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5. Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

Author

Boettiger, D.C., Law, M.G., Ross, J., Huy, B.V., Heng, B.S.L., Ditangco, R., Kiertiburanakul, S., Avihingsanon, A., Cuong, D.D., Kumarasamy, N., Kamarulzaman, A., Ly, P.S., Yunihastuti, E., Parwati Merati, T., Zhang, F., Khusuwan, S., Chaiwarith, R., Lee, M.P., Sangle, S., Choi, J.Y., Ku, W.W., Tanuma, J., Ng, O.T., Sohn, A.H., Wester, C.W., Nash, D., Mugglin, C., and Pujari, S.

Published
2020
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6. HIV treatment outcomes among people who acquired HIV via injecting drug use in the Asia‐Pacific region: a longitudinal cohort study

Author

Han, Win Min, Jiamsakul, Awachana, Salleh, Nur Afiqah Mohd, Choi, Jun Yong, Huy, Bui Vu, Yunihastuti, Evy, Do, Cuong Duy, Merati, Tuti P., Gani, Yasmin M., Kiertiburanakul, Sasisopin, Zhang, Fujie, Chan, Yu?Jiun, Lee, Man?Po, Chaiwarith, Romanee, Ng, Oon Tek, Khusuwan, Suwimon, Ditangco, Rossana, Kumarasamy, Nagalingeswaran, Sangle, Shashikala, Ross, Jeremy, Avihingsanon, Anchalee, Ly, Ps, Khol, V, Zhang, Fj, Zhao, Hx, Han, N, Lee, Mp, Li, Pck, Lam, W, Chan, Yt, Kumarasamy, N, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Sangle, S, Mave, V, Marbaniang, I, Nimkar, S, Merati, Tp, Wirawan, Dn, Yuliana, F, Yunihastuti, E, Widhani, A, Maria, S, Karjadi, Th, Oka, S, Nishijima, T, Choi, Jy, Na, S, Kim, Jm, Gani, Ym, Rudi, Nb, Azwa, I, Kamarulzaman, A, Omar, Sf Syed, Ponnampalavanar, S, Ditangco, R, Pasayan, Mk, Mationg, Ml, Chan, Yj, Ku, Ww, Wu, Pc, Ke, E, Ng, Ot, Lim, Pl, Lee, Ls, Liang, D, Avihingsanon, A, Gatechompol, S, Phanuphak, P, Phadungphon, C, Kiertiburanakul, S, Phuphuakrat, A, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Praparattanapan, J, Nuket, K, Khusuwan, S, Kantipong, P, Kambua, P, Nguyen, Kv, Bui, Hv, Nguyen, Dth, Nguyen, Dt, Do, Cd, Ngo, Av, Nguyen, Lt, Sohn, Ah, Ross, Jl, Petersen, B, Law, Mg, Jiamsakul, A, Bijker, R, and Rupasinghe, D

Subjects
Antiviral agents -- Dosage and administration, Intravenous drug abuse -- Complications and side effects -- Care and treatment, HIV infection -- Causes of -- Care and treatment, Health
Abstract

: INTRODUCTION: Data on HIV treatment outcomes in people who inject drugs (PWID) in the Asia‐Pacific are sparse despite the high burden of drug use. We assessed immunological and virological responses, AIDS‐defining events and mortality among PWID receiving antiretroviral therapy (ART). METHODS: We investigated HIV treatment outcomes among people who acquired HIV via injecting drug use in the TREAT Asia HIV Observational Database (TAHOD) between January 2003 and March 2019. Trends in CD4 count and viral suppression (VS, HIV viral load RESULTS: Of 622 PWID from 12 countries in the Asia‐Pacific, 93% were male and the median age at ART initiation was 31 years (IQR, 28 to 34). The median pre‐ART CD4 count was 71 cells/µL. CD4 counts increased over time, with a mean difference of 401 (95% CI, 372 to 457) cells/µL at year‐10 (n = 78). Higher follow‐up HIV viral load and pre‐ART CD4 counts were associated with smaller increases in CD4 counts. Among 361 PWID with ≥1 viral load after six months on ART, proportions with VS were 82%, 88% and 93% at 2‐, 5‐ and 10‐years following ART initiation. There were 52 new AIDS‐defining events and 50 deaths during 3347 person‐years of follow‐up (PYS) (incidence 3.05/100 PYS, 95% CI, 2.51 to 3.70). Previous AIDS or TB diagnosis, lower current CD4 count and adherence CONCLUSIONS: Despite improved outcomes over time, our findings highlight the need for rapid ART initiation and adherence support among PWID within Asian settings., INTRODUCTION Globally, injecting drug use is a major public health concern leading to substantial health burden and transmission risk of blood‐borne infections from injecting equipment sharing behaviours. In a multi‐stage [...]

Published
2021
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8. Cotrimoxazole prophylaxis decreases tuberculosis risk among Asian patients with HIV

Author

Ku, Stephane Wen?Wei, Jiamsakul, Awachana, Joshi, Kedar, Pasayan, Mark Kristoffer Ungos, Widhani, Alvina, Chaiwarith, Romanee, Kiertiburanakul, Sasisopin, Avihingsanon, Anchalee, Ly, Penh Sun, Kumarasamy, Nagalingeswaran, Do, Cuong D., Merati, Tuti P., Van Nguyen, Kinh, Kamarulzaman, Adeeba, Zhang, Fujie, Lee, Man Po, Choi, Jun Yong, Tanuma, Junko, Khusuwan, Suwimon, Sim, Benedict Lim Heng, Ng, Oon Tek, Ratanasuwan, Winai, Ross, Jeremy, Wong, Wing?Wai, Ly, Ps, Khol, V, Zhang, Fj, Zhao, Hx, Han, N, Lee, Mp, Li, Pck, Lam, W, Chan, Yt, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Sangle, S, Mave, V, Marbaniang, I, Wirawan, Dn, Yuliana, F, Yunihastuti, E, Imran, D, Widhani, A, Tanuma, J, Oka, S, Nishijima, T, Choi, Jy, S, Na, Kim, Jm, Sim, Blh, Gani, Ym, Rudi, Nb, Kamarulzaman, A, Omar, Sf Syed, Ponnampalavanar, S, Azwa, I, Ditangco, R, Pasayan, Mk, Mationg, Ml, Wong, Ww, Ku, Sww, Wu, Pc, Ng, Ot, Lim, Pl, Lee, Ls, Ferdous, Z, Vihingsanon, A, Gatechompol, S, Phanuphak, P, Phadungphon, C, Kiertiburanakul, S, Phuphuakrat, A, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Khusuwan, S, Kantipong, P, Kambua, P, Ratanasuwan, W, Sriondee, R, Nguyen, Kv, Bui, Hv, Nguyen, Dth, Nguyen, Dt, Do, Cd, Ngo, Av, Nguyen, Lt, Sohn, Ah, Ross, Jl, Petersen, B, Cooper, Da, Law, Mg, Jiamsakul, A, and Rupasinghe, D

Subjects
Co-trimoxazole -- Statistics -- Complications and side effects, Tuberculosis -- Statistics -- Risk factors, HIV patients -- Statistics -- Drug therapy, Health
Abstract

: Introduction: Cotrimoxazole (CTX) is recommended as prophylaxis against Pneumocystis jiroveci pneumonia, malaria and other serious bacterial infections in HIV‐infected patients. Despite its in vitro activity against Mycobacterium tuberculosis, the effects of CTX preventive therapy on tuberculosis (TB) remain unclear. Methods: Adults living with HIV enrolled in a regional observational cohort in Asia who had initiated combination antiretroviral therapy (cART) were included in the analysis. Factors associated with new TB diagnoses after cohort entry and survival after cART initiation were analysed using Cox regression, stratified by site. Results: A total of 7355 patients from 12 countries enrolled into the cohort between 2003 and 2016 were included in the study. There were 368 reported cases of TB after cohort entry with an incidence rate of 0.99 per 100 person‐years (/100 pys). Multivariate analyses adjusted for viral load (VL), CD4 count, body mass index (BMI) and cART duration showed that CTX reduced the hazard for new TB infection by 28% (HR 0.72, 95% CI l 0.56, 0.93). Mortality after cART initiation was 0.85/100 pys, with a median follow‐up time of 4.63 years. Predictors of survival included age, female sex, hepatitis C co‐infection, TB diagnosis, HIV VL, CD4 count and BMI. Conclusions: CTX was associated with a reduction in the hazard for new TB infection but did not impact survival in our Asian cohort. The potential preventive effect of CTX against TB during periods of severe immunosuppression should be further explored., Introduction Cotrimoxazole (CTX) has been recommended as prophylaxis against Pneumocystis jiroveci pneumonia (PJP), toxoplasmosis, malaria and other serious bacterial infections in adults with severe or advanced HIV clinical disease, with [...]

Published
2019
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42. Comparative study of electrophysiological changes in snake bites

Author

Panduranga, Patwari, Sangle, S., Mane, Abhay, Doshi, Suyog, and Kadam, D.

Subjects
Bites (Injuries) -- Care and treatment, Electrophysiology -- Analysis, Facial nerve -- Care and treatment, Health
Abstract

Byline: Patwari. Panduranga, S. Sangle, Abhay. Mane, Suyog. Doshi, D. Kadam Aims: To study and compare the electrophysiological changes in neuroparalytic or vasculotoxic snakebites. Materials and Methods: 40 patients who [...]

Published
2015

43. Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia‐Pacific

Author

Rupasinghe, D, primary, Kiertiburanakul, S, additional, Kamarulzaman, A, additional, Zhang, F, additional, Kumarasamy, N, additional, Chaiwarith, R, additional, Merati, TP, additional, Do, CD, additional, Khusuwan, S, additional, Avihingsanon, A, additional, Lee, MP, additional, Ly, PS, additional, Yunihastuti, E, additional, Nguyen, KV, additional, Ditangco, R, additional, Chan, YJ, additional, Pujari, S, additional, Ng, OT, additional, Choi, JY, additional, Sim, BLH, additional, Tanuma, J, additional, Sangle, S, additional, Ross, J, additional, and Law, M, additional

Published
2019
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47. Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis

Author

Tamirou, F. D'Cruz, D. Sangle, S. Remy, P. Vasconcelos, C. Fiehn, C. Del Mar Ayala Guttierez, M. Gilboe, I.-M. Tektonidou, M. Blockmans, D. Ravelingien, I. Le Guern, V. Depresseux, G. Guillevin, L. Cervera, R. Houssiau, F.A. Abramowicz, D. Atzeni, F. Danieli, M.G. De Clercq, L. De Ramon Garrido, E. De Keyser, F. Delahousse, M. Espinosa, G. Golstein, M. Hirsch, M. Karras, A. Lang, P. Marchal, M. Marinho, A. Max, R. Peeters, P. Petera, P. Petrovic, R. Quémeneur, T. Raeman, F. Sarzi-Puttini, P. De Santis, L.V. Verresen, L. Weiss, L. Westhovens, R. MAINTAIN Nephritis Trial Group

Subjects
urologic and male genital diseases
Abstract

Objective: To report the 10-year follow-up of the MAINTAIN Nephritis Trial comparing azathioprine (AZA) and mycophenolate mofetil (MMF) as maintenance therapy of proliferative lupus nephritis, and to test different definitions of early response as predictors of long-term renal outcome. Methods: In 2014, data on survival, kidney function, 24 h proteinuria, renal flares and other outcomes were collected for the 105 patients randomised between 2002 and 2006, except in 13 lost to follow-up. Results: Death (2 and 3 in the AZA and MMF groups, respectively) and end-stage renal disease (1 and 3, respectively) were rare events. Time to renal flare (22 and 19 flares in AZA and MMF groups, respectively) did not differ between AZA and MMF patients. Patients with good long-term renal outcome had a much more stringent early decrease of 24 h proteinuria compared with patients with poor outcome. The positive predictive value of a 24 h proteinuria

Published
2016

48. Repeat kidney biopsies fail to detect differences between azathioprine and mycophenolate mofetil maintenance therapy for lupus nephritis: data from the MAINTAIN Nephritis Trial

Author

Stoenoiu, Maria S, Aydin, Selda, Tektonidou, Maria, Ravelingien, Isabelle, le Guern, Véronique, Fiehn, Christoph, Remy, Philippe, Delahousse, Michel, Petera, Peter, Quémeneur, Thomas, Vasconcelos, Carlos, D'Cruz, David, Gilboe, Inge-Magrethe, Jadoul, Michel, Karras, Alexandre, Depresseux, Geneviève, Guillevin, Loïc, Cervera, Ricard, Cosyns, Jean-Pierre, Houssiau, Frédéric A, Abramowicz, D, Atzeni, F, Blockmans, D, Danieli, Mg, de Keyser, F, Espinosa, G, Golstein, M, Hirsch, M, Lang, P, Marchal, M, Marinho, A, Max, R, Peeters, P, Petrovic, R, Raeman, F, Sarzi-Puttini, P, Sangle, S, Solé, M, de Santis LV, Verresen, L, Weiss, L, and Westhovens, R.

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, Adolescent, Biopsy, Lupus nephritis, Pain, Azathioprine, Kidney, Gastroenterology, Mycophenolic acid, Young Adult, renal biopsy, Maintenance therapy, Internal medicine, medicine, Humans, Transplantation, medicine.diagnostic_test, azathioprine, lupus nephritis, mycophenolate mofetil, pathology, Female, Follow-Up Studies, Immunosuppressive Agents, Incidence, Lupus Nephritis, Middle Aged, Mycophenolic Acid, Treatment Outcome, business.industry, medicine.disease, Surgery, Renal biopsy, business, Nephritis, medicine.drug
Abstract

BACKGROUND: In the MAINTAIN Nephritis Trial, azathioprine (AZA) and mycophenolate mofetil (MMF) were compared as maintenance immunosuppressive treatment of proliferative lupus nephritis (LN) after a short-course of intravenous cyclophosphamide. Here, we compare the pathological findings on repeat kidney biopsies between the two groups. METHODS: Per protocol, repeat renal biopsies were obtained in 30 patients (16 AZA and 14 MMF) at 2 years (±6 months). Baseline and follow-up biopsies were graded according to the International Society of Nephrology/Renal Pathological Society (ISN/RPS) classification. The activity and chronicity indices (AI, CI) were calculated using two different semiquantitative scoring systems (Morel-Maroger and National Institutes of Health). Statistics were performed by non-parametric tests. RESULTS: The clinical characteristics of the 30 re-biopsied patients only marginally differ from the entire MAINTAIN cohort (105 patients). Clinical baseline and follow-up characteristics of AZA- and MMF-treated re-biopsied patients did not differ. Time (SD) to repeat renal biopsy was 25.0 (2.0) and 26.5 (3.3) months in AZA and MMF patients, respectively. More patients had normal renal biopsies or Classes I/II/V LN at follow-up compared to baseline and conversely, less patients had Class IV LN at follow-up. In both groups, the AI statistically decreased at follow-up compared to baseline, while the CI slightly, but significantly, increased. No differences could be detected between the groups. CONCLUSION: Centralized pathological analyses, including ISN/RPS classification and comparisons of AI/CI, failed to find differences between MMF and AZA at 2 years, a result well in line with the absence of difference in long-term clinical outcome reported elsewhere.

Published
2011
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50. A proteinuria cut-off level of 0.7 g /day after 12 months of treatment best predicts long-term renal outcome in lupus nephritis: Data from the MAINTAIN Nephritis Trial

Author

Tamirou, F. Lauwerys, B.R. Dall'Era, M. Mackay, M. Rovin, B. Cervera, R. Houssiau, F.A. Abramowicz, D. Atzeni, F. Blockmans, D. Danieli, M.G. De Clercq, L. D'Cruz, D. Del Mar Ayala Guttierez, M. De Ramon Garrido, E. Gilboe, I.-M. De Keyser, F. Delahousse, M. Espinosa, G. Fiehn, C. Golstein, M. Guillevin, L. Hirsch, M. Karras, A. Lang, P. Le Guern, V. Marchal, M. Marinho, A. Max, R. Peeters, P. Petera, P. Petrovic, R. Quémeneur, T. Raeman, F. Remy, P. Ravelingien, I. Sarzi-Puttini, P. Sangle, S. Tektonidou, M. De Santis, L.V. Vasconcelos, C. Verresen, L. Weiss, L. Westhovens, R. MAINTAIN Nephritis Trial investigators

Abstract

Background: Although an early decrease in proteinuria has been correlated with good long-term renal outcome in lupus nephritis (LN), studies aimed at defining a cut-off proteinuria value are missing, except a recent analysis performed on patients randomised in the Euro-Lupus Nephritis Trial, demonstrating that a target value of 0.8 g/day at month 12 optimised sensitivity and specificity for the prediction of good renal outcome. The objective of the current work is to validate this target in another LN study, namely the MAINTAIN Nephritis Trial (MNT). Methods: Long-term (at least 7 years) renal function data were available for 90 patients randomised in the MNT. Receiver operating characteristic curves were built to test the performance of proteinuria measured within the 1st year as short-term predictor of long-term renal outcome. We calculated the positive and negative predictive values (PPV, NPV). Results: After 12 months of treatment, achievement of a proteinuria

Published
2015

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