Lars Jørgen Østergaard

Where is the greatest impact of uncontrolled HIV infection on AIDS and non-AIDS events in HIV?

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Amanda Mocroft, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
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  • Kamilla Laut, Department of Infectious Diseases, CHIP, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • Peter Reiss, Stichting HIV Monitoring, Amsterdam, The Netherlands.
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  • Jose Gatell, Hospital Clinic Universitari de Barcelona, Barcelona, Spain.
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  • Vidar Ormaasen, Ullevaal University Hospital, Oslo, Norway.
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  • Matthias Cavassini, University Hospital Center and University of Lausanne, Lausanne, Switzerland.
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  • Vesna Hadziosmanovic, Klinicki Centar Univerziteta Sarajevo, Sarajevo, Bosnia and Herzegovina.
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  • Kamal Mansinho, Centro Hospitalar Lisboa Ocidental, EPE/Hospital de Egas Moniz, Lisbon, Portugal.
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  • Christian Pradier, Hôpital de l'Archet, Nice, France.
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  • Marta Vasylyev, Luhansk State Medical University, Luhansk, Ukraine.
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  • Victor Mitsura, Gomel State Medical University, Gomel, Belarus.
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  • Linos Vandekerckhove, Universitair Ziekenhuis Gent (Ghent University Hospital), Gent, Belgium; Representative of the European Heart Rhythm Association (EHRA).
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  • Lars Ostergaard
  • Amanda Clarke, Royal Sussex County Hospital, Brighton, UK.
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  • Olaf Degen, Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, 20246 Hamburg, Germany.
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  • Fiona Mulcahy, Neuropsychiatric Genetics Group, Department of Psychiatry, Trinity College Dublin, St James Hospital, Dublin, Ireland.
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  • Antonella Castagna, Responsabile Unità Funzionale, Divisione Malattie Infettive, Istituto Scientifico San Raffaele, Milano, Italy.
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  • Zed Sthoeger, AIDS Center (Neve Or), Rehovot, Israel.
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  • Leo Flamholc, Reproductive Medicine Center, Skåne University Hospital, Lund University, Malmö, Sweden.
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  • Dalibor Sedláček, Charles University Hospital Plzeň, Pilsen, Czech Republic.
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  • Iwona Mozer-Lisewska, Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Collegium Maius, Fredry 10, 61-701, Poznań, Poland.
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  • Jens D Lundgren, Department of Infectious Diseases, CHIP, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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  • EuroSIDA Study

OBJECTIVE: The extent to which controlled and uncontrolled HIV interact with ageing, European region of care and calendar year of follow-up is largely unknown.

METHOD: EuroSIDA participants were followed after 1 January 2001 and grouped according to current HIV progression risk; high risk (CD4 cell count ≤350/μl, viral load ≥10 000 copies/ml), low risk (CD4 cell count ≥500 cells/μl, viral load <50 copies/ml) and intermediate (other combinations). Poisson regression investigated interactions between HIV progression risk, age, European region of care and year of follow-up and incidence of AIDS or non-AIDS events.

RESULTS: A total of 16 839 persons were included with 136 688 person-years of follow-up. In persons aged 30 years or less, those at high risk had a six-fold increased incidence of non-AIDS compared with those at low risk, compared with a two-to-three-fold increase in older persons (P = 0.0004, interaction). In Eastern Europe, those at highest risk of non-AIDS had a 12-fold increased incidence compared with a two-to-four-fold difference in all other regions (P = 0.0029, interaction). Those at high risk of non-AIDS during 2001-2004 had a two-fold increased incidence compared with those at low risk, increasing to a five-fold increase between 2013 and 2016 (P < 0.0001, interaction). Differences among high, intermediate and low risk of AIDS were similar across age groups, year of follow-up and Europe (P = 0.57, 0.060 and 0.090, respectively, interaction).

CONCLUSION: Factors other than optimal control of HIV become increasingly important with ageing for predicting non-AIDS, whereas differences across Europe reflect differences in patient management as well as underlying socioeconomic circumstances. The differences between those at high, intermediate and low risk of non-AIDS between 2013 and 2016 likely reflects better quality of care.

Original languageEnglish
JournalAIDS
Volume32
Issue2
Pages (from-to)205-215
Number of pages11
ISSN0269-9370
DOIs
Publication statusPublished - 14 Jan 2018

    Research areas

  • Journal Article

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