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\n \n\n \n \n Luu, B.; Ruderman, S.; Nance, R.; Delaney, J. A. C.; Ma, J.; Hahn, A.; Heckbert, S. R.; Budoff, M. J.; Crothers, K.; Mathews, W. C.; Christopolous, K.; Hunt, P. W.; Eron, J.; Moore, R.; Keruly, J.; Lober, W. B.; Burkholder, G. A.; Willig, A.; Chander, G.; McCaul, M. E.; Cropsey, K.; O'Cleirigh, C.; Peter, I.; Feinstein, M.; Tsui, J. I.; Lindstroem, S.; Saag, M.; Kitahata, M. M.; Crane, H. M.; Drumright, L. N.; and Whitney, B. M.\n\n\n \n \n \n \n Tobacco smoking and binge alcohol use are associated with incident venous thromboembolism in an HIV cohort.\n \n \n \n\n\n \n\n\n\n HIV medicine. March 2022.\n Place: England\n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{luu_tobacco_2022,\n\ttitle = {Tobacco smoking and binge alcohol use are associated with incident venous thromboembolism in an {HIV} cohort.},\n\tcopyright = {© 2022 British HIV Association.},\n\tissn = {1468-1293 1464-2662},\n\tdoi = {10.1111/hiv.13309},\n\tabstract = {BACKGROUND: People with HIV (PWH) are at increased risk of cardiovascular comorbidities and substance use is a potential predisposing factor. We evaluated  associations of tobacco smoking and alcohol use with venous thromboembolism (VTE) in  PWH. METHODS: We assessed incident, centrally adjudicated VTE among 12 957 PWH  within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS)  cohort between January 2009 and December 2018. Using separate Cox proportional  hazards models, we evaluated associations of time-updated alcohol and cigarette use  with VTE, adjusting for demographic and clinical characteristics. Smoking was  evaluated as pack-years and never, former, or current use with current cigarettes  per day. Alcohol use was parameterized using categorical and continuous alcohol use  score, frequency of use, and binge frequency. RESULTS: During a median of 3.6 years  of follow-up, 213 PWH developed a VTE. One-third of PWH reported binge drinking and  40\\% reported currently smoking. In adjusted analyses, risk of VTE was increased  among both current (HR: 1.44, 95\\% CI: 1.02-2.03) and former (HR: 1.44, 95\\% CI:  0.99-2.07) smokers compared to PWH who never smoked. Additionally, total pack-years  among ever-smokers (HR: 1.10 per 5 pack-years; 95\\% CI: 1.03-1.18) was associated  with incident VTE in a dose-dependent manner. Frequency of binge drinking was  associated with incident VTE (HR: 1.30 per 7 days/month, 95\\% CI: 1.11-1.52);  however, alcohol use frequency was not. Severity of alcohol use was not  significantly associated with VTE. CONCLUSIONS: Current smoking and pack-year  smoking history were dose-dependently associated with incident VTE among PWH in  CNICS. Binge drinking was also associated with VTE. Interventions for smoking and  binge drinking may decrease VTE risk among PWH.},\n\tlanguage = {eng},\n\tjournal = {HIV medicine},\n\tauthor = {Luu, Brandon and Ruderman, Stephanie and Nance, Robin and Delaney, Joseph A. C. and Ma, Jimmy and Hahn, Andrew and Heckbert, Susan R. and Budoff, Matthew J. and Crothers, Kristina and Mathews, William C. and Christopolous, Katerina and Hunt, Peter W. and Eron, Joseph and Moore, Richard and Keruly, Jeanne and Lober, William B. and Burkholder, Greer A. and Willig, Amanda and Chander, Geetanjali and McCaul, Mary E. and Cropsey, Karen and O'Cleirigh, Conall and Peter, Inga and Feinstein, Matthew and Tsui, Judith I. and Lindstroem, Sara and Saag, Michael and Kitahata, Mari M. and Crane, Heidi M. and Drumright, Lydia N. and Whitney, Bridget M.},\n\tmonth = mar,\n\tyear = {2022},\n\tpmid = {35343038},\n\tnote = {Place: England},\n\tkeywords = {HIV, binge drinking, smoking, substance use, venous thromboembolism},\n}\n\n

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\n \n\n \n \n Crane, H. M.; Nance, R. M.; Whitney, B. M.; Ruderman, S.; Tsui, J. I.; Chander, G.; McCaul, M. E.; Lau, B.; Mayer, K. H.; Batey, D. S.; Safren, S. A.; Moore, R. D.; Eron, J. J.; Napravnik, S.; Mathews, W. C.; Fredericksen, R. J.; Hahn, A. W.; Mugavero, M. J.; Lober, W. B.; Saag, M. S.; Kitahata, M. M.; and Delaney, J. A. C.\n\n\n \n \n \n \n \n Drug and alcohol use among people living with HIV in care in the United States by geographic region.\n \n \n \n \n\n\n \n\n\n\n AIDS Care, 0(0): 1–8. January 2021.\n Publisher: Taylor & Francis _eprint: https://doi.org/10.1080/09540121.2021.1874274\n\n\n\n
\n\n\n\n \n \n $\"Drug$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{crane_drug_2021,\n\ttitle = {Drug and alcohol use among people living with {HIV} in care in the {United} {States} by geographic region},\n\tvolume = {0},\n\tissn = {0954-0121},\n\turl = {https://doi.org/10.1080/09540121.2021.1874274},\n\tdoi = {10.1080/09540121.2021.1874274},\n\tabstract = {Substance use in the U.S. varies by geographic region. Opioid prescribing practices and marijuana, heroin, and methamphetamine availability are evolving differently across regions. We examined self-reported substance use among people living with HIV (PLWH) in care at seven sites from 2017–2019 to understand current regional substance use patterns. We calculated the percentage and standardized percentage of PLWH reporting current drug use and at-risk and binge alcohol use by U.S. Census Bureau geographic region and examined associations in adjusted logistic regression analyses. Among 7,686 PLWH, marijuana use was the most prevalent drug (30\\%), followed by methamphetamine/crystal (8\\%), cocaine/crack (7\\%), and illicit opioids (3\\%). One-third reported binge alcohol use (32\\%). Differences in percent of current use by region were seen for marijuana (24–41\\%) and methamphetamine/crystal (2–15\\%), with more use in the West and Northeast, and binge alcohol use (26–40\\%). In adjusted analyses, PLWH in the Midwest were significantly less likely to use methamphetamine/crystal (aOR: 0.13;0.06–0.25) or illicit opioids (aOR:0.16;0.05–0.53), and PLWH in the Northeast were more likely to use cocaine/crack (aOR:1.59;1.16–2.17), compared to PLWH in the West. Understanding differences in substance use patterns in the current era, as policies continue to evolve, will enable more targeted interventions in clinical settings among PLWH.},\n\tnumber = {0},\n\turldate = {2021-08-13},\n\tjournal = {AIDS Care},\n\tauthor = {Crane, Heidi M. and Nance, Robin M. and Whitney, Bridget M. and Ruderman, Stephanie and Tsui, Judith I. and Chander, Geetanjali and McCaul, Mary E. and Lau, Bryan and Mayer, Kenneth H. and Batey, D. Scott and Safren, Steven A. and Moore, Richard D. and Eron, Joseph J. and Napravnik, Sonia and Mathews, W. Chris and Fredericksen, Rob J. and Hahn, Andrew W. and Mugavero, Michael J. and Lober, William B. and Saag, Michael S. and Kitahata, Mari M. and Delaney, Joseph A. C.},\n\tmonth = jan,\n\tyear = {2021},\n\tpmid = {33486978},\n\tnote = {Publisher: Taylor \\& Francis\n\\_eprint: https://doi.org/10.1080/09540121.2021.1874274},\n\tkeywords = {Drug use, HIV, alcohol use, marijuana, methamphetamine},\n\tpages = {1--8},\n}\n\n

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\n \n\n \n \n Davy-Mendez, T.; Napravnik, S.; Hogan, B. C; Althoff, K. N; Gebo, K. A; Moore, R. D; Horberg, M. A; Silverberg, M. J; Gill, M J.; Crane, H. M; Marconi, V. C; Bosch, R. J; Colasanti, J. A; Sterling, T. R; Mathews, W C.; Mayor, A. M; Nanditha, N. G. A.; Buchacz, K.; Li, J.; Rebeiro, P. F; Thorne, J. E; Nijhawan, A.; van Duin, D.; Wohl, D. A; Eron, J. J; Berry, S. A; North American AIDS Cohort Collaboration on Research; and of IeDEA, D.\n\n\n \n \n \n \n \n Hospitalization Rates and Causes Among Persons With HIV in the United States and Canada, 2005–2015.\n \n \n \n \n\n\n \n\n\n\n The Journal of Infectious Diseases, 223(12): 2113–2123. June 2021.\n \n\n\n\n
\n\n\n\n \n \n $\"Hospitalization$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

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@article{davy-mendez_hospitalization_2021,\n\ttitle = {Hospitalization {Rates} and {Causes} {Among} {Persons} {With} {HIV} in the {United} {States} and {Canada}, 2005–2015},\n\tvolume = {223},\n\tissn = {0022-1899},\n\turl = {https://doi.org/10.1093/infdis/jiaa661},\n\tdoi = {10.1093/infdis/jiaa661},\n\tabstract = {To assess the possible impact of antiretroviral therapy improvements, aging, and comorbidities, we examined trends in all-cause and cause-specific hospitalization rates among persons with HIV (PWH) from 2005 to 2015.In 6 clinical cohorts, we followed PWH in care (≥1 outpatient CD4 count or HIV load [VL] every 12 months) and categorized ICD codes of primary discharge diagnoses using modified Clinical Classifications Software. Poisson regression estimated hospitalization rate ratios for calendar time trends, adjusted for demographics, HIV risk factor, and annually updated age, CD4, and VL.Among 28 057 patients (125 724 person-years), from 2005 to 2015, the median CD4 increased from 389 to 580 cells/µL and virologic suppression from 55\\% to 85\\% of patients. Unadjusted all-cause hospitalization rates decreased from 22.3 per 100 person-years in 2005 (95\\% confidence interval [CI], 20.6–24.1) to 13.0 in 2015 (95\\% CI, 12.2–14.0). Unadjusted rates decreased for almost all diagnostic categories. Adjusted rates decreased for all-cause, cardiovascular, and AIDS-defining conditions, increased for non-AIDS–defining infection, and were stable for most other categories.Among PWH with increasing CD4 counts and viral suppression, unadjusted hospitalization rates decreased for all-cause and most cause-specific hospitalizations, despite the potential effects of aging, comorbidities, and cumulative exposure to HIV and antiretrovirals.},\n\tnumber = {12},\n\turldate = {2022-01-24},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Davy-Mendez, Thibaut and Napravnik, Sonia and Hogan, Brenna C and Althoff, Keri N and Gebo, Kelly A and Moore, Richard D and Horberg, Michael A and Silverberg, Michael J and Gill, M John and Crane, Heidi M and Marconi, Vincent C and Bosch, Ronald J and Colasanti, Jonathan A and Sterling, Timothy R and Mathews, W Christopher and Mayor, Angel M and Nanditha, Ni Gusti Ayu and Buchacz, Kate and Li, Jun and Rebeiro, Peter F and Thorne, Jennifer E and Nijhawan, Ank and van Duin, David and Wohl, David A and Eron, Joseph J and Berry, Stephen A and {North American AIDS Cohort Collaboration on Research and Design of IeDEA}},\n\tmonth = jun,\n\tyear = {2021},\n\tpages = {2113--2123},\n}\n\n

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\n \n\n \n \n McGinnis, K. A; Justice, A. C; Moore, R. D; Silverberg, M. J; Althoff, K. N; Karris, M.; Lima, V. D; Crane, H. M; Horberg, M. A; Klein, M. B; Gange, S. J; Gebo, K. A; Mayor, A.; Tate, J. P; North American AIDS Cohort Collaboration on Research; of the International Epidemiologic Databases to Evaluate AIDS (IeDEA), D. (.; and (VACS), V. A. C. S.\n\n\n \n \n \n \n \n Discrimination and Calibration of the Veterans Aging Cohort Study Index 2.0 for Predicting Mortality Among People With Human Immunodeficiency Virus in North America.\n \n \n \n \n\n\n \n\n\n\n Clinical Infectious Diseases,ciab883. October 2021.\n \n\n\n\n
\n\n\n\n \n \n $\"Discrimination$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

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@article{mcginnis_discrimination_2021,\n\ttitle = {Discrimination and {Calibration} of the {Veterans} {Aging} {Cohort} {Study} {Index} 2.0 for {Predicting} {Mortality} {Among} {People} {With} {Human} {Immunodeficiency} {Virus} in {North} {America}},\n\tissn = {1058-4838},\n\turl = {https://doi.org/10.1093/cid/ciab883},\n\tdoi = {10.1093/cid/ciab883},\n\tabstract = {The updated Veterans Aging Cohort Study (VACS) Index 2.0 combines general and human immunodeficiency virus (HIV)–specific biomarkers to generate a continuous score that accurately discriminates risk of mortality in diverse cohorts of persons with HIV (PWH), but a score alone is difficult to interpret. Using data from the North American AIDS Cohort Collaboration (NA-ACCORD), we translate VACS Index 2.0 scores into validated probability estimates of mortality.Because complete mortality ascertainment is essential for accurate calibration, we restricted analyses to cohorts with mortality from the National Death Index or equivalent sources. VACS Index 2.0 components were ascertained from October 1999 to April 2018. Mortality was observed up to March 2019. Calibration curves compared predicted (estimated by fitting a gamma model to the score) to observed mortality overall and within subgroups: cohort (VACS/NA-ACCORD subset), sex, age \\&lt;50 or ≥50 years, race/ethnicity, HIV-1 RNA ≤500 or \\&gt;500 copies/mL, CD4 count \\&lt;350 or ≥350 cells/µL, and years 1999–2009 or 2010–2018. Because mortality rates have decreased over time, the final model was limited to 2010–2018.Among 37230 PWH in VACS and 8061 PWH in the NA-ACCORD subset, median age was 53 and 44 years; 3\\% and 19\\% were women; and 48\\% and 39\\% were black. Discrimination in NA-ACCORD (C-statistic = 0.842 [95\\% confidence interval \\{CI\\}, .830–.854]) was better than in VACS (C-statistic = 0.813 [95\\% CI, .809–.817]). Predicted and observed mortality largely overlapped in VACS and the NA-ACCORD subset, overall and within subgroups.Based on this validation, VACS Index 2.0 can reliably estimate probability of all-cause mortality, at various follow-up times, among PWH in North America.},\n\turldate = {2022-01-24},\n\tjournal = {Clinical Infectious Diseases},\n\tauthor = {McGinnis, Kathleen A and Justice, Amy C and Moore, Richard D and Silverberg, Michael J and Althoff, Keri N and Karris, Maile and Lima, Viviane D and Crane, Heidi M and Horberg, Michael A and Klein, Marina B and Gange, Stephen J and Gebo, Kelly A and Mayor, Angel and Tate, Janet P and {North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)a of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) and Veterans Aging Cohort Study (VACS)}},\n\tmonth = oct,\n\tyear = {2021},\n\tpages = {ciab883},\n}\n\n

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\n \n\n \n \n Crane, H. M.; Nance, R. M.; Avoundjian, T.; Harding, B. N.; Whitney, B. M.; Chow, F. C.; Becker, K. J.; Marra, C. M.; Zunt, J. R.; Ho, E. L.; Kalani, R.; Huffer, A.; Burkholder, G. A.; Willig, A. L.; Moore, R. D.; Mathews, W. C.; Eron, J. J.; Napravnik, S.; Lober, W. B.; Barnes, G. S.; McReynolds, J.; Feinstein, M. J.; Heckbert, S. R.; Saag, M. S.; Kitahata, M. M.; Delaney, J. A. C.; and Tirschwell, D. L.\n\n\n \n \n \n \n \n Types of Stroke Among People Living With HIV in the United States.\n \n \n \n \n\n\n \n\n\n\n JAIDS Journal of Acquired Immune Deficiency Syndromes, 86(5): 568–578. April 2021.\n \n\n\n\n
\n\n\n\n \n \n $\"Types$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

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@article{crane_types_2021,\n\ttitle = {Types of {Stroke} {Among} {People} {Living} {With} {HIV} in the {United} {States}},\n\tvolume = {86},\n\tissn = {1525-4135},\n\turl = {https://journals.lww.com/jaids/Fulltext/2021/04150/Types_of_Stroke_Among_People_Living_With_HIV_in.11.aspx?casa_token=jOkwzWWCmawAAAAA:V7XvfOz0ec2AW0TWwk6ynoz__9-qoJTX6cJRGe6vE3zhlJvz50TzeHYv43pV8OHz3JsnUEVZtQz8lJVSEQd3zH9i},\n\tdoi = {10.1097/QAI.0000000000002598},\n\tabstract = {Background: \n        Most studies of stroke in people living with HIV (PLWH) do not use verified stroke diagnoses, are small, and/or do not differentiate stroke types and subtypes.\n        Setting: \n        CNICS, a U.S. multisite clinical cohort of PLWH in care.\n        Methods: \n        We implemented a centralized adjudication stroke protocol to identify stroke type, subtype, and precipitating conditions identified as direct causes including infection and illicit drug use in a large diverse HIV cohort.\n        Results: \n        Among 26,514 PLWH, there were 401 strokes, 75\\% of which were ischemic. Precipitating factors such as sepsis or same-day cocaine use were identified in 40\\% of ischemic strokes. Those with precipitating factors were younger, had more severe HIV disease, and fewer traditional stroke risk factors such as diabetes and hypertension. Ischemic stroke subtypes included cardioembolic (20\\%), large vessel atherosclerosis (13\\%), and small vessel (24\\%) ischemic strokes. Individuals with small vessel strokes were older, were more likely to have a higher current CD4 cell count than those with cardioembolic strokes and had the highest mean blood pressure of the ischemic stroke subtypes.\n        Conclusion: \n        Ischemic stroke, particularly small vessel and cardioembolic subtypes, were the most common strokes among PLWH. Traditional and HIV-related risk factors differed by stroke type/subtype. Precipitating factors including infections and drug use were common. These results suggest that there may be different biological phenomena occurring among PLWH and that understanding HIV-related and traditional risk factors and in particular precipitating factors for each type/subtype may be key to understanding, and therefore preventing, strokes among PLWH.},\n\tlanguage = {en-US},\n\tnumber = {5},\n\turldate = {2021-08-13},\n\tjournal = {JAIDS Journal of Acquired Immune Deficiency Syndromes},\n\tauthor = {Crane, Heidi M. and Nance, Robin M. and Avoundjian, Tigran and Harding, Barbara N. and Whitney, Bridget M. and Chow, Felicia C. and Becker, Kyra J. and Marra, Christina M. and Zunt, Joseph R. and Ho, Emily L. and Kalani, Rizwan and Huffer, Andrew and Burkholder, Greer A. and Willig, Amanda L. and Moore, Richard D. and Mathews, William C. and Eron, Joseph J. and Napravnik, Sonia and Lober, William B. and Barnes, Greg S. and McReynolds, Justin and Feinstein, Matthew J. and Heckbert, Susan R. and Saag, Michael S. and Kitahata, Mari M. and Delaney, Joseph A. C. and Tirschwell, David L.},\n\tmonth = apr,\n\tyear = {2021},\n\tpages = {568--578},\n}\n\n

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\n \n\n \n \n Lee, J. S.; Humes, E. A.; Hogan, B. C.; Buchacz, K.; Eron, J. J.; Gill, M. J.; Sterling, T. R.; Rebeiro, P. F.; Lima, V. D.; Mayor, A.; Silverberg, M. J.; Horberg, M. A.; Moore, R. D.; and Althoff, K. N.\n\n\n \n \n \n \n CD4 Count at Entry into Care and at Antiretroviral Therapy Prescription among Adults with Human Immunodeficiency Virus in the United States, 2005-2018.\n \n \n \n\n\n \n\n\n\n Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 73(7): e2334–e2337. October 2021.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{lee_cd4_2021,\n\ttitle = {{CD4} {Count} at {Entry} into {Care} and at {Antiretroviral} {Therapy} {Prescription} among {Adults} with {Human} {Immunodeficiency} {Virus} in the {United} {States}, 2005-2018.},\n\tvolume = {73},\n\tcopyright = {© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail:  journals.permissions@oup.com.},\n\tissn = {1537-6591 1058-4838},\n\tdoi = {10.1093/cid/ciaa1904},\n\tabstract = {From 2005 to 2018, among 32013 adults with human immunodeficiency virus entering care, median time to antiretroviral therapy (ART) prescription declined from 69 to 6  days, CD4 count at entry into care increased from 300 to 362 cells/μL, and CD4 count  at ART prescription increased from 160 to 364 cells/μL.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},\n\tauthor = {Lee, Jennifer S. and Humes, Elizabeth A. and Hogan, Brenna C. and Buchacz, Kate and Eron, Joseph J. and Gill, M. John and Sterling, Timothy R. and Rebeiro, Peter F. and Lima, Viviane Dias and Mayor, Angel and Silverberg, Michael J. and Horberg, Michael A. and Moore, Richard D. and Althoff, Keri N.},\n\tmonth = oct,\n\tyear = {2021},\n\tpmid = {33383586},\n\tpmcid = {PMC8492212},\n\tkeywords = {*Anti-HIV Agents/therapeutic use, *CD4 count, *HIV, *HIV Infections/drug therapy/epidemiology, *antiretroviral therapy, *treat all, *universal treatment, Adult, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, HIV, Humans, Prescriptions, United States/epidemiology},\n\tpages = {e2334--e2337},\n}\n\n

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\n \n\n \n \n Trefzer, A.; Kadam, P.; Wang, S.; Pennavaria, S.; Lober, B.; Akçabozan, B.; Kranich, J.; Brocker, T.; Nakano, N.; Irmler, M.; Beckers, J.; Straub, T.; and Obst, R.\n\n\n \n \n \n \n Dynamic adoption of anergy by antigen-exhausted CD4(+) T cells.\n \n \n \n\n\n \n\n\n\n Cell reports, 34(6): 108748. February 2021.\n Place: United States\n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{trefzer_dynamic_2021,\n\ttitle = {Dynamic adoption of anergy by antigen-exhausted {CD4}(+) {T} cells.},\n\tvolume = {34},\n\tcopyright = {Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.},\n\tissn = {2211-1247},\n\tdoi = {10.1016/j.celrep.2021.108748},\n\tabstract = {Exhausted immune responses to chronic diseases represent a major challenge to global health. We study CD4(+) T cells in a mouse model with regulatable antigen  presentation. When the cells are driven through the effector phase and are then  exposed to different levels of persistent antigen, they lose their T helper 1 (Th1)  functions, upregulate exhaustion markers, resemble naturally anergic cells, and  modulate their MAPK, mTORC1, and Ca(2+)/calcineurin signaling pathways with  increasing dose and time. They also become unable to help B cells and, at the  highest dose, undergo apoptosis. Transcriptomic analyses show the dynamic adjustment  of gene expression and the accumulation of T cell receptor (TCR) signals over a  period of weeks. Upon antigen removal, the cells recover their functionality while  losing exhaustion and anergy markers. Our data suggest an adjustable response of  CD4(+) T cells to different levels of persisting antigen and contribute to a better  understanding of chronic disease.},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {Cell reports},\n\tauthor = {Trefzer, Anne and Kadam, Pallavi and Wang, Shu-Hung and Pennavaria, Stefanie and Lober, Benedikt and Akçabozan, Batuhan and Kranich, Jan and Brocker, Thomas and Nakano, Naoko and Irmler, Martin and Beckers, Johannes and Straub, Tobias and Obst, Reinhard},\n\tmonth = feb,\n\tyear = {2021},\n\tpmid = {33567282},\n\tnote = {Place: United States},\n\tkeywords = {*CD4(+) T cells, *Clonal Anergy, *T cell receptor, *anergy, *exhaustion, *gene expression, *microarray, *tolerance, *transcriptomics, *tuning, Animals, Antigens/genetics/*immunology, B-Lymphocytes/immunology, Calcium Signaling/genetics/*immunology, Female, Gene Expression Profiling, Gene Expression Regulation/*immunology, MAP Kinase Signaling System/genetics/*immunology, Mechanistic Target of Rapamycin Complex 1/genetics/immunology, Mice, Mice, Transgenic, Receptors, Antigen, T-Cell/genetics/immunology, Th1 Cells/*immunology},\n\tpages = {108748},\n}\n\n

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\n \n\n \n \n Davy-Mendez, T.; Napravnik, S.; Eron, J.; Cole, S.; van Duin, D.; Wohl, D.; Hogan, B.; Althoff, K.; Gebo, K.; Moore, R.; Silverberg, M.; Horberg, M.; Gill, M.; Whalen, C.; Klein, M.; Colasanti, J.; Sterling, T.; Mayor, A.; Rebeiro, P.; and Berry, S.\n\n\n \n \n \n \n Current and Past Immunodeficiency are Associated with Higher Hospitalization Rates among Persons on Virologically Suppressive Antiretroviral Therapy for up to Eleven Years.\n \n \n \n\n\n \n\n\n\n The Journal of Infectious Diseases. December 2020.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

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@article{davy-mendez_current_2020,\n\ttitle = {Current and {Past} {Immunodeficiency} are {Associated} with {Higher} {Hospitalization} {Rates} among {Persons} on {Virologically} {Suppressive} {Antiretroviral} {Therapy} for up to {Eleven} {Years}},\n\tdoi = {10.1093/infdis/jiaa786},\n\tabstract = {Background\nPersons with HIV (PWH) with persistently low CD4 counts despite efficacious antiretroviral therapy could have higher hospitalization risk.\n\nMethods\nIn six US and Canadian clinical cohorts, PWH with virologic suppression for ≥1 year in 2005-2015 were followed until virologic failure, loss to follow-up, death, or study end. Stratified by early (Years 2–5) and long-term (Years 6–11) suppression and lowest pre-suppression CD4 count {\\textless}200 and ≥200 cells/µL, Poisson regression models estimated hospitalization incidence rate ratios (aIRR) comparing patients by time-updated CD4 count category, adjusted for cohort, age, gender, calendar year, suppression duration, and lowest pre-suppression CD4 count.\n\nResults\nThe 6997 included patients (19 980 person-years) were 81\\% cisgender men and 40\\% White. Among patients with lowest pre-suppression CD4 {\\textless}200 cells/μL (44\\%), patients with current CD4 200-350 versus {\\textgreater}500 cells/μL had an aIRR of 1.44 during early suppression (95\\% CI 1.01-2.06), and 1.67 (1.03-2.72) during long-term suppression. Among patients with lowest pre-suppression CD4 ≥200 (56\\%), patients with current CD4 351-500 versus {\\textgreater}500 cells/μL had an aIRR of 1.22 (0.93-1.60) during early suppression and 2.09 (1.18-3.70) during long-term suppression.\n\nConclusions\nVirologically suppressed patients with lower CD4 counts experienced higher hospitalization rates, and could potentially benefit from targeted clinical management strategies.},\n\tjournal = {The Journal of Infectious Diseases},\n\tauthor = {Davy-Mendez, Thibaut and Napravnik, Sonia and Eron, Joseph and Cole, Stephen and van Duin, David and Wohl, David and Hogan, Brenna and Althoff, Keri and Gebo, Kelly and Moore, Richard and Silverberg, Michael and Horberg, Michael and Gill, Michael and Whalen, Christopher and Klein, Marina and Colasanti, Jonathan and Sterling, Timothy and Mayor, Angel and Rebeiro, Peter and Berry, Stephen},\n\tmonth = dec,\n\tyear = {2020},\n}\n\n

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\n \n\n \n \n Lee, R. Y.; Brumback, L. C.; Sathitratanacheewin, S.; Lober, W. B.; Modes, M. E.; Lynch, Y. T.; Ambrose, C. I.; Sibley, J.; Vranas, K. C.; Sullivan, D. R.; Engelberg, R. A.; Curtis, J. R.; and Kross, E. K.\n\n\n \n \n \n \n \n Association of Physician Orders for Life-Sustaining Treatment With ICU Admission Among Patients Hospitalized Near the End of Life.\n \n \n \n \n\n\n \n\n\n\n JAMA. February 2020.\n \n\n\n\n
\n\n\n\n \n \n $\"Association$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

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@article{lee_association_2020,\n\ttitle = {Association of {Physician} {Orders} for {Life}-{Sustaining} {Treatment} {With} {ICU} {Admission} {Among} {Patients} {Hospitalized} {Near} the {End} of {Life}},\n\turl = {https://jamanetwork.com/journals/jama/fullarticle/2761227},\n\tdoi = {10.1001/jama.2019.22523},\n\tabstract = {Importance  Patients with chronic illness frequently use Physician Orders for Life-Sustaining Treatment (POLST) to document treatment limitations.\n\nObjectives  To evaluate the association between POLST order for medical interventions and intensive care unit (ICU) admission for patients hospitalized near the end of life.\n\nDesign, Setting, and Participants  Retrospective cohort study of patients with POLSTs and with chronic illness who died between January 1, 2010, and December 31, 2017, and were hospitalized 6 months or less before death in a 2-hospital academic health care system.\n\nExposures  POLST order for medical interventions (“comfort measures only” vs “limited additional interventions” vs “full treatment”), age, race/ethnicity, education, days from POLST completion to admission, histories of cancer or dementia, and admission for traumatic injury.\n\nMain Outcomes and Measures  The primary outcome was the association between POLST order and ICU admission during the last hospitalization of life; the secondary outcome was receipt of a composite of 4 life-sustaining treatments: mechanical ventilation, vasopressors, dialysis, and cardiopulmonary resuscitation. For evaluating factors associated with POLST-discordant care, the outcome was ICU admission contrary to POLST order for medical interventions during the last hospitalization of life.\n\nResults  Among 1818 decedents (mean age, 70.8 [SD, 14.7] years; 41\\% women), 401 (22\\%) had POLST orders for comfort measures only, 761 (42\\%) had orders for limited additional interventions, and 656 (36\\%) had orders for full treatment. ICU admissions occurred in 31\\% (95\\% CI, 26\\%-35\\%) of patients with comfort-only orders, 46\\% (95\\% CI, 42\\%-49\\%) with limited-interventions orders, and 62\\% (95\\% CI, 58\\%-66\\%) with full-treatment orders. One or more life-sustaining treatments were delivered to 14\\% (95\\% CI, 11\\%-17\\%) of patients with comfort-only orders and to 20\\% (95\\% CI, 17\\%-23\\%) of patients with limited-interventions orders. Compared with patients with full-treatment POLSTs, those with comfort-only and limited-interventions orders were significantly less likely to receive ICU admission (comfort only: 123/401 [31\\%] vs 406/656 [62\\%], aRR, 0.53 [95\\% CI, 0.45-0.62]; limited interventions: 349/761 [46\\%] vs 406/656 [62\\%], aRR, 0.79 [95\\% CI, 0.71-0.87]). Across patients with comfort-only and limited-interventions POLSTs, 38\\% (95\\% CI, 35\\%-40\\%) received POLST-discordant care. Patients with cancer were significantly less likely to receive POLST-discordant care than those without cancer (comfort only: 41/181 [23\\%] vs 80/220 [36\\%], aRR, 0.60 [95\\% CI, 0.43-0.85]; limited interventions: 100/321 [31\\%] vs 215/440 [49\\%], aRR, 0.63 [95\\% CI, 0.51-0.78]). Patients with dementia and comfort-only orders were significantly less likely to receive POLST-discordant care than those without dementia (23/111 [21\\%] vs 98/290 [34\\%], aRR, 0.44 [95\\% CI, 0.29-0.67]). Patients admitted for traumatic injury were significantly more likely to receive POLST-discordant care (comfort only: 29/64 [45\\%] vs 92/337 [27\\%], aRR, 1.52 [95\\% CI, 1.08-2.14]; limited interventions: 51/91 [56\\%] vs 264/670 [39\\%], aRR, 1.36 [95\\% CI, 1.09-1.68]). In patients with limited-interventions orders, older age was significantly associated with less POLST-discordant care (aRR, 0.93 per 10 years [95\\% CI, 0.88-1.00]).\n\nConclusions and Relevance  Among patients with POLSTs and with chronic life-limiting illness who were hospitalized within 6 months of death, treatment-limiting POLSTs were significantly associated with lower rates of ICU admission compared with full-treatment POLSTs. However, 38\\% of patients with treatment-limiting POLSTs received intensive care that was potentially discordant with their POLST.},\n\tlanguage = {en},\n\turldate = {2020-02-27},\n\tjournal = {JAMA},\n\tauthor = {Lee, Robert Y. and Brumback, Lyndia C. and Sathitratanacheewin, Seelwan and Lober, William B. and Modes, Matthew E. and Lynch, Ylinne T. and Ambrose, Corey I. and Sibley, James and Vranas, Kelly C. and Sullivan, Donald R. and Engelberg, Ruth A. and Curtis, J. Randall and Kross, Erin K.},\n\tmonth = feb,\n\tyear = {2020},\n}\n\n

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\n Importance Patients with chronic illness frequently use Physician Orders for Life-Sustaining Treatment (POLST) to document treatment limitations. Objectives To evaluate the association between POLST order for medical interventions and intensive care unit (ICU) admission for patients hospitalized near the end of life. Design, Setting, and Participants Retrospective cohort study of patients with POLSTs and with chronic illness who died between January 1, 2010, and December 31, 2017, and were hospitalized 6 months or less before death in a 2-hospital academic health care system. Exposures POLST order for medical interventions (“comfort measures only” vs “limited additional interventions” vs “full treatment”), age, race/ethnicity, education, days from POLST completion to admission, histories of cancer or dementia, and admission for traumatic injury. Main Outcomes and Measures The primary outcome was the association between POLST order and ICU admission during the last hospitalization of life; the secondary outcome was receipt of a composite of 4 life-sustaining treatments: mechanical ventilation, vasopressors, dialysis, and cardiopulmonary resuscitation. For evaluating factors associated with POLST-discordant care, the outcome was ICU admission contrary to POLST order for medical interventions during the last hospitalization of life. Results Among 1818 decedents (mean age, 70.8 [SD, 14.7] years; 41% women), 401 (22%) had POLST orders for comfort measures only, 761 (42%) had orders for limited additional interventions, and 656 (36%) had orders for full treatment. ICU admissions occurred in 31% (95% CI, 26%-35%) of patients with comfort-only orders, 46% (95% CI, 42%-49%) with limited-interventions orders, and 62% (95% CI, 58%-66%) with full-treatment orders. One or more life-sustaining treatments were delivered to 14% (95% CI, 11%-17%) of patients with comfort-only orders and to 20% (95% CI, 17%-23%) of patients with limited-interventions orders. Compared with patients with full-treatment POLSTs, those with comfort-only and limited-interventions orders were significantly less likely to receive ICU admission (comfort only: 123/401 [31%] vs 406/656 [62%], aRR, 0.53 [95% CI, 0.45-0.62]; limited interventions: 349/761 [46%] vs 406/656 [62%], aRR, 0.79 [95% CI, 0.71-0.87]). Across patients with comfort-only and limited-interventions POLSTs, 38% (95% CI, 35%-40%) received POLST-discordant care. Patients with cancer were significantly less likely to receive POLST-discordant care than those without cancer (comfort only: 41/181 [23%] vs 80/220 [36%], aRR, 0.60 [95% CI, 0.43-0.85]; limited interventions: 100/321 [31%] vs 215/440 [49%], aRR, 0.63 [95% CI, 0.51-0.78]). Patients with dementia and comfort-only orders were significantly less likely to receive POLST-discordant care than those without dementia (23/111 [21%] vs 98/290 [34%], aRR, 0.44 [95% CI, 0.29-0.67]). Patients admitted for traumatic injury were significantly more likely to receive POLST-discordant care (comfort only: 29/64 [45%] vs 92/337 [27%], aRR, 1.52 [95% CI, 1.08-2.14]; limited interventions: 51/91 [56%] vs 264/670 [39%], aRR, 1.36 [95% CI, 1.09-1.68]). In patients with limited-interventions orders, older age was significantly associated with less POLST-discordant care (aRR, 0.93 per 10 years [95% CI, 0.88-1.00]). Conclusions and Relevance Among patients with POLSTs and with chronic life-limiting illness who were hospitalized within 6 months of death, treatment-limiting POLSTs were significantly associated with lower rates of ICU admission compared with full-treatment POLSTs. However, 38% of patients with treatment-limiting POLSTs received intensive care that was potentially discordant with their POLST.\n

\n\n\n

\n \n\n \n \n Lee, R. Y.; Brumback, L. C.; Sathitratanacheewin, S.; Lober, W. B.; Modes, M. E.; Lynch, Y. T.; Ambrose, C. I.; Sibley, J.; Vranas, K. C.; Sullivan, D. R.; Engelberg, R. A.; Curtis, J. R.; and Kross, E. K.\n\n\n \n \n \n \n \n Association of Physician Orders for Life-Sustaining Treatment With ICU Admission Among Patients Hospitalized Near the End of Life.\n \n \n \n \n\n\n \n\n\n\n JAMA. February 2020.\n \n\n\n\n
\n\n\n\n \n \n $\"Association$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

\n

@article{lee_association_2020-1,\n\ttitle = {Association of {Physician} {Orders} for {Life}-{Sustaining} {Treatment} {With} {ICU} {Admission} {Among} {Patients} {Hospitalized} {Near} the {End} of {Life}},\n\turl = {https://jamanetwork.com/journals/jama/fullarticle/2761227},\n\tdoi = {10.1001/jama.2019.22523},\n\tabstract = {Importance  Patients with chronic illness frequently use Physician Orders for Life-Sustaining Treatment (POLST) to document treatment limitations.\n\nObjectives  To evaluate the association between POLST order for medical interventions and intensive care unit (ICU) admission for patients hospitalized near the end of life.\n\nDesign, Setting, and Participants  Retrospective cohort study of patients with POLSTs and with chronic illness who died between January 1, 2010, and December 31, 2017, and were hospitalized 6 months or less before death in a 2-hospital academic health care system.\n\nExposures  POLST order for medical interventions (“comfort measures only” vs “limited additional interventions” vs “full treatment”), age, race/ethnicity, education, days from POLST completion to admission, histories of cancer or dementia, and admission for traumatic injury.\n\nMain Outcomes and Measures  The primary outcome was the association between POLST order and ICU admission during the last hospitalization of life; the secondary outcome was receipt of a composite of 4 life-sustaining treatments: mechanical ventilation, vasopressors, dialysis, and cardiopulmonary resuscitation. For evaluating factors associated with POLST-discordant care, the outcome was ICU admission contrary to POLST order for medical interventions during the last hospitalization of life.\n\nResults  Among 1818 decedents (mean age, 70.8 [SD, 14.7] years; 41\\% women), 401 (22\\%) had POLST orders for comfort measures only, 761 (42\\%) had orders for limited additional interventions, and 656 (36\\%) had orders for full treatment. ICU admissions occurred in 31\\% (95\\% CI, 26\\%-35\\%) of patients with comfort-only orders, 46\\% (95\\% CI, 42\\%-49\\%) with limited-interventions orders, and 62\\% (95\\% CI, 58\\%-66\\%) with full-treatment orders. One or more life-sustaining treatments were delivered to 14\\% (95\\% CI, 11\\%-17\\%) of patients with comfort-only orders and to 20\\% (95\\% CI, 17\\%-23\\%) of patients with limited-interventions orders. Compared with patients with full-treatment POLSTs, those with comfort-only and limited-interventions orders were significantly less likely to receive ICU admission (comfort only: 123/401 [31\\%] vs 406/656 [62\\%], aRR, 0.53 [95\\% CI, 0.45-0.62]; limited interventions: 349/761 [46\\%] vs 406/656 [62\\%], aRR, 0.79 [95\\% CI, 0.71-0.87]). Across patients with comfort-only and limited-interventions POLSTs, 38\\% (95\\% CI, 35\\%-40\\%) received POLST-discordant care. Patients with cancer were significantly less likely to receive POLST-discordant care than those without cancer (comfort only: 41/181 [23\\%] vs 80/220 [36\\%], aRR, 0.60 [95\\% CI, 0.43-0.85]; limited interventions: 100/321 [31\\%] vs 215/440 [49\\%], aRR, 0.63 [95\\% CI, 0.51-0.78]). Patients with dementia and comfort-only orders were significantly less likely to receive POLST-discordant care than those without dementia (23/111 [21\\%] vs 98/290 [34\\%], aRR, 0.44 [95\\% CI, 0.29-0.67]). Patients admitted for traumatic injury were significantly more likely to receive POLST-discordant care (comfort only: 29/64 [45\\%] vs 92/337 [27\\%], aRR, 1.52 [95\\% CI, 1.08-2.14]; limited interventions: 51/91 [56\\%] vs 264/670 [39\\%], aRR, 1.36 [95\\% CI, 1.09-1.68]). In patients with limited-interventions orders, older age was significantly associated with less POLST-discordant care (aRR, 0.93 per 10 years [95\\% CI, 0.88-1.00]).\n\nConclusions and Relevance  Among patients with POLSTs and with chronic life-limiting illness who were hospitalized within 6 months of death, treatment-limiting POLSTs were significantly associated with lower rates of ICU admission compared with full-treatment POLSTs. However, 38\\% of patients with treatment-limiting POLSTs received intensive care that was potentially discordant with their POLST.},\n\tlanguage = {en},\n\turldate = {2020-02-27},\n\tjournal = {JAMA},\n\tauthor = {Lee, Robert Y. and Brumback, Lyndia C. and Sathitratanacheewin, Seelwan and Lober, William B. and Modes, Matthew E. and Lynch, Ylinne T. and Ambrose, Corey I. and Sibley, James and Vranas, Kelly C. and Sullivan, Donald R. and Engelberg, Ruth A. and Curtis, J. Randall and Kross, Erin K.},\n\tmonth = feb,\n\tyear = {2020},\n}\n\n

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\n Importance Patients with chronic illness frequently use Physician Orders for Life-Sustaining Treatment (POLST) to document treatment limitations. Objectives To evaluate the association between POLST order for medical interventions and intensive care unit (ICU) admission for patients hospitalized near the end of life. Design, Setting, and Participants Retrospective cohort study of patients with POLSTs and with chronic illness who died between January 1, 2010, and December 31, 2017, and were hospitalized 6 months or less before death in a 2-hospital academic health care system. Exposures POLST order for medical interventions (“comfort measures only” vs “limited additional interventions” vs “full treatment”), age, race/ethnicity, education, days from POLST completion to admission, histories of cancer or dementia, and admission for traumatic injury. Main Outcomes and Measures The primary outcome was the association between POLST order and ICU admission during the last hospitalization of life; the secondary outcome was receipt of a composite of 4 life-sustaining treatments: mechanical ventilation, vasopressors, dialysis, and cardiopulmonary resuscitation. For evaluating factors associated with POLST-discordant care, the outcome was ICU admission contrary to POLST order for medical interventions during the last hospitalization of life. Results Among 1818 decedents (mean age, 70.8 [SD, 14.7] years; 41% women), 401 (22%) had POLST orders for comfort measures only, 761 (42%) had orders for limited additional interventions, and 656 (36%) had orders for full treatment. ICU admissions occurred in 31% (95% CI, 26%-35%) of patients with comfort-only orders, 46% (95% CI, 42%-49%) with limited-interventions orders, and 62% (95% CI, 58%-66%) with full-treatment orders. One or more life-sustaining treatments were delivered to 14% (95% CI, 11%-17%) of patients with comfort-only orders and to 20% (95% CI, 17%-23%) of patients with limited-interventions orders. Compared with patients with full-treatment POLSTs, those with comfort-only and limited-interventions orders were significantly less likely to receive ICU admission (comfort only: 123/401 [31%] vs 406/656 [62%], aRR, 0.53 [95% CI, 0.45-0.62]; limited interventions: 349/761 [46%] vs 406/656 [62%], aRR, 0.79 [95% CI, 0.71-0.87]). Across patients with comfort-only and limited-interventions POLSTs, 38% (95% CI, 35%-40%) received POLST-discordant care. Patients with cancer were significantly less likely to receive POLST-discordant care than those without cancer (comfort only: 41/181 [23%] vs 80/220 [36%], aRR, 0.60 [95% CI, 0.43-0.85]; limited interventions: 100/321 [31%] vs 215/440 [49%], aRR, 0.63 [95% CI, 0.51-0.78]). Patients with dementia and comfort-only orders were significantly less likely to receive POLST-discordant care than those without dementia (23/111 [21%] vs 98/290 [34%], aRR, 0.44 [95% CI, 0.29-0.67]). Patients admitted for traumatic injury were significantly more likely to receive POLST-discordant care (comfort only: 29/64 [45%] vs 92/337 [27%], aRR, 1.52 [95% CI, 1.08-2.14]; limited interventions: 51/91 [56%] vs 264/670 [39%], aRR, 1.36 [95% CI, 1.09-1.68]). In patients with limited-interventions orders, older age was significantly associated with less POLST-discordant care (aRR, 0.93 per 10 years [95% CI, 0.88-1.00]). Conclusions and Relevance Among patients with POLSTs and with chronic life-limiting illness who were hospitalized within 6 months of death, treatment-limiting POLSTs were significantly associated with lower rates of ICU admission compared with full-treatment POLSTs. However, 38% of patients with treatment-limiting POLSTs received intensive care that was potentially discordant with their POLST.\n

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\n \n 2019\n \n \n (2)\n \n \n

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\n \n\n \n \n Hernández-Ramírez, R. U.; Qin, L.; Lin, H.; Leyden, W.; Neugebauer, R. S.; Althoff, K. N.; Achenbach, C. J.; Hessol, N. A.; D'Souza, G.; Gebo, K. A.; Gill, M. J.; Grover, S.; Horberg, M. A.; Li, J.; Mathews, W. C.; Mayor, A. M.; Park, L. S.; Rabkin, C. S.; Salters, K.; Justice, A. C.; Moore, R. D.; Engels, E. A.; Silverberg, M. J.; Dubrow, R.; North American AIDS Cohort Collaboration on Research; and of the International Epidemiologic Databases to Evaluate AIDS, D.\n\n\n \n \n \n \n \n Association of immunosuppression and HIV viraemia with non-Hodgkin lymphoma risk overall and by subtype in people living with HIV in Canada and the USA: a multicentre cohort study.\n \n \n \n \n\n\n \n\n\n\n The lancet. HIV, 6(4): e240–e249. April 2019.\n \n\n\n\n
\n\n\n\n \n \n $\"Association$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

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@article{hernandez-ramirez_association_2019,\n\ttitle = {Association of immunosuppression and {HIV} viraemia with non-{Hodgkin} lymphoma risk overall and by subtype in people living with {HIV} in {Canada} and the {USA}: a multicentre cohort study},\n\tvolume = {6},\n\tissn = {2352-3018},\n\tshorttitle = {Association of immunosuppression and {HIV} viraemia with non-{Hodgkin} lymphoma risk overall and by subtype in people living with {HIV} in {Canada} and the {USA}},\n\turl = {https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(18)30360-6/fulltext},\n\tdoi = {10.1016/S2352-3018(18)30360-6},\n\tabstract = {BACKGROUND: Research is needed to better understand relations between immunosuppression and HIV viraemia and risk for non-Hodgkin lymphoma, a common cancer in people living with HIV. We aimed to identify key CD4 count and HIV RNA (viral load) predictors of risk for non-Hodgkin lymphoma, overall and by subtype.\nMETHODS: We studied people living with HIV during 1996-2014 from 21 Canadian and US cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. To determine key independent predictors of risk for non-Hodgkin lymphoma, we assessed associations with time-updated recent, past, cumulative, and nadir or peak measures of CD4 count and viral load, using demographics-adjusted, cohort-stratified Cox models, and we compared models using Akaike's information criterion.\nFINDINGS: Of 102 131 people living with HIV during the study period, 712 people developed non-Hodgkin lymphoma. The key independent predictors of risk for overall non-Hodgkin lymphoma were recent CD4 count (ie, lagged by 6 months; {\\textless}50 cells per μL vs ≥500 cells per μL, hazard ratio [HR] 3·2, 95\\% CI 2·2-4·7) and average viral load during a 3-year window lagged by 6 months (a cumulative measure; ≥100 000 copies per mL vs ≤500 copies per mL, HR 9·6, 95\\% CI 6·5-14·0). These measures were also the key predictors of risk for diffuse large B-cell lymphoma (recent CD4 count {\\textless}50 cells per μL vs ≥500 cells per μL, HR 2·4, 95\\% CI 1·4-4·2; average viral load ≥100 000 copies per mL vs ≤500 copies per mL, HR 7·5, 95\\% CI 4·5-12·7). However, recent CD4 count was the sole key predictor of risk for CNS non-Hodgkin lymphoma ({\\textless}50 cells per μL vs ≥500 cells per μL, HR 426·3, 95\\% CI 58·1-3126·4), and proportion of time viral load was greater than 500 copies per mL during the 3-year window (a cumulative measure) was the sole key predictor for Burkitt lymphoma (100\\% vs 0\\%, HR 41·1, 95\\% CI 9·1-186·6).\nINTERPRETATION: Both recent immunosuppression and prolonged HIV viraemia have important independent roles in the development of non-Hodgkin lymphoma, with likely subtype heterogeneity. Early and sustained antiretroviral therapy to decrease HIV replication, dampen B-cell activation, and restore overall immune function is crucial for preventing non-Hodgkin lymphoma.\nFUNDING: National Institutes of Health, Centers for Disease Control and Prevention, US Agency for Healthcare Research and Quality, US Health Resources and Services Administration, Canadian Institutes of Health Research, Ontario Ministry of Health and Long Term Care, and the Government of Alberta.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {The lancet. HIV},\n\tauthor = {Hernández-Ramírez, Raúl U. and Qin, Li and Lin, Haiqun and Leyden, Wendy and Neugebauer, Romain S. and Althoff, Keri N. and Achenbach, Chad J. and Hessol, Nancy A. and D'Souza, Gypsyamber and Gebo, Kelly A. and Gill, M. John and Grover, Surbhi and Horberg, Michael A. and Li, Jun and Mathews, W. Christopher and Mayor, Angel M. and Park, Lesley S. and Rabkin, Charles S. and Salters, Kate and Justice, Amy C. and Moore, Richard D. and Engels, Eric A. and Silverberg, Michael J. and Dubrow, Robert and {North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS}},\n\tmonth = apr,\n\tyear = {2019},\n\tpmid = {30826282},\n\tpmcid = {PMC6531288},\n\tpages = {e240--e249},\n}\n\n

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\n BACKGROUND: Research is needed to better understand relations between immunosuppression and HIV viraemia and risk for non-Hodgkin lymphoma, a common cancer in people living with HIV. We aimed to identify key CD4 count and HIV RNA (viral load) predictors of risk for non-Hodgkin lymphoma, overall and by subtype. METHODS: We studied people living with HIV during 1996-2014 from 21 Canadian and US cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. To determine key independent predictors of risk for non-Hodgkin lymphoma, we assessed associations with time-updated recent, past, cumulative, and nadir or peak measures of CD4 count and viral load, using demographics-adjusted, cohort-stratified Cox models, and we compared models using Akaike's information criterion. FINDINGS: Of 102 131 people living with HIV during the study period, 712 people developed non-Hodgkin lymphoma. The key independent predictors of risk for overall non-Hodgkin lymphoma were recent CD4 count (ie, lagged by 6 months; \\textless50 cells per μL vs ≥500 cells per μL, hazard ratio [HR] 3·2, 95% CI 2·2-4·7) and average viral load during a 3-year window lagged by 6 months (a cumulative measure; ≥100 000 copies per mL vs ≤500 copies per mL, HR 9·6, 95% CI 6·5-14·0). These measures were also the key predictors of risk for diffuse large B-cell lymphoma (recent CD4 count \\textless50 cells per μL vs ≥500 cells per μL, HR 2·4, 95% CI 1·4-4·2; average viral load ≥100 000 copies per mL vs ≤500 copies per mL, HR 7·5, 95% CI 4·5-12·7). However, recent CD4 count was the sole key predictor of risk for CNS non-Hodgkin lymphoma (\\textless50 cells per μL vs ≥500 cells per μL, HR 426·3, 95% CI 58·1-3126·4), and proportion of time viral load was greater than 500 copies per mL during the 3-year window (a cumulative measure) was the sole key predictor for Burkitt lymphoma (100% vs 0%, HR 41·1, 95% CI 9·1-186·6). INTERPRETATION: Both recent immunosuppression and prolonged HIV viraemia have important independent roles in the development of non-Hodgkin lymphoma, with likely subtype heterogeneity. Early and sustained antiretroviral therapy to decrease HIV replication, dampen B-cell activation, and restore overall immune function is crucial for preventing non-Hodgkin lymphoma. FUNDING: National Institutes of Health, Centers for Disease Control and Prevention, US Agency for Healthcare Research and Quality, US Health Resources and Services Administration, Canadian Institutes of Health Research, Ontario Ministry of Health and Long Term Care, and the Government of Alberta.\n

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\n \n\n \n \n Feinstein, M. J.; Nance, R. M.; Delaney, J. A. C.; Heckbert, S. R.; Budoff, M. J.; Drozd, D. R.; Burkholder, G. A.; Willig, J. H.; Mugavero, M. J.; Mathews, W. C.; Moore, R. D.; Eron, J. J.; Napravnik, S.; Hunt, P. W.; Geng, E.; Hsue, P.; Peter, I.; Lober, W. B.; Crothers, K.; Grunfeld, C.; Saag, M. S.; Kitahata, M. M.; Lloyd-Jones, D. M.; and Crane, H. M.\n\n\n \n \n \n \n \n Mortality following myocardial infarction among HIV-infected persons: the Center for AIDS Research Network Of Integrated Clinical Systems (CNICS).\n \n \n \n \n\n\n \n\n\n\n BMC medicine, 17(1): 149. July 2019.\n \n\n\n\n
\n\n\n\n \n \n $\"Mortality$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{feinstein_mortality_2019,\n\ttitle = {Mortality following myocardial infarction among {HIV}-infected persons: the {Center} for {AIDS} {Research} {Network} {Of} {Integrated} {Clinical} {Systems} ({CNICS})},\n\tvolume = {17},\n\tissn = {1741-7015},\n\tshorttitle = {Mortality following myocardial infarction among {HIV}-infected persons},\n\turl = {https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-019-1385-7},\n\tdoi = {10.1186/s12916-019-1385-7},\n\tabstract = {BACKGROUND: Persons with human immunodeficiency virus (HIV) have higher risks for myocardial infarction (MI) than the general population. This is driven in part by higher type 2 MI (T2MI, due to coronary supply-demand mismatch) rates among persons with HIV (PWH). In the general population, T2MI has higher mortality than type 1 MI (T1MI, spontaneous and generally due to plaque rupture and thrombosis). PWH have a greater burden of comorbidities and may therefore have an even greater excess risk for complication and death in the setting of T2MI. However, mortality patterns after T1MI and T2MI in HIV are unknown.\nMETHODS: We analyzed mortality after MI among PWH enrolled in the multicenter, US-based Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort (N = 28,186). Incident MIs occurring between January 1, 1996, and December 31, 2014, were centrally adjudicated and classified as T1MI or T2MI. We first compared mortality following T1MI vs. T2MI among PWH. Cox survival analyses and Bayesian model averaging were then used to evaluate pre-MI covariates associated with mortality following T1MI and T2MI.\nRESULTS: Among the 596 out of 28,186 PWH who experienced MI (2.1\\%; 293 T1MI and 303 T2MI), mortality rates were significantly greater after T2MI (22.2/100 person-years; 1-, 3-, and 5-year mortality 39\\%, 52\\%, and 62\\%) than T1MI (8.2/100 person-years; 1-, 3-, and 5-year mortality 15\\%, 22\\%, and 30\\%). Significant mortality predictors after T1MI were higher HIV viral load, renal dysfunction, and older age. Significant predictors of mortality after T2MI were low body-mass index (BMI) and detectable HIV viral load.\nCONCLUSIONS: Mortality is high following MI for PWH and substantially greater after T2MI than T1MI. Predictors of death after MI differed by type of MI, reinforcing the different clinical scenarios associated with each MI type and the importance of considering MI types separately.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMC medicine},\n\tauthor = {Feinstein, Matthew J. and Nance, Robin M. and Delaney, J. A. Chris and Heckbert, Susan R. and Budoff, Matthew J. and Drozd, Daniel R. and Burkholder, Greer A. and Willig, James H. and Mugavero, Michael J. and Mathews, William C. and Moore, Richard D. and Eron, Joseph J. and Napravnik, Sonia and Hunt, Peter W. and Geng, Elvin and Hsue, Priscilla and Peter, Inga and Lober, William B. and Crothers, Kristina and Grunfeld, Carl and Saag, Michael S. and Kitahata, Mari M. and Lloyd-Jones, Donald M. and Crane, Heidi M.},\n\tmonth = jul,\n\tyear = {2019},\n\tpmid = {31362721},\n\tpmcid = {PMC6668167},\n\tkeywords = {Acquired Immunodeficiency Syndrome, Adult, Aged, Cardiovascular diseases, Cohort Studies, Community Networks, Comorbidity, Epidemiology, Female, HIV Infections, Human immunodeficiency virus, Humans, Male, Middle Aged, Mortality, Multicenter study, Myocardial Infarction, Myocardial infarction, Plaque, Atherosclerotic, United States},\n\tpages = {149},\n}\n\n

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\n \n 2017\n \n \n (2)\n \n \n

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\n \n\n \n \n Crane, H. M.; Paramsothy, P.; Drozd, D. R.; Nance, R. M.; Delaney, J. A. C.; Heckbert, S. R.; Budoff, M. J.; Burkholder, G. A.; Willig, J. H.; Mugavero, M. J.; Mathews, W. C.; Crane, P. K.; Moore, R. D.; Eron, J. J.; Napravnik, S.; Hunt, P. W.; Geng, E.; Hsue, P.; Rodriguez, C.; Peter, I.; Barnes, G. S.; McReynolds, J.; Lober, W. B.; Crothers, K.; Feinstein, M. J.; Grunfeld, C.; Saag, M. S.; Kitahata, M. M.; and Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) Cohort\n\n\n \n \n \n \n Types of Myocardial Infarction Among Human Immunodeficiency Virus-Infected Individuals in the United States.\n \n \n \n\n\n \n\n\n\n JAMA cardiology, 2(3): 260–267. 2017.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{crane_types_2017,\n\ttitle = {Types of {Myocardial} {Infarction} {Among} {Human} {Immunodeficiency} {Virus}-{Infected} {Individuals} in the {United} {States}},\n\tvolume = {2},\n\tissn = {2380-6591},\n\tdoi = {10.1001/jamacardio.2016.5139},\n\tabstract = {Importance: The Second Universal Definition of Myocardial Infarction (MI) divides MIs into different types. Type 1 MIs result spontaneously from instability of atherosclerotic plaque, whereas type 2 MIs occur in the setting of a mismatch between oxygen demand and supply, as with severe hypotension. Type 2 MIs are uncommon in the general population, but their frequency in human immunodeficiency virus (HIV)-infected individuals is unknown.\nObjectives: To characterize MIs, including type; identify causes of type 2 MIs; and compare demographic and clinical characteristics among HIV-infected individuals with type 1 vs type 2 MIs.\nDesign, Setting, and Participants: This longitudinal study identified potential MIs among patients with HIV receiving clinical care at 6 US sites from January 1, 1996, to March 1, 2014, using diagnoses and cardiac biomarkers recorded in the centralized data repository. Sites assembled deidentified packets, including physician notes and electrocardiograms, procedures, and clinical laboratory tests. Two physician experts adjudicated each event, categorizing each definite or probable MI as type 1 or type 2 and identifying the causes of type 2 MI.\nMain Outcomes and Measures: The number and proportion of type 1 vs type 2 MIs, demographic and clinical characteristics among those with type 1 vs type 2 MIs, and the causes of type 2 MIs.\nResults: Among 571 patients (median age, 49 years [interquartile range, 43-55 years]; 430 men and 141 women) with definite or probable MIs, 288 MIs (50.4\\%) were type 2 and 283 (49.6\\%) were type 1. In analyses of type 1 MIs, 79 patients who underwent cardiac interventions, such as coronary artery bypass graft surgery, were also included, totaling 362 patients. Sepsis or bacteremia (100 [34.7\\%]) and recent use of cocaine or other illicit drugs (39 [13.5\\%]) were the most common causes of type 2 MIs. A higher proportion of patients with type 2 MIs were younger than 40 years (47 of 288 [16.3\\%] vs 32 of 362 [8.8\\%]) and had lower current CD4 cell counts (median, 230 vs 383 cells/µL), lipid levels (mean [SD] total cholesterol level, 167 [63] vs 190 [54] mg/dL, and mean (SD) Framingham risk scores (8\\% [7\\%] vs 10\\% [8\\%]) than those with type 1 MIs or who underwent cardiac interventions.\nConclusions and Relevance: Approximately half of all MIs among HIV-infected individuals were type 2 MIs caused by heterogeneous clinical conditions, including sepsis or bacteremia and recent use of cocaine or other illicit drugs. Demographic characteristics and cardiovascular risk factors among those with type 1 and type 2 MIs differed, suggesting the need to specifically consider type among HIV-infected individuals to further understand MI outcomes and to guide prevention and treatment.},\n\tlanguage = {eng},\n\tnumber = {3},\n\tjournal = {JAMA cardiology},\n\tauthor = {Crane, Heidi M. and Paramsothy, Pathmaja and Drozd, Daniel R. and Nance, Robin M. and Delaney, J. A. Chris and Heckbert, Susan R. and Budoff, Matthew J. and Burkholder, Greer A. and Willig, James H. and Mugavero, Michael J. and Mathews, William C. and Crane, Paul K. and Moore, Richard D. and Eron, Joseph J. and Napravnik, Sonia and Hunt, Peter W. and Geng, Elvin and Hsue, Priscilla and Rodriguez, Carla and Peter, Inga and Barnes, Greg S. and McReynolds, Justin and Lober, William B. and Crothers, Kristina and Feinstein, Matthew J. and Grunfeld, Carl and Saag, Michael S. and Kitahata, Mari M. and {Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) Cohort}},\n\tyear = {2017},\n\tpmid = {28052152},\n\tpmcid = {PMC5538773},\n\tkeywords = {Adult, Coronary Angiography, Electrocardiography, Female, Follow-Up Studies, HIV, HIV Infections, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Retrospective Studies, Risk Assessment, Risk Factors, Survival Rate, Time Factors, United States},\n\tpages = {260--267},\n}\n\n

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\n Importance: The Second Universal Definition of Myocardial Infarction (MI) divides MIs into different types. Type 1 MIs result spontaneously from instability of atherosclerotic plaque, whereas type 2 MIs occur in the setting of a mismatch between oxygen demand and supply, as with severe hypotension. Type 2 MIs are uncommon in the general population, but their frequency in human immunodeficiency virus (HIV)-infected individuals is unknown. Objectives: To characterize MIs, including type; identify causes of type 2 MIs; and compare demographic and clinical characteristics among HIV-infected individuals with type 1 vs type 2 MIs. Design, Setting, and Participants: This longitudinal study identified potential MIs among patients with HIV receiving clinical care at 6 US sites from January 1, 1996, to March 1, 2014, using diagnoses and cardiac biomarkers recorded in the centralized data repository. Sites assembled deidentified packets, including physician notes and electrocardiograms, procedures, and clinical laboratory tests. Two physician experts adjudicated each event, categorizing each definite or probable MI as type 1 or type 2 and identifying the causes of type 2 MI. Main Outcomes and Measures: The number and proportion of type 1 vs type 2 MIs, demographic and clinical characteristics among those with type 1 vs type 2 MIs, and the causes of type 2 MIs. Results: Among 571 patients (median age, 49 years [interquartile range, 43-55 years]; 430 men and 141 women) with definite or probable MIs, 288 MIs (50.4%) were type 2 and 283 (49.6%) were type 1. In analyses of type 1 MIs, 79 patients who underwent cardiac interventions, such as coronary artery bypass graft surgery, were also included, totaling 362 patients. Sepsis or bacteremia (100 [34.7%]) and recent use of cocaine or other illicit drugs (39 [13.5%]) were the most common causes of type 2 MIs. A higher proportion of patients with type 2 MIs were younger than 40 years (47 of 288 [16.3%] vs 32 of 362 [8.8%]) and had lower current CD4 cell counts (median, 230 vs 383 cells/µL), lipid levels (mean [SD] total cholesterol level, 167 [63] vs 190 [54] mg/dL, and mean (SD) Framingham risk scores (8% [7%] vs 10% [8%]) than those with type 1 MIs or who underwent cardiac interventions. Conclusions and Relevance: Approximately half of all MIs among HIV-infected individuals were type 2 MIs caused by heterogeneous clinical conditions, including sepsis or bacteremia and recent use of cocaine or other illicit drugs. Demographic characteristics and cardiovascular risk factors among those with type 1 and type 2 MIs differed, suggesting the need to specifically consider type among HIV-infected individuals to further understand MI outcomes and to guide prevention and treatment.\n

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\n \n\n \n \n Engels, E. A.; Yanik, E. L.; Wheeler, W.; Gill, M. J.; Shiels, M. S.; Dubrow, R.; Althoff, K. N.; Silverberg, M. J.; Brooks, J. T.; Kitahata, M. M.; Goedert, J. J.; Grover, S.; Mayor, A. M.; Moore, R. D.; Park, L. S.; Rachlis, A.; Sigel, K.; Sterling, T. R.; Thorne, J. E.; Pfeiffer, R. M.; North American AIDS Cohort Collaboration on Research; of the International Epidemiologic Databases to Evaluate AIDS, D.; North American AIDS Cohort Collaboration on Research; and of the International Epidemiologic Databases to Evaluate AIDS, D.\n\n\n \n \n \n \n Cancer-Attributable Mortality Among People With Treated Human Immunodeficiency Virus Infection in North America.\n \n \n \n\n\n \n\n\n\n Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 65(4): 636–643. August 2017.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{engels_cancer-attributable_2017,\n\ttitle = {Cancer-{Attributable} {Mortality} {Among} {People} {With} {Treated} {Human} {Immunodeficiency} {Virus} {Infection} in {North} {America}},\n\tvolume = {65},\n\tissn = {1537-6591},\n\tdoi = {10.1093/cid/cix392},\n\tabstract = {Background: Cancer remains an important cause of morbidity and mortality in people with human immunodeficiency virus (PWHIV) on effective antiretroviral therapy (ART). Estimates of cancer-attributable mortality can inform public health efforts.\nMethods: We evaluated 46956 PWHIV receiving ART in North American HIV cohorts (1995-2009). Using information on incident cancers and deaths, we calculated population-attributable fractions (PAFs), estimating the proportion of deaths due to cancer. Calculations were based on proportional hazards models adjusted for age, sex, race, HIV risk group, calendar year, cohort, CD4 count, and viral load.\nResults: There were 1997 incident cancers and 8956 deaths during 267145 person-years of follow-up, and 11.9\\% of decedents had a prior cancer. An estimated 9.8\\% of deaths were attributable to cancer (cancer-attributable mortality rate 327 per 100000 person-years). PAFs were 2.6\\% for AIDS-defining cancers (ADCs, including non-Hodgkin lymphoma, 2.0\\% of deaths) and 7.1\\% for non-AIDS-defining cancers (NADCs: lung cancer, 2.3\\%; liver cancer, 0.9\\%). PAFs for NADCs were higher in males and increased strongly with age, reaching 12.5\\% in PWHIV aged 55+ years. Mortality rates attributable to ADCs and NADCs were highest for PWHIV with CD4 counts {\\textless}100 cells/mm3. PAFs for NADCs increased during 1995-2009, reaching 10.1\\% in 2006-2009.\nConclusions: Approximately 10\\% of deaths in PWHIV prescribed ART during 1995-2009 were attributable to cancer, but this fraction increased over time. A large proportion of cancer-attributable deaths were associated with non-Hodgkin lymphoma, lung cancer, and liver cancer. Deaths due to NADCs will likely grow in importance as AIDS mortality declines and PWHIV age.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},\n\tauthor = {Engels, Eric A. and Yanik, Elizabeth L. and Wheeler, Willian and Gill, M. John and Shiels, Meredith S. and Dubrow, Robert and Althoff, Keri N. and Silverberg, Michael J. and Brooks, John T. and Kitahata, Mari M. and Goedert, James J. and Grover, Surbhi and Mayor, Angel M. and Moore, Richard D. and Park, Lesley S. and Rachlis, Anita and Sigel, Keith and Sterling, Timothy R. and Thorne, Jennifer E. and Pfeiffer, Ruth M. and {North American AIDS Cohort Collaboration on Research and\n                    Design of the International Epidemiologic Databases to Evaluate AIDS} and {North American AIDS Cohort Collaboration on Research and Design\n                    of the International Epidemiologic Databases to Evaluate AIDS}},\n\tmonth = aug,\n\tyear = {2017},\n\tpmid = {29017269},\n\tpmcid = {PMC5849088},\n\tkeywords = {AIDS, Adolescent, Adult, CD4 Lymphocyte Count, Female, HIV, HIV Infections, Humans, Male, Middle Aged, Neoplasms, North America, Proportional Hazards Models, Retrospective Studies, Viral Load, Young Adult, aging, cancer, mortality},\n\tpages = {636--643},\n}\n\n

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\n \n 2016\n \n \n (4)\n \n \n

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\n \n\n \n \n Althoff, K. N.; Rebeiro, P. F.; Hanna, D. B.; Padgett, D.; Horberg, M. A.; Grinsztejn, B.; Abraham, A. G.; Hogg, R.; Gill, M. J.; Wolff, M. J.; Mayor, A.; Rachlis, A.; Williams, C.; Sterling, T. R.; Kitahata, M. M.; Buchacz, K.; Thorne, J. E.; Cesar, C.; Cordero, F. M.; Rourke, S. B.; Sierra-Madero, J.; Pape, J. W.; Cahn, P.; McGowan, C.; North American Aids Cohort Collaboration on Research; (NA-ACCORD), D.; Caribbean, C.; and for Hiv Epidemiology (CCASAnet), S. A. N.\n\n\n \n \n \n \n \n A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts.\n \n \n \n \n\n\n \n\n\n\n Journal of the International AIDS Society, 19(1): 20707. April 2016.\n \n\n\n\n
\n\n\n\n \n \n $\"A$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{althoff_picture_2016,\n\ttitle = {A picture is worth a thousand words: maps of {HIV} indicators to inform research, programs, and policy from {NA}-{ACCORD} and {CCASAnet} clinical cohorts},\n\tvolume = {19},\n\tissn = {1758-2652},\n\tshorttitle = {A picture is worth a thousand words},\n\turl = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821890/pdf/JIAS-19-20707.pdf},\n\tdoi = {10.7448/IAS.19.1.20707},\n\tabstract = {INTRODUCTION: Maps are powerful tools for visualization of differences in health indicators by geographical region, but multi-country maps of HIV indicators do not exist, perhaps due to lack of consistent data across countries. Our objective was to create maps of four HIV indicators in North, Central, and South American countries.\nMETHODS: Using data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and the Caribbean, Central, and South America network for HIV epidemiology (CCASAnet), we mapped median CD4 at presentation for HIV clinical care, proportion retained in HIV primary care, proportion prescribed antiretroviral therapy (ART), and the proportion with suppressed plasma HIV viral load (VL) from 2010 to 2012 for North, Central, and South America. The 15 Canadian and US clinical cohorts and 7 clinical cohorts in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru represented approximately 2-7\\% of persons known to be living with HIV in these countries.\nRESULTS: Study populations were selected for each indicator: median CD4 at presentation for care was estimated among 14,811 adults; retention was estimated among 87,979 adults; ART use was estimated among 84,757 adults; and suppressed VL was estimated among 51,118 adults. Only three US states and the District of Columbia had a median CD4 at presentation {\\textgreater}350 cells/mm(3). Haiti, Mexico, and several states had {\\textgreater}85\\% retention in care; lower (50-74\\%) retention in care was observed in the US West, South, and Mid-Atlantic, and in Argentina, Brazil, and Peru. ART use was highest (90\\%) in Mexico. The percentages of patients with suppressed VL in the US South and Northeast were lower than in most of Central and South America.\nCONCLUSIONS: These maps provide visualization of gaps in the quality of HIV care and allow for comparison between and within countries as well as monitoring policy and programme goals within geographical boundaries.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Journal of the International AIDS Society},\n\tauthor = {Althoff, Keri N. and Rebeiro, Peter F. and Hanna, David B. and Padgett, Denis and Horberg, Michael A. and Grinsztejn, Beatriz and Abraham, Alison G. and Hogg, Robert and Gill, M. John and Wolff, Marcelo J. and Mayor, Angel and Rachlis, Anita and Williams, Carolyn and Sterling, Timothy R. and Kitahata, Mari M. and Buchacz, Kate and Thorne, Jennifer E. and Cesar, Carina and Cordero, Fernando M. and Rourke, Sean B. and Sierra-Madero, Juan and Pape, Jean W. and Cahn, Pedro and McGowan, Catherine and {North American Aids Cohort Collaboration on Research and Design (NA-ACCORD) and Caribbean, Central and South America Network for Hiv Epidemiology (CCASAnet)}},\n\tmonth = apr,\n\tyear = {2016},\n\tpmid = {27049052},\n\tpmcid = {PMC4821890},\n\tkeywords = {Adult, CD4 Lymphocyte Count, CD4 T-lymphocyte count, Central America, Cohort Studies, Cooperative Behavior, Cross-Sectional Studies, Female, HIV Infections, HIV RNA suppression, HIV indicators, Health Policy, Humans, Male, Map, Middle Aged, North America, Research Design, South America, antiretroviral therapy, implementation science, retention in care},\n\tpages = {20707},\n}\n\n

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\n \n\n \n \n Cesar, C.; Koethe, J. R.; Giganti, M. J.; Rebeiro, P.; Althoff, K. N.; Napravnik, S.; Mayor, A.; Grinsztejn, B.; Wolff, M.; Padgett, D.; Sierra-Madero, J.; Gotuzzo, E.; Sterling, T. R.; Willig, J.; Levison, J.; Kitahata, M.; Rodriguez-Barradas, M. C.; Moore, R. D.; McGowan, C.; Shepherd, B. E.; Cahn, P.; Caribbean, Central; for HIV epidemiology (CCASAnet), S. A. N.; on Research, N. A. A. C. C.; and (NA-ACCORD), D.\n\n\n \n \n \n \n Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America.\n \n \n \n\n\n \n\n\n\n Journal of the International AIDS Society, 19(1): 20684. 2016.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{cesar_health_2016,\n\ttitle = {Health outcomes among {HIV}-positive {Latinos} initiating antiretroviral therapy in {North} {America} versus {Central} and {South} {America}},\n\tvolume = {19},\n\tissn = {1758-2652},\n\tdoi = {10.7448/IAS.19.1.20684},\n\tabstract = {INTRODUCTION: Latinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America.\nMETHODS: HIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts.\nRESULTS: The study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27\\% vs. 20\\%) and had lower nadir CD4 count (median 148 vs. 195 cells/µL, p{\\textless}0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95\\% confidence interval (CI): 1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95\\% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95\\% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95\\% CI: 0.48 to 0.57).\nCONCLUSIONS: HIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Journal of the International AIDS Society},\n\tauthor = {Cesar, Carina and Koethe, John R. and Giganti, Mark J. and Rebeiro, Peter and Althoff, Keri N. and Napravnik, Sonia and Mayor, Angel and Grinsztejn, Beatriz and Wolff, Marcelo and Padgett, Denis and Sierra-Madero, Juan and Gotuzzo, Eduardo and Sterling, Timothy R. and Willig, James and Levison, Julie and Kitahata, Mari and Rodriguez-Barradas, Maria C. and Moore, Richard D. and McGowan, Catherine and Shepherd, Bryan E. and Cahn, Pedro and {Caribbean, Central and South America Network for HIV epidemiology (CCASAnet) and North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)}},\n\tyear = {2016},\n\tpmid = {26996992},\n\tpmcid = {PMC4800379},\n\tkeywords = {Adult, Anti-HIV Agents, Canada, Female, HIV, HIV Infections, Hispanic Americans, Humans, Latin America, Male, North America, Proportional Hazards Models, South America, Treatment Outcome, United States, antiretroviral therapy, cohort studies, highly active, mortality},\n\tpages = {20684},\n}\n\n

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\n \n\n \n \n Crane, H. M.; Fredericksen, R. J.; Church, A.; Harrington, A.; Ciechanowski, P.; Magnani, J.; Nasby, K.; Brown, T.; Dhanireddy, S.; Harrington, R. D.; Lober, W. B.; Simoni, J.; Safren, S. A.; Edwards, T. C.; Patrick, D. L.; Saag, M. S.; Crane, P. K.; and Kitahata, M. M.\n\n\n \n \n \n \n A Randomized Controlled Trial Protocol to Evaluate the Effectiveness of an Integrated Care Management Approach to Improve Adherence Among HIV-Infected Patients in Routine Clinical Care: Rationale and Design.\n \n \n \n\n\n \n\n\n\n JMIR research protocols, 5(4): e156. October 2016.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{crane_randomized_2016,\n\ttitle = {A {Randomized} {Controlled} {Trial} {Protocol} to {Evaluate} the {Effectiveness} of an {Integrated} {Care} {Management} {Approach} to {Improve} {Adherence} {Among} {HIV}-{Infected} {Patients} in {Routine} {Clinical} {Care}: {Rationale} and {Design}},\n\tvolume = {5},\n\tissn = {1929-0748},\n\tshorttitle = {A {Randomized} {Controlled} {Trial} {Protocol} to {Evaluate} the {Effectiveness} of an {Integrated} {Care} {Management} {Approach} to {Improve} {Adherence} {Among} {HIV}-{Infected} {Patients} in {Routine} {Clinical} {Care}},\n\tdoi = {10.2196/resprot.5492},\n\tabstract = {BACKGROUND: Adherence to antiretroviral medications is a key determinant of clinical outcomes. Many adherence intervention trials investigated the effects of time-intensive or costly interventions that are not feasible in most clinical care settings.\nOBJECTIVE: We set out to evaluate a collaborative care approach as a feasible intervention applicable to patients in clinical care including those with mental illness and/or substance use issues.\nMETHODS: We developed a randomized controlled trial (RCT) investigating an integrated, clinic-based care management approach to improve clinical outcomes that could be integrated into the clinical care setting. This is based on the routine integration and systematic follow-up of a clinical assessment of patient-reported outcomes targeting adherence, depression, and substance use, and adapts previously developed and tested care management approaches. The primary health coach or care management role is provided by clinic case managers allowing the intervention to be generalized to other human immunodeficiency virus (HIV) clinics that have case managers. We used a stepped-care approach to target interventions to those at greatest need who are most likely to benefit rather than to everyone to maintain feasibility in a busy clinical care setting.\nRESULTS: The National Institutes of Health funded this study and had no role in study design, data collection, or decisions regarding whether or not to submit manuscripts for publication. This trial is currently underway, enrollment was completed in 2015, and follow-up time still accruing. First results are expected to be ready for publication in early 2017.\nDISCUSSION: This paper describes the protocol for an ongoing clinical trial including the design and the rationale for key methodological decisions. There is a need to identify best practices for implementing evidence-based collaborative care models that are effective and feasible in clinical care. Adherence efficacy trials have not led to sufficient improvements, and there remains little guidance regarding how adherence interventions should be implemented into clinical care. By focusing on improving adherence within care settings using existing staff, routine assessment of key domains, such as depression, adherence, and substance use, and feasible interventions, we propose to evaluate this innovative way to improve clinical outcomes.\nTRIAL REGISTRATION: Clinicaltrials.gov NCT01505660; http://clinicaltrials.gov/ct2/show/NCT01505660 (Archived by WebCite at http://www.webcitation/ 6ktOq6Xj7).},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {JMIR research protocols},\n\tauthor = {Crane, Heidi M. and Fredericksen, Rob J. and Church, Anna and Harrington, Anna and Ciechanowski, Paul and Magnani, Jennifer and Nasby, Kari and Brown, Tyler and Dhanireddy, Shireesha and Harrington, Robert D. and Lober, William B. and Simoni, Jane and Safren, Stevan A. and Edwards, Todd C. and Patrick, Donald L. and Saag, Michael S. and Crane, Paul K. and Kitahata, Mari M.},\n\tmonth = oct,\n\tyear = {2016},\n\tpmid = {27707688},\n\tpmcid = {PMC5071617},\n\tkeywords = {HIV, adherence, alcohol use, care management, depression, intervention, randomized controlled trial, substance use},\n\tpages = {e156},\n}\n\n

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\n BACKGROUND: Adherence to antiretroviral medications is a key determinant of clinical outcomes. Many adherence intervention trials investigated the effects of time-intensive or costly interventions that are not feasible in most clinical care settings. OBJECTIVE: We set out to evaluate a collaborative care approach as a feasible intervention applicable to patients in clinical care including those with mental illness and/or substance use issues. METHODS: We developed a randomized controlled trial (RCT) investigating an integrated, clinic-based care management approach to improve clinical outcomes that could be integrated into the clinical care setting. This is based on the routine integration and systematic follow-up of a clinical assessment of patient-reported outcomes targeting adherence, depression, and substance use, and adapts previously developed and tested care management approaches. The primary health coach or care management role is provided by clinic case managers allowing the intervention to be generalized to other human immunodeficiency virus (HIV) clinics that have case managers. We used a stepped-care approach to target interventions to those at greatest need who are most likely to benefit rather than to everyone to maintain feasibility in a busy clinical care setting. RESULTS: The National Institutes of Health funded this study and had no role in study design, data collection, or decisions regarding whether or not to submit manuscripts for publication. This trial is currently underway, enrollment was completed in 2015, and follow-up time still accruing. First results are expected to be ready for publication in early 2017. DISCUSSION: This paper describes the protocol for an ongoing clinical trial including the design and the rationale for key methodological decisions. There is a need to identify best practices for implementing evidence-based collaborative care models that are effective and feasible in clinical care. Adherence efficacy trials have not led to sufficient improvements, and there remains little guidance regarding how adherence interventions should be implemented into clinical care. By focusing on improving adherence within care settings using existing staff, routine assessment of key domains, such as depression, adherence, and substance use, and feasible interventions, we propose to evaluate this innovative way to improve clinical outcomes. TRIAL REGISTRATION: Clinicaltrials.gov NCT01505660; http://clinicaltrials.gov/ct2/show/NCT01505660 (Archived by WebCite at http://www.webcitation/ 6ktOq6Xj7).\n

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\n \n\n \n \n Klein, M. B.; Althoff, K. N.; Jing, Y.; Lau, B.; Kitahata, M.; Lo Re, V.; Kirk, G. D.; Hull, M.; Kim, H. N.; Sebastiani, G.; Moodie, E. E. M.; Silverberg, M. J.; Sterling, T. R.; Thorne, J. E.; Cescon, A.; Napravnik, S.; Eron, J.; Gill, M. J.; Justice, A.; Peters, M. G.; Goedert, J. J.; Mayor, A.; Thio, C. L.; Cachay, E. R.; Moore, R.; North American AIDS Cohort Collaboration on Research; of IeDEA, D.; North American AIDS Cohort Collaboration on Research; and of IeDEA, D. (.\n\n\n \n \n \n \n Risk of End-Stage Liver Disease in HIV-Viral Hepatitis Coinfected Persons in North America From the Early to Modern Antiretroviral Therapy Eras.\n \n \n \n\n\n \n\n\n\n Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 63(9): 1160–1167. 2016.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{klein_risk_2016,\n\ttitle = {Risk of {End}-{Stage} {Liver} {Disease} in {HIV}-{Viral} {Hepatitis} {Coinfected} {Persons} in {North} {America} {From} the {Early} to {Modern} {Antiretroviral} {Therapy} {Eras}},\n\tvolume = {63},\n\tissn = {1537-6591},\n\tdoi = {10.1093/cid/ciw531},\n\tabstract = {BACKGROUND: Human immunodeficiency virus (HIV)-infected patients coinfected with hepatitis B (HBV) and C (HCV) viruses are at increased risk of end-stage liver disease (ESLD). Whether modern antiretroviral therapy has reduced ESLD risk is unknown.\nMETHODS: Twelve clinical cohorts in the United States and Canada participating in the North American AIDS Cohort Collaboration on Research and Design validated ESLD events from 1996 to 2010. ESLD incidence rates and rate ratios according to hepatitis status adjusted for age, sex, race, cohort, time-updated CD4 cell count and HIV RNA were estimated in calendar periods corresponding to major changes in antiretroviral therapy: early (1996-2000), middle (2001-2005), and modern (2006-2010) eras.\nRESULTS: Among 34 119 HIV-infected adults followed for 129 818 person-years, 380 incident ESLD outcomes occurred. ESLD incidence (per 1000 person-years) was highest in triply infected (11.57) followed by HBV- (8.72) and HCV- (6.10) coinfected vs 1.27 in HIV-monoinfected patients. Adjusted incidence rate ratios (95\\% confidence intervals) comparing the modern to the early antiretroviral era were 0.95 (.61-1.47) for HCV, 0.95 (.40-2.26) for HBV, and 1.52 (.46-5.02) for triply infected patients. Use of antiretrovirals dually activity against HBV increased over time. However, in the modern era, 35\\% of HBV-coinfected patients were not receiving tenofovir. There was little use of HCV therapy.\nCONCLUSIONS: Despite increasing use of antiretrovirals, no clear reduction in ESLD risk was observed over 15 years. Treatment with direct-acting antivirals for HCV and wider use of tenofovir-based regimens for HBV should be prioritized for coinfected patients.},\n\tlanguage = {eng},\n\tnumber = {9},\n\tjournal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},\n\tauthor = {Klein, Marina B. and Althoff, Keri N. and Jing, Yuezhou and Lau, Bryan and Kitahata, Mari and Lo Re, Vincent and Kirk, Gregory D. and Hull, Mark and Kim, H. Nina and Sebastiani, Giada and Moodie, Erica E. M. and Silverberg, Michael J. and Sterling, Timothy R. and Thorne, Jennifer E. and Cescon, Angela and Napravnik, Sonia and Eron, Joe and Gill, M. John and Justice, Amy and Peters, Marion G. and Goedert, James J. and Mayor, Angel and Thio, Chloe L. and Cachay, Edward R. and Moore, Richard and {North American AIDS Cohort Collaboration on Research and Design of IeDEA} and {North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA}},\n\tyear = {2016},\n\tpmid = {27506682},\n\tpmcid = {PMC5064164},\n\tkeywords = {Adult, Aged, Alcohol Drinking, Anti-HIV Agents, Canada, Cohort Studies, Coinfection, End Stage Liver Disease, Female, HIV, HIV Infections, Hepatitis B, Hepatitis C, Humans, Incidence, Male, Middle Aged, Risk Factors, United States, coinfection, end-stage liver disease, hepatitis B virus, hepatitis C virus},\n\tpages = {1160--1167},\n}\n\n

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\n \n 2015\n \n \n (2)\n \n \n

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\n \n\n \n \n Kitahata, M. M.; Drozd, D. R.; Crane, H. M.; Van Rompaey, S. E.; Althoff, K. N.; Gange, S. J.; Klein, M. B.; Lucas, G. M.; Abraham, A. G.; Lo Re, V.; McReynolds, J.; Lober, W. B.; Mendes, A.; Modur, S. P.; Jing, Y.; Morton, E. J.; Griffith, M. A.; Freeman, A. M.; and Moore, R. D.\n\n\n \n \n \n \n Ascertainment and verification of end-stage renal disease and end-stage liver disease in the north american AIDS cohort collaboration on research and design.\n \n \n \n\n\n \n\n\n\n AIDS research and treatment, 2015: 923194. January 2015.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n

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@article{kitahata_ascertainment_2015,\n\ttitle = {Ascertainment and verification of end-stage renal disease and end-stage liver disease in the north american {AIDS} cohort collaboration on research and design},\n\tvolume = {2015},\n\tissn = {2090-1240},\n\tdoi = {10.1155/2015/923194},\n\tabstract = {The burden of HIV disease has shifted from traditional AIDS-defining illnesses to serious non-AIDS-defining comorbid conditions. Research aimed at improving HIV-related comorbid disease outcomes requires well-defined, verified clinical endpoints. We developed methods to ascertain and verify end-stage renal disease (ESRD) and end-stage liver disease (ESLD) and validated screening algorithms within the largest HIV cohort collaboration in North America (NA-ACCORD). Individuals who screened positive among all participants in twelve cohorts enrolled between January 1996 and December 2009 underwent medical record review to verify incident ESRD or ESLD using standardized protocols. We randomly sampled 6\\% of contributing cohorts to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ESLD and ESRD screening algorithms in a validation subcohort. Among 43,433 patients screened for ESRD, 822 screened positive of which 620 met clinical criteria for ESRD. The algorithm had 100\\% sensitivity, 99\\% specificity, 82\\% PPV, and 100\\% NPV for ESRD. Among 41,463 patients screened for ESLD, 2,024 screened positive of which 645 met diagnostic criteria for ESLD. The algorithm had 100\\% sensitivity, 95\\% specificity, 27\\% PPV, and 100\\% NPV for ESLD. Our methods proved robust for ascertainment of ESRD and ESLD in persons infected with HIV.},\n\tlanguage = {eng},\n\tjournal = {AIDS research and treatment},\n\tauthor = {Kitahata, Mari M. and Drozd, Daniel R. and Crane, Heidi M. and Van Rompaey, Stephen E. and Althoff, Keri N. and Gange, Stephen J. and Klein, Marina B. and Lucas, Gregory M. and Abraham, Alison G. and Lo Re, Vincent and McReynolds, Justin and Lober, William B. and Mendes, Adell and Modur, Sharada P. and Jing, Yuezhou and Morton, Elizabeth J. and Griffith, Margaret A. and Freeman, Aimee M. and Moore, Richard D.},\n\tmonth = jan,\n\tyear = {2015},\n\tpmid = {25789171},\n\tpmcid = {PMC4350581},\n\tpages = {923194},\n}\n\n

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\n \n\n \n \n Silverberg, M. J.; Lau, B.; Achenbach, C. J.; Jing, Y.; Althoff, K. N.; D'Souza, G.; Engels, E. A.; Hessol, N. A.; Brooks, J. T.; Burchell, A. N.; Gill, M. J.; Goedert, J. J.; Hogg, R.; Horberg, M. A.; Kirk, G. D.; Kitahata, M. M.; Korthuis, P. T.; Mathews, W. C.; Mayor, A.; Modur, S. P.; Napravnik, S.; Novak, R. M.; Patel, P.; Rachlis, A. R.; Sterling, T. R.; Willig, J. H.; Justice, A. C.; Moore, R. D.; Dubrow, R.; North American AIDS Cohort Collaboration on Research; and of the International Epidemiologic Databases to Evaluate AIDS, D.\n\n\n \n \n \n \n Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study.\n \n \n \n\n\n \n\n\n\n Annals of Internal Medicine, 163(7): 507–518. October 2015.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{silverberg_cumulative_2015,\n\ttitle = {Cumulative {Incidence} of {Cancer} {Among} {Persons} {With} {HIV} in {North} {America}: {A} {Cohort} {Study}},\n\tvolume = {163},\n\tissn = {1539-3704},\n\tshorttitle = {Cumulative {Incidence} of {Cancer} {Among} {Persons} {With} {HIV} in {North} {America}},\n\tdoi = {10.7326/M14-2768},\n\tabstract = {BACKGROUND: Cancer is increasingly common among persons with HIV.\nOBJECTIVE: To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status.\nDESIGN: Cohort study.\nSETTING: North American AIDS Cohort Collaboration on Research and Design during 1996 to 2009.\nPARTICIPANTS: 86 620 persons with HIV and 196 987 uninfected adults.\nMEASUREMENTS: Cancer type-specific cumulative incidence by age 75 years and calendar trends in cumulative incidence and hazard rates, each by HIV status.\nRESULTS: Cumulative incidences of cancer by age 75 years for persons with and without HIV, respectively, were as follows: Kaposi sarcoma, 4.4\\% and 0.01\\%; non-Hodgkin lymphoma, 4.5\\% and 0.7\\%; lung cancer, 3.4\\% and 2.8\\%; anal cancer, 1.5\\% and 0.05\\%; colorectal cancer, 1.0\\% and 1.5\\%; liver cancer, 1.1\\% and 0.4\\%; Hodgkin lymphoma, 0.9\\% and 0.09\\%; melanoma, 0.5\\% and 0.6\\%; and oral cavity/pharyngeal cancer, 0.8\\% and 0.8\\%. Among persons with HIV, calendar trends in cumulative incidence and hazard rate decreased for Kaposi sarcoma and non-Hodgkin lymphoma. For anal, colorectal, and liver cancer, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (-9\\% per year), allowing greater opportunity to be diagnosed. Despite decreasing hazard rate trends for lung cancer, Hodgkin lymphoma, and melanoma, cumulative incidence trends were not seen because of the compensating effect of the declining mortality rate.\nLIMITATION: Secular trends in screening, smoking, and viral co-infections were not evaluated.\nCONCLUSION: Cumulative cancer incidence by age 75 years, approximating lifetime risk in persons with HIV, may have clinical utility in this population. The high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {Annals of Internal Medicine},\n\tauthor = {Silverberg, Michael J. and Lau, Bryan and Achenbach, Chad J. and Jing, Yuezhou and Althoff, Keri N. and D'Souza, Gypsyamber and Engels, Eric A. and Hessol, Nancy A. and Brooks, John T. and Burchell, Ann N. and Gill, M. John and Goedert, James J. and Hogg, Robert and Horberg, Michael A. and Kirk, Gregory D. and Kitahata, Mari M. and Korthuis, Philip T. and Mathews, William C. and Mayor, Angel and Modur, Sharada P. and Napravnik, Sonia and Novak, Richard M. and Patel, Pragna and Rachlis, Anita R. and Sterling, Timothy R. and Willig, James H. and Justice, Amy C. and Moore, Richard D. and Dubrow, Robert and {North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS}},\n\tmonth = oct,\n\tyear = {2015},\n\tpmid = {26436616},\n\tpmcid = {PMC4711936},\n\tkeywords = {Adult, Age Distribution, Aged, Anus Neoplasms, Cohort Studies, Colorectal Neoplasms, Comorbidity, Female, HIV Infections, Humans, Incidence, Liver Neoplasms, Lung Neoplasms, Lymphoma, Non-Hodgkin, Male, Middle Aged, Neoplasms, North America, Proportional Hazards Models, Sarcoma, Kaposi},\n\tpages = {507--518},\n}\n

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\n \n 2014\n \n \n (4)\n \n \n

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\n \n\n \n \n Althoff, K. N.; Rebeiro, P.; Brooks, J. T.; Buchacz, K.; Gebo, K.; Martin, J.; Hogg, R.; Thorne, J. E.; Klein, M.; Gill, M. J.; Sterling, T. R.; Yehia, B.; Silverberg, M. J.; Crane, H.; Justice, A. C.; Gange, S. J.; Moore, R.; Kitahata, M. M.; Horberg, M. A.; North American AIDS Cohort Collaboration on Research; and (NA-ACCORD), D.\n\n\n \n \n \n \n Disparities in the quality of HIV care when using US Department of Health and Human Services indicators.\n \n \n \n\n\n \n\n\n\n Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 58(8): 1185–1189. April 2014.\n \n\n\n\n
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@article{althoff_disparities_2014,\n\ttitle = {Disparities in the quality of {HIV} care when using {US} {Department} of {Health} and {Human} {Services} indicators},\n\tvolume = {58},\n\tissn = {1537-6591},\n\tdoi = {10.1093/cid/ciu044},\n\tabstract = {We estimated US Department of Health and Human Services (DHHS)-approved human immunodeficiency virus (HIV) indicators. Among patients, 71\\% were retained in care, 82\\% were prescribed treatment, and 78\\% had HIV RNA ≤200 copies/mL; younger adults, women, blacks, and injection drug users had poorer outcomes. Interventions are needed to reduce retention- and treatment-related disparities.},\n\tlanguage = {eng},\n\tnumber = {8},\n\tjournal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},\n\tauthor = {Althoff, Keri N. and Rebeiro, Peter and Brooks, John T. and Buchacz, Kate and Gebo, Kelly and Martin, Jeffrey and Hogg, Robert and Thorne, Jennifer E. and Klein, Marina and Gill, M. John and Sterling, Timothy R. and Yehia, Baligh and Silverberg, Michael J. and Crane, Heidi and Justice, Amy C. and Gange, Stephen J. and Moore, Richard and Kitahata, Mari M. and Horberg, Michael A. and {North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)}},\n\tmonth = apr,\n\tyear = {2014},\n\tpmid = {24463281},\n\tpmcid = {PMC3967825},\n\tkeywords = {Adult, Aged, Aged, 80 and over, Anti-Retroviral Agents, Cohort Studies, Continuity of Patient Care, Cross-Sectional Studies, Female, HIV, HIV Infections, HIV RNA suppression, Healthcare Disparities, Humans, Male, Middle Aged, United States, United States Dept. of Health and Human Services, Viral Load, antiretroviral therapy, quality of care, retention in care},\n\tpages = {1185--1189},\n}\n\n

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\n \n\n \n \n Duda, S. N.; Farr, A. M.; Lindegren, M. L.; Blevins, M.; Wester, C. W.; Wools-Kaloustian, K.; Ekouevi, D. K.; Egger, M.; Hemingway-Foday, J.; Cooper, D. A.; Moore, R. D.; McGowan, C. C.; Nash, D.; and International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration\n\n\n \n \n \n \n Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration.\n \n \n \n\n\n \n\n\n\n Journal of the International AIDS Society, 17: 19045. 2014.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{duda_characteristics_2014,\n\ttitle = {Characteristics and comprehensiveness of adult {HIV} care and treatment programmes in {Asia}-{Pacific}, sub-{Saharan} {Africa} and the {Americas}: results of a site assessment conducted by the {International} epidemiologic {Databases} to {Evaluate} {AIDS} ({IeDEA}) {Collaboration}},\n\tvolume = {17},\n\tissn = {1758-2652},\n\tshorttitle = {Characteristics and comprehensiveness of adult {HIV} care and treatment programmes in {Asia}-{Pacific}, sub-{Saharan} {Africa} and the {Americas}},\n\tdoi = {10.7448/IAS.17.1.19045},\n\tabstract = {INTRODUCTION: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide.\nMETHODS: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services.\nRESULTS: Most sites reported serving urban (61\\%; region range (rr): 33-100\\%) and both adult and paediatric populations (77\\%; rr: 29-96\\%). Only 45\\% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72\\%, respectively. The remaining four essential services - nutritional support (82\\%), combination antiretroviral therapy adherence support (88\\%), prevention of mother-to-child transmission (PMTCT) (94\\%) and other prevention and clinical management services (97\\%) - were uniformly available. Approximately half (46\\%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services.\nCONCLUSIONS: This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.},\n\tlanguage = {eng},\n\tjournal = {Journal of the International AIDS Society},\n\tauthor = {Duda, Stephany N. and Farr, Amanda M. and Lindegren, Mary Lou and Blevins, Meridith and Wester, C. William and Wools-Kaloustian, Kara and Ekouevi, Didier K. and Egger, Matthias and Hemingway-Foday, Jennifer and Cooper, David A. and Moore, Richard D. and McGowan, Catherine C. and Nash, Denis and {International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration}},\n\tyear = {2014},\n\tpmid = {25516092},\n\tpmcid = {PMC4268491},\n\tkeywords = {Adult, Africa South of the Sahara, Americas, Australasia, Child, Child, Preschool, Comprehensive Health Care, Female, HIV Infections, HIV care capacity, HIV/AIDS, Health Services Research, Humans, Male, clinic characteristics, comprehensive care, resource-limited settings},\n\tpages = {19045},\n}\n\n

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\n INTRODUCTION: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. METHODS: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. RESULTS: Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. CONCLUSIONS: This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.\n

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\n \n\n \n \n Edwards, J. K.; Cole, S. R.; Westreich, D.; Moore, R.; Mathews, C.; Geng, E.; Eron, J. J.; Mugavero, M. J.; and CNICS Research Network\n\n\n \n \n \n \n Loss to clinic and five-year mortality among HIV-infected antiretroviral therapy initiators.\n \n \n \n\n\n \n\n\n\n PloS One, 9(7): e102305. 2014.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{edwards_loss_2014,\n\ttitle = {Loss to clinic and five-year mortality among {HIV}-infected antiretroviral therapy initiators},\n\tvolume = {9},\n\tissn = {1932-6203},\n\tdoi = {10.1371/journal.pone.0102305},\n\tabstract = {Missing outcome data due to loss to follow-up occurs frequently in clinical cohort studies of HIV-infected patients. Censoring patients when they become lost can produce inaccurate results if the risk of the outcome among the censored patients differs from the risk of the outcome among patients remaining under observation. We examine whether patients who are considered lost to follow up are at increased risk of mortality compared to those who remain under observation. Patients from the US Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) who newly initiated combination antiretroviral therapy between January 1, 1998 and December 31, 2009 and survived for at least one year were included in the study. Mortality information was available for all participants regardless of continued observation in the CNICS. We compare mortality between patients retained in the cohort and those lost-to-clinic, as commonly defined by a 12-month gap in care. Patients who were considered lost-to-clinic had modestly elevated mortality compared to patients who remained under observation after 5 years (risk ratio (RR): 1.2; 95\\% CI: 0.9, 1.5). Results were similar after redefining loss-to-clinic as 6 months (RR: 1.0; 95\\% CI: 0.8, 1.3) or 18 months (RR: 1.2; 95\\% CI: 0.8, 1.6) without a documented clinic visit. The small increase in mortality associated with becoming lost to clinic suggests that these patients were not lost to care, rather they likely transitioned to care at a facility outside the study. The modestly higher mortality among patients who were lost-to-clinic implies that when we necessarily censor these patients in studies of time-varying exposures, we are likely to incur at most a modest selection bias.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {PloS One},\n\tauthor = {Edwards, Jessie K. and Cole, Stephen R. and Westreich, Daniel and Moore, Richard and Mathews, Christopher and Geng, Elvin and Eron, Joseph J. and Mugavero, Michael J. and {CNICS Research Network}},\n\tyear = {2014},\n\tpmid = {25010739},\n\tpmcid = {PMC4092142},\n\tkeywords = {Adult, Antiretroviral Therapy, Highly Active, Cohort Studies, Female, HIV, HIV Infections, Humans, Male, Middle Aged, United States, Viral Load},\n\tpages = {e102305},\n}\n\n

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\n \n\n \n \n Fredericksen, R.; Feldman, B. J.; Brown, T.; Schmidt, S.; Crane, P. K.; Harrington, R. D.; Dhanireddy, S.; McReynolds, J.; Lober, W. B.; Bangsberg, D. R.; Kitahata, M. M.; and Crane, H. M.\n\n\n \n \n \n \n Unannounced telephone-based pill counts: a valid and feasible method for monitoring adherence.\n \n \n \n\n\n \n\n\n\n AIDS and behavior, 18(12): 2265–2273. December 2014.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{fredericksen_unannounced_2014,\n\ttitle = {Unannounced telephone-based pill counts: a valid and feasible method for monitoring adherence},\n\tvolume = {18},\n\tissn = {1573-3254},\n\tshorttitle = {Unannounced telephone-based pill counts},\n\tdoi = {10.1007/s10461-014-0916-7},\n\tabstract = {Phone-based unannounced pill counts to measure medication adherence are much more practical and less expensive than home-based unannounced pill counts, but their validity has not been widely assessed. We examined the validity of phone versus home-based pill counts using a simplified protocol streamlined for studies embedded in clinical care settings. A total of 100 paired counts were used to compare concordance between unannounced phone and home-based pill counts using interclass correlations. Discrepancy analyses using χ(2) tests compared demographic and clinical characteristics across patients who were concordant between phone and home-based pill counts and patients who were not concordant. Concordance was high for phone-based and home-based unannounced total pill counts, as well as individual medication counts and calculated adherence. This study demonstrates that a simplified phone-based pill count protocol can be implemented among patients from a routine clinical care setting and is a feasible means of monitoring medication adherence.},\n\tlanguage = {eng},\n\tnumber = {12},\n\tjournal = {AIDS and behavior},\n\tauthor = {Fredericksen, R. and Feldman, B. J. and Brown, T. and Schmidt, S. and Crane, P. K. and Harrington, R. D. and Dhanireddy, S. and McReynolds, J. and Lober, W. B. and Bangsberg, D. R. and Kitahata, M. M. and Crane, Heidi M.},\n\tmonth = dec,\n\tyear = {2014},\n\tpmid = {25331265},\n\tpmcid = {PMC4495998},\n\tkeywords = {Adult, Anti-HIV Agents, Clinical Protocols, Drug Administration Schedule, Female, HIV Infections, House Calls, Humans, Male, Medication Adherence, Middle Aged, Reproducibility of Results, Self Report, Telephone, Washington},\n\tpages = {2265--2273},\n}\n\n

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\n \n 2012\n \n \n (1)\n \n \n

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\n \n\n \n \n May, M. T.; Hogg, R. S.; Justice, A. C.; Shepherd, B. E.; Costagliola, D.; Ledergerber, B.; Thiébaut, R.; Gill, M. J.; Kirk, O.; van Sighem, A.; Saag, M. S.; Navarro, G.; Sobrino-Vegas, P.; Lampe, F.; Ingle, S.; Guest, J. L.; Crane, H. M.; D'Arminio Monforte, A.; Vehreschild, J. J.; Sterne, J. A. C.; and Antiretroviral Therapy Cohort Collaboration (ART-CC)\n\n\n \n \n \n \n Heterogeneity in outcomes of treated HIV-positive patients in Europe and North America: relation with patient and cohort characteristics.\n \n \n \n\n\n \n\n\n\n International Journal of Epidemiology, 41(6): 1807–1820. December 2012.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{may_heterogeneity_2012,\n\ttitle = {Heterogeneity in outcomes of treated {HIV}-positive patients in {Europe} and {North} {America}: relation with patient and cohort characteristics},\n\tvolume = {41},\n\tissn = {1464-3685},\n\tshorttitle = {Heterogeneity in outcomes of treated {HIV}-positive patients in {Europe} and {North} {America}},\n\tdoi = {10.1093/ije/dys164},\n\tabstract = {BACKGROUND: HIV cohort collaborations, which pool data from diverse patient cohorts, have provided key insights into outcomes of antiretroviral therapy (ART). However, the extent of, and reasons for, between-cohort heterogeneity in rates of AIDS and mortality are unclear.\nMETHODS: We obtained data on adult HIV-positive patients who started ART from 1998 without a previous AIDS diagnosis from 17 cohorts in North America and Europe. Patients were followed up from 1 month to 2 years after starting ART. We examined between-cohort heterogeneity in crude and adjusted (age, sex, HIV transmission risk, year, CD4 count and HIV-1 RNA at start of ART) rates of AIDS and mortality using random-effects meta-analysis and meta-regression.\nRESULTS: During 61 520 person-years, 754/38 706 (1.9\\%) patients died and 1890 (4.9\\%) progressed to AIDS. Between-cohort variance in mortality rates was reduced from 0.84 to 0.24 (0.73 to 0.28 for AIDS rates) after adjustment for patient characteristics. Adjusted mortality rates were inversely associated with cohorts' estimated completeness of death ascertainment [excellent: 96-100\\%, good: 90-95\\%, average: 75-89\\%; mortality rate ratio 0.66 (95\\% confidence interval 0.46-0.94) per category]. Mortality rate ratios comparing Europe with North America were 0.42 (0.31-0.57) before and 0.47 (0.30-0.73) after adjusting for completeness of ascertainment.\nCONCLUSIONS: Heterogeneity between settings in outcomes of HIV treatment has implications for collaborative analyses, policy and clinical care. Estimated mortality rates may require adjustment for completeness of ascertainment. Higher mortality rate in North American, compared with European, cohorts was not fully explained by completeness of ascertainment and may be because of the inclusion of more socially marginalized patients with higher mortality risk.},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {International Journal of Epidemiology},\n\tauthor = {May, Margaret T. and Hogg, Robert S. and Justice, Amy C. and Shepherd, Bryan E. and Costagliola, Dominique and Ledergerber, Bruno and Thiébaut, Rodolphe and Gill, M. John and Kirk, Ole and van Sighem, Ard and Saag, Michael S. and Navarro, Gemma and Sobrino-Vegas, Paz and Lampe, Fiona and Ingle, Suzanne and Guest, Jodie L. and Crane, Heidi M. and D'Arminio Monforte, Antonella and Vehreschild, Jörg J. and Sterne, Jonathan A. C. and {Antiretroviral Therapy Cohort Collaboration (ART-CC)}},\n\tmonth = dec,\n\tyear = {2012},\n\tpmid = {23148105},\n\tpmcid = {PMC3535877},\n\tkeywords = {Acquired Immunodeficiency Syndrome, Adolescent, Adult, Age Factors, Aged, Anti-Retroviral Agents, CD4 Lymphocyte Count, Europe, Female, HIV Infections, HIV Seropositivity, Humans, Male, Middle Aged, North America, Prognosis, Risk Factors, Sex Factors, Young Adult},\n\tpages = {1807--1820},\n}\n\n

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\n \n 2009\n \n \n (1)\n \n \n

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\n \n\n \n \n Kitahata, M. M.; Gange, S. J.; Abraham, A. G.; Merriman, B.; Saag, M. S.; Justice, A. C.; Hogg, R. S.; Deeks, S. G.; Eron, J. J.; Brooks, J. T.; Rourke, S. B.; Gill, M. J.; Bosch, R. J.; Martin, J. N.; Klein, M. B.; Jacobson, L. P.; Rodriguez, B.; Sterling, T. R.; Kirk, G. D.; Napravnik, S.; Rachlis, A. R.; Calzavara, L. M.; Horberg, M. A.; Silverberg, M. J.; Gebo, K. A.; Goedert, J. J.; Benson, C. A.; Collier, A. C.; Van Rompaey, S. E.; Crane, H. M.; McKaig, R. G.; Lau, B.; Freeman, A. M.; Moore, R. D.; and NA-ACCORD Investigators\n\n\n \n \n \n \n Effect of early versus deferred antiretroviral therapy for HIV on survival.\n \n \n \n\n\n \n\n\n\n The New England Journal of Medicine, 360(18): 1815–1826. April 2009.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{kitahata_effect_2009,\n\ttitle = {Effect of early versus deferred antiretroviral therapy for {HIV} on survival},\n\tvolume = {360},\n\tissn = {1533-4406},\n\tdoi = {10.1056/NEJMoa0807252},\n\tabstract = {BACKGROUND: The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain.\nMETHODS: We conducted two parallel analyses involving a total of 17,517 asymptomatic patients with HIV infection in the United States and Canada who received medical care during the period from 1996 through 2005. None of the patients had undergone previous antiretroviral therapy. In each group, we stratified the patients according to the CD4+ count (351 to 500 cells per cubic millimeter or {\\textgreater}500 cells per cubic millimeter) at the initiation of antiretroviral therapy. In each group, we compared the relative risk of death for patients who initiated therapy when the CD4+ count was above each of the two thresholds of interest (early-therapy group) with that of patients who deferred therapy until the CD4+ count fell below these thresholds (deferred-therapy group).\nRESULTS: In the first analysis, which involved 8362 patients, 2084 (25\\%) initiated therapy at a CD4+ count of 351 to 500 cells per cubic millimeter, and 6278 (75\\%) deferred therapy. After adjustment for calendar year, cohort of patients, and demographic and clinical characteristics, among patients in the deferred-therapy group there was an increase in the risk of death of 69\\%, as compared with that in the early-therapy group (relative risk in the deferred-therapy group, 1.69; 95\\% confidence interval [CI], 1.26 to 2.26; P{\\textless}0.001). In the second analysis involving 9155 patients, 2220 (24\\%) initiated therapy at a CD4+ count of more than 500 cells per cubic millimeter and 6935 (76\\%) deferred therapy. Among patients in the deferred-therapy group, there was an increase in the risk of death of 94\\% (relative risk, 1.94; 95\\% CI, 1.37 to 2.79; P{\\textless}0.001).\nCONCLUSIONS: The early initiation of antiretroviral therapy before the CD4+ count fell below two prespecified thresholds significantly improved survival, as compared with deferred therapy.},\n\tlanguage = {eng},\n\tnumber = {18},\n\tjournal = {The New England Journal of Medicine},\n\tauthor = {Kitahata, Mari M. and Gange, Stephen J. and Abraham, Alison G. and Merriman, Barry and Saag, Michael S. and Justice, Amy C. and Hogg, Robert S. and Deeks, Steven G. and Eron, Joseph J. and Brooks, John T. and Rourke, Sean B. and Gill, M. John and Bosch, Ronald J. and Martin, Jeffrey N. and Klein, Marina B. and Jacobson, Lisa P. and Rodriguez, Benigno and Sterling, Timothy R. and Kirk, Gregory D. and Napravnik, Sonia and Rachlis, Anita R. and Calzavara, Liviana M. and Horberg, Michael A. and Silverberg, Michael J. and Gebo, Kelly A. and Goedert, James J. and Benson, Constance A. and Collier, Ann C. and Van Rompaey, Stephen E. and Crane, Heidi M. and McKaig, Rosemary G. and Lau, Bryan and Freeman, Aimee M. and Moore, Richard D. and {NA-ACCORD Investigators}},\n\tmonth = apr,\n\tyear = {2009},\n\tpmid = {19339714},\n\tpmcid = {PMC2854555},\n\tkeywords = {Adult, Anti-Retroviral Agents, CD4 Lymphocyte Count, Confounding Factors, Epidemiologic, Drug Administration Schedule, Female, HIV, HIV Infections, Humans, Male, Middle Aged, Proportional Hazards Models, RNA, Viral, Risk, Survival Analysis},\n\tpages = {1815--1826},\n}\n\n

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\n BACKGROUND: The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain. METHODS: We conducted two parallel analyses involving a total of 17,517 asymptomatic patients with HIV infection in the United States and Canada who received medical care during the period from 1996 through 2005. None of the patients had undergone previous antiretroviral therapy. In each group, we stratified the patients according to the CD4+ count (351 to 500 cells per cubic millimeter or \\textgreater500 cells per cubic millimeter) at the initiation of antiretroviral therapy. In each group, we compared the relative risk of death for patients who initiated therapy when the CD4+ count was above each of the two thresholds of interest (early-therapy group) with that of patients who deferred therapy until the CD4+ count fell below these thresholds (deferred-therapy group). RESULTS: In the first analysis, which involved 8362 patients, 2084 (25%) initiated therapy at a CD4+ count of 351 to 500 cells per cubic millimeter, and 6278 (75%) deferred therapy. After adjustment for calendar year, cohort of patients, and demographic and clinical characteristics, among patients in the deferred-therapy group there was an increase in the risk of death of 69%, as compared with that in the early-therapy group (relative risk in the deferred-therapy group, 1.69; 95% confidence interval [CI], 1.26 to 2.26; P\\textless0.001). In the second analysis involving 9155 patients, 2220 (24%) initiated therapy at a CD4+ count of more than 500 cells per cubic millimeter and 6935 (76%) deferred therapy. Among patients in the deferred-therapy group, there was an increase in the risk of death of 94% (relative risk, 1.94; 95% CI, 1.37 to 2.79; P\\textless0.001). CONCLUSIONS: The early initiation of antiretroviral therapy before the CD4+ count fell below two prespecified thresholds significantly improved survival, as compared with deferred therapy.\n

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\n \n 1997\n \n \n (1)\n \n \n

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\n \n\n \n \n Bey, T. A.; Walter, F. G.; Lober, W.; Schmidt, J.; Spark, R.; and Schlievert, P. M.\n\n\n \n \n \n \n \n Loxosceles arizonica bite associated with shock.\n \n \n \n \n\n\n \n\n\n\n Annals of Emergency Medicine, 30(5): 701–703. November 1997.\n \n\n\n\n
\n\n\n\n \n \n $\"Loxosceles$ Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n

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@article{bey_loxosceles_1997,\n\ttitle = {Loxosceles arizonica bite associated with shock},\n\tvolume = {30},\n\tissn = {0196-0644},\n\turl = {https://pdf.sciencedirectassets.com/272873/1-s2.0-S0196064405X70858/1-s2.0-S0196064497700921/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEMv%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJGMEQCIDLKw8FNGgMOciyeyEMy%2BQ5psbgEWPvvK2y5zjh7GQZ6AiAdVZR1Qs%2Ft%2BlP8iJxw5UiGTVeLwvDR9f2qK0okEJ1ZWiq0AwhkEAIaDDA1OTAwMzU0Njg2NSIMC1YsNptzs0vhandOKpEDPJMEteueNN0FnwW%2Fca51EDIY2VPG0sjXsBccTHVG3tewnGHDzE4BdiIOmI9SBfimAMjfXDoa%2FZx6Vy23bSjxXUdG5FeU0amh9DqChgCoPiU8H8b3qAwJ7JT%2FUpTPVrDaGlAkpOW0ka3OVBQEio5VIwoDznZRSrw6PTFa99cmCJMIJi3bEtUCsmOYsKVMILc%2FOZ%2BiqndeJ1KdBtr%2BW20WYHa4Muc3ehx6qnOtBCAadXUK3hvlVlq7sh7usy4njp5RMDDmSxpueb6vqf2rrx3%2BonZcq6CrM5YZlf3Es%2FTvqfSZRtsZ3FcTFpnwxIF43d9hh4geGb4mHn97fyyAJfZu8ybzToOjpnw9aroaglUxpSGqYgEFJeSCnm7UQOB7My3Z2xV1AX%2FtMmis6rE5uz%2FII5x61g4zlnA18GmgbRih%2Bf9jEG0R3xfHibd6s%2BU4fMsnpn4MYU9f%2BXOSWaFNXtiBN1D0ZiqxyxMZ9sDSj6EuheCMZFCtbhD5VRmM8nSKQ7FiayOgq6J1fP9OP5ruRTvwqJkwqfys8QU67AE9SDF9HkbaRn4su%2BSAtzKefbyiTJTJbz79pEXy1aZMh%2BGY9ClMCX2JwRcSlmBCLmVI2JPTCJJWELAJa1ZkZGyO08OTkrWv3MwX3PRHFsg4UQjdkhMS6ngW3JWm0FHpA27V8Dz0lDBGxGf0tHGiLL100wb6aJCEbhkwxQGF%2B6tYIgv%2BlD2crufhAqYCloqJWYb1gRzT3I%2FdULY%2Fwzi6ACCnT%2Fl5i4X3E3OG7%2B30EeXV4T2rS9BHBS9U4TK2Htqe7%2FqoeUzaeIJYy4%2FtDkmRWelfQk%2Br1%2BU8MDie%2FRPHEK4epOvGZQiZErkgxUb2kg%3D%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20200124T194448Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTY2Z6GW3OM%2F20200124%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=6271860958f25861caace21c7af669679e624e3117bbb3bb12a388e6756f6698&hash=52af8b46abb842b0dd5fc74ab0a438e4d880e5089f7a62b23056604be4d4d3b6&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S0196064497700921&tid=spdf-242d13ad-ba8b-4a5a-9834-dd14b16e358f&sid=844d24293e08504656187b4786f9f24812a4gxrqa&type=client},\n\tdoi = {10.1016/s0196-0644(97)70092-1},\n\tabstract = {Envenomation by the brown recluse spider (Loxosceles reclusa) is associated with shock, significant hemolysis, renal insufficiency, and disseminated intravascular coagulation (DIC). Shock has never been associated with envenomation by L arizonica, a related species indigenous to Arizona, southern California, and northwestern Mexico. We report the case of a 13-year-old girl, bitten by a specimen of L arizonica (the spider was identified by an entomologist), in whom shock and a typical cutaneous lesion developed. She did not experience renal insufficiency or disseminated intravascular coagulation. Infectious causes of shock were excluded. She recovered completely with supportive care.},\n\tlanguage = {eng},\n\tnumber = {5},\n\tjournal = {Annals of Emergency Medicine},\n\tauthor = {Bey, T. A. and Walter, F. G. and Lober, W. and Schmidt, J. and Spark, R. and Schlievert, P. M.},\n\tmonth = nov,\n\tyear = {1997},\n\tpmid = {9360587},\n\tkeywords = {Adolescent, Animals, Female, Humans, Shock, Spider Bites, Spiders},\n\tpages = {701--703},\n}\n\n

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