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1. Real-world trough concentrations and effectiveness of long-acting cabotegravir and rilpivirine: a multicenter prospective observational study in Switzerland

Author

Abela, I, Aebi-Popp, K, Anagnostopoulos, A, Battegay, M, Bernasconi, E, Braun, DL, Bucher, HC, Calmy, A, Cavassini, M, Ciuffi, A, Dollenmaier, G, Egger, M, Elzi, L, Fehr, J, Fellay, J, Furrer, H, Fux, CA, Günthard, HF, Hachfeld, A, Haerry, D, Hasse, B, Hirsch, HH, Hoffmann, M, Hösli, I, Huber, M, Jackson-Perry, D, Kahlert, CR, Kaiser, L, Keiser, O, Klimkait, T, Kouyos, RD, Kovari, H, Kusejko, K, Labhardt, N, Leuzinger, K, Martinez de Tejada, B, Marzolini, C, Metzner, KJ, Müller, N, Nemeth, J, Nicca, D, Notter, J, Paioni, P, Pantaleo, G, Perreau, M, Rauch, A, Salazar-Vizcaya, L, Schmid, P, Speck, R, Stöckle, M, Tarr, P, Trkola, A, Wandeler, G, Weisser, M, Yerly, S, Thoueille, Paul, Saldanha, Susana Alves, Schaller, Fabian, Choong, Eva, Munting, Aline, Cavassini, Matthias, Braun, Dominique, Günthard, Huldrych F., Kusejko, Katharina, Surial, Bernard, Furrer, Hansjakob, Rauch, Andri, Rougemont, Mathieu, Ustero, Pilar, Calmy, Alexandra, Stöckle, Marcel, Marzolini, Catia, Di Benedetto, Caroline, Bernasconi, Enos, Schmid, Patrick, Piso, Rein Jan, Andre, Pascal, Girardin, François R., Guidi, Monia, Buclin, Thierry, and Decosterd, Laurent A.

Published
2024
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2. Viral suppression and retention in HIV care during the postpartum period among women living with HIV: a longitudinal multicenter cohort study

Author

Abela, I., Aebi-Popp, K., Anagnostopoulos, A., Battegay, M., Baumann, M., Bernasconi, E., Braun, D.L., Bucher, H.C., Calmy, A., Cavassini, M., Ciuffi, A., Crisinel, P.A., Darling, K., Duppenthaler, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Francini, K., Furrer, H., Fux, C.A., Günthard, H.F., Hachfeld, A., Haerry, D., Hasse, B., Hirsch, H.H., Hoffmann, M., Hösli, I., Huber, M., Jackson-Perry, D., Kahlert, C.R., Kaiser, L., Kapfhammer, E., Keiser, O., Klimkait, T., Kohns, M., Kottanattu, L., Kouyos, R.D., Kovari, H., Kusejko, K., Labhardt, N., Martinez de Tejada, B., Marzolini, C., Metzner, K.J., Müller, N., Nemeth, J., Nicca, D., Notter, J., Paioni, P., Pantaleo, G., Perreau, M., Polli, Ch, Rauch, A., Salazar-Vizcaya, L., Schmid, P., Speck, R., Stöckle, M., Tarr, P., Thanh Lecompte, M., Trkola, A., Wagner, N., Wandeler, G., Weisser, M., Yerly, S., Paioni, Paolo, Aebi-Popp, Karoline, Martinez de Tejada, Begoña, Rudin, Christoph, Bernasconi, Enos, Braun, Dominique L., Kouyos, Roger, Wagner, Noémie, Crisinel, Pierre Alex, Güsewell, Sabine, Darling, Katharine E.A., Duppenthaler, Andrea, Baumann, Marc, Polli, Christian, Fischer, Tina, and Kahlert, Christian R.

Published
2023
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3. Revealing viral and cellular dynamics of HIV-1 at the single-cell level during early treatment periods

Author

Abela, I., Aebi-Popp, K., Anagnostopoulos, A., Battegay, M., Bernasconi, E., Braun, D.L., Bucher, H.C., Calmy, A., Cavassini, M., Ciuffi, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Fux, C.A., Günthard, H.F., Hachfeld, A., Haerry, D., Hasse, B., Hirsch, H.H., Hoffmann, M., Hösli, I., Huber, M., Jackson-Perry, D., Kahlert, C.R., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R.D., Kovari, H., Kusejko, K., Labhardt, N., Leuzinger, K., Martinez de Tejada, B., Marzolini, C., Metzner, K.J., Müller, N., Nemeth, J., Nicca, D., Notter, J., Paioni, P., Pantaleo, G., Perreau, M., Rauch, A., Salazar-Vizcaya, L., Schmid, P., Speck, R., Stöckle, M., Tarr, P., Trkola, A., Wandeler, G., Weisser, M., Yerly, S., Otte, Fabian, Zhang, Yuepeng, Spagnuolo, Julian, Thielen, Alexander, Däumer, Martin, Wiethe, Carsten, Stoeckle, Marcel, Kusejko, Katharina, Klein, Florian, Metzner, Karin J., and Klimkait, Thomas

Published
2023
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4. External validation of the PAGE-B score for HCC risk prediction in people living with HIV/HBV coinfection

Author

Abela, I., Aebi-Popp, K., Anagnostopoulos, A., Battegay, M., Bernasconi, E., Braun, D.L., Bucher, H.C., Calmy, A., Cavassini, M., Ciuffi, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Fux, C.A., Günthard, H.F., Hachfeld, A., Haerry, D., Hasse, B., Hirsch, H.H., Hoffmann, M., Hösli, I., Huber, M., Jackson-Perry, D., Kahlert, C.R., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R.D., Kovari, H., Kusejko, K., Labhardt, N., Leuzinger, K., de Tejada B, Martinez, Marzolini, C., Metzner, K.J., Müller, N., Nemeth, J., Nicca, D., Notter, J., Paioni, P., Pantaleo, G., Perreau, M., Rauch, A., Salazar-Vizcaya, L., Schmid, P., Speck, R., Stöckle, M., Tarr, P., Trkola, A., Wandeler, G., Weisser, M., Yerly, S., van der Valk, M., Geerlings, S.E., Goorhuis, A., Harris, V.C., Hovius, J.W., Lempkes, B., Nellen, F.J.B., van der Poll, T., Prins, J.M., Spoorenberg, V., van Vugt, M., Wiersinga, W.J., Wit, F.W.M.N., Bruins, C., van Eden, J., Hylkema-van den Bout, I.J., van Hes, A.M.H., Pijnappel, F.J.J., Smalhout, S.Y., Weijsenfeld, A.M., Back, N.K.T., Berkhout, B., Cornelissen, M.T.E., van Houdt, R., Jonges, M., Jurriaans, S., Schinkel, C.J., Wolthers, K.C., Zaaijer, H.L., Peters, E.J.G., van Agtmael, M.A., Autar, R.S., Bomers, M., Sigaloff, K.C.E., Heitmuller, M., Laan, L.M., van den Berge, M., Stegeman, A., Baas, S., Hage de Looff, L., van Arkel, A., Stohr, J., Wintermans, B., Pronk, M.J.H., Ammerlaan, H.S.M., de Munnik, E.S., Deiman, B., Jansz, A.R., Scharnhorst, V., Tjhie, J., Wegdam, M.C.A., van Eeden, A., Hoornenborg, E., Nellen, J., Alers, W., Elsenburg, L.J.M., Nobel, H., van Kasteren, M.E.E., Berrevoets, M.A.H., Brouwer, A.E., de Kruijf-van de Wiel, B.A.F.M., Adams, A., Rijkevoorsel, M. Pawels-van, Buiting, A.G.M., Murck, J.L., Rokx, C., Anas, A.A., Bax, H.I., van Gorp, E.C.M., de Mendonça Melo, M., van Nood, E., Nouwen, J.L., Rijnders, B.J.A., Schurink, C.A.M., Slobbe, L., de Vries-Sluijs, T.E.M.S., Bassant, N., van Beek, J.E.A., Vriesde, M., van Zonneveld, L.M., de Groot, J., van Kampen, J.J.A., Koopmans, M.P.G., Rahamat-Langendoen, J.C., Branger, J., Douma, R.A., Cents-Bosma, A.S., Duijf-van de Ven, C.J.H.M., Schippers, E.F., van Nieuwkoop, C., Geilings, J., van Winden, S., van der Hut, G., van Burgel, N.D., Leyten, E.M.S., Gelinck, L.B.S., Mollema, F., Wildenbeest, G.S., Nguyen, T., Groeneveld, P.H.P., Bouwhuis, J.W., Lammers, A.J.J., van Hulzen, A.G.W., Kraan, S., Kruiper, M.S.M., van der Bliek, G.L., Bor, P.C.J., Debast, S.B., Wagenvoort, G.H.J., Roukens, A.H.E., de Boer, M.G.J., Jolink, H., Lambregts, M.M.C., Scheper, H., Dorama, W., van Holten, N., Claas, E.C.J., Wessels, E., Hollander, J.G. den, El Moussaoui, R., Pogany, K., Brouwer, C.J., Heida-Peters, D., Mulder, E., Smit, J.V., Struik-Kalkman, D., van Niekerk, T., Pontesilli, O., van Tienen, C., Lowe, S.H., Lashof, A.M.L. Oude, Posthouwer, D., van Wolfswinkel, M.E., Ackens, R.P., Burgers, K., Elasri, M., Schippers, J., Havenith, T.R.A., van Loo, M., van Vonderen, M.G.A., Kampschreur, L.M., van Broekhuizen, M.C., S, Faber, Al Moujahid, A., Kootstra, G.J., Delsing, C.E., van der Burg-van de Plas, M., Scheiberlich, L., Kortmann, W., van Twillert, G., Renckens, R., Wagenaar, J., Ruiter-Pronk, D., van Truijen-Oud, F.A., Stuart, J.W.T. Cohen, Hoogewerf, M., Rozemeijer, W., Sinnige, J.C., Brinkman, K., van den Berk, G.E.L., Lettinga, K.D., de Regt, M., Schouten, W.E.M., Stalenhoef, J.E., Veenstra, J., Vrouenraets, S.M.E., Blaauw, H., Geerders, G.F., Kleene, M.J., Knapen, M., Kok, M., van der Meché, I.B., Toonen, A.J.M., Wijnands, S., Wttewaal, E., Kwa, D., van de Laar, T.J.W., van Crevel, R., van Aerde, K., Dofferhoff, A.S.M., Henriet, S.S.V., Hofstede, H.J.M. ter, Hoogerwerf, J., Richel, O., Albers, M., Grintjes-Huisman, K.J.T., de Haan, M., Marneef, M., McCall, M., Burger, D., Gisolf, E.H., Claassen, M., Hassing, R.J., Beest, G. ter, van Bentum, P.H.M., Gelling, M., Neijland, Y., Swanink, C.M.A., Velderman, M. Klein, van Lelyveld, S.F.L., Soetekouw, R., van der Prijt, L.M.M., van der Swaluw, J., Kalpoe, J.S., Wagemakers, A., Vahidnia, A., Lauw, F.N., Verhagen, D.W.M., van Wijk, M., Bierman, W.F.W., Bakker, M., van Bentum, R.A., van den Boomgaard, M.A., Kleinnijenhuis, J., Kloeze, E., Middel, A., Postma, D.F., Schenk, H.M., Stienstra, Y., Wouthuyzen-Bakker, M., Boonstra, A., de Jonge, H., Maerman, M.M.M., de Weerd, D.A., van Eije, K.J., Knoester, M., van Leer-Buter, C.C., Niesters, H.G.M., T.Mudrikova, Barth, R.E., Bruns, A.H.W., Ellerbroek, P.M., Hensgens, M.P.M., Oosterheert, J.J., Schadd, E.M., Verbon, A., van Welzen, B.J., Berends, H., Santen, B.M.G. Griffioen-van, de Kroon, I., Lunel, F.M. Verduyn, Wensing, A.M.J., Zaheri, S., Boyd, A.C., Bezemer, D.O., van Sighem, A.I., Smit, C., Hillebregt, M.M.J., Woudstra, T.J., Rutkens, T., Bergsma, D., Brétin, N.M., Lelivelt, K.J., van de Sande, L., van der Vliet, K.M. Visser.S.T., Paling, F., de Groot-Berndsen, L.G.M., van den Akker, M., Alexander, R., Bakker, Y., El Berkaoui, A., Bezemer-Goedhart, M., Djoechro, E.A., Groters, M., Koster, L.E., Lodewijk, C.R.E., Lucas, E.G.A., Munjishvili, L., Peeck, B.M., Ree, C.M.J., Regtop, R., van Rijk, A.F., Ruijs-Tiggelman, Y.M.C., Schnörr, P.P., Schoorl, M.J.C., Tuijn, E.M., Veenenberg, D.P., Witte, E.C.M., Karpov, I., Losso, M., Lundgren, J., Rockstroh, J., Aho, I., Rasmussen, L.D., Novak, P., Pradier, C., Chkhartishvili, N., Matulionyte, R., Oprea, C., Kowalska, J.D., Begovac, J., Miró, J.M., Guaraldi, G., Paredes, R., Peters, L., Larsen, J.F., Neesgaard, B., Jaschinski, N., Fursa, O., Raben, D., Kristensen, D., Fischer, A.H., Jensen, S.K., Elsing, T.W., Gardizi, M., Mocroft, A., Phillips, A., Reekie, J., Cozzi-Lepri, A., Pelchen-Matthews, A., Roen, A., Tusch, E.S., Bannister, W., Bellecave, P., Blanco, P., Bonnet, F., Bouchet, S., Breilh, D., Cazanave, C., Desjardin, S., Gaborieau, V., Gimbert, A., Hessamfar, M., Lacaze-Buzy, L., Lacoste, D., Lafon, M.E., Lazaro, E., Leleux, O., Le Marec, F., Le Moal, G., Malvy, D., Marchand, L., Mercié, P., Neau, D., Pellegrin, I., Perrier, A., Petrov-Sanchez, V., Vareil, M.O., Wittkop, L., Bernard, N., Chaussade, D. Bronnimann H., Dondia, D., Duffau, P., Faure, I., Morlat, P., Mériglier, E., Paccalin, F., Riebero, E., Rivoisy, C., Vandenhende, M.A., Barthod, L., Dauchy, F.A., Desclaux, A., Ducours, M., Dutronc, H., Duvignaud, A., Leitao, J., Lescure, M., Nguyen, D., Pistone, T., Puges, M., Wirth, G., Courtault, C., Camou, F., Greib, C., Pellegrin, J.L., Rivière, E., Viallard, J.F., Imbert, Y., Thierry-Mieg, M., Rispal, P., Caubet, O., Ferrand, H., Tchamgoué, S., Farbos, S., Wille, H., Andre, K., Caunegre, L., Gerard, Y., Osorio-Perez, F., Chossat, I., Iles, G., Labasse-Depis, M., Lacassin, F., Barret, A., Castan, B., Koffi, J., Rouanes, N., Saunier, A., Zabbe, J.B., Dumondin, G., Beraud, G., Catroux, M., Garcia, M., Giraud, V., Martellosio, J.P., Roblot, F., Pasdeloup, T., Riché, A., Grosset, M., Males, S., Bell, C. Ngo, Carpentier, C., Bellecave, Virology P., Tumiotto, C., Miremeont-Salamé, G., Arma, D., Arnou, G., Blaizeau, M.J., Camps, P., Decoin, M., Delveaux, S., Diarra, F., Gabrea, L., Lawson-Ayayi, S., Lenaud, E., Plainchamps, D., Pougetoux, A., Uwamaliya, B., Zara, K., Conte, V., Gapillout, M., Surial, Bernard, Ramírez Mena, Adrià, Roumet, Marie, Limacher, Andreas, Smit, Colette, Leleux, Olivier, Mocroft, Amanda, van der Valk, Marc, Bonnet, Fabrice, Peters, Lars, Rockstroh, Jürgen K., Günthard, Huldrych F., Berzigotti, Annalisa, Rauch, Andri, and Wandeler, Gilles

Published
2023
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5. Viral suppression and retention in HIV care during the postpartum period among women living with HIV: a longitudinal multicenter cohort study

Author

Paioni, Paolo, primary, Aebi-Popp, Karoline, additional, Martinez de Tejada, Begoña, additional, Rudin, Christoph, additional, Bernasconi, Enos, additional, Braun, Dominique L., additional, Kouyos, Roger, additional, Wagner, Noémie, additional, Crisinel, Pierre Alex, additional, Güsewell, Sabine, additional, Darling, Katharine E.A., additional, Duppenthaler, Andrea, additional, Baumann, Marc, additional, Polli, Christian, additional, Fischer, Tina, additional, Kahlert, Christian R., additional, Abela, I., additional, Aebi-Popp, K., additional, Anagnostopoulos, A., additional, Battegay, M., additional, Baumann, M., additional, Bernasconi, E., additional, Braun, D.L., additional, Bucher, H.C., additional, Calmy, A., additional, Cavassini, M., additional, Ciuffi, A., additional, Crisinel, P.A., additional, Darling, K., additional, Duppenthaler, A., additional, Dollenmaier, G., additional, Egger, M., additional, Elzi, L., additional, Fehr, J., additional, Fellay, J., additional, Francini, K., additional, Furrer, H., additional, Fux, C.A., additional, Günthard, H.F., additional, Hachfeld, A., additional, Haerry, D., additional, Hasse, B., additional, Hirsch, H.H., additional, Hoffmann, M., additional, Hösli, I., additional, Huber, M., additional, Jackson-Perry, D., additional, Kahlert, C.R., additional, Kaiser, L., additional, Kapfhammer, E., additional, Keiser, O., additional, Klimkait, T., additional, Kohns, M., additional, Kottanattu, L., additional, Kouyos, R.D., additional, Kovari, H., additional, Kusejko, K., additional, Labhardt, N., additional, Martinez de Tejada, B., additional, Marzolini, C., additional, Metzner, K.J., additional, Müller, N., additional, Nemeth, J., additional, Nicca, D., additional, Notter, J., additional, Paioni, P., additional, Pantaleo, G., additional, Perreau, M., additional, Polli, Ch, additional, Rauch, A., additional, Salazar-Vizcaya, L., additional, Schmid, P., additional, Speck, R., additional, Stöckle, M., additional, Tarr, P., additional, Thanh Lecompte, M., additional, Trkola, A., additional, Wagner, N., additional, Wandeler, G., additional, Weisser, M., additional, and Yerly, S., additional

Published
2023
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7. Revealing viral and cellular dynamics of HIV-1 at the single-cell level during early treatment periods

Author

Otte, Fabian, primary, Zhang, Yuepeng, additional, Spagnuolo, Julian, additional, Thielen, Alexander, additional, Däumer, Martin, additional, Wiethe, Carsten, additional, Stoeckle, Marcel, additional, Kusejko, Katharina, additional, Klein, Florian, additional, Metzner, Karin J., additional, Klimkait, Thomas, additional, Abela, I., additional, Aebi-Popp, K., additional, Anagnostopoulos, A., additional, Battegay, M., additional, Bernasconi, E., additional, Braun, D.L., additional, Bucher, H.C., additional, Calmy, A., additional, Cavassini, M., additional, Ciuffi, A., additional, Dollenmaier, G., additional, Egger, M., additional, Elzi, L., additional, Fehr, J., additional, Fellay, J., additional, Furrer, H., additional, Fux, C.A., additional, Günthard, H.F., additional, Hachfeld, A., additional, Haerry, D., additional, Hasse, B., additional, Hirsch, H.H., additional, Hoffmann, M., additional, Hösli, I., additional, Huber, M., additional, Jackson-Perry, D., additional, Kahlert, C.R., additional, Kaiser, L., additional, Keiser, O., additional, Klimkait, T., additional, Kouyos, R.D., additional, Kovari, H., additional, Kusejko, K., additional, Labhardt, N., additional, Leuzinger, K., additional, Martinez de Tejada, B., additional, Marzolini, C., additional, Metzner, K.J., additional, Müller, N., additional, Nemeth, J., additional, Nicca, D., additional, Notter, J., additional, Paioni, P., additional, Pantaleo, G., additional, Perreau, M., additional, Rauch, A., additional, Salazar-Vizcaya, L., additional, Schmid, P., additional, Speck, R., additional, Stöckle, M., additional, Tarr, P., additional, Trkola, A., additional, Wandeler, G., additional, Weisser, M., additional, and Yerly, S., additional

Published
2023
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8. Effectiveness of a peer educator-coordinated preference-based differentiated service delivery model on viral suppression among young people living with HIV in Lesotho: the PEBRA cluster-randomized trial

Author

Kopo, M., Lejone, T. I., Tschumi, N., Glass, T. R., Kao, M., Brown, J. A., Seiler, O., Muhairwe, J., Moletsane, N., Labhardt, N. D., and Amstutz, A.

Abstract

BACKGROUND: Southern and Eastern Africa is home to more than 2.1 million young people aged 15 to 24 years living with HIV. As compared with other age groups, this population group has poorer outcomes along the HIV care cascade. Young people living with HIV and the research team co-created the PEBRA (Peer Educator-Based Refill of ART) care model. In PEBRA, a peer educator (PE) delivered services as per regularly assessed patient preferences for medication pick-up, short message service (SMS) notifications, and psychosocial support. The cluster-randomized trial compared PEBRA model versus standard clinic care (no PE and ART refill done by nurses) in 3 districts in Lesotho. METHODS AND FINDINGS: Individuals taking antiretroviral therapy (ART) aged 15 to 24 years at 20 clinics (clusters) were eligible. In the 10 clinics randomized to the intervention arm, participants were offered the PEBRA model, coordinated by a trained PE and supported by an eHealth application (PEBRApp). In the 10 control clusters, participants received standard nurse-coordinated care without any service coordination by a PE. The primary endpoint was 12-month viral suppression below 20 copies/mL. Analyses were intention-to-treat and adjusted for sex. From November 6, 2019 to February 4, 2020, we enrolled 307 individuals (150 intervention, 157 control; 218 [71%] female, median age 19 years [interquartile range, IQR, 17 to 22]). At 12 months, 99 of 150 (66%) participants in the intervention versus 95 of 157 (61%) participants in the control arm had viral suppression (adjusted odds ratio (OR) 1.27; 95% confidence interval [CI] [0.79 to 2.03]; p = 0.327); 4 of 150 (2.7%) versus 1 of 157 (0.6%) had died (adjusted OR 4.12; 95% CI [0.45 to 37.62]; p = 0.210); and 12 of 150 (8%) versus 23 of 157 (14.7%) had transferred out (adjusted OR 0.53; 95% CI [0.25 to 1.13]; p = 0.099). There were no significant differences between arms in other secondary outcomes. Twenty participants (11 in intervention and 9 in control) were lost to follow-up over the entire study period. The main limitation was that the data collectors in the control clusters were also young peers; however, they used a restricted version of the PEBRApp to collect data and thus were not able to provide the PEBRA model. The trial was prospectively registered on ClinicalTrials.gov (NCT03969030). CONCLUSIONS: Preference-based peer-coordinated care for young people living with HIV, compared to nurse-based care only, did not lead to conclusive evidence for an effect on viral suppression. TRIAL REGISTRATION: clinicaltrials.gov, NCT03969030, https://clinicaltrials.gov/ct2/show/NCT03969030.

Published
2023

9. Prevalence of HIV-1 drug resistance among patients with high viral loads while on second-line antiretroviral treatment in Butha-Buthe and Mokhotlong, Lesotho.

Author

Cheleboi, M., Brown, J., Olivier, D., Klimkait, T., and Labhardt, N. D.

Subjects
ANTIRETROVIRAL agents, HIV, DRUG resistance in microorganisms, BLOOD plasma, HOSPITAL laboratories, REVERSE transcriptase, DISEASES, DEATH rate
Abstract

Background: Access to antiretroviral therapy (ART) for the human immunodeficiency virus type 1 (HIV-1) has lowered morbidity and mortality in people living with HIV. Unfortunately, over time, some experience the development of viral drug resistance (DR) under therapy. Little is known about the percentages of people experiencing DR, and about the genetic patterns of DR among patients failing second-line ART in Lesotho. This study aimed to assess the prevalence of HIV-1 resistance-associated mutations (RAMs) in the viral target genes of the respective drugs in individuals with unsuppressed viral loads while taking second-line ART. Methods: In a retrospective cross-sectional study, we sequenced all available plasma samples from individuals with a viral load measurement = 1 000 copies/mL while taking second-line ART between January 2016 and October 2020. Sequencing was performed using the commercial SeqStudio™ Genetic Analyser at the Seboche Mission Hospital Laboratory. Results: Out of 55 samples meeting the eligibility criteria, 30 samples were successfully amplified and sequenced. The median age of patients was 41 years (interquartile range [IQR] 30-49), and the majority (62%) of participants were female. The median duration on a second-line ART regimen at the time of phlebotomy was 1.9 years (IQR 0.5-3.0). Most participants were taking ritonavirboosted lopinavir-based ART as their second-line therapy. Major RAMs describing those mutations in targeted gene therapy reverse transcriptase (RT) and/or protease (PR) that led to virological treatment failure, were observed in 62% of participants; one patient had major RAMs in the PR region, while 18 had RAMs in the RT region. Conclusion: In our study, we found that 31% of the included individuals (10/30) had RAMs conferring resistance to their second-line regimen during the first two years after switching to second-line ART. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Offering ART refill through community health workers versus clinic-based follow-up after home-based same-day ART initiation in rural Lesotho: the VIBRA cluster-randomized clinical trial

Author

Amstutz, A., Lejone, T. I., Khesa, L., Kopo, M., Kao, M., Muhairwe, J., Bresser, M., Räber, F., Klimkait, T., Battegay, M., Glass, T. R., and Labhardt, N. D.

Subjects
RNA viruses, Male, Health Care Providers, Nurses, Social Sciences, Pathology and Laboratory Medicine, Geographical Locations, Immunodeficiency Viruses, Sociology, Antiretroviral Therapy, Highly Active, Medicine and Health Sciences, Cluster Analysis, Public and Occupational Health, Medical Personnel, Virus Testing, Community Health Workers, Viral Load, Middle Aged, Vaccination and Immunization, Lesotho, Professions, Medical Microbiology, Viral Pathogens, Viruses, Social Systems, Medicine, Female, Pathogens, Research Article, Adult, Endpoint Determination, Immunology, Antiretroviral Therapy, Microbiology, Antiviral Therapy, Diagnostic Medicine, Virology, Retroviruses, Humans, Microbial Pathogens, Lentivirus, Organisms, Biology and Life Sciences, HIV, Health Care, Health Care Facilities, People and Places, Africa, Population Groupings, Preventive Medicine, Viral Transmission and Infection, Follow-Up Studies
Abstract

Background Community-based antiretroviral therapy (ART) dispensing by lay workers is an important differentiated service delivery model in sub-Sahara Africa. However, patients new in care are generally excluded from such models. Home-based same-day ART initiation is becoming widespread practice, but linkage to the clinic is challenging. The pragmatic VIBRA (Village-Based Refill of ART) trial compared ART refill by existing lay village health workers (VHWs) versus clinic-based refill after home-based same-day ART initiation. Methods and findings The VIBRA trial is a cluster-randomized open-label clinical superiority trial conducted in 249 rural villages in the catchment areas of 20 health facilities in 2 districts (Butha-Buthe and Mokhotlong) in Lesotho. In villages (clusters) randomized to the intervention arm, individuals found to be HIV-positive during a door-to-door HIV testing campaign were offered same-day ART initiation with the option of refill by VHWs. The trained VHWs dispensed drugs and scheduled clinic visits for viral load measurement at 6 and 12 months. In villages randomized to the control arm, participants were offered same-day ART initiation with clinic-based ART refill. The primary outcome was 12-month viral suppression. Secondary endpoints included linkage and 12-month engagement in care. Analyses were intention-to-treat. The trial was registered on ClinicalTrials.gov (NCT03630549). From 16 August 2018 until 28 May 2019, 118 individuals from 108 households in 57 clusters in the intervention arm, and 139 individuals from 130 households in 60 clusters in the control arm, were enrolled (150 [58%] female; median age 36 years [interquartile range 30–48]; 200 [78%] newly diagnosed). In the intervention arm, 48/118 (41%) opted for VHW refill. At 12 months, 46/118 (39%) participants in the intervention arm and 64/139 (46%) in the control arm achieved viral suppression (adjusted risk difference −0.07 [95% CI −0.20 to 0.06]; p = 0.256). Arms were similar in linkage (adjusted risk difference 0.03 [−0.10 to 0.16]; p = 0.630), but engagement in care was non-significantly lower in the intervention arm (adjusted risk difference −0.12 [−0.23 to 0.003]; p = 0.058). Seven and 0 deaths occurred in the intervention and control arm, respectively. Of the intervention participants who did not opt for drug refill from the VHW at enrollment, 41/70 (59%) mentioned trust or conflict issues as the primary reason. Study limitations include a rather small sample size, 9% missing viral load measurements in the primary endpoint window, the low uptake of the VHW refill option in the intervention arm, and substantial migration among the study population. Conclusions The offer of village-based ART refill after same-day initiation led to similar outcomes as clinic-based refill. The intervention did not amplify the effect of home-based same-day ART initiation alone. The findings raise concerns about acceptance and safety of ART delivered by lay health workers after initiation in the community. Trial registration Registered with Clinicaltrials.gov (NCT03630549)., Alain Amstutz and co-workers compare village- and clinic-based antiretroviral refills for people with HIV infection in Lesotho., Author summary Why was this study done? Community-based antiretroviral therapy (ART) dispensing by community health workers (CHWs) is an important differentiated service delivery (DSD) model in sub-Saharan Africa. However, patients new in care are generally excluded from such DSD models for the first 6 to 12 months. Same-day ART initiation during home-based HIV testing campaigns yields improved linkage and engagement in care, but still a third of patients do not link to care within 12 months. To date, to our knowledge, involving existing nearby CHWs in drug refills directly after home-based same-day ART start, versus clinic-based refill, has not been evaluated yet. What did the researchers do and find? Our open-label, pragmatic cluster-randomized trial in rural Lesotho evaluated ART delivery by an existing lay CHW cadre following home-based same-day ART initiation. In intervention clusters, persons found living with HIV during a door-to-door testing campaign could opt for drug refill by the CHW, with a first routine clinic visit at 6 months. At 12 months, 39% and 46% participants in the intervention and control arm, respectively, achieved viral suppression, with no significant difference between arms. We found that arms were similar in linkage to care. Engagement in care was non-significantly lower in the intervention arm. Seven and 0 deaths occurred in the intervention and control arms, respectively. Of the intervention participants who did not opt for drug refill from the VHW at enrollment, we found that 59% mentioned trust or conflict issues as the primary reason. What do these findings mean? The offer of village-based ART refill led to similar outcomes as clinic-based refill and did not amplify the effect of home-based same-day ART initiation alone. The findings raise concerns about the acceptance and safety of ART delivered by lay health workers after ART initiation in the community.

Published
2021
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12. Post-exposure lopinavir-ritonavir prophylaxis versus surveillance for individuals exposed to SARS-CoV-2: the COPEP pragmatic open-label, cluster randomized trial

Author

Labhardt, N. D., Smit, M., Petignat, I., Perneger, T., Marinosci, A., Ustero, P., Diniz Ribeiro, M. P., Ragozzino, S., Nicoletti, G. J., Faré, P. B., Andrey, D. O., Jacquerioz, F., Lebowitz, D., Agoritsas, T., Meyer, B., Spechbach, H., Salamun, J., Guessous, I., Chappuis, F., Kaiser, L., Decosterd, L. A., Grinsztejn, B., Bernasconi, E., Cardoso, S. W., Calmy, A., and Team, Ftcs

Subjects
Article
Abstract

Background Since the beginning of the COVID-19 pandemic, no direct antiviral treatment is effective as post-exposure prophylaxis (PEP). Lopinavir/ritonavir (LPV/r) was repurposed as a potential PEP agent against COVID-19. Methods We conducted a pragmatic open-label, parallel, cluster-randomised superiority trial in four sites in Switzerland and Brazil between March 2020 to March 2021. Clusters were randomised to receive LPV/r PEP (400/100 mg) twice daily for 5 days or no PEP (surveillance). Exposure to SARS-CoV-2 was defined as a close contact of >15 minutes in

Published
2021

17. Adoption of new HIV treatment guidelines and drug substitutions within first-line as a measure of quality of care in rural Lesotho: health centers and hospitals compared

Author

Labhardt, N. D., Sello, M., Lejone, T., Ehmer, J., Mokhantso, M., Lynen, L., and Pfeiffer, K.

Subjects
HAART, Quality of care, HIV, Antiretrovirals, Viral diseases, Hospitals, Africa, Southern, AIDS, Lesotho, Stavudine, First-line drugs, Acceptability, Health centers, Lamivudine, Treatment guidelines, Drug policy, National policies, Tenofovir, Substitution, Zidovudine, Compliance
Abstract

Objective: In 2007, Lesotho launched new national antiretroviral treatment (ART) guidelines, prioritising tenofovir and zidovudine over stavudine as a backbone together with lamivudine. We compared the rate of adoption of these new guidelines and substitution of first-line drugs by health centers (HC) and hospitals in two catchment areas in rural Lesotho. Methods: Retrospective cohort analysis. Patients aged >/=16 years were stratified into a HC- and a hospital-group. Main outcome variables: Type of backbone at ART-initiation (i), substitutions within first line (ii) and type of backbone among patients retained by December 2010 (iii). A multiple logistic regression model including HC vs. hospital, patient characteristics (sex, age, WHO-stage, baseline CD4-count, concurrent pregnancy, concurrent tuberculosis treatment) and year of ART-start, was used. Results: Of 3936 adult patients initiated on ART between 2007 and 2010, 1971 started at hospitals and 1965 at HCs. Hospitals were more likely to follow the new guidelines as measured by prescription of backbones without stavudine (Odds-ratio 1.55; 95%CI: 1.32-1.81) and had a higher rate of drug substitutions while on first-line ART (2.39; 1.83-3.13). By December 2010, patients followed at health centres were more likely to still receive stavudine (2.28; 1.83-2.84). Conclusions: Health centers took longer to adopt the new guidelines and substituted drugs less frequently. Decentralised ART-programmes need close support, supervision and mentoring to absorb new guidelines and to adhere to them.

Published
2012

19. Task shifting to non-physician clinicians for integrated management of hypertension and diabetes in rural Cameroon: a programme assessment at two years

Author

Grimm Jean-Jacques, Ndam Mama, Balo Jean-Richard, Labhardt Niklaus D, and Manga Engelbert

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background The burden of non-communicable chronic diseases, such as hypertension and diabetes, increases in sub-Saharan Africa. However, the majority of the rural population does still not have access to adequate care. The objective of this study is to examine the effectiveness of integrating care for hypertension and type 2 diabetes by task shifting to non-physician clinician (NPC) facilities in eight rural health districts in Cameroon. Methods Of the 75 NPC facilities in the area, 69 (87%) received basic equipment and training in hypertension and diabetes care. Effectiveness was assessed after two years on status of equipment, knowledge among trained NPCs, number of newly detected patients, retention of patients under care, treatment cost to patients and changes in blood pressure (BP) and fasting plasma glucose (FPG) among treated patients. Results Two years into the programme, of 54 facilities (78%) available for re-assessment, all possessed a functional sphygmomanometer and stethoscope (65% at baseline); 96% stocked antihypertensive drugs (27% at baseline); 70% possessed a functional glucose meter and 72% stocked oral anti-diabetics (15% and 12% at baseline). NPCs' performance on multiple-choice questions of the knowledge-test was significantly improved. During a period of two years, trained NPCs initiated treatment for 796 patients with hypertension and/or diabetes. The retention of treated patients at one year was 18.1%. Hypertensive and diabetic patients paid a median monthly amount of 1.4 and 0.7 Euro respectively for their medication. Among hypertensive patients with ≥ 2 documented visits (n = 493), systolic BP decreased by 22.8 mmHg (95% CI: -20.6 to -24.9; p < 0.0001) and diastolic BP by 12.4 mmHg (-10.9 to -13.9; p < 0.0001). Among diabetic patients (n = 79) FPG decreased by 3.4 mmol/l (-2.3 to -4.5; p < 0.001). Conclusions The integration of hypertension and diabetes into primary health care of NPC facilities in rural Cameroon was feasible in terms of equipment and training, accessible in terms of treatment cost and showed promising BP- and FPG-trends. However, low case-detection rates per NPC and a very high attrition among patients enrolled into care, limited the effectiveness of the programme.

Published
2010
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20. Same-day versus rapid ART initiation in HIV-positive individuals presenting with symptoms of tuberculosis: Protocol for an open-label randomized non-inferiority trial in Lesotho and Malawi.

Author

Gerber F, Semphere R, Lukau B, Mahlatsi P, Mtenga T, Lee T, Kohler M, Glass TR, Amstutz A, Molatelle M, MacPherson P, Marake NB, Nliwasa M, Ayakaka I, Burke R, and Labhardt N

Subjects
Humans, Lesotho, Malawi, Anti-HIV Agents therapeutic use, HIV Infections complications, HIV Infections drug therapy, HIV Infections diagnosis, Tuberculosis drug therapy
Abstract

Background: In absence of contraindications, same-day initiation (SDI) of antiretroviral therapy (ART) is recommended for people testing HIV-positive who are ready to start treatment. Until 2021, World Health Organization (WHO) guidelines considered the presence of TB symptoms (presumptive TB) a contraindication to SDI due to the risk of TB-immune reconstitution inflammatory syndrome (TB-IRIS). To reduce TB-IRIS risk, ART initiation was recommended to be postponed until results of TB investigations were available, and TB treatment initiated if active TB was confirmed. In 2021, the WHO guidelines changed to recommending SDI even in the presence of TB symptoms without awaiting results of TB investigations based on the assumption that TB investigations often unnecessarily delay ART initiation, increasing the risk for pre-ART attrition from care, and noting that the clinical relevance of TB-IRIS outside the central nervous system remains unclear. However, this guideline change was not based on conclusive evidence, and it remains unclear whether SDI of ART or TB test results should be prioritized in people with HIV (PWH) and presumptive TB., Design and Methods: SaDAPT is an open-label, pragmatic, parallel, 1:1 individually randomized, non-inferiority trial comparing two strategies for the timing of ART initiation in PWH with presumptive TB ("ART first" versus "TB results first"). PWH in Lesotho and Malawi, aged 12 years and older (re)initiating ART who have at least one TB symptom (cough, fever, night sweats or weight loss) and no signs of intracranial infection are eligible. After a baseline assessment, participants in the "ART first" arm will be offered SDI of ART, while those in the "TB results first" arm will be offered ART only after active TB has been confirmed or refuted. We hypothesize that the "ART first" approach is safe and non-inferior to the "TB results first" approach with regard to HIV viral suppression (<400 copies/ml) six months after enrolment. Secondary outcomes include retention in care and adverse events consistent with TB-IRIS., Expected Outcomes: SaDAPT will provide evidence on the safety and effects of SDI of ART in PWH with presumptive TB in a pragmatic clinical trial setting., Trial Registration: The trial has been registered on clinicaltrials.gov (NCT05452616; July 11 2022)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gerber et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2024
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21. Severe acute respiratory syndrome coronavirus 2, primary varicella zoster virus coinfection, and a polymicrobial ventilator-associated tracheobronchitis in an adult immunocompetent male: a case report.

Author

Bruno J, Ragozzino S, Quitt J, Siegemund M, and Labhardt N

Subjects
Adult, Herpesvirus 3, Human, Humans, Male, Middle Aged, SARS-CoV-2, Ventilators, Mechanical, COVID-19, Coinfection, Herpes Zoster
Abstract

Background: The spectrum of clinical manifestations and differential diagnosis associated with coronavirus disease 2019 is broad, ranging from fever and cutaneous eruptions to respiratory distress or even neurological disorders. Coexisting multipathogen infections significantly increase the complexity of the proper diagnostic and therapeutic approach and correlate with the rate of intensive care unit admissions and in-hospital mortality., Case Presentation: We present a case of multipathogen respiratory infection with severe acute respiratory syndrome coronavirus 2, varicella zoster virus, and polymicrobial tracheobronchitis in a 48-year-old Caucasian male hospitalized after traumatic brain injury. The patient tested positive for severe acute respiratory syndrome coronavirus 2 infection upon admission. During his stay in the intensive care unit, the patient developed a vesicular exanthema along with respiratory failure and signs of septic shock., Conclusion: This case of an adult presenting with severe acute respiratory syndrome coronavirus 2 infection and simultaneous primary varicella zoster virus infection illustrates the importance of considering coinfections in patients with coronavirus disease 2019 with unusual clinical manifestations., (© 2022. The Author(s).)

Published
2022
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22. Changing Trends in International Versus Domestic HCV Transmission in HIV-Positive Men Who Have Sex With Men: A Perspective for the Direct-Acting Antiviral Scale-Up Era.

Author

Salazar-Vizcaya L, Kouyos RD, Metzner KJ, Caraballo Cortes K, Böni J, Shah C, Fehr J, Braun DL, Bernasconi E, Mbunkah HA, Hoffmann M, Labhardt N, Cavassini M, Rougemont M, Günthard HF, Keiser O, and Rauch A

Subjects
Adult, Antiviral Agents therapeutic use, Coinfection drug therapy, Epidemics, HIV Seropositivity drug therapy, HIV Seropositivity virology, Hepacivirus drug effects, Hepatitis C drug therapy, Hepatitis C virology, Homosexuality, Male, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk Factors, Coinfection transmission, Coinfection virology, HIV Infections virology, Hepacivirus pathogenicity, Hepatitis C epidemiology, Hepatitis C transmission
Abstract

Background: Scale-up of direct-acting antiviral therapy is expected to abate hepatitis C virus (HCV) incidence among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). International transmission could influence this process. We classified HCV infections in HIV-positive MSM as either domestically or internationally acquired, and estimated how this classification changed over time., Methods: HCV subtype 1a (the most frequent subtype among MSM) genomes from 99 persons enrolled in the Swiss HIV Cohort Study and diagnosed with replicating HCV infections, were sequenced. Sixty-six of these sequences were from MSM. We inferred maximum-likelihood phylogenetic trees and time trees containing a fragment of the NS5B region of these and 374 circulating strains. We inferred transmission clusters from these trees and used the country composition of such clusters to attribute infections to domestic or international transmission., Results: Of HCV transmissions, 50% to 80% were classified as domestic depending on the classification criterion. Between 2000 and 2007, the fraction attributable to domestic transmission was 54% (range 0-75%). It increased to 85% (range 67%-100%) between 2008 and 2016., Conclusions: International and domestic transmission have played major roles in this epidemic. While international transmission persists, local transmission has established as the main source of infections., (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.)

Published
2019
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23. Staphylococcus aureus Endocarditis as a Complication of Toxocariasis-Associated Endomyocarditis With Fibrosis: A Case Report.

Author

Kuenzli E, Labhardt N, Balestra G, Weisser M, Zellweger MJ, and Blum J

Abstract

Complications associated with Toxocara canis infection are rare. We present a case of a patient with Staphylococcus aureus endocarditis as a complication of an endomyocardial fibrosis caused by T canis . The epidemiological, pathological, and clinical features of this rare complication are described here.

Published
2016
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