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

Author

Bernard Surial, Adrià Ramírez Mena, Marie Roumet, Andreas Limacher, Colette Smit, Olivier Leleux, Amanda Mocroft, Marc van der Valk, Fabrice Bonnet, Lars Peters, Jürgen K. Rockstroh, Huldrych F. Günthard, Annalisa Berzigotti, Andri Rauch, Gilles Wandeler, I. Abela, K. Aebi-Popp, A. Anagnostopoulos, M. Battegay, E. Bernasconi, D.L. Braun, H.C. Bucher, A. Calmy, M. Cavassini, A. Ciuffi, G. Dollenmaier, M. Egger, L. Elzi, J. Fehr, J. Fellay, H. Furrer, C.A. Fux, H.F. Günthard, A. Hachfeld, D. Haerry, B. Hasse, H.H. Hirsch, M. Hoffmann, I. Hösli, M. Huber, D. Jackson-Perry, C.R. Kahlert, L. Kaiser, O. Keiser, T. Klimkait, R.D. Kouyos, H. Kovari, K. Kusejko, N. Labhardt, K. Leuzinger, Martinez de Tejada B, C. Marzolini, K.J. Metzner, N. Müller, J. Nemeth, D. Nicca, J. Notter, P. Paioni, G. Pantaleo, M. Perreau, A. Rauch, L. Salazar-Vizcaya, P. Schmid, R. Speck, M. Stöckle, P. Tarr, A. Trkola, G. Wandeler, M. Weisser, S. Yerly, M. van der Valk, S.E. Geerlings, A. Goorhuis, V.C. Harris, J.W. Hovius, B. Lempkes, F.J.B. Nellen, T. van der Poll, J.M. Prins, V. Spoorenberg, M. van Vugt, W.J. Wiersinga, F.W.M.N. Wit, C. Bruins, J. van Eden, I.J. Hylkema-van den Bout, A.M.H. van Hes, F.J.J. Pijnappel, S.Y. Smalhout, A.M. Weijsenfeld, N.K.T. Back, B. Berkhout, M.T.E. Cornelissen, R. van Houdt, M. Jonges, S. Jurriaans, C.J. Schinkel, K.C. Wolthers, H.L. Zaaijer, E.J.G. Peters, M.A. van Agtmael, R.S. Autar, M. Bomers, K.C.E. Sigaloff, M. Heitmuller, L.M. Laan, M. van den Berge, A. Stegeman, S. Baas, L. Hage de Looff, A. van Arkel, J. Stohr, B. Wintermans, M.J.H. Pronk, H.S.M. Ammerlaan, E.S. de Munnik, B. Deiman, A.R. Jansz, V. Scharnhorst, J. Tjhie, M.C.A. Wegdam, A. van Eeden, E. Hoornenborg, J. Nellen, W. Alers, L.J.M. Elsenburg, H. Nobel, M.E.E. van Kasteren, M.A.H. Berrevoets, A.E. Brouwer, B.A.F.M. de Kruijf-van de Wiel, A. Adams, M. Pawels-van Rijkevoorsel, A.G.M. Buiting, J.L. Murck, C. Rokx, A.A. Anas, H.I. Bax, E.C.M. van Gorp, M. de Mendonça Melo, E. van Nood, J.L. Nouwen, B.J.A. Rijnders, C.A.M. Schurink, L. Slobbe, T.E.M.S. de Vries-Sluijs, N. Bassant, J.E.A. van Beek, M. Vriesde, L.M. van Zonneveld, J. de Groot, J.J.A. van Kampen, M.P.G. Koopmans, J.C. Rahamat-Langendoen, J. Branger, R.A. Douma, A.S. Cents-Bosma, C.J.H.M. Duijf-van de Ven, E.F. Schippers, C. van Nieuwkoop, J. Geilings, S. van Winden, G. van der Hut, N.D. van Burgel, E.M.S. Leyten, L.B.S. Gelinck, F. Mollema, G.S. Wildenbeest, T. Nguyen, P.H.P. Groeneveld, J.W. Bouwhuis, A.J.J. Lammers, A.G.W. van Hulzen, S. Kraan, M.S.M. Kruiper, G.L. van der Bliek, P.C.J. Bor, S.B. Debast, G.H.J. Wagenvoort, A.H.E. Roukens, M.G.J. de Boer, H. Jolink, M.M.C. Lambregts, H. Scheper, W. Dorama, N. van Holten, E.C.J. Claas, E. Wessels, J.G. den Hollander, R. El Moussaoui, K. Pogany, C.J. Brouwer, D. Heida-Peters, E. Mulder, J.V. Smit, D. Struik-Kalkman, T. van Niekerk, O. Pontesilli, C. van Tienen, S.H. Lowe, A.M.L. Oude Lashof, D. Posthouwer, M.E. van Wolfswinkel, R.P. Ackens, K. Burgers, M. Elasri, J. Schippers, T.R.A. Havenith, M. van Loo, M.G.A. van Vonderen, L.M. Kampschreur, M.C. van Broekhuizen, null S, null Faber, A. Al Moujahid, G.J. Kootstra, C.E. Delsing, M. van der Burg-van de Plas, L. Scheiberlich, W. Kortmann, G. van Twillert, R. Renckens, J. Wagenaar, D. Ruiter-Pronk, F.A. van Truijen-Oud, J.W.T. Cohen Stuart, M. Hoogewerf, W. Rozemeijer, J.C. Sinnige, K. Brinkman, G.E.L. van den Berk, K.D. Lettinga, M. de Regt, W.E.M. Schouten, J.E. Stalenhoef, J. Veenstra, S.M.E. Vrouenraets, H. Blaauw, G.F. Geerders, M.J. Kleene, M. Knapen, M. Kok, I.B. van der Meché, A.J.M. Toonen, S. Wijnands, E. Wttewaal, D. Kwa, T.J.W. van de Laar, R. van Crevel, K. van Aerde, A.S.M. Dofferhoff, S.S.V. Henriet, H.J.M. ter Hofstede, J. Hoogerwerf, O. Richel, M. Albers, K.J.T. Grintjes-Huisman, M. de Haan, M. Marneef, M. McCall, D. Burger, E.H. Gisolf, M. Claassen, R.J. Hassing, G. ter Beest, P.H.M. van Bentum, M. Gelling, Y. Neijland, C.M.A. Swanink, M. Klein Velderman, S.F.L. van Lelyveld, R. Soetekouw, L.M.M. van der Prijt, J. van der Swaluw, J.S. Kalpoe, A. Wagemakers, A. Vahidnia, F.N. Lauw, D.W.M. Verhagen, M. van Wijk, W.F.W. Bierman, M. Bakker, R.A. van Bentum, M.A. van den Boomgaard, J. Kleinnijenhuis, E. Kloeze, A. Middel, D.F. Postma, H.M. Schenk, Y. Stienstra, M. Wouthuyzen-Bakker, A. Boonstra, H. de Jonge, M.M.M. Maerman, D.A. de Weerd, K.J. van Eije, M. Knoester, C.C. van Leer-Buter, H.G.M. Niesters, null T.Mudrikova, R.E. Barth, A.H.W. Bruns, P.M. Ellerbroek, M.P.M. Hensgens, J.J. Oosterheert, E.M. Schadd, A. Verbon, B.J. van Welzen, H. Berends, B.M.G. Griffioen-van Santen, I. de Kroon, F.M. Verduyn Lunel, A.M.J. Wensing, S. Zaheri, A.C. Boyd, D.O. Bezemer, A.I. van Sighem, C. Smit, M.M.J. Hillebregt, T.J. Woudstra, T. Rutkens, D. Bergsma, N.M. Brétin, K.J. Lelivelt, L. van de Sande, K.M. Visser.S.T. van der Vliet, F. Paling, L.G.M. de Groot-Berndsen, M. van den Akker, R. Alexander, Y. Bakker, A. El Berkaoui, M. Bezemer-Goedhart, E.A. Djoechro, M. Groters, L.E. Koster, C.R.E. Lodewijk, E.G.A. Lucas, L. Munjishvili, B.M. Peeck, C.M.J. Ree, R. Regtop, A.F. van Rijk, Y.M.C. Ruijs-Tiggelman, P.P. Schnörr, M.J.C. Schoorl, E.M. Tuijn, D.P. Veenenberg, E.C.M. Witte, I. Karpov, M. Losso, J. Lundgren, J. Rockstroh, I. Aho, L.D. Rasmussen, P. Novak, C. Pradier, N. Chkhartishvili, R. Matulionyte, C. Oprea, J.D. Kowalska, J. Begovac, J.M. Miró, G. Guaraldi, R. Paredes, L. Peters, J.F. Larsen, B. Neesgaard, N. Jaschinski, O. Fursa, D. Raben, D. Kristensen, A.H. Fischer, S.K. Jensen, T.W. Elsing, M. Gardizi, A. Mocroft, A. Phillips, J. Reekie, A. Cozzi-Lepri, A. Pelchen-Matthews, A. Roen, E.S. Tusch, W. Bannister, P. Bellecave, P. Blanco, F. Bonnet, S. Bouchet, D. Breilh, C. Cazanave, S. Desjardin, V. Gaborieau, A. Gimbert, M. Hessamfar, L. Lacaze-Buzy, D. Lacoste, M.E. Lafon, E. Lazaro, O. Leleux, F. Le Marec, G. Le Moal, D. Malvy, L. Marchand, P. Mercié, D. Neau, I. Pellegrin, A. Perrier, V. Petrov-Sanchez, M.O. Vareil, L. Wittkop, N. Bernard, D. Bronnimann H. Chaussade, D. Dondia, P. Duffau, I. Faure, P. Morlat, E. Mériglier, F. Paccalin, E. Riebero, C. Rivoisy, M.A. Vandenhende, L. Barthod, F.A. Dauchy, A. Desclaux, M. Ducours, H. Dutronc, A. Duvignaud, J. Leitao, M. Lescure, D. Nguyen, T. Pistone, M. Puges, G. Wirth, C. Courtault, F. Camou, C. Greib, J.L. Pellegrin, E. Rivière, J.F. Viallard, Y. Imbert, M. Thierry-Mieg, P. Rispal, O. Caubet, H. Ferrand, S. Tchamgoué, S. Farbos, H. Wille, K. Andre, L. Caunegre, Y. Gerard, F. Osorio-Perez, I. Chossat, G. Iles, M. Labasse-Depis, F. Lacassin, A. Barret, B. Castan, J. Koffi, N. Rouanes, A. Saunier, J.B. Zabbe, G. Dumondin, G. Beraud, M. Catroux, M. Garcia, V. Giraud, J.P. Martellosio, F. Roblot, T. Pasdeloup, A. Riché, M. Grosset, S. Males, C. Ngo Bell, C. Carpentier, Virology P. Bellecave, C. Tumiotto, G. Miremeont-Salamé, D. Arma, G. Arnou, M.J. Blaizeau, P. Camps, M. Decoin, S. Delveaux, F. Diarra, L. Gabrea, S. Lawson-Ayayi, E. Lenaud, D. Plainchamps, A. Pougetoux, B. Uwamaliya, K. Zara, V. Conte, M. Gapillout, Internal medicine, VU University medical center, Medical Microbiology and Infection Prevention, AII - Infectious diseases, CCA - Cancer biology and immunology, AII - Inflammatory diseases, AMS - Rehabilitation & Development, APH - Quality of Care, Pulmonary medicine, ACS - Pulmonary hypertension & thrombosis, Ethics, Law & Medical humanities, APH - Methodology, Midwifery Science, Amsterdam Reproduction & Development (AR&D), Infectious diseases, APH - Digital Health, APH - Personalized Medicine, APH - Aging & Later Life, APH - Global Health, Global Health, APH - Health Behaviors & Chronic Diseases, Center of Experimental and Molecular Medicine, General Internal Medicine, AII - Cancer immunology, Landsteiner Laboratory, Cardiology, ACS - Heart failure & arrhythmias, Obstetrics and Gynaecology, ARD - Amsterdam Reproduction and Development, Microbes in Health and Disease (MHD), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Global Health in the Global South (GHiGS), Institut de Recherche pour le Développement (IRD)- Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Hepatitis B virus, model validation, Hepatology, liver neoplasms, risk prediction models, liver cirrhosis, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], risk assessment, 610 Medicine & health, hepatocellular carcinoma, HIV infection, tenofovir, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 610 Medizin und Gesundheit
Abstract

Background & Aims: HBV coinfection is common among people living with HIV (PLWH) and is the most important cause of hepatocellular carcinoma (HCC). While risk prediction tools for HCC have been validated in patients with HBV monoinfection, they have not been evaluated in PLWH. Thus, we performed an external validation of PAGE-B in people with HIV/HBV coinfection.Methods: We included data on PLWH from four European cohorts who were positive for HBsAg and did not have HCC before starting tenofovir. We estimated the predictive performance of PAGE-B for HCC occurrence over 15 years in patients receiving tenofovir-containing antiretroviral therapy. Model discrimination was assessed after multiple imputation using Cox regression with the prognostic index as a covariate, and by calculating Harrell's c-index. Calibration was assessed by comparing our cumulative incidence with the PAGE-B derivation study using Kaplan-Meier curves.Results: In total, 2,963 individuals with HIV/HBV coinfection on tenofovir-containing antiretroviral therapy were included. PAGE-B was Conclusions: For individuals with HIV/HBV coinfection, PAGE-B is a valid tool to determine the need for HCC screening. Impact and implications: Chronic HBV infection is the most important cause of hepatocellular carcinoma (HCC) among people living with HIV. Valid risk prediction may enable better targeting of HCC screening efforts to high-risk individuals. We aimed to validate PAGE-B, a risk prediction tool that is based on age, sex, and platelets, in 2,963 individuals with HIV/HBV coinfection who received tenofovir-containing antiretroviral therapy. In the present study, PAGE-B showed good discrimination, adequate calibration, and a cut-off of

Published
2023
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2. Incidence of a first venous thrombotic event in people with HIV in the Netherlands

Author

M. van der Valk, M.E.E. van Kasteren, Frank P. Kroon, Casper Rokx, M. Hillebregt, M.E. van der Ende, Selwyn H. Lowe, Emile F. Schippers, Jaime F Borjas Howard, S. Zaheri, J. W. Mulder, J. G. Den Hollander, Peter Reiss, Elise D. Pieterman, E. H. Gisolf, Bart J. A. Rijnders, Eliane M. S. Leyten, Colette Smit, Karina Meijer, Ferdinand W. N. M. Wit, Wouter F W Bierman, Kees Brinkman, Y. I. G. Vladimir Tichelaar, Global Health, Infectious diseases, APH - Aging & Later Life, AII - Infectious diseases, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Internal Medicine, and Medical Microbiology & Infectious Diseases

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Epidemiology, Immunology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Virology, Internal medicine, medicine, Humans, 030212 general & internal medicine, Netherlands, Retrospective Studies, Venous Thrombosis, Proportional hazards model, business.industry, Incidence, Incidence (epidemiology), Hazard ratio, Retrospective cohort study, Middle Aged, Viral Load, 030112 virology, CD4 Lymphocyte Count, Infectious Diseases, Cohort, Female, Risk assessment, business, Viral load
Abstract

BACKGROUND: The risk of venous thrombotic events is elevated in people with HIV, but overall risk estimates and estimates specific to immune status and antiretroviral medication remain i mprecise. In this study, we aimed to estimate these parameters in a large cohort of people with HIV in the Netherlands.METHODS: In this retrospective cohort study, we used the Dutch ATHENA cohort to estimate crude, age and sex standardised, and risk period-specific incidences of a first venous thrombotic event in people with HIV aged 18 years or older attending 12 HIV treatment centres in the Netherlands. Crude and standardised incidences were compared with European population-level studies of venous thrombotic events. We used time-updated Cox regression to estimate the risk of a first venous thrombotic event in association with HIV-specific factors (CD4 cell count, viral load, recent opportunistic infections, antiretroviral medication use) adjusted for traditional risk factors for venous thrombotic events.FINDINGS: With data collected from Jan 1, 2003, to April 1, 2015, our study cohort included 14 389 people with HIV and 99 762 person-years of follow-up, with a median follow-up of 7·2 years (IQR 3·3-11·1). During this period, 232 first venous thrombotic events occurred, yielding a crude incidence of 2·33 events per 1000 person-years (95% CI 2·04-2·64) and an incidence standardised for age and sex of 2·50 events per 1000 (2·18-2·82). CD4 counts less than 200 cells per μL were independently associated with higher risk of a venous thrombotic event: adjusted hazard ratio (aHR) 3·40 (95% CI 2·28-5·08) relative to counts of 500 cells per μL. A high viral load (aHR 3·15, 95% CI 2·00-5·02; >100 000 copies per mL vs INTERPRETATION: Our findings support neither prescribing primary outpatient thromboprophylaxis nor avoiding any type of antiretroviral medication in people with HIV at high risk of a venous thrombotic event.FUNDING: Dutch Ministry of Health, Welfare and Sport.

Published
2019
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3. HCV micro-elimination in individuals with HIV in the Netherlands 4 years after universal access to direct-acting antivirals

Author

Colette Smit, Anders Boyd, Bart J A Rijnders, Thijs J W van de Laar, Eliane M Leyten, Wouter F Bierman, Kees Brinkman, Mark A A Claassen, Jan den Hollander, Anne Boerekamps, Astrid M Newsum, Janke Schinkel, Maria Prins, Joop E Arends, Eline L M Op de Coul, Marc van der Valk, Peter Reiss, M. van der Valk, S.E. Geerlings, A. Goorhuis, J.W. Hovius, B. Lempkes, F.J.B. Nellen, T. van der Poll, J.M. Prins, M. van Vugt, W.J. Wiersinga, F.W.M.N. Wit, M. van Duinen, J. van Eden, A. Hazenberg, A.M.H. van Hes, F.J.J. Pijnappel, S.Y. Smalhout, A.M. Weijsenfeld, S. Jurriaans, N.K.T. Back, H.L. Zaaijer, B. Berkhout, M.T.E. Cornelissen, C.J. Schinkel, K.C. Wolthers, E.J.G. Peters, M.A. van Agtmael, R.S. Autar, M. Bomers, K.C.E. Sigaloff, M. Heitmuller, L.M. Laan, C.W. Ang, R. van Houdt, M. Jonges, M. van den Berge, A. Stegeman, S. Baas, L. Hage de Looff, A. Buiting, A. Reuwer, J. Veenemans, B. Wintermans, M.J.H. Pronk, H.S.M. Ammerlaan, D.N.J. van den Bersselaar, E.S. de Munnik, B. Deiman, A.R. Jansz, V. Scharnhorst, J. Tjhie, M.C.A. Wegdam, A. van Eeden, J. Nellen, W. Brokking, L.J.M. Elsenburg, H. Nobel, M.E.E. van Kasteren, M.A.H. Berrevoets, A.E. Brouwer, A. Adams, R. van Erve, B.A.F.M. de Kruijf-van de Wiel, S. Keelan-Phaf, B. van de Ven, A.G.M. Buiting, J.L. Murck, T.E.M.S. de Vries-Sluijs, H.I. Bax, E.C.M. van Gorp, N.C. de Jong-Peltenburg, M. de Mendonça Melo, E. van Nood, J.L. Nouwen, B.J.A. Rijnders, C. Rokx, C.A.M. Schurink, L. Slobbe, A. Verbon, N. Bassant, J.E.A. van Beek, M. Vriesde, L.M. van Zonneveld, J. de Groot, C.A.B. Boucher, M.P.G. Koopmans, J.J.A. van Kampen, J. Branger, R.A. Douma, A.S. Cents-Bosma, C.J.H.M. Duijf-van de Ven, E.F. Schippers, C. van Nieuwkoop, J.M. van IJperen, J. Geilings, N.D. van Burgel, E.M.S. Leyten, G. van der Hut, L.B.S. Gelinck, F. Mollema, S. Davids-Veldhuis, C. Tearno, G.S. Wildenbeest, E. Heikens, P.H.P. Groeneveld, J.W. Bouwhuis, A.J.J. Lammers, S. Kraan, A.G.W. van Hulzen, M.S.M. Kruiper, G.L. van der Bliek, P.C.J. Bor, S.B. Debast, G.H.J. Wagenvoort, F.P. Kroon, M.G.J. de Boer, H. Jolink, M.M.C. Lambregts, A.H.E. Roukens, H. Scheper, W. Dorama, N. van Holten, E.C.J. Claas, E. Wessels, J.G. den Hollander, C.J. Brouwer, J.V. Smit, D. Struik-Kalkman, T. van Niekerk, R. El Moussaoui, K. Pogany, O. Pontesilli, S.H. Lowe, A.M.L. Oude Lashof, D. Posthouwer, M.E. van Wolfswinkel, R.P. Ackens, K. Burgers, J. Schippers, B. Weijenberg-Maes, I.H.M. van Loo, T.R.A. Havenith, M.G.A. van Vonderen, L.M. Kampschreur, S. Faber, R. Steeman-Bouma, A. Al Moujahid, G.J. Kootstra, C.E. Delsing, M. van der Burg-van de Plas, L. Scheiberlich, W. Kortmann, G. van Twillert, R. Renckens, D. Ruiter-Pronk, F.A. van Truijen-Oud, J.W.T. Cohen Stuart, E.R. Jansen, M. Hoogewerf, W. Rozemeijer, W.A. van der Reijden, J.C. Sinnige, K. Brinkman, G.E.L. van den Berk, W.L. Blok, K.D. Lettinga, M. de Regt, W.E.M. Schouten, J.E. Stalenhoef, J. Veenstra, S.M.E. Vrouenraets, H. Blaauw, G.F. Geerders, M.J. Kleene, M. Kok, M. Knapen, I.B. van der Meché, E. Mulder-Seeleman, A.J.M. Toonen, S. Wijnands, E. Wttewaal, D. Kwa, R. van Crevel, A.S.M. Dofferhoff, H.J.M. ter Hofstede, J. Hoogerwerf, M. Keuter, O. Richel, M. Albers, K.J.T. Grintjes-Huisman, M. de Haan, M. Marneef, R. Strik-Albers, J. Rahamat-Langendoen, F.F. Stelma, D. Burger, E.H. Gisolf, R.J. Hassing, M. Claassen, G. ter Beest, P.H.M. van Bentum, N. Langebeek, R. Tiemessen, C.M.A. Swanink, S.F.L. van Lelyveld, R. Soetekouw, L.M.M. van der Prijt, J. van der Swaluw, N. Bermon, R. Jansen, B.L. Herpers, D. Veenendaal, D.W.M. Verhagen, F.N. Lauw, M.C. van Broekhuizen, M. van Wijk, W.F.W. Bierman, M. Bakker, J. Kleinnijenhuis, E. Kloeze, A. Middel, D.F. Postma, Y. Stienstra, M. Wouthuyzen-Bakker, A. Boonstra, H. de Groot-de Jonge, P.A. van der Meulen, D.A. de Weerd, H.G.M. Niesters, C.C. van Leer-Buter, M. Knoester, A.I.M. Hoepelman, J.E. Arends, R.E. Barth, A.H.W. Bruns, P.M. Ellerbroek, T. Mudrikova, J.J. Oosterheert, E.M. Schadd, B.J. van Welzen, K. Aarsman, B.M.G. Griffioen-van Santen, I. de Kroon, M. van Berkel, C.S.A.M. van Rooijen, R. Schuurman, F. Verduyn-Lunel, A.M.J. Wensing, P. Reiss, S. Zaheri, A.C. Boyd, D.O. Bezemer, A.I. van Sighem, C. Smit, M. Hillebregt, A. de Jong, T. Woudstra, D. Bergsma, R. Meijering, L. van de Sande, T. Rutkens, S. van der Vliet, L. de Groot, M. van den Akker, Y. Bakker, A. El Berkaoui, M. Bezemer, N. Brétin, E. Djoechro, M. Groters, E. Kruijne, K.J. Lelivelt, C. Lodewijk, E. Lucas, L. Munjishvili, F. Paling, B. Peeck, C. Ree, R. Regtop, Y. Ruijs, M. Schoorl, P. Schnörr, A. Scheigrond, E. Tuijn, L. Veenenberg, K.M. Visser, E.C. Witte, Infectious diseases, Medical Microbiology and Infection Prevention, AII - Infectious diseases, APH - Global Health, Global Health, APH - Aging & Later Life, APH - Quality of Care, Center of Experimental and Molecular Medicine, Landsteiner Laboratory, AII - Inflammatory diseases, Obstetrics and Gynaecology, ARD - Amsterdam Reproduction and Development, Gastroenterology and Hepatology, APH - Health Behaviors & Chronic Diseases, APH - Methodology, APH - Digital Health, APH - Personalized Medicine, Internal medicine, ACS - Diabetes & metabolism, General practice, Internal Medicine, and Medical Microbiology & Infectious Diseases

Subjects
0301 basic medicine, Adult, Male, Epidemiology, Immunology, HIV Infections, Hepacivirus, Antiviral Agents, Men who have sex with men, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Virology, Medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, Substance Abuse, Intravenous, Netherlands, Retrospective Studies, Proportional hazards model, business.industry, Coinfection, Incidence (epidemiology), Incidence, Retrospective cohort study, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, 030112 virology, Chronic infection, Infectious Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Cohort, HIV-1, Female, business, Demography
Abstract

Contains fulltext : 232443.pdf (Publisher’s version ) (Closed access) BACKGROUND: In the Netherlands, access to direct-acting antivirals (DAAs) against hepatitis C virus (HCV) has been unrestricted for chronic infection since 2015. We evaluated whether the nationwide incidence of HCV infections in individuals with HIV has changed since 2015. METHODS: In this retrospective cohort study, data from the ATHENA cohort of people with HIV aged 18 years or older attending any of the 24 HIV treatment centres in the Netherlands between 2000 and 2019 were assessed. We used parametric proportional hazards models with a piecewise exponential survival function to model HCV primary infection and reinfection incidence per 1000 person-years. FINDINGS: Of the 23 590 individuals without previous HCV infection, 1269 cases of HCV primary infection were documented (incidence 5·2 per 1000 person-years [95% CI 5·0-5·5]). The highest incidence was observed in men who have sex with men (MSM; 7·7 per 1000 person-years [7·3-8·2]) and was lower in people who inject drugs (PWID; 1·7 per 1000 person-years [0·7-4·1]) and other key populations (1·0 per 1000 person-years [0·8-1·2]). In MSM, incidence increased in 2007 to 14·3 per 1000 person-years and fluctuated between 8·7 and 13·0 per 1000 person-years from 2008 to 2015. In 2016, incidence declined to 6·1 cases per 1000 person-years and remained steady between 4·1 and 4·9 per 1000 person-years from 2017 to 2019. Of the 1866 individuals with a previous HCV infection, 274 reinfections were documented (incidence 26·9 per 1000 person-years [95% CI 23·9-30·3]). The highest incidence rate was observed in MSM (38·5 per 1000 person-years [33·9-43·7]) and was lower in PWID (10·9 per 1000 person-years [3·5-33·8]) and other key populations (8·9 per 1000 person-years [6·3-12·5]). In MSM, reinfection incidence fluctuated between 38·0 and 88·9 per 1000 person-years from 2006 to 2015, reaching 55·6 per 1000 person-years in 2015. In 2016, reinfection incidence declined to 41·4 per 1000 person-years, followed by further decreases to 24·4 per 1000 person-years in 2017 and 11·4 per 1000 person-years in 2019. INTERPRETATION: The sharp decline in HCV incidence in MSM with HIV shortly after restrictions on DAAs were lifted suggests a treatment-as-prevention effect. HCV incidence was already low in PWID and other groups before unrestricted access. Ongoing HCV transmission is occurring in MSM, as illustrated by a declining but high rate of reinfection, stressing the need for additional preventive measures. FUNDING: Dutch Ministry of Health, Welfare, and Sport.

Published
2021
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4. Temporary antiretroviral treatment during primary HIV-1 infection has a positive impact on health-related quality of life: data from the Primo-SHM cohort study

Author

Jan M. Prins, F. De Wolf, M.E.E. van Kasteren, GJ Kootstra, Marlous L. Grijsen, Pythia T. Nieuwkerk, Radjin Steingrover, Gaia T Koster, and Mga van Vonderen

Subjects
Cart, Pediatrics, medicine.medical_specialty, Abdominal pain, Nausea, business.industry, Health Policy, Checklist, law.invention, Infectious Diseases, Quality of life, Randomized controlled trial, law, medicine, Pharmacology (medical), medicine.symptom, business, Prospective cohort study, Cohort study
Abstract

Objectives The aim of the study was to compare health-related quality of life (HRQL) over 96 weeks in patients receiving no treatment or 24 or 60 weeks of combination antiretroviral therapy (cART) during primary HIV-1 infection (PHI). Methods A multicentre prospective cohort study of PHI patients, with an embedded randomized trial, was carried out. HRQL was assessed with the Medical Outcomes Study Health Survey for HIV (MOS-HIV) and a symptom checklist administered at weeks 0, 8, 24, 36, 48, 60, 72, 84 and 96. Mixed linear models were used for the analysis of differences in HRQL among the three groups. Results A total of 112 patients were included in the study: 28 received no treatment, 45 received 24 weeks of cART and 39 received 60 weeks of cART. Over 96 weeks of follow-up, the groups receiving 24 and 60 weeks of cART had better cognitive functioning than the no-treatment group (P = 0.005). Patients receiving 60 weeks of cART had less pain (P = 0.004), better role functioning (P = 0.001), better physical functioning (P = 0.02) and a better physical health summary score (P = 0.006) than the groups receiving no treatment or 24 weeks of cART. Mental health was better in patients receiving 24 weeks of cART than in patients in the no-treatment group or the group receiving 60 weeks of cART (P = 0.02). At week 8, patients in the groups receiving 24 and 60 weeks of cART reported more nausea (P = 0.002), diarrhoea (P

Published
2012
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5. Virological and Social Outcomes of HIV-Infected Adolescents and Young Adults in The Netherlands Before and After Transition to Adult Care

Author

P. L. A. Fraaij, F. W. N. M. Wit, Sophie Cohen, W. E. M. Schouten, W. Kortmann, Laura van Zonneveld, J. G. den Hollander, J. V. Smit, Marien H. J. Kuipers-Jansen, F. J. B. Nellen, Jan M Prins, M. P. W. Kastelijns, J. W. Bouwhuis, Kees Brinkman, H. de Jonge, Joke C. Patist, Eline G. Visser, K. Pogány, S. Cohen, N. Nauta, G. J. A. Driessen, Michelle Mutschelknauss, I. B. van der Meche, L. M. van Zonneveld, P. P. Koopmans, J. A. Schippers, Bert J. Zomer, Dasja Pajkrt, I. M. Hoepelman, S. H. Lowe, D. C. Pronk, Peter Reiss, Linda C. van der Knaap, H. J. Scherpbier, A. van der Plas, A. M. C. van Rossum, Charlotte Blokhuis, R. Strik Albers, Frank P. Kroon, Colette Smit, A. M. Weijsenfeld, M.E. van der Ende, Esther P. Smit, S. P. M. Geelen, P. A. van der Meulen, C. Richter, M. H. J. Kuipers-Jansen, Annouschka M. Weijsenfeld, A. E. Brouwer, B. J. Zomer, T. F. W. Wolfs, W. F. W. Bierman, Stefanie S. V. Henriet, G. ter Beest, Ferdinand W. N. M. Wit, J. F. van den Berg, C. Moons, C. Blokhuis, S. Faber, M. van Vonderen, M. Mutschelknauss, Nike Nauta, M. E. Vriesde, M. van der Flier, J. C. Patist, E. H. Gisolf, M.E.E. van Kasteren, Erasmus Smit, C. Smit, T. Mudrikova, L. van der Knaap, E. Oude Geerdink, E. H. Scholvink, N. Y. Bassant, D. Pajkrt, Other departments, Global Health, Infectious diseases, Paediatric Infectious Diseases / Rheumatology / Immunology, Med Microbiol, Infect Dis & Infect Prev, MUMC+: MA Alg Interne Geneeskunde (9), MUMC+: DA MMI Staf (9), and RS: FHML non-thematic output

Subjects
Microbiology (medical), young adults, Pediatrics, medicine.medical_specialty, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Virological outcomes, CHILDREN, Logistic regression, Adolescents, 03 medical and health sciences, 0302 clinical medicine, ADHERENCE, Health care, Journal Article, Medicine, 030212 general & internal medicine, adolescents, NETWORK, Young adult, Reference group, PERINATALLY ACQUIRED HIV, 030505 public health, business.industry, MEDICINE, Medical record, virological outcomes, HIV, transition, Odds ratio, SERVICES, Educational attainment, Confidence interval, Infectious Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], YOUTH, Transition, HUMAN-IMMUNODEFICIENCY-VIRUS, HEALTH-CARE, 0305 other medical science, business, POSITION PAPER, Young adults
Abstract

Item does not contain fulltext BACKGROUND: As a result of effective combination antiretroviral therapy (cART) and advanced supportive healthcare, a growing number of human immunodeficiency virus (HIV)-infected children survive into adulthood. The period of transition to adult care is often associated with impaired adherence to treatment and discontinuity of care. We aimed to evaluate virological and social outcomes of HIV-infected adolescents and young adults (AYAs) before and after transition, and explore which factors are associated with virological failure. METHODS: We included 59 HIV-infected AYAs from the Netherlands who had entered into pediatric care and transitioned from pediatric to adult healthcare. We used HIV RNA load and cART data from the Dutch Stichting HIV Monitoring database (1996-2014), and collected social and treatment data from patients' medical records from all Dutch pediatric HIV treatment centers and 14 Dutch adult treatment centers involved. We evaluated risk factors for virological failure (VF) in a logistic regression model adjusted for repeated measurements. RESULTS: HIV VF occurred frequently during the study period (14%-36%). During the transition period (from 18 to 19 years of age) there was a significant increase in VF compared with the reference group of children aged 12-13 years (odds ratio, 4.26 [95% confidence interval, 1.12-16.28]; P = .03). Characteristics significantly associated with VF were low educational attainment and lack of autonomy regarding medication adherence at transition. CONCLUSIONS: HIV-infected AYAs are vulnerable to VF, especially during the transition period. Identification of HIV-infected adolescents at high risk for VF might help to improve treatment success in this group.

Published
2016

6. Adherence to local hospital guidelines for surgical antimicrobial prophylaxis: a multicentre audit in Dutch hospitals

Author

J Mintjes-de Groot, M.E.E. van Kasteren, B.J. Kullberg, Inge C. Gyssens, A. S. de Boer, and Medical Microbiology & Infectious Diseases

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, MEDLINE, Audit, Surgical prophylaxis, Effective Primary Care and Public Health [EBP 3], medicine, Humans, Pharmacology (medical), Prospective Studies, Medical prescription, Intensive care medicine, Prospective cohort study, Aged, Netherlands, Antibacterial agent, Aged, 80 and over, Pharmacology, Medical Audit, business.industry, Guideline, Antibiotic Prophylaxis, Middle Aged, Antimicrobial, Hospitals, Infectious Diseases, Practice Guidelines as Topic, Female, Guideline Adherence, Microbial pathogenesis and host defense [UMCN 4.1], business, Surgery Department, Hospital
Abstract

Item does not contain fulltext OBJECTIVE: To study the adherence to local hospital guidelines for antimicrobial prophylaxis in surgery, and explore reasons for non-adherence. METHODS: A prospective, multicentre audit of elective procedures, without prior suspicion of infection, was carried out in 13 Dutch hospitals. By reviewing medical, anaesthetic and nursing records, and medication charts, the prescription of antibiotics was compared with the local hospital guideline on antibiotic choice, duration of prophylaxis, dose, dosing interval and timing of the first dose. RESULTS: Between January 2000 and January 2001, 1763 procedures were studied. Antibiotic choice, duration, dose, dosing interval and timing of the first dose were concordant with the hospital guideline in 92%, 82%, 89%, 43% and 50%, respectively. Overall adherence to all aspects of the guideline, however, was achieved in only 28%. The most important barriers to local guideline adherence were lack of awareness due to ineffective distribution of the most recent version of the guidelines, lack of agreement by surgeons with the local hospital guidelines, and environmental factors, such as organizational constraints in the surgical suite and in the ward. CONCLUSION: This study shows that, although adherence to separate aspects of local hospital guidelines for surgical prophylaxis in the Netherlands is favourable, overall adherence to all parameters is hard to achieve. Adherence to guidelines on dosing interval and timing needs improvement, in particular. To increase the quality of antimicrobial prophylaxis in surgery, effort should be put into developing guidelines acceptable to surgeons, in adequately distributing the guidelines and to facilitating logistics. Audits of surgical prophylaxis may help hospitals identify barriers to guideline adherence.

Published
2003

7. Chronic Q fever in the Netherlands 5 years after the start of the Q fever epidemic: results from the Dutch chronic Q fever database

Author

Jan Jelrik Oosterheert, Peter C. Wever, Rolf H.H. Groenwold, Marrigje H. Nabuurs-Franssen, Chantal P. Bleeker-Rovers, Andy I.M. Hoepelman, Corine E Delsing, M.E.E. van Kasteren, L. M. Kampschreur, Nicole H. M. Renders, M. G. L. de Jager-Leclercq, M. C. A. Wegdam-Blans, and J. Buijs

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Databases, Factual, Q fever, Disease Outbreaks, Cohort Studies, Internal medicine, Chronic Q fever, Prevalence, Medicine, Endocarditis, Humans, Epidemics, Aged, Netherlands, biology, business.industry, Mortality rate, Zoonosis, Outbreak, Bacteriology, Middle Aged, medicine.disease, Coxiella burnetii, biology.organism_classification, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Immunology, Chronic Disease, Female, business, Q Fever, Cohort study
Abstract

Coxiella burnetii causes Q fever, a zoonosis, which has acute and chronic manifestations. From 2007 to 2010, the Netherlands experienced a large Q fever outbreak, which has offered a unique opportunity to analyze chronic Q fever cases. In an observational cohort study, baseline characteristics and clinical characteristics, as well as mortality, of patients with proven, probable, or possible chronic Q fever in the Netherlands, were analyzed. In total, 284 chronic Q fever patients were identified, of which 151 (53.7%) had proven, 64 (22.5%) probable, and 69 (24.3%) possible chronic Q fever. Among proven and probable chronic Q fever patients, vascular infection focus (56.7%) was more prevalent than endocarditis (34.9%). An acute Q fever episode was recalled by 27.0% of the patients. The all-cause mortality rate was 19.1%, while the chronic Q fever-related mortality rate was 13.0%, with mortality rates of 9.3% among endocarditis patients and 18% among patients with a vascular focus of infection. Increasing age ( P = 0.004 and 0.010), proven chronic Q fever ( P = 0.020 and 0.002), vascular chronic Q fever ( P = 0.024 and 0.005), acute presentation with chronic Q fever ( P = 0.002 and P < 0.001), and surgical treatment of chronic Q fever ( P = 0.025 and P < 0.001) were significantly associated with all-cause mortality and chronic Q fever-related mortality, respectively.

Published
2014

8. A combination of interferon-gamma and interleukin-2 production by Coxiella burnetii-stimulated circulating cells discriminates between chronic Q fever and past Q fever

Author

M.E.E. van Kasteren, J.W.M. van der Meer, M. van Deuren, Marjolijn J. H. Pronk, Chantal P. Bleeker-Rovers, Teske Schoffelen, Leo A. B. Joosten, Yvonne E. P. Soethoudt, Anne Ammerdorffer, Tineke Herremans, M. C. A. Wegdam-Blans, Mihai G. Netea, Tom Sprong, and H.A. Bijlmer

Subjects
Interleukin 2, Adult, Male, Microbiology (medical), diagnosis, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Q fever, Biology, Sensitivity and Specificity, Interferon-gamma, Immune system, medicine, Endocarditis, Humans, Interferon gamma, Aged, Aged, 80 and over, Interleukin, General Medicine, Chronic Q fever, Middle Aged, Coxiella burnetii, biology.organism_classification, medicine.disease, cytokines, Chronic infection, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Infectious Diseases, Immunology, Chronic Disease, Leukocytes, Mononuclear, Interleukin-2, Female, Q Fever, medicine.drug
Abstract

Contains fulltext : 137608.pdf (Publisher’s version ) (Closed access) Infection with Coxiella burnetii may lead to life-threatening chronic Q fever endocarditis or vascular infections, which are often difficult to diagnose. The present study aims to investigate whether measurement of in-vitro interferon-gamma (IFN-gamma) production, a key cytokine in the immune response against C. burnetii, differentiates chronic from a past cleared infection, and whether measurement of other cytokines would improve the discriminative power. First, C. burnetii-specific IFN-gamma production was measured in whole blood of 28 definite chronic Q fever patients and compared with 135 individuals with past Q fever (seropositive controls) and 908 seronegative controls. IFN-gamma production was significantly higher in chronic Q fever patients than in controls, but with overlapping values between patients and seropositives. Secondly, the production of a series of other cytokines was measured in a subset of patients and controls, which showed that interleukin (IL)-2 production was significantly lower in patients than in seropositive controls. Subsequently, measuring IL-2 in all patients and all controls with substantial IFN-gamma production showed that an IFN-gamma/IL-2 ratio >11 had a sensitivity and specificity of 79% and 96%, respectively, to diagnose chronic Q fever. This indicates that a high IFN-gamma/IL-2 ratio is highly suggestive for chronic Q fever. In an additional group of 25 individuals with persistent high anti-Coxiella phase I IgG titres without definite chronic infection, all but six showed an IFN-gamma/IL-2 ratio

Published
2014

9. Fatal pulmonary infection caused by the Basidiomycete Hormographiella Aspergillata

Author

Jacques F. Meis, J.A.P. van de Nes, M.E.E. van Kasteren, B.E. de Pauw, Paul E. Verweij, and G.S. de Hoog

Subjects
Lung Diseases, Male, Quinolone, Immunologische ontstekingsprocessen in de nier, Antifungal Agents, Coprinus, Preventie en behandeling van infecties bij de neutropenische patient, Pathogenese, epidemiologie en behandeling van microbiële infecties, Aspergillosis, medicine.disease_cause, Kidney, Polymerase Chain Reaction, Anti-Infective Agents, Recurrence, Antibiotics, Inflammatory reactions in the kidneys, Prevention and treatment of infections in the neutropenic patient, Amphotericin B, Anti-Infective Agents, Quinolone, Yeasts, Lung, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Cross Infection, Gram-Negative Aerobic Bacteria, Infectious, Candidiasis, Brain, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Bacteria, Aerobic, Fungal, Cell Aging, Superinfection, Cytokines, Restriction fragment length polymorphism, Cell aging, Fungemia, Research Article, medicine.drug, Adult, Microbiology (medical), Infections in patients with decreased host defence, Itraconazole, Bronchi, Microbial Sensitivity Tests, Biology, Opportunistic Infections, Reiter's Disease, DNA, Ribosomal, Microbiology, Pathogenesis, epidemiology, and treatment of microbial infections, Gram-Negative Bacteria, medicine, Blood-Borne Pathogens, Humans, Meningitis, Mycosis, Arthritis, Infectious, Bacteria, Lung Diseases, Fungal, Arthritis, Infecties bij verminderde weerstand, Immunity, Aerobic, medicine.disease, biology.organism_classification, Meningitis, Fungal, RNA, Ribosomal, Molecular Probes, Gram-Negative Bacterial Infections
Abstract

A fatal case of a pulmonary infection caused by Hormographiella aspergillata, the anamorph of the mushroom Coprinus cinereus, is reported for a patient receiving treatment for a second relapse of acute lymphoblastic leukemia. The filamentous basidiomycete was identified with restriction fragment length polymorphism patterns of PCR-amplified internally transcribed spacers and small subunit ribosomal DNA with four restriction enzymes. The patient failed to respond to treatment with amphotericin B and itraconazole. The fungus was cultured from the lungs at autopsy: the MIC of amphotericin B for the fungus was low (0.5 mg/liter), and that of itraconazole was high (8 mg/liter).

Published
1997

10. Acute hepatitis C in the Netherlands: characteristics of the epidemic in 2014

Author

Joop E. Arends, Robin Soetekouw, Bart J. A. Rijnders, A.I. van Sighem, Kamilla D. Lettinga, Sebastiaan J. Hullegie, Mark A. A. Claassen, Clemens Richter, M.E.E. van Kasteren, Frank P. Kroon, Paul H. P. Groeneveld, F. N. Lauw, G.E.L. van den Berk, Edgar J G Peters, D. W. M. Verhagen, Peter P. Koopmans, Eliane M. S. Leyten, Wouter F W Bierman, J.T.M. van der Meer, Dirk Posthouwer, A. van Eeden, Internal Medicine, Internal medicine, AII - Inflammatory diseases, Surgery, Med Microbiol, Infect Dis & Infect Prev, MUMC+: DA MMI Staf (9), RS: FHML non-thematic output, Interne Geneeskunde, Amsterdam institute for Infection and Immunity, and Infectious diseases

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Hepatitis C virus, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, Epidemiology, Humans, Medicine, 030212 general & internal medicine, Men having sex with men, Homosexuality, Male, Epidemics, Netherlands, Coinfection, business.industry, Incidence, Incidence (epidemiology), virus diseases, General Medicine, Hepatitis C, Middle Aged, medicine.disease, Virology, digestive system diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Infectious Diseases, Population Surveillance, 030211 gastroenterology & hepatology, Acute hepatitis C, business
Abstract

Item does not contain fulltext Within the Dutch Acute HCV in HIV Study, a surveillance system was initiated to estimate the incidence of hepatitis C virus (HCV) infections in 2014. Following the Dutch HIV treatment guidelines, HIV-positive men having sex with men (MSM) in 19 participating centers were screened. Ninety-nine acute HCV infections were reported, which resulted in a mean incidence of 11 per 1000 patient-years of follow-up. Unfortunately, the HCV epidemic among Dutch HIV-positive MSM is not coming to a halt.

Published
2016
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11. A gait disorder with an unexpected twist

Author

Lucille D.A. Dorresteijn, P. Portegies, B.R. Bloem, and M.E.E. van Kasteren

Subjects
Gait Ataxia, Male, Myoclonus, medicine.medical_specialty, MEDLINE, HIV Infections, Diagnosis, Differential, Central nervous system disease, Hypotension, Orthostatic, Physical medicine and rehabilitation, Gait (human), Cognitive neurosciences [UMCN 3.2], Immunopathology, Effective Primary Care and Public Health [EBP 3], medicine, Humans, Twist, Sida, biology, business.industry, General Medicine, Middle Aged, medicine.disease, biology.organism_classification, Immunology, Viral disease, Microbial pathogenesis and host defense [UMCN 4.1], business
Abstract

Item does not contain fulltext

Published
2003

12. Guidelines for the prevention of antimicrobial resistance in hospitals

Author

M.E.E. van Kasteren, Stephanie Natsch, B.J. Kullberg, and J.W.M. van der Meer

Subjects
Microbiology (medical), Cross infection, medicine.medical_specialty, Pediatrics, Optimalisering van het antibioticagebruik in het ziekenhuis, business.industry, MEDLINE, Drug resistance, Towards optimal use of antibiotics in hospitals, Infectious Diseases, Antibiotic resistance, medicine, Intensive care medicine, business
Abstract

Item does not contain fulltext

Published
1998

13. Adherence to local hospital guidelines for surgical antimicrobial prophylaxis: a multicentre audit in Dutch hospitals.

Author

M.E.E. van Kasteren, B.J. Kullberg, A.S. de Boer, J. Mintjes-de Groot, and I.C. Gyssens

Subjects
BACTERIAL diseases, HOSPITALS, PATIENTS
Abstract

Objective: To study the adherence to local hospital guidelines for antimicrobial prophylaxis in surgery, and explore reasons for non-adherence. Methods: A prospective, multicentre audit of elective procedures, without prior suspicion of infection, was carried out in 13 Dutch hospitals. By reviewing medical, anaesthetic and nursing records, and medication charts, the prescription of antibiotics was compared with the local hospital guideline on antibiotic choice, duration of prophylaxis, dose, dosing interval and timing of the first dose. Results: Between January 2000 and January 2001, 1763 procedures were studied. Antibiotic choice, duration, dose, dosing interval and timing of the first dose were concordant with the hospital guideline in 92%, 82%, 89%, 43% and 50%, respectively. Overall adherence to all aspects of the guideline, however, was achieved in only 28%. The most important barriers to local guideline adherence were lack of awareness due to ineffective distribution of the most recent version of the guidelines, lack of agreement by surgeons with the local hospital guidelines, and environmental factors, such as organizational constraints in the surgical suite and in the ward. Conclusion: This study shows that, although adherence to separate aspects of local hospital guidelines for surgical prophylaxis in the Netherlands is favourable, overall adherence to all parameters is hard to achieve. Adherence to guidelines on dosing interval and timing needs improvement, in particular. To increase the quality of antimicrobial prophylaxis in surgery, effort should be put into developing guidelines acceptable to surgeons, in adequately distributing the guidelines and to facilitating logistics. Audits of surgical prophylaxis may help hospitals identify barriers to guideline adherence. [ABSTRACT FROM AUTHOR]

Published
2003
Full Text
View/download PDF

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