arminio Monforte, Antonella, Wit, Stephane de, Girardi, Enrico, Svedhem, Veronica, Morlat, Philippe, Mussini, Cristina, Noguera-Julian, Antoni, Stephan, Christoph, Touloumi, Giota, Kirk, Ole, Mocroft, Amanda, Reiss, Peter, Miró, Jose Maria, Carpenter, James R., Furrer, Hansjakob, Opportunistic Infections Project Working Group of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord, Atkinson, Andrew, Zwahlen, Marcel, Barger, Diana, d’Arminio Monforte, Antonella, Wit, Stephane de, Girardi, Enrico, Svedhem, Veronica, Morlat, Philippe, Mussini, Cristina, Noguera-Julian, Antoni, Stephan, Christoph, Touloumi, Giota, Kirk, Ole, Mocroft, Amanda, Reiss, Peter, Miró, Jose Maria, Carpenter, James R., and Furrer, Hansjakob

Abstract

Background: Using data from the COHERE collaboration, we investigated whether primary prophylaxis for pneumocystis pneumonia (PcP) might be withheld in all patients on antiretroviral therapy (ART) with suppressed plasma human immunodeficiency virus (HIV) RNA (≤400 copies/mL), irrespective of CD4 count. Methods: We implemented an established causal inference approach whereby observational data are used to emulate a randomized trial. Patients taking PcP prophylaxis were eligible for the emulated trial if their CD4 count was ≤200 cells/µL in line with existing recommendations. We compared the following 2 strategies for stopping prophylaxis: (1) when CD4 count was >200 cells/µL for >3 months or (2) when the patient was virologically suppressed (2 consecutive HIV RNA ≤400 copies/mL). Patients were artificially censored if they did not comply with these stopping rules. We estimated the risk of primary PcP in patients on ART, using the hazard ratio (HR) to compare the stopping strategies by fitting a pooled logistic model, including inverse probability weights to adjust for the selection bias introduced by the artificial censoring. Results: A total of 4813 patients (10 324 person-years) complied with eligibility conditions for the emulated trial. With primary PcP diagnosis as an endpoint, the adjusted HR (aHR) indicated a slightly lower, but not statistically significant, different risk for the strategy based on viral suppression alone compared with the existing guidelines (aHR, .8; 95% confidence interval, .6–1.1; P = .2). Conclusions: This study suggests that primary PcP prophylaxis might be safely withheld in confirmed virologically suppressed patients on ART, regardless of their CD4 count.

Published
2021

146. Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe:associated factors and effect on mortality—a multicentre prospective cohort study

Author

Kraef, Christian, Bentzon, Adrian, Panteleev, Alexander, Skrahina, Alena, Bolokadze, Natalie, Tetradov, Simona, Podlasin, Regina, Karpov, Igor, Borodulina, Elena, Denisova, Elena, Azina, Inga, Lundgren, Jens, Johansen, Isik Somuncu, Mocroft, Amanda, Podlekareva, Daria, Kirk, Ole, Vassilenko, A., Klimuk, D., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Mitsura, V., Kozorez, E., Tumash, O., Suetnov, O., Paduto, D., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Kancauskiene, Z., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Grezesczuk, A., Bura, M., Knysz, B., Inglot, M., Garlicki, A., Obel, N., Gerstoft, J., Kronborg, G., Kraef, Christian, Bentzon, Adrian, Panteleev, Alexander, Skrahina, Alena, Bolokadze, Natalie, Tetradov, Simona, Podlasin, Regina, Karpov, Igor, Borodulina, Elena, Denisova, Elena, Azina, Inga, Lundgren, Jens, Johansen, Isik Somuncu, Mocroft, Amanda, Podlekareva, Daria, Kirk, Ole, Vassilenko, A., Klimuk, D., Kondratenko, O., Zalutskaya, A., Bondarenko, V., Mitsura, V., Kozorez, E., Tumash, O., Suetnov, O., Paduto, D., Iljina, V., Kummik, T., Mshvidobadze, K., Lanchava, N., Goginashvili, L., Mikiashvili, L., Bablishvili, N., Rozentale, B., Zeltina, I., Janushkevich, I., Caplinskiene, I., Caplinskas, S., Kancauskiene, Z., Wiercinska-Drapalo, A., Thompson, M., Kozlowska, J., Grezesczuk, A., Bura, M., Knysz, B., Inglot, M., Garlicki, A., Obel, N., Gerstoft, J., and Kronborg, G.

Abstract

Background: Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods: PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings: 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. < 50 years, aOR = 2.51; 1.18–5.32; p = 0.016), injecting drug use (IDU) (vs. non-IDU aOR = 1.66; 1.21–2.29; p = 0.002), being ART naïve (aOR = 1.77; 1.24–2.54; p = 0.002), disseminated TB (vs. pulmonary TB, aOR = 1.56, 1.10–2.19, p = 0.012), and presenting with weight loss (vs. no weight loss, aOR = 1.63; 1.18–2.24; p = 0.003) were associated with delayed diagnosis. PLWH with a delayed diagnosis were at 36% increased risk of death (hazard ratio = 1.36; 1.04–1.77; p = 0.023, adjusted hazard ratio 1.27; 0.95–1.70; p = 0.103). Conclusion: Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

Published
2021

147. Clinical Outcomes of 2-Drug Regimens vs 3-Drug Regimens in Antiretroviral Treatment-Experienced People Living With Human Immunodeficiency Virus

Author

Greenberg, Lauren, Ryom, Lene, Neesgaard, Bastian, Wandeler, Gilles, Staub, Therese, Gisinger, Martin, Skoll, Michael, Günthard, Huldrych F., Scherrer, Alexandra, Mussini, Cristina, Smith, Colette, Johnson, Margaret, De Wit, Stéphane, Necsoi, Coca, Pradier, Christian, Wit, Ferdinand, Lehmann, Clara, d'Arminio Monforte, Antonella, Miró, Jose M., Castagna, Antonella, Spagnuolo, Vincenzo, Sönnerborg, Anders, Law, Matthew, Hutchinson, Jolie, Chkhartishvili, Nikoloz, Bolokadze, Natalia, Wasmuth, Jan Christian, Stephan, Christoph, Vannappagari, Vani, Rogatto, Felipe, Llibre, Josep M., Duvivier, Claudine, Hoy, Jennifer, Bloch, Mark, Bucher, Heiner C., Calmy, Alexandra, Volny Anne, Alain, Pelchen-Matthews, Annegret, Lundgren, Jens D., Peters, Lars, Bansi-Matharu, Loveleen, Mocroft, Amanda, Greenberg, Lauren, Ryom, Lene, Neesgaard, Bastian, Wandeler, Gilles, Staub, Therese, Gisinger, Martin, Skoll, Michael, Günthard, Huldrych F., Scherrer, Alexandra, Mussini, Cristina, Smith, Colette, Johnson, Margaret, De Wit, Stéphane, Necsoi, Coca, Pradier, Christian, Wit, Ferdinand, Lehmann, Clara, d'Arminio Monforte, Antonella, Miró, Jose M., Castagna, Antonella, Spagnuolo, Vincenzo, Sönnerborg, Anders, Law, Matthew, Hutchinson, Jolie, Chkhartishvili, Nikoloz, Bolokadze, Natalia, Wasmuth, Jan Christian, Stephan, Christoph, Vannappagari, Vani, Rogatto, Felipe, Llibre, Josep M., Duvivier, Claudine, Hoy, Jennifer, Bloch, Mark, Bucher, Heiner C., Calmy, Alexandra, Volny Anne, Alain, Pelchen-Matthews, Annegret, Lundgren, Jens D., Peters, Lars, Bansi-Matharu, Loveleen, and Mocroft, Amanda

Abstract

BACKGROUND: Limited data exist that compare clinical outcomes of 2-drug regimens (2DRs) and 3-drug regimens (3DRs) in people living with human immunodeficiency virus. METHODS: Antiretroviral treatment-experienced individuals in the International Cohort Consortium of Infectious Diseases (RESPOND) who switched to a new 2DR or 3DR from 1 January 2012-1 October 2018 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular disease, end-stage liver and renal disease, death) was compared between regimens using Poisson regression. RESULTS: Of 9791 individuals included, 1088 (11.1%) started 2DRs and 8703 (88.9%) started 3DRs. The most common 2DRs were dolutegravir plus lamivudine (22.8%) and raltegravir plus boosted darunavir (19.8%); the most common 3DR was dolutegravir plus 2 nucleoside reverse transcriptase inhibitors (46.9%). Individuals on 2DRs were older (median, 52.6 years [interquartile range, 46.7-59.0] vs 47.7 [39.7-54.3]), and a higher proportion had ≥1 comorbidity (81.6% vs 73.9%). There were 619 events during 27 159 person-years of follow-up (PYFU): 540 (incidence rate [IR] 22.5/1000 PYFU; 95% confidence interval [CI]: 20.7-24.5) on 3DRs and 79 (30.9/1000 PYFU; 95% CI: 24.8-38.5) on 2DRs. The most common events were death (7.5/1000 PYFU; 95% CI: 6.5-8.6) and non-AIDS cancer (5.8/1000 PYFU; 95% CI: 4.9-6.8). After adjustment for baseline demographic and clinical characteristics, there was a similar incidence of events on both regimen types (2DRs vs 3DRs IR ratio, 0.92; 95% CI: .72-1.19; P = .53). CONCLUSIONS: This is the first large, international cohort to assess clinical outcomes on 2DRs. After accounting for baseline characteristics, there was a similar incidence of events on 2DRs and 3DRs. 2DRs appear to be a viable treatment option with regard to clinical outcomes. Further research on resistance barriers and long-term durability of 2DRs is needed.

Published
2021

149. Cost‐effectiveness of statins for primary prevention of atherosclerotic cardiovascular disease among people living with HIV in the United States

Author

Boettiger, David C, Newall, Anthony T, Phillips, Andrew, Bendavid, Eran, Law, Matthew G, Ryom, Lene, Reiss, Peter, Mocroft, Amanda, Bonnet, Fabrice, Weber, Rainer, El‐sadr, Wafaa, D’arminio Monforte, Antonella, Wit, Stephane, Pradier, Christian, Hatleberg, Camilla I, Lundgren, Jens, Sabin, Caroline, Kahn, James G, Kazi, Dhruv S, Boettiger, David C, Newall, Anthony T, Phillips, Andrew, Bendavid, Eran, Law, Matthew G, Ryom, Lene, Reiss, Peter, Mocroft, Amanda, Bonnet, Fabrice, Weber, Rainer, El‐sadr, Wafaa, D’arminio Monforte, Antonella, Wit, Stephane, Pradier, Christian, Hatleberg, Camilla I, Lundgren, Jens, Sabin, Caroline, Kahn, James G, and Kazi, Dhruv S

Published
2021

150. Risk for Non–AIDS-Defining and AIDS-Defining Cancer of Early Versus Delayed Initiation of Antiretroviral Therapy:A Multinational Prospective Cohort Study

Author

Chammartin, Frédérique, Lodi, Sara, Logan, Roger, Ryom, Lene, Mocroft, Amanda, Kirk, Ole, D’arminio Monforte, Antonella, Reiss, Peter, Phillips, Andrew, El-sadr, Wafaa, Hatleberg, Camilla I., Pradier, Christian, Bonnet, Fabrice, Law, Matthew, De Wit, Stéphane, Sabin, Caroline, Lundgren, Jens D., Bucher, Heiner C., Chammartin, Frédérique, Lodi, Sara, Logan, Roger, Ryom, Lene, Mocroft, Amanda, Kirk, Ole, D’arminio Monforte, Antonella, Reiss, Peter, Phillips, Andrew, El-sadr, Wafaa, Hatleberg, Camilla I., Pradier, Christian, Bonnet, Fabrice, Law, Matthew, De Wit, Stéphane, Sabin, Caroline, Lundgren, Jens D., and Bucher, Heiner C.

Published
2021

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