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Abacavir and risk of myocardial infarction in HIV-infected patients on highly active antiretroviral therapy: a population-based nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature99479
Source
HIV Med. 2010 Feb;11(2):130-6
Publication Type
Article
Date
Feb-2010
Author
Niels Obel
D K Farkas
G. Kronborg
C S Larsen
G. Pedersen
A. Riis
C. Pedersen
J. Gerstoft
H T Sørensen
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark. niels.obel@rh.regionh.dk
Source
HIV Med. 2010 Feb;11(2):130-6
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - adverse effects
Antiretroviral Therapy, Highly Active
Comorbidity
Denmark - epidemiology
Dideoxynucleosides - adverse effects
Epidemiologic Methods
Female
HIV Infections - drug therapy
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Myocardial Infarction - chemically induced - epidemiology
Myocardial Ischemia - epidemiology
Proportional Hazards Models
Time Factors
Abstract
OBJECTIVE: The aim of the study was to examine whether exposure to abacavir increases the risk for myocardial infarction (MI). DESIGN, SETTING AND SUBJECTS: This was a prospective nationwide cohort study which included all Danish HIV-infected patients on highly active antiretroviral therapy (HAART) from 1995 to 2005 (N = 2952). Data on hospitalization for MI and comorbidity were obtained from Danish medical databases. Hospitalization rates for MI after HAART initiation were calculated for patients who used abacavir and those who did not. We used Cox's regression to compute incidence rate ratios (IRR) as a measure of relative risk for MI, while controlling for potential confounders (as separate variables and via propensity score) including comorbidity. MAIN OUTCOME: Relative risk of hospitalization with MI in abacavir users compared with abacavir nonusers. RESULTS: Hospitalization rates for MI were 2.4/1000 person-years (PYR) [95% confidence interval (CI) 1.7-3.4] for abacavir nonusers and 5.7/1000 PYR (95% CI 4.1-7.9) for abacavir users. The risk of MI increased after initiation of abacavir [unadjusted IRR = 2.22 (95% CI 1.31-3.76); IRR adjusted for confounders = 2.00 (95% CI 1.10-3.64); IRR adjusted for propensity score = 2.00 (95% CI 1.07-3.76)]. This effect was also observed among patients initiating abacavir within 2 years after the start of HAART and among patients who started abacavir as part of a triple nucleoside reverse transcriptase inhibitor (NRTI) regimen. CONCLUSIONS: We confirmed the association between abacavir use and increased risk of MI. Further studies are needed to control for potential confounding not measured in research to date.
PubMed ID
19682101 View in PubMed
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The acquired immunodeficiency syndrome (AIDS) in Denmark. A report from the Copenhagen study group of AIDS on the first 20 Danish patients.

https://arctichealth.org/en/permalink/ahliterature8796
Source
Acta Med Scand. 1985;217(2):213-24
Publication Type
Article
Date
1985
Author
J. Gerstoft
J O Nielsen
E. Dickmeiss
T. Rønne
P. Platz
L. Mathiesen
Source
Acta Med Scand. 1985;217(2):213-24
Date
1985
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - epidemiology - immunology - transmission
Adult
Africa, Central
Denmark
Homosexuality
Humans
Male
Middle Aged
Travel
United States
Abstract
Twenty Danish patients with the acquired immunodeficiency syndrome (AIDS) had been diagnosed by January 1984, 14 of them after 1982. Eighteen patients were male homosexuals, 8 of whom had visited the USA after 1979, 2 were heterosexual males with a history of sexual contacts in Central Africa, suggesting a transmission of AIDS from woman to man. AIDS has not been observed in drug abusers, hemophiliacs or transfused non-risk persons in Denmark. The clinical picture varied according to the presence of Kaposi sarcoma or the type of opportunistic infections, but was in general similar to that reported from the USA. Investigation of T-lymphocyte subsets revealed that the AIDS patients differed from controls and healthy homosexual men by having either a very low number of helper cells or a low helper/suppressor cell ratio. Functional immunological studies revealed a decreased natural killer cell activity and decreased blast transformation by mitogens. The survival two years after diagnosis was 16%.
PubMed ID
3993435 View in PubMed
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[AIDS in Denmark. 1. Opportunistic infections and malignant diseases. Danish Study Group for HIV infection]

https://arctichealth.org/en/permalink/ahliterature7897
Source
Ugeskr Laeger. 1995 Mar 6;157(10):1347-51
Publication Type
Article
Date
Mar-6-1995
Author
J D Lundgren
K D Bentsen
C. Pedersen
J. Gerstoft
T. Seefeldt-Nielsen
T L Nielsen
G F Jensen
Author Affiliation
Infektionsmedicinsk afdeling, Hvidovre Hospital, København.
Source
Ugeskr Laeger. 1995 Mar 6;157(10):1347-51
Date
Mar-6-1995
Language
Danish
Publication Type
Article
Keywords
AIDS-Related Opportunistic Infections - diagnosis - epidemiology - microbiology
Acquired Immunodeficiency Syndrome - complications
Blood Transfusion - adverse effects
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes - immunology
Denmark - epidemiology
English Abstract
HIV Infections - complications
Humans
Male
Sarcoma, Kaposi - etiology
Sexual Behavior
Substance Abuse, Intravenous - complications
Abstract
To examine the distribution of AIDS-defining illnesses among Danish AIDS patients, data on 687 AIDS patients diagnosed in the period from 1980 to 1990 (93% of all reported cases in the period) were collected. The most frequent AIDS-defining illness was Pneumocystis carinii pneumonia followed by candida oesophagitis and Kaposis sarcoma. The proportion of homo/bisexual men presenting with Kaposis sarcoma as the initial AIDS-defining illness declined over time. Patients with extrapulmonary tuberculosis had higher CD4 cell counts than patients presenting with other illnesses. Cytomegalovirus chorioretinitis and atypical mycobacteriosis were seen more frequently after the time of the AIDS diagnosis, and a low CD4 cell count at time of the AIDS diagnosis was a significant predictor for the development of these opportunistic infections during follow-up. Danish AIDS patients present with a wide spectrum of HIV-related illnesses, reflecting their exposure to opportunistic microorganisms and the degree of immune deficiency. The pattern of HIV-related illnesses is changing over time, and therefore continuous surveillance is needed to optimize therapeutic and prophylactic regimens.
PubMed ID
7709482 View in PubMed
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[AIDS in Denmark. 2. Survival after the diagnosis of AIDS. Danish Study Group for HIV infection]

https://arctichealth.org/en/permalink/ahliterature7896
Source
Ugeskr Laeger. 1995 Mar 6;157(10):1352-6
Publication Type
Article
Date
Mar-6-1995
Author
J D Lundgren
C. Pedersen
K D Bentsen
J. Gerstoft
T. Seefeldt-Nielsen
T L Nielsen
G F Jensen
Author Affiliation
Infektionsmedicinsk afdeling, Hvidovre Hospital, København.
Source
Ugeskr Laeger. 1995 Mar 6;157(10):1352-6
Date
Mar-6-1995
Language
Danish
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - diagnosis - immunology - mortality
Adult
Age Factors
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes - immunology
Denmark - epidemiology
English Abstract
Female
HIV Infections - diagnosis - mortality
Humans
Male
Prognosis
Survival Rate
Time Factors
Abstract
The survival pattern was studied for 687 Danish AIDS patients (93% of notified cases in the study period) who were diagnosed with AIDS during the period from 1980 to 1990. The median survival was 17 months. Factors significantly associated with a shortened survival were transfusion-acquired HIV infection, age > 40 years, year of diagnosis before 1987, and the presence of either disseminated infection with Mycobacterium avium-complex, Cytomegalovirus chorioretinitis or malignant lymphoma at time of the AIDS diagnosis. There was also a significant association between survival and CD4 cell count at time of AIDS diagnosis. Patients who had CD4 cell counts above 200 x 10(6)/l had twice as long a survival as patients who had CD4 cell counts less than 50 x 10(6)/l. The prognosis of Danish AIDS patients remains poor. The most important determinant of survival time appears to be the degree of immune deficiency at time of diagnosis.
PubMed ID
7709483 View in PubMed
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AIDS in Denmark 1980-1984. Immunological, epidemiological and clinical studies among patients and high risk groups.

https://arctichealth.org/en/permalink/ahliterature8703
Source
Dan Med Bull. 1987 Oct;34(5):217-34
Publication Type
Article
Date
Oct-1987

Alterations in T-lymphocyte subsets among Danish haemophiliacs: relation to source of factor VIII preparations and high dose factor VIII treatment.

https://arctichealth.org/en/permalink/ahliterature39856
Source
Scand J Haematol. 1984 May;32(5):544-51
Publication Type
Article
Date
May-1984
Author
J. Gerstoft
K. Bentsen
E. Scheibel
J. Dalsgård-Nielsen
J. Gormsen
E. Dickmeiss
Source
Scand J Haematol. 1984 May;32(5):544-51
Date
May-1984
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alanine Transaminase - metabolism
Antibodies, Viral - analysis
Child
Child, Preschool
Cytomegalovirus - isolation & purification
Denmark
Drug Industry
Europe
Factor VIII - therapeutic use
Hemophilia A - immunology
Humans
Immunoglobulin G - analysis
Infant
Liver - enzymology
Middle Aged
T-Lymphocytes, Helper-Inducer - classification
T-Lymphocytes, Regulatory - classification
United States
Abstract
Screening of 43 healthy Danish haemophiliacs revealed a significantly lower helper/suppressor (H/S) ratio than in controls. 8 of the haemophiliacs had an H/S ratio less than or equal to 1.0. A significant negative correlation occurred between the total lifetime factor VIII treatment and the H/S ratio. However, high-dose factor VIII treatment given to patients with antibodies against factor VIII was not associated with immunological abnormalities. Children had a significantly higher H/S ratio than the adult haemophiliacs. Patients exclusively treated with Danish cryoprecipitate during the last year had a significantly higher H/S ratio than patients receiving preparations from other sources. This difference might, however, be explained by lower age and lower total lifetime dose in the group receiving Danish preparations. Haemophiliacs treated with American preparations did not differ immunologically from those treated with preparations of other origin. Total serum IgG was increased in 23% of the patients. This parameter was negatively correlated with the H/S ratio. The possible relation of the observed immunological alterations among otherwise healthy haemophiliacs to the acquired immune deficiency syndrome warrants further attention.
PubMed ID
6328639 View in PubMed
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Alternating treatment with didanosine and zidovudine versus either drug alone for the treatment of advanced HIV infection. The Alter Study. Nordic HIV Therapy Group.

https://arctichealth.org/en/permalink/ahliterature7764
Source
Scand J Infect Dis. 1997;29(2):121-8
Publication Type
Article
Date
1997
Author
J. Gerstoft
H. Melander
J N Bruun
C. Pedersen
P C Gltzsche
O. Berglund
L. Mathiesen
P. Skinhlj
S R Norrby
Author Affiliation
Department of Infectious Diseases, RHIMA, Rigshospitalet, University of Copenhagen, Denmark.
Source
Scand J Infect Dis. 1997;29(2):121-8
Date
1997
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - administration & dosage - adverse effects - therapeutic use
CD4 Lymphocyte Count - drug effects
Didanosine - administration & dosage - adverse effects - therapeutic use
Drug Administration Schedule
Drug Therapy, Combination
Female
HIV Infections - drug therapy
Humans
Male
Middle Aged
Research Support, Non-U.S. Gov't
Zidovudine - administration & dosage - adverse effects - therapeutic use
Abstract
The efficacy and safety of an alternating regime with zidovudine and didanosine versus treatment with either drug alone were investigated in a randomized, open, controlled trial, 552 patients with advanced HIV infection, 47% of whom had received prior treatment with zidovudine, were enrolled. The patients were randomly assigned to zidovudine 600 mg/day, didanosine 400 mg/day or 4-week alternations with the 2 drugs in the same dose. The study had a median length of follow-up of 88 weeks. In the overall analyses, time to death (p = 0.48) and time to death or new AIDA event (0.80) were equally distributed between the 3 treatment groups. In the subgroup of patients with a CD4 count
PubMed ID
9181646 View in PubMed
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Causes of death among Danish HIV patients compared with population controls in the period 1995-2008.

https://arctichealth.org/en/permalink/ahliterature122652
Source
Infection. 2012 Dec;40(6):627-34
Publication Type
Article
Date
Dec-2012
Author
M. Helleberg
G. Kronborg
C S Larsen
G. Pedersen
C. Pedersen
J. Gerstoft
N. Obel
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark. mhelleberg@sund.ku.dk
Source
Infection. 2012 Dec;40(6):627-34
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Adult
Anti-Retroviral Agents - therapeutic use
Antiretroviral Therapy, Highly Active - methods
Case-Control Studies
Cause of Death
Denmark
HIV Infections - drug therapy - mortality
HIV Seropositivity - drug therapy - mortality
Humans
Middle Aged
Abstract
To compare the mortality and causes of death in human immunodeficiency syndrome (HIV) patients with the background population.
All adult HIV patients treated in Danish HIV centers from 1995 to 2008 and 14 controls for each HIV patient were included. Age-adjusted mortality rates (MR) and mortality rate ratios (MRR) were estimated using direct standardization and Poisson regression analyses. Up to four contributory causes of death for each person were included in analyses of cause-specific MR.
A total of 5,137 HIV patients and 71,918 controls were followed for 37,838 and 671,339 person-years (PY), respectively. Among non-injection drug use (IDU) HIV patients, the acquired immune deficiency syndrome (AIDS)-related MR/1,000 PY declined dramatically from 122.9 [95 % confidence interval (CI) 106.8-141.4] in 1995 to 5.0 (95 % CI 3.1-8.1) in 2008. The non-AIDS-related MR did not change substantially from 6.9 (95 % CI 3.8-12.5) to 5.6 (95 % CI 3.6-8.8). The MR of unnatural causes declined from 6.9 (95 % CI 3.8-12.5) to 2.7 (95 % CI 1.4-5.1). The MRR of infections declined from 46.6 (95 % CI 19.6-110.9) to 3.3 (95 % CI 1.6-6.6). The MRR of other natural causes of death remained constant.
After the introduction of highly active antiretroviral therapy (HAART), the AIDS-related mortality has decreased substantially, but the long-term exposure to HIV and HAART has not translated into increasing mortality from malignancy, cardiovascular, and hepatic diseases.
PubMed ID
22791407 View in PubMed
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Changing patterns of Kaposi's sarcoma in Danish acquired immunodeficiency syndrome patients with complete follow-up. The Danish Study Group for HIV Infection (DASHI).

https://arctichealth.org/en/permalink/ahliterature7893
Source
Am J Epidemiol. 1995 Apr 1;141(7):652-8
Publication Type
Article
Date
Apr-1-1995
Author
J D Lundgren
M. Melbye
C. Pedersen
P S Rosenberg
J. Gerstoft
Author Affiliation
Department of Infectious Diseases (Unit 144), Hvidovre Hospital, Denmark.
Source
Am J Epidemiol. 1995 Apr 1;141(7):652-8
Date
Apr-1-1995
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - blood - complications
Adult
CD4-Positive T-Lymphocytes
Denmark - epidemiology
Female
Follow-Up Studies
HIV-1
Humans
Incidence
Lymphocyte Count
Male
Middle Aged
Population Surveillance
Predictive value of tests
Research Support, Non-U.S. Gov't
Risk factors
Sarcoma, Kaposi - epidemiology - virology
Abstract
The objective was to study changes in the occurrence of human immunodeficiency virus type 1-related Kaposi's sarcoma and the association with degree of immunodeficiency over time. Danish patients with acquired immunodeficiency syndrome (AIDS) diagnosed between 1979 and 1990 (n = 687) were followed clinically and with consecutive CD4 cell count measurement from time of AIDS-defining illness to date of death or censoring date, whichever came first. The proportion of homo-/bisexual men (n = 520) with Kaposi's sarcoma (n = 100) at AIDS diagnosis declined from 31% before 1985 to 13% in 1990, whereas the proportion of patients who died with Kaposi's sarcoma remained constant over time. Furthermore, the CD4 cell count at time of AIDS for patients diagnosed with Kaposi's sarcoma has declined in recent years. A CD4 cell count
PubMed ID
7702040 View in PubMed
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51 records – page 1 of 6.