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Adherence to national guidelines for initiation of antiretroviral regimens in HIV patients: a Danish nationwide study.

https://arctichealth.org/en/permalink/ahliterature137186
Source
Br J Clin Pharmacol. 2011 Jul;72(1):116-24
Publication Type
Article
Date
Jul-2011
Author
Tonny S Petersen
Stig E Andersen
January Gerstoft
Kristina Thorsteinsson
Carsten S Larsen
Gitte Pedersen
Court Pedersen
Niels Obel
Author Affiliation
Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark. tsp@person.dk
Source
Br J Clin Pharmacol. 2011 Jul;72(1):116-24
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - administration & dosage
Antiretroviral Therapy, Highly Active - methods - standards
Cohort Studies
Denmark
Drug Administration Schedule
Female
Guideline Adherence
HIV Infections - drug therapy
Humans
Male
Patient compliance
Practice Guidelines as Topic
Regression Analysis
State Medicine
Treatment Outcome
Abstract
To determine the adherence to the national guidelines for start of highly active antiretroviral treatment (HAART) in HIV infected patients.
We used a Danish nationwide cohort of HIV infected patients to calculate the fraction of patients who in the period 1997-2006 started HAART according to the guidelines from The Danish Society of Infectious Diseases. We used Kaplan-Meier tables to estimate time from fulfilling the criteria for start of HAART to initiation of the treatment. Cox regression and logistic regression was used to identify risk factors for delayed initiation of treatment and chance of being included in clinical trials.
The study included 3223 patients, 74% of whom initiated HAART in the study period. Ninety-four% fulfilled the criteria for start of HAART, with minor differences over calendar periods. Ninety-four% initiated a recommended regimen or were included in a clinical trial. Intravenous drug use predicted initiation of a non-recommended regimen and delay in start of HAART, while non-Caucasians were less likely to be included in clinical trials.
In a Western world setting, the adherence to national guidelines for start of HAART can be high. We suggest that simplicity of the guidelines, centralization of treatment and involvement of local clinicians in the development of guidelines are of major importance for high adherence to treatment guidelines.
Notes
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PubMed ID
21306418 View in PubMed
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Anal carcinoma in HIV-infected patients in the period 1995-2009: a Danish nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature117489
Source
Scand J Infect Dis. 2013 Jun;45(6):453-9
Publication Type
Article
Date
Jun-2013
Author
Rebecca Legarth
Marie Helleberg
Gitte Kronborg
Carsten S Larsen
Gitte Pedersen
Court Pedersen
Janne Jensen
Lars Nørregård Nielsen
Jan Gerstoft
Niels Obel
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital , Rigshospitalet, DK-2100 Copenhagen Ø , Denmark. Rebeccalegarth@gmail.com
Source
Scand J Infect Dis. 2013 Jun;45(6):453-9
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adult
Antiretroviral Therapy, Highly Active
Anus Neoplasms - epidemiology - virology
Cohort Studies
Denmark - epidemiology
Female
HIV Infections - drug therapy - epidemiology - pathology
Humans
Incidence
Male
Middle Aged
Poisson Distribution
Survival Analysis
Treatment Outcome
Abstract
Several studies have demonstrated an increased risk of non-AIDS cancers in HIV patients and, for some cancers, also in relatives of HIV patients. We aimed to estimate (1) the risk of anal carcinoma among HIV patients and their parents, and (2) the mortality after a diagnosis of anal carcinoma.
We used Poisson regression to estimate the incidence rate ratios (IRR) of anal carcinoma in (1) a population of HIV patients identified from the Danish HIV Cohort Study (n = 4993) compared with a population control cohort matched on age and gender (n = 59,916) for the period 1995-2009, and (2) parents of HIV patients compared with parents of controls for the period 1978-2009. Cancer diagnoses were identified from The Danish Cancer Registry. We further estimated the mortality rate ratios (MRR) of HIV patients compared with controls after the diagnosis of anal carcinoma.
Thirty-six HIV patients versus 8 population controls were diagnosed with anal carcinoma. HIV patients had an increased risk of anal carcinoma (IRR 77.9, 95% CI 36.2-167.7), especially among men who have sex with men (MSM) (IRR 101.4, 95% CI 39.3-261.5). Fathers of HIV patients had an increased risk of anal carcinoma (IRR 7.4, 95% CI 1.4-38.3) compared to fathers of population controls. Mortality after diagnosis of anal carcinoma was increased in male HIV patients compared with the male control cohort (MRR 3.2, 95% CI 1.1-9.2).
Danish HIV patients, especially MSM, have a considerably increased risk of anal carcinoma. We cannot exclude that fathers of HIV patients have an increased risk of anal carcinoma.
PubMed ID
23294033 View in PubMed
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Association Between Educational Level and Risk of Cancer in HIV-infected Individuals and the Background Population: Population-based Cohort Study 1995-2011.

https://arctichealth.org/en/permalink/ahliterature269824
Source
J Infect Dis. 2015 Nov 15;212(10):1552-62
Publication Type
Article
Date
Nov-15-2015
Author
Rebecca Legarth
Lars H Omland
Susanne O Dalton
Gitte Kronborg
Carsten S Larsen
Court Pedersen
Gitte Pedersen
Jan Gerstoft
Niels Obel
Source
J Infect Dis. 2015 Nov 15;212(10):1552-62
Date
Nov-15-2015
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Denmark - epidemiology
Educational Status
Female
HIV Infections - complications
Humans
Incidence
Male
Middle Aged
Neoplasms - epidemiology - mortality
Risk assessment
Survival Analysis
Abstract
Human immunodeficiency virus (HIV)-infected individuals have increased risk of cancer. To our knowledge, no previous study has examined the impact of socioeconomic position on risk and prognosis of cancer in HIV infection.
Population-based cohort-study, including HIV-infected individuals diagnosed (without intravenous drug abuse or hepatitis C infection) (n = 3205), and a background population cohort matched by age, gender, and country of birth (n = 22 435) were analyzed. Educational level (low or high) and cancer events were identified in Danish national registers. Cumulative incidences, incidence rate ratios (IRRs), and survival using Kaplan-Meier methods were estimated.
Low educational level was associated with increased risk of cancer among HIV-infected individuals compared to population controls: all (adjusted-IRRs: 1.4 [95% confidence interval {CI}, 1.1-1.7] vs 1.1 [95% CI, .9-1.2]), tobacco- and alcohol-related (2.1 [95% CI, 1.3-3.4] vs 1.3 [95% CI, 1.1-1.6]), and other (1.7 [95% CI, 1.1-2.8] vs 0.9 [95% CI, .7-1.0]). Educational level was not associated with infection-related or ill-defined cancers. One-year-survival was not associated with educational level, but HIV-infected individuals with low educational level had lower 5-year-survival following infection-related and ill-defined cancers.
Education is associated with risk and prognosis of some cancers in HIV infection, and diverges from what is observed in the background population.
PubMed ID
25904603 View in PubMed
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Bacteremia is associated with excess long-term mortality: a 12-year population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature270063
Source
J Infect. 2015 Feb;70(2):111-26
Publication Type
Article
Date
Feb-2015
Author
Stig Lønberg Nielsen
Annmarie Touborg Lassen
Kim Oren Gradel
Thøger Gorm Jensen
Hans Jørn Kolmos
Jesper Hallas
Court Pedersen
Source
J Infect. 2015 Feb;70(2):111-26
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia - epidemiology - mortality
Cohort Studies
Denmark - epidemiology
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Young Adult
Abstract
Little is known about long-term outcomes following bacteremia. We investigated long-term mortality and causes of death among bacteremia patients compared with population controls.
Population-based cohort study of bacteremia patients and population controls matched on sex, year of birth, residency and calendar time, in Denmark during 2000-2008. We calculated absolute mortality and adjusted mortality rate ratios (MRRs) in predefined follow-up periods.
The absolute mortality for bacteremia patients (n = 7783) and population controls (n = 38,906) was 22.0% vs. 0.2% (30 days), 41.4% vs. 2.6% (1 year) and 75.8% vs. 36.6% (10 years). For bacteremia patients, the MRR was 115.3 (95% CI, 88.2-150.9) 0-30 days after bacteremia and 2.1 (95% CI, 1.8-2.3) from 5 years to end of follow-up. The most common causes of death were cancer and cardiovascular diseases. Within one year of bacteremia, the relative risk of death was highest for genitourinary diseases and infectious diseases. Among one-year survivors of bacteremia, the relative risk of death was increased for all major causes of death.
Bacteremia is associated with a poor prognosis and considerable excess long-term mortality compared with the general population. The most common causes of death after bacteremia are cancer and cardiovascular diseases.
This population-based cohort study reports an excess long-term mortality among 7783 bacteremia patients compared with matched population controls during 12 years of follow-up. We identified patients in particular risk of death and reported novel information on causes of death.
PubMed ID
25218427 View in PubMed
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Cause-specific excess mortality in siblings of patients co-infected with HIV and hepatitis C virus.

https://arctichealth.org/en/permalink/ahliterature161814
Source
PLoS One. 2007;2(8):e738
Publication Type
Article
Date
2007
Author
Ann-Brit Eg Hansen
Nicolai Lohse
Jan Gerstoft
Gitte Kronborg
Alex Laursen
Court Pedersen
Henrik Toft Sørensen
Niels Obel
Author Affiliation
Department of Infectious Diseases, Odense University Hospital, Odense, Denmark. ann-brit.eg.hansen@rh.regionh.dk
Source
PLoS One. 2007;2(8):e738
Date
2007
Language
English
Publication Type
Article
Keywords
Cause of Death
Comorbidity
Denmark - epidemiology
HIV Infections - complications - epidemiology - etiology - mortality
Hepatitis C - complications - epidemiology - etiology - mortality
Humans
Registries
Risk assessment
Risk factors
Siblings
Substance-Related Disorders - complications - epidemiology - mortality
Abstract
Co-infection with hepatitis C in HIV-infected individuals is associated with 3- to 4-fold higher mortality among these patients' siblings, compared with siblings of mono-infected HIV-patients or population controls. This indicates that risk factors shared by family members partially account for the excess mortality of HIV/HCV-co-infected patients. We aimed to explore the causes of death contributing to the excess sibling mortality.
We retrieved causes of death from the Danish National Registry of Deaths and estimated cause-specific excess mortality rates (EMR) for siblings of HIV/HCV-co-infected individuals (n = 436) and siblings of HIV mono-infected individuals (n = 1837) compared with siblings of population controls (n = 281,221). Siblings of HIV/HCV-co-infected individuals had an all-cause EMR of 3.03 (95% CI, 1.56-4.50) per 1,000 person-years, compared with siblings of matched population controls. Substance abuse-related deaths contributed most to the elevated mortality among siblings [EMR = 2.25 (1.09-3.40)] followed by unnatural deaths [EMR = 0.67 (-0.05-1.39)]. No siblings of HIV/HCV co-infected patients had a liver-related diagnosis as underlying cause of death. Siblings of HIV-mono-infected individuals had an all-cause EMR of 0.60 (0.16-1.05) compared with siblings of controls. This modest excess mortality was due to deaths from an unknown cause [EMR = 0.28 (0.07-0.48)], deaths from substance abuse [EMR = 0.19 (-0.04-0.43)], and unnatural deaths [EMR = 0.18 (-0.06-0.42)].
HCV co-infection among HIV-infected patients was a strong marker for family-related mortality due to substance abuse and other unnatural causes. To reduce morbidity and mortality in HIV/HCV-co-infected patients, the advances in antiviral treatment of HCV should be accompanied by continued focus on interventions targeted at substance abuse-related risk factors.
Notes
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PubMed ID
17710138 View in PubMed
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CD4 decline is associated with increased risk of cardiovascular disease, cancer, and death in virally suppressed patients with HIV.

https://arctichealth.org/en/permalink/ahliterature114835
Source
Clin Infect Dis. 2013 Jul;57(2):314-21
Publication Type
Article
Date
Jul-2013
Author
Marie Helleberg
Gitte Kronborg
Carsten S Larsen
Gitte Pedersen
Court Pedersen
Niels Obel
Jan Gerstoft
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. mhelleberg@sund.ku.dk
Source
Clin Infect Dis. 2013 Jul;57(2):314-21
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Anti-Retroviral Agents - therapeutic use
CD4 Lymphocyte Count
Cardiovascular Diseases - epidemiology - mortality
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
HIV Infections - complications - drug therapy - immunology - mortality
Humans
Male
Middle Aged
Neoplasms - epidemiology - mortality
Risk assessment
Survival Analysis
Viral Load
Abstract
The clinical implications of a considerable CD4 decline despite antiretroviral treatment and viral suppression are unknown. We aimed to test the hypothesis that a major CD4 decline could be a marker of cardiovascular disease or undiagnosed cancer.
Patients with human immunodeficiency virus (HIV) were followed in the Danish nationwide, population-based cohort study in the period 1995-2010 with quarterly CD4 measurements. Associations between a CD4 decline of =30% and cardiovascular disease, cancer, and death were analyzed using Poisson regression with date of CD4 decline as a time-updated variable.
We followed 2584 virally suppressed HIV patients for 13 369 person-years (PY; median observation time, 4.7 years). Fifty-six patients developed CD4 decline (incidence rate, 4.2/1000 PY [95% confidence interval {CI}, 3.2-5.4]). CD4 counts dropped from a median of 492 cells/µL to 240 cells/µL. CD8, CD3, and total lymphocyte counts dropped concomitantly. No HIV-related factors, apart from treatment with didanosine, were associated with CD4 decline. The risk of cardiovascular disease, cancer, and death increased markedly =6 months after CD4 decline (incidence rate ratio, 11.7 [95% CI, 3.6-37.4] and 13.7 [95% CI, 4.3-43.6], respectively, and mortality rate ratio 4.3 [95% CI, 1.1-17.6]).
A major decline in CD4 count is associated with a marked increased risk of cardiovascular disease, cancer, and death among virally suppressed HIV patients.
PubMed ID
23575194 View in PubMed
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Characteristics of patients with community-acquired bacteremia who have low levels of C-reactive protein (=20 mg/L).

https://arctichealth.org/en/permalink/ahliterature256875
Source
J Infect. 2014 Feb;68(2):149-55
Publication Type
Article
Date
Feb-2014
Author
Fredrikke Christie Knudtzen
Stig Lønberg Nielsen
Kim Oren Gradel
Annmarie Touborg Lassen
Hans Jørn Kolmos
Thøger Gorm Jensen
Pernille Just Vinholt
Court Pedersen
Author Affiliation
Department of Infectious Diseases, Odense University Hospital, Sdr. Boulevard 29, Entrance 20, 5000 Odense C, Denmark. Electronic address: fredrikkeknudtzen@hotmail.com.
Source
J Infect. 2014 Feb;68(2):149-55
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Aged
Bacteremia - blood - epidemiology - microbiology
C-Reactive Protein - metabolism
Cohort Studies
Community-Acquired Infections
Denmark - epidemiology
Female
Humans
Male
Pneumococcal Infections - blood - epidemiology - microbiology
Staphylococcal Infections - blood - epidemiology - microbiology
Staphylococcus aureus - isolation & purification
Streptococcus pneumoniae - isolation & purification
Abstract
To characterize patients presenting with community-acquired bacteremia and a low C-reactive protein (CRP) plasma level at date of bacteremia.
Population-based cohort study. Patient characteristics were compared for three CRP groups (=20 mg/L, 21-100 mg/L and >100 mg/L) using chi-square test and oneway anova. The 30-day mortality rates were compared using logistic regression analyses.
Of the 2017 patients included, 193 (9.6%) had a CRP =20 mg/L. These patients were younger, more likely to be male, overrepresented in the intensive care unit and had more comorbidities. In blood cultures from the low CRP group hemolytic streptococci and coagulase-negative staphylococci were found relatively more common, whereas Streptococcus pneumoniae or Staphylococcus aureus were found relatively less common compared to the other CRP groups. The majority of patients with an initial low CRP mounted a CRP response the following days. The 30-day mortality rate was lower in the low CRP group (13.5%) than in the group with CRP >100 mg/L (20.6%).
A considerable proportion of patients with community-acquired bacteremia has a normal or low initial CRP level. The plasma CRP level should not be used to rule out serious infection or withhold antibiotic therapy.
PubMed ID
24429297 View in PubMed
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Characterization of HIV-1 from patients with virological failure to a boosted protease inhibitor regimen.

https://arctichealth.org/en/permalink/ahliterature137635
Source
J Med Virol. 2011 Mar;83(3):377-83
Publication Type
Article
Date
Mar-2011
Author
Marie Rathcke Lillemark
Jan Gerstoft
Niels Obel
Gitte Kronborg
Court Pedersen
Louise Bruun Jørgensen
Tina Vasehus Madsen
Terese Lea Katzenstein
Author Affiliation
Department of Virology, State Serum Institute, Copenhagen, Denmark. mml@ssi.dk
Source
J Med Virol. 2011 Mar;83(3):377-83
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Anti-HIV Agents - blood - therapeutic use
Antiretroviral Therapy, Highly Active
Cohort Studies
Denmark
Drug Resistance, Viral
Female
Genes, gag
Genes, pol
HIV Infections - drug therapy - epidemiology - virology
HIV-1 - drug effects - genetics
Humans
Male
Mutation
Protease Inhibitors - blood - therapeutic use
Ritonavir - blood - therapeutic use
Treatment Outcome
Viral Load
Abstract
The use of highly active antiretroviral treatment (HAART) regimens with unboosted protease inhibitors (PIs) has resulted in a high level of virological failure primarily due to the development of resistant virus. Current boosted PI regimens combine successfully low-dose ritonavir (r) with a second PI. The aim of the study was to estimate the proportion of patients, in a population based setting, who develop virological failure on a PI/r regimen. Through The Danish HIV Cohort Study 1,007 patients who received PI/r based treatment between 1995 and 2008 were identified. Twenty-three (2.3%) experienced virological failure, of whom 19 (83%) started PI/r treatment before 2001. Patients from Copenhagen (n=19) were selected to study the development of protease (PR) and gag cleavage site (CS) mutations during PI/r treatment and PI plasma levels at the time of virological failure. Three patients (16%) developed major PI resistance mutations. Mutations in the p7/p1 and p1/p6 gag CS only developed in patients with major or minor mutations in PR. Drug concentrations were low or undetectable in 10 out of the 19 patients. In total PR resistance mutations and low drug levels could account for 12 (63%) of the failure cases. In conclusion, virological failure to PI/r is a low and decreasing problem primarily caused by low plasma drug levels and to a lesser extent major PR mutations. Gag CS mutations did not contribute significantly to resistance development and virological failure.
PubMed ID
21264856 View in PubMed
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Comorbidity acquired before HIV diagnosis and mortality in persons infected and uninfected with HIV: a Danish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature134959
Source
J Acquir Immune Defic Syndr. 2011 Aug 1;57(4):334-9
Publication Type
Article
Date
Aug-1-2011
Author
Nicolai Lohse
Jan Gerstoft
Gitte Kronborg
Carsten Schade Larsen
Court Pedersen
Gitte Pedersen
Lars Nielsen
Henrik Toft Sørensen
Niels Obel
Author Affiliation
Department of Clinical Epidemiology, Århus University Hospital, Århus, Denmark. niclohse@gmail.com
Source
J Acquir Immune Defic Syndr. 2011 Aug 1;57(4):334-9
Date
Aug-1-2011
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death
Cohort Studies
Comorbidity
Denmark - epidemiology
Female
HIV Infections - complications - epidemiology - mortality
Hepatitis C - epidemiology - mortality
Humans
Life expectancy
Male
Middle Aged
Vital statistics
Abstract
We aimed to estimate the impact of comorbidity acquired before HIV diagnosis on mortality in individuals infected with HIV.
This cohort study compared 2 different cohorts. The prospective population-based nationwide observational Danish HIV Cohort Study was used to compare all adults diagnosed with HIV in Denmark from 1997 with a matched general population cohort. Comorbidity history was ascertained from the Danish National Patient Registry and vital statistics obtained from the Danish Civil Registration System. Cox regression was used to estimate the impact of Charlson comorbidity index (CCI) and hepatitis C virus coinfection on mortality, and population attributable risk was used to assess the proportional impact of comorbidity on mortality.
CCI comorbidity was present before HIV diagnosis in 11.3% of 1638 persons with HIV, and in 8.0% of 156,506 persons in the general population. The risk for death in patients with HIV with at least 1 CCI point was 1.84 times higher than in those with no CCI points (adjusted mortality rate ratio, 95% confidence interval: 1.32 to 2.57). The annual risk of dying for patients with HIV vs general population with 0, 1, 2, and 3+ CCI points was 1.70% (1.44 to 2.00) vs 0.27% (0.26 to 0.28), 4.37% (3.01 to 6.32) vs 1.36% (1.26 to 1.47), 8.06% (4.94 to 13.16) vs 2.44% (2.22 to 2.68), and 10.15% (5.08 to 20.30) vs 5.84% (5.19 to 6.58), respectively. Comorbidity acquired before HIV, hepatitis C virus coinfection, and background mortality accounted for 45% of total mortality in the population infected with HIV.
Almost half of deaths in persons diagnosed with HIV in a health care setting with free access to highly active antiretroviral therapy stemmed from factors unrelated to HIV disease.
PubMed ID
21522017 View in PubMed
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A comparison of high-mobility group-box 1 protein, lipopolysaccharide-binding protein and procalcitonin in severe community-acquired infections and bacteraemia: a prospective study.

https://arctichealth.org/en/permalink/ahliterature162518
Source
Crit Care. 2007;11(4):R76
Publication Type
Article
Date
2007
Author
Shahin Gaïni
Ole G Koldkjaer
Holger J Møller
Court Pedersen
Svend S Pedersen
Author Affiliation
Department of Infectious Diseases, Odense University Hospital, Søndre Boulevard 29, DK-5000 Odense C, Denmark. shahin.gaini@ouh.regionsddanmark.dk
Source
Crit Care. 2007;11(4):R76
Date
2007
Language
English
Publication Type
Article
Keywords
Acute-Phase Proteins
Aged
Bacteremia - blood - diagnosis - mortality
Biological Markers - blood
Calcitonin - blood
Carrier Proteins - blood
Community-Acquired Infections - blood - diagnosis - mortality
Denmark - epidemiology
Female
HMGB1 Protein - blood
Humans
Male
Membrane Glycoproteins - blood
Middle Aged
Predictive value of tests
Prospective Studies
Protein Precursors - blood
Severity of Illness Index
Survival Analysis
Abstract
High-mobility group box-1 protein (HMGB1) has been known as a chromosomal protein for many years. HMGB1 has recently been shown to be a proinflammatory cytokine with a role in the immunopathogenesis of sepsis. Lipopolysaccharide-binding protein (LBP) has a central role in the innate immune response when the host is challenged by bacterial pathogens. Procalcitonin (PCT) has been suggested as a marker of severe bacterial infections and sepsis. The aim of the present study was to investigate levels of HMGB1, LBP and PCT in a well-characterised sepsis cohort. The study plan included analysis of the levels of the inflammatory markers in relation to the severity of infection, to the prognosis and to the ability to identify patients with bacteraemia.
Patients suspected of having severe infections and admitted to a department of internal medicine were included in a prospective manner. Demographic data, comorbidity, routine biochemistry, microbiological data, infection focus, severity score and mortality on day 28 were recorded. Plasma and serum were sampled within 24 hours after admission. Levels of all studied markers (HMGB1, LBP, PCT, IL-6, C-reactive protein, white blood cell count and neutrophils) were measured with commercially available laboratory techniques.
A total of 185 adult patients were included in the study; 154 patients fulfilled our definition of infection. Levels of HMGB1, LBP and PCT were higher in infected patients compared with a healthy control group (P
Notes
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