DOCSLIB.ORG

Assessment of Simple Risk Markers for Early Mortality Among HIV-Infected Patients in Guinea-Bissau: a Cohort Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Assessment of Simple Risk Markers for Early Mortality Among HIV-Infected Patients in Guinea-Bissau: a Cohort Study BMJ Open: first published as 10.1136/bmjopen-2012-001587 on 14 November 2012. Downloaded from Open Access Research Assessment of simple risk markers for early mortality among HIV-infected patients in Guinea-Bissau: a cohort study Inés Oliveira,1,2 Andreas Andersen,1 Alcino Furtado,1 Candida Medina,3 David da Silva,3 Zacarias J da Silva,1,4 Peter Aaby,1,5 Alex Lund Laursen,6 Christian Wejse,6,7 Jesper Eugen-Olsen,2 for the Bissau HIV cohort study group To cite: Oliveira I, ABSTRACT et al ARTICLE SUMMARY Andersen A, Furtado A, . Background: Decisions about when to start an Assessment of simple risk antiretroviral therapy (ART) are normally based on CD4 markers for early mortality Article focus cell counts and viral load (VL). However, these among HIV-infected patients ▪ The measurement of CD4 cell counts and viral in Guinea-Bissau: measurements require equipment beyond the capacity load require equipment beyond the capacity of a cohort study. BMJ Open of most laboratories in low-income and middle-income most laboratories in low-income and middle- 2012;2:e001587. settings. Thus, there is an urgent need to identify and income countries. doi:10.1136/bmjopen-2012- test simple markers to guide the optimal time for ▪ There is an urgent need to test simple markers 001587 starting and for monitoring the effect of ART in to guide the optimal time for starting antiretro- developing countries. viral therapy (ART) in these settings. ▸ Prepublication history and Objectives: (1) To evaluate anthropometric ▪ The objectives of the study were: (1) to evaluate additional material for this measurements and measurement of plasma-soluble anthropometric measurements and a soluble paper are available online. To form of the urokinase plasminogen activator receptor form of the urokinase plasminogen activator view these files please visit (suPAR) levels as potential risk factors for early receptor (suPAR) levels as potential risk factors the journal online mortality among HIV-infected patients; (2) to assess for early mortality in an urban cohort of (http://dx.doi.org/10.1136/ whether these markers could help identify patients to HIV-infected patients in Bissau and (2) to assess bmjopen-2012-001587). whom ART should be prioritised and (3) to determine whether these markers may add information to http://bmjopen.bmj.com/ Received 31 May 2012 if these markers may add information to CD4 cell count CD4 cell count and aid in selection of patients Accepted 26 August 2012 when VL is not available. most in need of ART. Design: An observational study. This final article is available Setting: The largest ART centre in Bissau, Guinea- Key messages ▪ A low body mass index, low middle-upper-arm- for use under the terms of Bissau. circumference (MUAC), low CD4 cell count and the Creative Commons Participants: 1083 ART-naïve HIV-infected patients. Attribution Non-Commercial high suPAR plasma levels were independent pre- 2.0 Licence; see Outcome measures: Associations between baseline dictors of early mortality in patients enrolled in anthropometric measurements, CD4 cell counts, http://bmjopen.bmj.com this cohort. on September 27, 2021 by guest. Protected copyright. plasma suPAR levels and survival were examined using ▪ Mortality among patients with a low CD4 cell Cox proportional hazards models. count, low MUAC or low BMI was concentrated ≤ 2 Results: Low body mass index (BMI 18.5 kg/m ), in the highest suPAR quartile. ≤ low mid-upper-arm-circumference (MUAC 250 mm), ▪ MUAC and suPAR could be useful in identifying ≤ μ low CD4 cell count ( 350 cells/ l) and high suPAR patients at the highest risk of short-term mortal- plasma levels (>5.3 ng/ml) were independent ity and may aid triage for ART when CD4 cell predictors of death. Furthermore, mortality among count is not available or when there is shortness patients with low CD4 cell count, low MUAC or of antiretroviral drugs. low BMI was concentrated in the highest suPAR quartile. Conclusions: Irrespective of ART initiation and baseline CD4 count, MUAC and suPAR plasma levels INTRODUCTION were independent predictors of early mortality in Since its introduction in the mid-1990s, anti- For numbered affiliations see this urban cohort. These markers could be useful in retroviral therapy (ART) has reduced the end of article. identifying patients at the highest risk of short-term morbidity and mortality of HIV-infected mortality and may aid triage for ART when CD4 cell – patients worldwide.1 3 Nevertheless, despite Correspondence to count is not available or when there is shortness of Dr Jesper Eugen-Olsen; antiretroviral drugs. progress, access to these lifesaving drugs [email protected] remains limited where the need is the Oliveira I, Andersen A, Furtado A, et al. BMJ Open 2012;2:e001587. doi:10.1136/bmjopen-2012-001587 1 BMJ Open: first published as 10.1136/bmjopen-2012-001587 on 14 November 2012. Downloaded from Risk markers for early mortality among HIV-infected patients in Guinea-Bissau easily measured on all patients, including bedridden ARTICLE SUMMARY ones, and does not require further calculations. Strengths and limitations of this study Nevertheless, studies assessing this marker in HIV adults ▪ Data presented could help health providers to identify patients in LMICs are scarce. fl with the highest risk of short-term mortality and to prioritise SuPAR is a risk biomarker protein that re ects the 21 treatment among eligible patients in a context of poor health- level of immune activation and inflammation. It is care infrastructure. known that immune activation plays an important role – ▪ There are several limitations to this study. First, information on in the pathogenesis of HIV infection.22 25 High blood all four investigated risk factors (CD4, suPAR, BMI and MUAC) levels of suPAR have been associated with poor clinical was only available in 58% (628/1083) of our population. outcome and independently predict mortality in Second, WHO-stage, pregnancy status and comorbidities pre- non-ART-treated HIV infected patients.15 24 26 27 sented at the time of inclusion were not recorded in the data- Furthermore, plasma concentrations of suPAR can be base. Third, contact information for some patients was not measured using a simple ELISA or lateral flow quick sufficient to allow active tracing in case of missed appoint- ments. Thus, it is likely that patients lost to follow-up may tests and thus require less-sophisticated laboratory infra- include unascertained deaths and that the effects of the risk structure than that needed for routine measurements of factors are underestimated in our work. CD4 count or plasma VL. The rollout of ART in Guinea-Bissau started in 2005. All treatments are free of charge in the country, however greatest, especially in subSaharan Africa.4 Treating HIV during the later years frequent shortages of ARV drugs patients in low-income and middle-income countries and reagents for CD4 count equipment, have hampered (LMICs) means working in a context of poor healthcare the management of HIV patients in the country and has infrastructure and limited human resources.5 To provide enforced clinicians to prioritise treatment among eli- sustainable access to ART to these regions, models of gible patients.28 care must be adapted to the realities of the developing The objectives of the present study were: (1) to evalu- world.6 Simplification and decentralisation of treatment ate anthropometric measurements, other than weight are essential components of a successful strategy for loss and measurement of suPAR levels as potential risk scaling-up ART.6 In this concept of simplification the factors for early mortality in an urban cohort of HIV-1, whole process of providing antiretroviral (ARV) drugs HIV-2 and HIV-double-infected patients; (2) to examine should be covered, starting with setting simple inclusion whether these markers could help in identifying patients criteria for an ART. In industrialised countries, decisions to whom ART should be prioritised when CD4 cell about when to start combined ART are based on CD4 count is not available or in situations of shortness of T-cell (CD4) cell count and plasma viral load (VL), two ARV drugs and (3) to assess whether these markers may of the strongest predictors of survival in HIV patients.78 add information to CD4 cell count and aid in selection http://bmjopen.bmj.com/ However, these measurements require equipment of patients most in need of ART among eligible patients beyond the capacity of most laboratories in LMICs.910 when VL is not available. Until accessible and affordable means of measuring CD4 cell count and VL become widely available, there is an urgent need to develop and test simple markers or METHODS clinical criteria to guide the optimal time for starting ART Setting in the developing world.11 Previous studies have shown The Republic of Guinea-Bissau has an estimated popula- that HIV patients with low haemoglobin level, low body tion of 1 600 000 inhabitants and an economy based pri- on September 27, 2021 by guest. Protected copyright. 12–14 fi mass index (BMI), advanced WHO-clinical stage, marily on farming and shing activities. More than 2/3 29 high-plasma levels of a soluble form of the urokinase plas- of the population lives below the poverty line. Ranking minogen activator receptor (suPAR)15 or with detectable 176 out of 187 countries on the United Nations Human cryptococcal antigenaemia16 17 are at a higher risk of dying Development Index 2011, it is one of the poorest coun- 30 during the first months of follow-up.18 tries in the world. The HIV National Programme was Weight loss is the only nutritional criterion used in the implemented by the Ministry of Health (MINSAP) in WHO classification system19 but has the disadvantage 2005. The combined ART is free of charge in the that it is not available at the first consultations because country, the cost being fully subsidised by the Global most patients do not know their normal weight.13 BMI Fund to Fight AIDS, Tuberculosis (TB) and Malaria, the (weight in kilograms divided by height in metres Brazilian Government and other international part- 31 squared) has been confirmed to be an easy-to-measure ners.
Load more

Recommended publications
  • Proposal for Assessment of New Health Technologies
    v4.0 11.12.2017 Proposal for assessment of new health technologies Important information – read this first! Submitted proposals for national health technologies (HTAs) will be published in full. If the proposer thinks there is information necessary for filling out the form, that should not be made public, please contact the secretariat (Nye Metoder) before submission. The proposer is aware that the form will be published in its entirety (tick): ☒ Proposer has filled out point 19 below «Interests and, if any, conflicts of interest» (tick): ☒ This form serves the purpose to submit proposals for health technology assessment (HTA) at the national level in Nye Metoder - the national system for managed introduction of new health technologies within the specialist health service in Norway. The form does not apply to proposals for research projects. A health technology assessment is a type of evidence review, and for this to be possible, documentation is required, e.g. from completed clinical trials. Lack of documentation may be one of the reasons why the Commissioning Forum (Bestillerforum RHF) does not assign a health technology assessment. If the proposal concerns a medical device, the proposer is familiar with the document «Guidance criteria for management of medical devices in the National System for Managed Introduction of New Health Technologies within the Specialist Health Service in Norway» (link) (tick): ☒ Contact information: Name of the proposer (organization / institution / company / manufacturer): ViroGates A/S, Denmark Name of proposal contact: Jesper Eugen-Olsen, PhD Telephone number: +45 51 51 80 51 E-mail address: [email protected] Date and locality: 03-01-2019, Copenhagen Side 1 av 9 v4.0 11.12.2017 1.
    [Show full text]
  • Virogates Has Been Granted a New Patent to Measure the Risk of Developing Life Style Related Diseases Using Its Suparnostic ® Biomarker Product
    ViroGates has been granted a new patent to measure the risk of developing life style related diseases using its suPARnostic ® biomarker product Denmark, August 22, 2011 ViroGates, that develops and distributes the biomarker suPARnostic ®, today announced that it has been granted a patent in the UK, patent number GB2461410, based on the international patent application PCT/EP2007/064497. The patent is entitled “Method and tool for predicting cancer and other diseases”. The patent grant is the first related to the international patent application, and will allow ViroGates to pursue measuring and monitoring of patients’ blood, to determine whether the individual is at risk of developing life style related diseases such as cardiovascular diseases, type-2 diabetes (T2D), COPD and cancer. The grant of this patent further strengthens ViroGates’ patent portfolio, which comprises patents related to measuring and monitoring of various infectious diseases such as HIV, tuberculosis and various conditions of sepsis. The MONICA10 study (published in the Journal of Internal Medicine, 28 May 2010 by Jesper Eugen-Olsen, Ove Andersen and Steen B. Haugaard, Hvidovre University Hospital) has been the scientific basis for establishing this relation between suPAR and life style related diseases. The study documented that suPAR was predictive of development of cardiovascular diseases, diabetes and cancer, and particularly in predicting which individuals would progress to develop lung cancer. ViroGates, supported by a network of international key opinion leaders, is working towards establishing suPARnostic ® as a clinical decision-making product worldwide. “We are very excited to receive the news of this first grant of a patent relating to predicting serious life style related diseases” comments Jakob Knudsen, CEO of ViroGates.
    [Show full text]
  • Novel Biomarkers in the Management of HPV-Positive & -Negative Oropharyngeal Carcinoma January 2016
    THE UNIVERSITY OF SHEFFIELD Novel Biomarkers in the Management of HPV-Positive & -Negative Oropharyngeal Carcinoma Thesis submitted to the University of Sheffield for the degree of Doctor of Philosophy Robert Bolt Department of Oral & Maxillofacial Pathology January 2016 Abstract Human Papillomavirus (HPV)-related oropharyngeal carcinoma is considered to be in the early stages of an epidemic1-12. A marked rise in the incidence of this sexually-transmissible cancer has captured the public interest, and much debate exists over both the prophylactic and therapeutic strategies currently employed to manage this healthcare priority. HPV-positive oropharyngeal carcinoma is associated with highly favourable oncological outcomes. Clinical attention over recent years has been paid to the potential de-escalation of therapy in order to account for the disease’s favourable prognosis, in addition to reducing therapeutic burden in a well-prognosticating, younger patient cohort, for which consequences of radical chemo-radiotherapy strategies may disproportionately impact on longer-term quality of life. Whilst optimising the management of the ever-increasing proportion of HPV-positive oropharyngeal carcinomas is desirable and highly justifiable, it appears the poorer prognosticating HPV-negative oropharyngeal carcinoma has at least in part become overlooked. Oropharyngeal carcinoma is unique in comparison to many other established HPV-related cancers inasmuch as a clear HPV-negative subset exists, to which established aetiological factors (tobacco smoking and alcohol consumption) strongly correlate. For most other HPV- related carcinomas, such as cervical, anal and penile, tumours classified as HPV-negative are either regarded as potentially-virus containing, or else cannot be correlated to a definitive aetiological agent. Comparison of HPV-positive and -negative oropharyngeal carcinoma therefore offers unprecedented insight into the biological significance of each aetiological agent, and how prognostication of each disease may relate to tumour behaviour at a molecular level.
    [Show full text]
  • See Virogates Presentation Here
    ViroGates ViroGates A/S Västra Hamnen Investor Day 2 December 2020 ViroGates 2 ViroGates - a commercial stage company with approved products for the hospital sector ViroGates suPARnostic® products suPAR is the biomarker detected by ViroGates’ three CE-IVD marked suPARnostic® products and is a protein found in plasma. Description ViroGates A/S is an international medical technology ViroGates has established clinical utility of suPARnostic® supported by company developing and marketing blood test products +700 peer reviewed publications. under the suPARnostic® brand for better triaging in hospitals to: ViroGates has patented the clinical use of suPAR levels as a risk stratification method and currently holds 4 granted patent families and one newly filed application (2018). improve patient care reduce healthcare costs AUTO Flex ELISA Quick Triage TurbiLatex empower clinical staff Application R&D & clinical Near-patient Automated, use lab centralized lab ViroGates was founded in 2001 and has since 2018 been listed on Nasdaq First North Growth Market DK – Ticker Technology ELISA Lateral flow Turbidimetric “VIRO” Launch year 2009 2015 2018 (CE-IVD) ViroGates 3 suPAR is a marker of immune activation and a strong predictor disease severity and progession uPAR suPAR suPARnostic® +700 peer (soluble urokinase Plasminogen Activator Receptor) suPAR DI DI DII DII reviewed papers supporting A prognostic inflammatory DIII DIII evidence biomarker for immune activation indicating: Kidney disease Liver disease • Disease presence (acute, Diabetes Elevated
    [Show full text]
  • Of Body Inflammation for Maxillofacial Surgery Purpose-To Make
    applied sciences Article Index of Body Inflammation for Maxillofacial Surgery Purpose-to Make the Soluble Urokinase-Type Plasminogen Activator Receptor Serum Level Independent on Patient Age Marcin Kozakiewicz 1,*, Magdalena Trzci´nska-Kubik 1 and Rafał Nikodem Wlazeł 2 1 Department of Maxillofacial Surgery, Medical University of Lodz, 113 Zeromskiego˙ Str., 90-549 Lodz, Poland; [email protected] 2 Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland; [email protected] * Correspondence: [email protected]; Tel.: +48-42-6393068 Featured Application: Inflammation is still a threat to patients of all age groups. Monitoring the infection is essential to control it. The soluble urokinase-type plasminogen activator receptor (suPAR) is a very sensitive marker. Maxillofacial surgery is one of the fields of medicine widely fighting against infections. The concentration of suPAR holds an independent information for risk stratification of morbidity and mortality in various acute and chronic diseases. The use of an ultra-sensitive measure of the development of inflammation and at the same time independent on the patient’s age would be clinically very beneficial. Abstract: Background: The serum suPAR level is affected in humans by it increases with age. Therefore it makes difficult interpretation and any comparison of age varied groups. The aim of this Citation: Kozakiewicz, M.; study is to find simple way to age independent presentation of suPAR serum level for maxillofacial Trzci´nska-Kubik,M.; Wlazeł, R.N. surgery purpose. Methods: In generally healthy patients from 15 to 59 y.o. suPAR level was tested Index of Body Inflammation for in serum before orthognathic or minor traumatologic procedures.
    [Show full text]
  • Plasma Levels of the Active Form of Supar Are Associated with COVID
    Huang et al. Crit Care (2020) 24:704 https://doi.org/10.1186/s13054-020-03336-0 LETTER Open Access Plasma levels of the active form of suPAR are associated with COVID-19 severity Mingxiang Huang1†, Linlin Li2†, Jianshan Shen1, Yao Wang1, Rui Wang1, Cai Yuan3, Mingdong Huang2* and Longguang Jiang2,4* We read with great interest the recent study by Rovina not only signifcantly higher than those in healthy con- et al., who found that the elevation of soluble urokinase trols (p < 0.0001) but also slightly higher than those in plasminogen activator receptor (suPAR) plasma levels COVID-19 patients (p = 0.0278) (Table 1, Fig. 1a). Even in coronavirus disease 2019 (COVID-19) patients, and though more data needs to be collected and the back- suggested the suPAR can be an early predictor of severe ground of these patients are not clear, this is a signifcant respiratory failure [1]. Tere are three diferent suPAR research direction to pursue. If asymptomatic carriers forms (suPAR DI-III, suPAR DI, and suPAR DII-III) in could be identifed and quarantined in an early stage, it circulation, in which suPAR DI-III is defned as the active will prevent them from increasing the disease transmis- form of suPAR by its capability of binding to uPA [2]. In sion to an uncontrollable manner. addition, the uPA/uPAR system as a therapeutic target Patients involved three types of symptoms: moderate, has been proposed to reduce mortality of COVID-19 [3]; severe, and critical in our study (Table 1). Our data show therefore, further evaluation of the active form of suPAR that active suPAR levels increase as the disease worsens plasma levels in diferent symptom types of COVID-19 (Fig.
    [Show full text]
  • Virogates A/S Investor Presentation 16 June 2020 Danske Bank, Copenhagen Virogates
    ViroGates ViroGates A/S Investor Presentation 16 June 2020 Danske Bank, Copenhagen ViroGates Forward-looking statements Certain information set forth and given in this presentation contains “forward-looking information”, including “future oriented financial information” and “financial outlook”, under applicable securities laws (collectively referred to herein as forward-looking statements). Except for statements of historical fact, information contained herein constitutes forward-looking statements and includes, but is not limited to, the (i) projected financial performance of ViroGates A/S (ViroGates); (ii) the expected development of ViroGates’ business, projects and joint ventures; (iii) execution of ViroGates’ vision and growth strategy, including with respect to future M&A activity and global growth; (iv) sources and availability of third-party financing for ViroGates’ projects; (v) completion of ViroGates’ projects that are currently underway, in development or otherwise under consideration; (vi) renewal of ViroGates’ current customer, supplier and other material agreements; and (vii) future liquidity, working capital, and capital requirements. Forward-looking statements are provided to allow potential investors the opportunity to understand management’s beliefs and opinions in respect of the future so that they may use such beliefs and opinions as one factor in evaluating an investment. These statements are not guarantees of future performance and undue reliance should not be placed on them. Such forward- looking statements necessarily
    [Show full text]
  • Virogates Appoints Dr
    Groundbreaking results from hospital trial: A simple blood test predicts mortality in discharged patients September 17, 2009 Hospitals can now avoid misjudging and sending home high-risk patients with life threatening diseases Post-hospital mortality is a major problem worldwide. The high cost of in-hospital care is a major burden, and selection of patients for early or late discharge is currently based on clinical observation. The Danish biotech company, ViroGates, released their first CE/IVD approved product suPARnostic® in 2007. suPARnostic® was developed to identify high risk patients, to aid in the decision on who to keep and who to discharge from the hospital. The suPARnostic® assay measures a biomarker in the blood that, if elevated, is associated with increased risk of mortality. ViroGates was awarded a grant from the European Commission, to investigate the prognostic potential of this “Risk Status Marker” test in an area with high mortality. In collaboration with the Bandim Health Project, Guinea-Bissau, West Africa, the study included more than 1600 patients with symptoms of tuberculosis (TB) in the period 2004-2007. All patients were screened for TB and 1007 of these had a negative diagnostic TB test, and were therefore sent home from the clinics with antibiotic treatment. These individuals were then visited at home three months after the hospital discharge, and a high number of them had died during those three months (51 out of 1007 individuals). The study revealed that those sent home from the hospital with a high suPARnostic® test value, were those who died. There was 16 % mortality among those in the highest suPAR quartile compared to 1% among the rest.
    [Show full text]
  • Supar As a Biomarker for Risk of Readmission and Mortality in the Acute Medical Setting
    Dan Med J 62/10 October 2015 DANISH MEDICAL JOURNAL 1 suPAR as a biomarker for risk of readmission and mortality in the acute medical setting Raj Kumar Nayak, Mikkel Allingstrup, Klaus Phanareth & Allan Kofoed-Enevoldsen ABSTRACT plasminogen activator receptor (uPAR) and its ligand ORIGINAL INTRODUCTION: The urokinase-type plasminogen activator (suPAR) are involved in numerous physiological and ARTICLE receptor (uPAR) and its ligand (suPAR) are involved in nu- pathological pathways, which include the plasminogen Department of merous physiological and pathological pathways. Previous activating pathway, regulation of pericellular proteoly- Medicine, Bispebjerg & studies have shown that an elevated plasma suPAR level is sis, and modulation of cell adhesion, migration and pro- Frederiksberg Hospital, associated with disease severity and mortality. The aim of liferation. uPAR is anchored to the external plasma Denmark this prospective observational study was to determine if the membrane through a glycolphosphatidylinositol (GPI)- Dan Med J suPAR level was associated with readmission and mortality anchor in a variety of body cells including neutrophils, 2015;62(10):A5146 in the acute medical setting. lymphocytes, macrophages, endothelial and malignant METHODS: Plasma suPAR levels were measured in 1,036 cells. By binding urokinase-type plasminogen activator patients at admission. Follow-up ranged 3-10 months. Cox (uPA) to the receptor, a variety of extracellular signalling proportional hazards model was used to assess the relative is initiated. Furthermore, the formation of the uPA-uPAR contribution of different risk factors to mortality and read- complex results in cleavage of the GPI anchor, meaning mission. The ANOVA test and Pearson’s chi-squared test that uPAR will be released into the extra cellular matrix were used to compare suPAR tertile level with various in a soluble form.
    [Show full text]
  • PRESS RELEASE 1 May 2020
    PRESS RELEASE 1 May 2020 ViroGates announces initial data on the use of suPARnostic® in the triaging of patients with COVID‐19 symptoms BIRKERØD, DENMARK ‐ ViroGates A/S, a medical technology company developing blood tests for better triaging in hospitals to improve patient care and reduce healthcare costs, today announces that clinical researchers from the US, Greece and Denmark have disclosed the first clinical data on suPAR in patients affected by the novel coronavirus SARS‐CoV‐2. The groups looked specifically at patients with a positive diagnostic test for the coronavirus and how the clinical symptoms developed over 14 days. About 20‐30% of patients with SARS‐CoV‐2 infection progress to develop severe respiratory failure (SRF). The researchers looked at whether suPAR levels at admission can predict which patients will develop SRF during a follow‐up of 14 days from the first presentation. The data showed that patients with a suPAR level above 6ng/ml had a significant (p < 0.0001) 16 times higher risk of developing SRF than those with a suPAR level below 6 ng/ml. The researches also looked at other biomarkers such as CRP and Neutrophils and none of these could predict the development of SRF. The findings in the letter suggest that suPAR may early trace COVID‐19 patients who develop SRF. Early identification of high‐risk COVID‐19 patients may be useful when deciding to admit or discharge patients to: 1. Decrease unnecessary hospitalizations of low‐risk patients that take up limited hospital beds in an already overburdened healthcare system 2. Lower the risk of sending home patients that require hospitalization and intensified management Jakob Knudsen, Chief Executive Officer of ViroGates, says: ”We are very enthusiastic about these new data.
    [Show full text]
  • Immunosenescence of the CD8+ T Cell Compartment Is Associated With
    Tavenier et al. BMC Immunology (2015) 16:72 DOI 10.1186/s12865-015-0136-6 RESEARCH ARTICLE Open Access Immunosenescence of the CD8+ T cell compartment is associated with HIV- infection, but only weakly reflects age- related processes of adipose tissue, metabolism, and muscle in antiretroviral therapy-treated HIV-infected patients and controls Juliette Tavenier1*† , Anne Langkilde1†, Thomas Huneck Haupt1, Jens Henrik Henriksen2, Frank Krieger Jensen3, Janne Petersen1,4 and Ove Andersen1,5 Abstract Background: Despite effective antiretroviral therapy (ART), HIV-infected patients exhibit systemic inflammation, early onset of age-related diseases, and features of immunosenescence. The role of inflammation in the development of age-related diseases is widely recognized. However, the role of immunosenescence is not well established. Studying immunosenescence in HIV-infection could give insight into its role in ageing processes. In this cross-sectional study, we aimed to investigate whether ART-treated HIV-infected patients exhibit immunosenescence; and whether immunosenescence is associated with age-related processes of inflammation, metabolism, adipose tissue, and muscle. T cell immunosenescence and exhaustion were assessed by flow cytometry analysis of CD8+ cells from 43 ART-treated HIV-infected patients (HIV+) and ten Controls using markers of differentiation: CD27/CD28; maturation: CD27/CD45RA; senescence: killer cell lectin-like receptor G1 (KLRG1); and exhaustion: programmed death-1 (PD-1). Relationships between CD8+ T cell immunosenescence, exhaustion, and age-related processes were assessed using linear regressions. Results: HIV-infection was strongly associated with more highly differentiated and mature CD8+ Tcell phenotypes. PD-1 and KLRG1 expression did not differ between HIV+ and Controls, but depended on differentiation and maturation stages of the cells.
    [Show full text]
  • ISA2018 Abstract Volaume
    XVIIIth International Symposium on Atherosclerosis June 9–12, 2018 TORONTO CANADA ABSTRACT VOLUME Abstracts, XVIII International Symposium on Atherosclerosis, Toronto, Canada, June 9 - 12, 2018 Table of Contents Oral Presentations C1-1 NLA - CSATVB Joint Session – Familial Hypercholesterolemia . .1 C1-3 NAVBO - CSATVB Joint Session: The Aging Vasculature . .2 C1-4 JAS - CSATVB Joint Session: Endothelial Dysfunction, Aging and Atherosclerosis . 5. C1-5 CIHR – IAPH/ICRH/IG Joint Session: From Molecules to Communities – The Complexities of Indigenous Heart and Brain Health . 8. C1-10 Lipoprotein(a): More Fascinating Than Ever . 9. C1-11 Smooth Muscle Cells: the Workhorse of the Vasculature . 12. C1-12 Pediatric Familial Hypercholesterolemia: Early Origins of Disease . .15 C1-13 Mazankowski Alberta Heart Institute Session: The pros-and-cons of Atherosclerosis Imaging for Drug Development . .17 C1-14 JAS - CSATVB Joint Session: Endothelial Dysfunction, Aging and Atherosclerosis . 19. C2-1 Lipid Therapy: What’s New and What’s Next? . .22 C2-2 Journal of Lipid Research Session: Genetics of Dyslipidemias – the Complexity Intensifies . 25. C2-3 IAS/ International Chair on Cardiometabolic Risk (ICCR) Joint Session – Obesity: The Weight of Evidence . 28. C2-4 Macrophages: Agents Provocateurs in Atherosclerosis . .30 C2-5 PCSK9: Exciting Times for Therapeutic Interventions . .34 C2-6 IAS – EAS Joint Session: Atherosclerosis: From Plaque Biology to Clinical Practice . .37 C2-7 Optimal Medical Treatment for ASCVD: Theory or Reality . .39 C2-8 NLA - CSATVB: Triglyceride Rich Lipoproteins and non-HDL: Residual Risk Embodied . 40. C2-10 Diet and Lifestyle: Turning the Tide Without Drugs . 43. C2-11 Statin Intolerance: a Barrier to Treatment .
    [Show full text]