Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{dfdc475198cf45c2a54ba3aa941f704c,
title = "Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era",
abstract = "BACKGROUND: HIV-associated incidence and prognosis of cerebral toxoplasmosis (CTX) is not well established during later years.METHODS: From the Danish HIV Cohort Study, we identified 6325 HIV-infected individuals. We assessed incidence, mortality, predictive and prognostic factors of CTX during the pre-combination antiretroviral therapy (pre-cART; 1995-1996) and cART-era (1997-2014). Adjusted incidence rate ratios (aIRR), mortality rate ratios (aMRR) and 95{\%} confidence intervals (CI) were assessed using Poisson regression analysis.RESULTS: CTX IR was 1.17/1000 PYR (95{\%} CI 0.93-1.47). We observed no change in CTX-risk in the first year after HIV-diagnosis, but a substantial reduction in mortality in the first 3 months after CTX diagnosis when comparing the cART-era to the pre-cART-era; {(aIRR: 0.79; 95{\%} CI: 0.37-1.72) (aMRR: 0.15; 95{\%} CI: 0.06-0.38)}. For individuals surviving the first year after HIV-diagnosis or the first 3 months after CTX-diagnosis, IRR and MRR had declined to minimal levels {(aIRR: 0.06; 95{\%} CI: 0.03-0.10); (aMRR: 0.02; 95{\%} CI: 0.01-0.05)}. Three years after CTX-diagnosis 30{\%} of the patients still had neurological deficits.CONCLUSION: Although, CTX remains an important cause of morbidity and mortality in the cART-era, with high prevalence of neurological sequelae, incidence and mortality has largely declined, especially among those surviving the first year after diagnosis.",
keywords = "Journal Article",
author = "Raquel Martin-Iguacel and Ahlstr{\"o}m, {Magnus Glindvad} and Madeleine Touma and Engsig, {Frederik Neess} and St{\ae}rke, {Nina Breinholt} and Mette St{\ae}rkind and Niels Obel and Rasmussen, {Line D}",
note = "Copyright {\circledC} 2017. Published by Elsevier Ltd.",
year = "2017",
month = "9",
day = "1",
doi = "10.1016/j.jinf.2017.05.018",
language = "English",
volume = "75",
pages = "263--273",
journal = "Journal of Infection",
issn = "0163-4453",
publisher = "W.B./Saunders Co. Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era

AU - Martin-Iguacel, Raquel

AU - Ahlström, Magnus Glindvad

AU - Touma, Madeleine

AU - Engsig, Frederik Neess

AU - Stærke, Nina Breinholt

AU - Stærkind, Mette

AU - Obel, Niels

AU - Rasmussen, Line D

N1 - Copyright © 2017. Published by Elsevier Ltd.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - BACKGROUND: HIV-associated incidence and prognosis of cerebral toxoplasmosis (CTX) is not well established during later years.METHODS: From the Danish HIV Cohort Study, we identified 6325 HIV-infected individuals. We assessed incidence, mortality, predictive and prognostic factors of CTX during the pre-combination antiretroviral therapy (pre-cART; 1995-1996) and cART-era (1997-2014). Adjusted incidence rate ratios (aIRR), mortality rate ratios (aMRR) and 95% confidence intervals (CI) were assessed using Poisson regression analysis.RESULTS: CTX IR was 1.17/1000 PYR (95% CI 0.93-1.47). We observed no change in CTX-risk in the first year after HIV-diagnosis, but a substantial reduction in mortality in the first 3 months after CTX diagnosis when comparing the cART-era to the pre-cART-era; {(aIRR: 0.79; 95% CI: 0.37-1.72) (aMRR: 0.15; 95% CI: 0.06-0.38)}. For individuals surviving the first year after HIV-diagnosis or the first 3 months after CTX-diagnosis, IRR and MRR had declined to minimal levels {(aIRR: 0.06; 95% CI: 0.03-0.10); (aMRR: 0.02; 95% CI: 0.01-0.05)}. Three years after CTX-diagnosis 30% of the patients still had neurological deficits.CONCLUSION: Although, CTX remains an important cause of morbidity and mortality in the cART-era, with high prevalence of neurological sequelae, incidence and mortality has largely declined, especially among those surviving the first year after diagnosis.

AB - BACKGROUND: HIV-associated incidence and prognosis of cerebral toxoplasmosis (CTX) is not well established during later years.METHODS: From the Danish HIV Cohort Study, we identified 6325 HIV-infected individuals. We assessed incidence, mortality, predictive and prognostic factors of CTX during the pre-combination antiretroviral therapy (pre-cART; 1995-1996) and cART-era (1997-2014). Adjusted incidence rate ratios (aIRR), mortality rate ratios (aMRR) and 95% confidence intervals (CI) were assessed using Poisson regression analysis.RESULTS: CTX IR was 1.17/1000 PYR (95% CI 0.93-1.47). We observed no change in CTX-risk in the first year after HIV-diagnosis, but a substantial reduction in mortality in the first 3 months after CTX diagnosis when comparing the cART-era to the pre-cART-era; {(aIRR: 0.79; 95% CI: 0.37-1.72) (aMRR: 0.15; 95% CI: 0.06-0.38)}. For individuals surviving the first year after HIV-diagnosis or the first 3 months after CTX-diagnosis, IRR and MRR had declined to minimal levels {(aIRR: 0.06; 95% CI: 0.03-0.10); (aMRR: 0.02; 95% CI: 0.01-0.05)}. Three years after CTX-diagnosis 30% of the patients still had neurological deficits.CONCLUSION: Although, CTX remains an important cause of morbidity and mortality in the cART-era, with high prevalence of neurological sequelae, incidence and mortality has largely declined, especially among those surviving the first year after diagnosis.

KW - Journal Article

U2 - 10.1016/j.jinf.2017.05.018

DO - 10.1016/j.jinf.2017.05.018

M3 - Journal article

VL - 75

SP - 263

EP - 273

JO - Journal of Infection

JF - Journal of Infection

SN - 0163-4453

IS - 3

ER -

ID: 50596551