X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Predictors of Hypertension and Changes of Blood Pressure in HIV-Infected Patients
    SAGE Publications ; 2005
    In:  Antiviral Therapy Vol. 10, No. 7 ( 2005-10), p. 811-823
    Details
    In: Antiviral Therapy, SAGE Publications, Vol. 10, No. 7 ( 2005-10), p. 811-823
    Abstract: We assessed predictors of changes in systolic (SBP) and diastolic (DBP) blood pressure during follow-up and of the development of hypertension in HIV-infected individuals. Methods International cohort collaborative study (D:A:D) of established prospective cohorts of HIV-1-infected patients. Longitudinal analysis of changes in blood pressure (BP) was performed using mixed effects models in 17170 patients. Predictors of development of hypertension during follow-up (systolic BP ≥140 and/or diastolic BP ≥90 mmHg or initiation of antihypertensive treatment) were assessed using Cox models in 8 984 patients with a normal BP level at baseline. Results 73548 BP measurements with a median of 4 per patient (interquartile range [IQR]: 2–6) were recorded over a median follow-up of 2.3 years (IQR: 1.5–2.6). Risk factors significantly associated with a development of higher systolic BP and diastolic BP (differences ≥5 mmHg and P-values 〈 0.001) during follow-up were: older age, male sex, higher body mass index (BMI) and use of BP-lowering drugs. In patients with normal BP at baseline, 1186 developed hypertension for an incidence of 72.1 per 1000 person-years (95% confidence interval: 68.2–76.0). Factors associated with development of hypertension were: male sex, higher BMI, older age, higher BP at baseline, high total cholesterol and clinical lipodystrophy. Cumulative duration of exposure to nucleoside reverse transcriptase inhibitors ( P=0.75), protease inhibitors ( P=0.92) as well as type of antiretroviral treatment at baseline ( P=0.18) were not associated with a higher risk of hypertension. Cumulative duration of exposure to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was significantly associated with lower risk of hypertension (hazard ratio=0.78 and 0.67 for those treated ≤10 months and 〉 10 months compared with no exposure; P=0.005). Conclusions Increased blood pressure in HIV-infected individuals is associated with established risk factors for hypertension. There was no evidence for an independent deleterious effect of any class of antiretroviral drugs on BP, although the use of NNRTIs was associated with a lower risk of development of hypertension.
    Type of Medium: Online Resource
    ISSN: 1359-6535 , 2040-2058
    URL: Article
    DOI: 10.1177/135965350501000706
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2118396-X
    SSG: 15,3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 2
    Online Resource
    Online Resource
    Patients’ perspectives on the development of HIV services to accommodate ageing with HIV: a qualitative study
    SAGE Publications ; 2018
    In:  International Journal of STD & AIDS Vol. 29, No. 5 ( 2018-04), p. 483-490
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 29, No. 5 ( 2018-04), p. 483-490
    Abstract: The objective of this study was to identify the aspects of healthcare that are most valued by people with HIV and to describe their concerns and preferences for the future delivery of services for non-HIV-related illness. Twelve focus groups of people receiving HIV care were conducted in community settings in South-East England. Groups were quota sampled based on age, gender, sexual orientation and ethnicity. Data were analysed using Framework Analysis. The results showed that among the 74 respondents (61% male), a preference for maintaining all care within specialist HIV clinics was commonplace, but was highest among participants with more extensive histories of HIV and comorbidities. Participants valued care-coordination, inter-service communication and timely updates to medical notes. There were high levels of concern around HIV skills in general practices and the capacity of general practitioners to manage patient confidentiality or deal appropriately with the emotional and social challenges of living with HIV. Participants valued, and had an overall preference for, the specialist knowledge and skills of HIV services, suggesting that non-HIV-specialist services will need to build their appeal if they are to have a greater future role in the care of people with HIV. Particular concerns that should be addressed include: patient confidence in the HIV knowledge and skills of non-specialist service providers; clear processes for prescribing and referrals; improved levels of care-coordination and communication between services and increased patient confidence in the capacity of primary care to maintain confidentiality and to appreciate the stigma associated with HIV.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462417735723
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2009782-7
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 3
    Online Resource
    Online Resource
    Sociodemography of genital co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis in Coventry, UK
    SAGE Publications ; 2005
    In:  International Journal of STD & AIDS Vol. 16, No. 4 ( 2005-04-01), p. 318-322
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 16, No. 4 ( 2005-04-01), p. 318-322
    Abstract: While genital co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis in the same individual is relatively common, little is known about the characteristics of individuals co-infected with both pathogens. We describe the sociodemographic and geographic characteristics of those with genital co-infection with N. gonorrhoeae and C. trachomatis. We reviewed the case-notes of all patients presenting with co-infection between March 1989 and February 2000. Incidence rates were calculated for those aged 15–64 living in the 18 different electoral wards of the city and subjects were assigned a Townsend deprivation score based on residence. A total of 332 cases of co-infection were included over the study period (overall mean annual incidence rate 16.1 [95% confidence interval [CI] 9.9–22.3] /100,000). The infection rate was significantly higher in those of black ethnicity (rate: 82.6/10 5 , relative rate 5.81, 95% CI [4.03–8.38], P=0.0001) than in those of other ethnicities. The highest incidence was noted in men aged 20–24 ( n=81, 45.6%) and in women aged 15–19 ( n=66, 45.2%) years, living in the most deprived area of the city. After controlling for year of diagnosis, those aged 25–64 years had significantly lower incidence rates (0.13 [0.10–0.17] , P=0.0001, Poisson regression) than those aged 〈 20 years. Increased incidence rates were also associated with high deprivation scores. There is a complex interaction between age, sex, ethnicity, geographic distribution, social deprivation and the risk of acquiring genital co-infection with N. gonorrhoeae and C. trachomatis. This study may help to identify the geographic areas of high incidence of sexually transmitted diseases in Coventry, and could be used as the baseline to measure the need for subsequent interventions.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1258/0956462053654320
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2009782-7
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 4
    Online Resource
    Online Resource
    Higher vaginal pH is associated with Chlamydia trachomatis infection in women: a prospective case–controlled study
    SAGE Publications ; 2005
    In:  International Journal of STD & AIDS Vol. 16, No. 4 ( 2005-04-01), p. 290-293
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 16, No. 4 ( 2005-04-01), p. 290-293
    Abstract: This is a prospective case–controlled study of female attendees in Coventry. This study found an association of higher vaginal pH with chlamydial infection, independent of any other factors. Studies in vitro have shown that an acidic vaginal secretion inhibits chlamydial infection. Our objective was to analyse the association of vaginal pH and chlamydial infection in women attending a genitourinary medicine clinic. Chlamydial infections were diagnosed with ELISA and confirmed with indirect immunofluorescence. Vaginal pH was measured by a pH indicator tape ranging from 3 to 8. Consecutive female attendees with no sexually transmitted infections (STIs) were included as controls. In all, 144 female cases, diagnosed with chlamydial infection, had a median age of 20 years. Seventeen women had associated bacterial vaginosis. Eighty-two women had no other STIs. Ninety-eight women were using the oral contraceptive pill (OCP). The 145 control women had a median age of 26 years and 52 were receiving the OCP. A significantly higher vaginal pH was seen in the cases ( P=0.0001, Wilcoxon test), even after adjusting for other risk factors associated with vaginal pH, including OCP use (odds ratio: 6.49, 95% confidence interval, 3.59–11.73, P=0.0001). Chlamydial infection in women was associated with a higher vaginal pH level, independent of any other factors. This study has implications for the treatment of other conditions known to lead to an increase in vaginal pH, even in asymptomatic individuals.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1258/0956462053654221
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2009782-7
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 5
    Online Resource
    Online Resource
    Methodological issues in the use of composite endpoints in clinical trials: examples from the HIV field
    SAGE Publications ; 2010
    In:  Clinical Trials Vol. 7, No. 1 ( 2010-02), p. 19-35
    Details
    In: Clinical Trials, SAGE Publications, Vol. 7, No. 1 ( 2010-02), p. 19-35
    Abstract: Background In many fields, the choice of a primary endpoint for a trial is not always the ultimate clinical endpoint of interest, but rather some surrogate endpoint believed to be relevant for predicting the effect of the intervention on the clinical endpoint. The classic example of such a field is clinical HIV treatment research, where a variety of primary endpoints are used to evaluate the efficacy of new antiretroviral drugs or new combinations of existing drugs. The choice of endpoint reflects either the goal of therapy as recommended by treatment guidelines (e.g. rapid virological suppression) or the licensing requirements of official drug approval organizations (e.g. time to loss of virological response [TLOVR]). Purpose To review the diversity of endpoints used in recent clinical trials in HIV infection and highlight the methodological issues. Methods We identified articles relating to antiretroviral therapy by searching PubMed and through hand searches of relevant conference abstracts. We restricted the search to randomized controlled trials conducted in HIV-infected adults published/presented from January 2005 until March 2008. Results We identified 28 trials in antiretroviral-naive patients (i.e. patients who were starting antiretroviral therapy for the first time at the time of randomization) and 23 trials in antiretroviral-experienced patients. Most trials were performed for purposes of drug licensing, but others were focused on strategies of using approved drugs. Most trials (40 of 51) used a composite primary endpoint (TLOVR in 13). Of note, 22 of these 40 studies reported that they had used a purely virological efficacy endpoint, but the primary endpoint was actually a composite one due to the way in which missing data and treatment switches were considered as failures. Limitations Examples are restricted to HIV clinical trials. Conclusions Whilst most current HIV clinical trials use composite primary endpoints, there are substantial differences in the components that make up these endpoints. In HIV and other fields where precise definitions are variable, guidelines for standardization of definition and reporting would greatly improve the ability to compare trial results. Clinical Trials 2010; 7: 19—35. http:// ctj.sagepub.com
    Type of Medium: Online Resource
    ISSN: 1740-7745 , 1740-7753
    URL: Article
    DOI: 10.1177/1740774509356117
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2159773-X
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 6
    Online Resource
    Online Resource
    Longitudinal Analysis of the Associations between Antiretroviral Therapy, Viraemia and Immunosuppression with Lipid Levels: The D:A:D Study
    SAGE Publications ; 2016
    In:  Antiviral Therapy Vol. 21, No. 6 ( 2016-08), p. 495-506
    Details
    In: Antiviral Therapy, SAGE Publications, Vol. 21, No. 6 ( 2016-08), p. 495-506
    Abstract: Antiretroviral (ART) drugs have been associated with higher triglycerides (TG), higher total cholesterol (TC) and lower high-density lipoprotein cholesterol (HDL-C) levels. Associations between lipid levels with HIV viraemia and immunosuppression in the presence of ART remain unclear. Methods Participants from the D:A:D study with at least one TG/TC/HDL-C measurement were included. Linear mixed effect models were used to determine the association of ART, viral load (VL), nadir and current CD4 + T-cell count and previous AIDS diagnosis with lipids. Results Of 49,717 participants, 90%, 92% and 80% contributed at least one TG/TC/HDL-C measurement (median follow-up 6.8, 6.8 and 5.0 years, respectively). Predicted mean (95% CI) baseline levels for TG, TC and HDL-C (mmol/l), were 2.10 (2.05, 2.14), 4.94 (4.91, 4.98) and 1.08 (1.07, 1.10), respectively. Lopinavir was associated with the worst TG profile, (27.2% higher levels compared to atazanavir; 95% CI 25.2%, 29.2%), and darunavir had a similar profile as atazanavir. The nucleoside pair lamivudine/tenofovir was associated with the most favourable TG profile (-2.8%; -3.5%, -2.0%) compared with emtricitabine/tenofovir, whereas lamivudine/abacavir (+10.2%; +9.3%, +11.2%) and lamivudine/ stavudine (+8.0%; +6.9%, +9.0%), were associated with the worst. Raltegravir was associated with lower TG (-5.2%; -6.4%, -3.9%), and nevirapine had a more favourable HDL-C profile (+11.3%; +10.8%, +11.7%) than efavirenz (+5.3%; 5.0%, 5.7%), compared to atazanavir. Higher VLs were associated with lower TG/TC/HDL-C, whereas higher CD4 + T-cell counts were associated with higher TG/TC/HDL-C. Conclusions TG, TC and HDL-C levels, which generally improved over time, are dependent on ART, viraemia and, to a lesser extent, immunosuppression.
    Type of Medium: Online Resource
    ISSN: 1359-6535 , 2040-2058
    URL: Article
    DOI: 10.3851/IMP3051
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2118396-X
    SSG: 15,3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 7
    Online Resource
    Online Resource
    Polypharmacy and Drug–drug Interactions in Older and Younger People Living with HIV: The POPPY Study
    SAGE Publications ; 2019
    In:  Antiviral Therapy Vol. 24, No. 3 ( 2019-04), p. 193-201
    Details
    In: Antiviral Therapy, SAGE Publications, Vol. 24, No. 3 ( 2019-04), p. 193-201
    Abstract: Polypharmacy (use of ≥ five medications) increases the risk of drug-drug interactions and can lead to negative health outcomes. This study aimed to review the medications of people living with HIV (PLWH) and HIV-negative controls in the POPPY study and evaluate the frequency of polypharmacy and potential drug-drug interactions (PDDIs). Methods PDDIs between non-antiretroviral (ARV) drugs were analysed using the Lexicomp® database, and PDDIs between non-ARV and ARV drugs using the Liverpool drug interaction database. Between-group differences were assessed using χ 2 , Mann-Whitney U and Kruskal-Wallis tests. Results This analysis included 698 PLWH ≥50 years, 374 PLWH 〈 50 years and 304 HIV-negative controls ≥50 years. The prevalence of polypharmacy was 65.8% in older PLWH, 48.1% in younger PLWH and 13.2% in the HIV-negative group. When ARVs were excluded, 29.8% of older PLWH and 14.2% of younger PLWH had polypharmacy. The prevalence of ≥1 PDDI involving non-ARV drugs was 36.1%, 20.3% and 16.4%, respectively, in older PLWH, younger PLWH and HIV-negative controls. In PLWH the prevalence of ≥1 PDDI involving ARV and non-ARV drugs was 57.3% in older PLWH and 32.4% in younger PLWH. Conclusions Polypharmacy and PDDIs involving non-ARV/ARV drugs and non-ARV/non-ARV drugs were common among older PLWH, highlighting the need for increased awareness and additional research on all types of PDDI.
    Type of Medium: Online Resource
    ISSN: 1359-6535 , 2040-2058
    URL: Article
    DOI: 10.3851/IMP3293
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2118396-X
    SSG: 15,3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 8
    Online Resource
    Online Resource
    Cognitive function and drivers of cognitive impairment in a European and a Korean cohort of people living with HIV
    SAGE Publications ; 2020
    In:  International Journal of STD & AIDS Vol. 31, No. 1 ( 2020-01), p. 30-37
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 31, No. 1 ( 2020-01), p. 30-37
    Abstract: Although cognitive impairments are still prevalent in the current antiretroviral therapy era, limited investigations have compared the prevalence of cognitive disorder in people living with HIV (PLWH) and its determinants in different regions and ethnicities. We compared cognitive performance across six domains using comparable batteries in 134 PLWH aged ≥45 years from the COBRA study (Netherlands, UK), and 194 PLWH aged ≥18 years from the NeuroAIDS Project (South Korea). Cognitive scores were standardized and averaged to obtain domain and global T-scores. Associations with global T-scores were evaluated using multivariable regression and the ability of individual tests to detect cognitive impairment (global T-score ≤45) was assessed using the area-under-the-receiver-operating-characteristic curve (AUROC). The median (interquartile range) age of participants was 56 (51, 62) years in COBRA (88% white ethnicity, 93% male) and 45 (37, 52) years in NeuroAIDS (100% Korean ethnicity, 94% male). The rate of cognitive impairment was 18.8% and 18.0%, respectively ( p = 0.86). In COBRA, Black-African ethnicity was the factor most strongly associated with cognitive function (11.1 [7.7, 14.5] lower scores vs. white ethnicity, p  〈  0.01), whereas in NeuroAIDS, age (0.6 [0.1, 1.3] per 10-year, p 〈 0.01) and education (0.7 [0.5, 0.9] per year, p 〈 0.01) were significantly associated with cognitive function with anemia showing only a weak association (−1.2 [−2.6, 0.3], p=0.12). Cognitive domains most associated with cognitive impairment were attention (AUROC = 0.86) and executive function (AUROC = 0.87) in COBRA and processing speed (AUROC = 0.80), motor function (AUROC = 0.78) and language (AUROC = 0.78) in NeuroAIDS. Two cohorts of PLWH from different geographical regions report similar rates of cognitive impairment but different risk factors and cognitive profiles of impairment.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462419881080
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2009782-7
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 9
    Online Resource
    Online Resource
    Prognostic Importance of Anaemia in HIV Type-1-Infected Patients Starting Antiretroviral Therapy: Collaborative Analysis of Prospective Cohort Studies
    SAGE Publications ; 2008
    In:  Antiviral Therapy Vol. 13, No. 8 ( 2008-11), p. 959-967
    Details
    In: Antiviral Therapy, SAGE Publications, Vol. 13, No. 8 ( 2008-11), p. 959-967
    Abstract: In HIV type-1-infected patients starting highly active antiretroviral therapy (HAART), the prognostic value of haemoglobin when starting HAART, and of changes in haemoglobin levels, are not well defined. Methods We combined data from 10 prospective studies of 12,100 previously untreated individuals (25% women). A total of 4,222 patients (35%) were anaemic: 131 patients (1.1%) had severe ( 〈 8.0 g/dl), 1,120 (9%) had moderate (male 8.0– 〈 11.0 g/dl and female 8.0– 〈 10.0 g/ dl) and 2,971 (25%) had mild (male 11.0– 〈 13.0 g/dl and female 10.0– 〈 12.0 g/dl) anaemia. We separately analysed progression to AIDS or death from baseline and from 6 months using Weibull models, adjusting for CD4 + T-cell count, age, sex and other variables. Results During 48,420 person-years of follow-up 1,448 patients developed at least one AIDS event and 857 patients died. Anaemia at baseline was independently associated with higher mortality: the adjusted hazard ratio (95% confidence interval) for mild anaemia was 1.42 (1.17–1.73), for moderate anaemia 2.56 (2.07–3.18) and for severe anaemia 5.26 (3.55–7.81). Corresponding figures for progression to AIDS were 1.60 (1.37–1.86), 2.00 (1.66–2.40) and 2.24 (1.46–3.42). At 6 months the prevalence of anaemia declined to 26%. Baseline anaemia continued to predict mortality (and to a lesser extent progression to AIDS) in patients with normal haemoglobin or mild anaemia at 6 months. Conclusions Anaemia at the start of HAART is an important factor for short- and long-term prognosis, including in patients whose haemoglobin levels improved or normalized during the first 6 months of HAART.
    Type of Medium: Online Resource
    ISSN: 1359-6535 , 2040-2058
    URL: Article
    DOI: 10.1177/135965350801300802
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2118396-X
    SSG: 15,3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 10
    Online Resource
    Online Resource
    Hypertension in HIV-infected patients
    SAGE Publications ; 2005
    In:  Antiviral Therapy Vol. 10, No. 8 ( 2005-11), p. 969-969
    Details
    In: Antiviral Therapy, SAGE Publications, Vol. 10, No. 8 ( 2005-11), p. 969-969
    Type of Medium: Online Resource
    ISSN: 1359-6535 , 2040-2058
    URL: Article
    DOI: 10.1177/135965350501000812
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2118396-X
    SSG: 15,3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
Nothing or not found what you are looking for? Please check your search query or use the Interlibrary Loan Search.
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages