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Browsing by Author "Uzdaviniene, V"

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  • Antiretrovirals, Fractures, and Osteonecrosis in a Large International HIV Cohort
    Publication . Borges, A; Hoy, J; Florence, E; Sedlacek, D; Stellbrink, HJ; Uzdaviniene, V; Tomazic, J; Gargalianos-Kakolyris, P; Schmid, P; Orkin, C; Pedersen, C; Leen, C; Pradier, C; Mulcahy, F; Ridolfo, A; Staub, T; Maltez, F; Weber, R; Flamholc, L; Kyselyova, G; Lungren, J; Mocroft, A; EuroSIDA
    Background: Antiretrovirals (ARVs) affect bone density and turnover, but their effect on risk of fractures and osteonecrosis of the femoral head is less understood. We investigated if exposure to ARVs increases the risk of both bone outcomes. Methods: EuroSIDA participants were followed to assess fractures and osteonecrosis. Poisson regression identified clinical, laboratory and demographic predictors of either bone outcome. Ever, current, and cumulative exposures to ARVs were assessed. Results: During 86118 PYFU among 11820 included persons (median age 41y, 75% male, median baseline CD4 440/mm3, 70.4% virologically suppressed), there were 619 fractures (incidence/1000 PYFU 7.2; 95% CI 6.6-7.7) and 89 osteonecrosis (1.0; 0.8-1.3). Older age, white race, lower BMI, IV drug use, lower baseline CD4, HCV coinfection, prior osteonecrosis, prior fracture, cardiovascular disease, and recent non-AIDS cancer (last 12 months) were associated with fractures. After adjustment, persons who had ever used tenofovir disoproxil fumarate (TDF) (1.40; 1.15-1.70) or who were currently on TDF (1.25; 1.05-1.49) had higher incidence of fractures. There was no association between cumulative exposure to TDF and fractures (1.08/5 y exposure; 0.94-1.25). No other ARV was associated with fractures (all P > .1). Risk of osteonecrosis was associated with white race, lower nadir CD4, prior osteonecrosis, prior fracture, and prior AIDS. After mutual adjustment, no ARV was associated with osteonecrosis. Conclusions: In human immunodeficiency virus (HIV) infection, host factors, HIV-specific variables, and comorbidities contribute to risk of fractures and osteonecrosis. Exposure to TDF, but not other ARVs, was an independent risk factor for fractures.
    2017Journal article Open access Show more
  • The Association Between Hepatitis B Virus Infection and Nonliver Malignancies in Persons Living with HIV: Results from the EuroSIDA Study
    Publication . Mocroft, A; Miro, J; Wandeler, G; Llibre, J; Boyd, A; van Bremen, K; Beniowski, M; Mikhalik, J; Cavassini, M; Maltez, F; Duvivier, C; Uberti Foppa, C; Knysz, B; Bakowska, E; Kuzovatova, E; Domingo, P; Zagalo, A; Viard, JP; Degen, O; Milinkovic, A; Benfield, T; Peters, L; Harxhi, A; Losso, M; Kundro, M; Schmied, B; Zangerle, R; Karpov, I; Vassilenko, A; Mitsura, V; Paduto, D; Clumeck, N; De Wit, S; Delforge, M; Florence, E; Vandekerckhove, L.; Hadziosmanovic, V; Begovac, J; Machala, L; Sedlacek, D; Kronborg, G; Gerstoft, J; Katzenstein, T; Pedersen, C; Johansen, I; Ostergaard, L; Wiese, L; Moller, N; Nielsen, L; Zilmer, K; Smidt, J; Aho, I; Lacombe, K; Pradier, C; Fontas, E; Rockstroh, J; Behrens, G; Hoffmann, C; Stellbrink, H; Stefan, C; Bogner, J; Fätkenheuer, G; Chkhartishvili, N; Sambatakou, H; Adamis, G; Paissios, N; Szlávik, J; Gottfredsson, M; Devitt, E; Tau, L; Turner, D; Burke, M; Shahar, E; Wattad, L; Elinav, H; Haouzi, M; Elbirt, D; D’Arminio Monforte, A; Esposito, R; Mazeu, I; Mussini, C; Mazzotta, F; Gabbuti, A; Lazzarin, A; Castagna, A; Gianotti, N; Galli, M; Ridolfo, A; Uzdaviniene, V; Matulionyte, R; Staub, T; Hemmer, R; Dragas, S; Stevanovic, M; vd Valk, M; Trajanovska, J; Reikvam, D; Maeland, A; Bruun, J; Szetela, B; Inglot, M; Flisiak, R; Grzeszczuk, A; Parczewski, M; Maciejewska, K; Aksak‐Was, B; Mularska, E; Jablonowska, E; Kamerys, J; Wojcik, K; Mozer‐Lisewska, I; Rozplochowski, B; Mansinho, K; Radoi, R; Oprea, C; Gusev, D; Trofimova, T; Khromova, I; Borodulina, E; Ranin, J; Tomazic, J; Miró, J; Laguno, M; Martinez, E; Garcia, F; Blanco, J; Martinez‐Rebollar, M; Mallolas, J; Callau, P; Rojas, J; Inciarta, A; Moreno, S; del Campo, S; Clotet, B; Jou, A; Paredes, R; Puig, J; Santos, J; Gutierrez, M; Mateo, G; Sambeat, M; Laporte, J; Svedhem, V; Thalme, A; Sönnerborg, A; Brännström, J; Flamholc, L; Kusejko, K; Braun, D; Calmy, A; Furrer, H; Battegay, M; Schmid, P; Kuznetsova, A; Sluzhynska, M; Johnson, A; Simons, E; Edwards, S; Phillips, A; Johnson, M; Orkin, C; Winston, A; Clarke, A; Leen, C; Karpov, I; Losso, M; Lundgren, J; Rockstroh, J; Aho, I; Rasmussen, L; Svedhem, V; Pradier, C; Chkhartishvili, N; Matulionyte, R; Oprea, C; Kowalska, J; Begovac, J; Miró, J; Guaraldi, G; Paredes, R; Paredes, R; Larsen, J; Bojesen, A; Neesgaard, B; Jaschinski, N; Fursa, O; Sather, M; Raben, D; Hansen, E; Kristensen, D; Fischer, A; Jensen, S; Elsing., T; Phillips, A; Reekie, J; Cozzi‐Lepri, A; Amele, S; Pelchen‐Matthews, A; Roen, A; Tusch, E; Bannister., W
    Objectives: The aim of this study was to assess the impact of hepatitis B virus (HBV) infection on non-liver malignancies in people living with HIV (PLWH). Methods: All persons aged ≥ 18 years with known hepatitis B virus (HBV) surface antigen (HBsAg) status after the latest of 1 January 2001 and enrolment in the EuroSIDA cohort (baseline) were included in the study; persons were categorized as HBV positive or negative using the latest HBsAg test and followed to their first diagnosis of nonliver malignancy or their last visit. Results: Of 17 485 PLWH included in the study, 1269 (7.2%) were HBV positive at baseline. During 151 766 person-years of follow-up (PYFU), there were 1298 nonliver malignancies, 1199 in those currently HBV negative [incidence rate (IR) 8.42/1000 PYFU; 95% confidence interval (CI) 7.94-8.90/1000 PYFU] and 99 in those HBV positive (IR 10.54/1000 PYFU; 95% CI 8.47-12.62/1000 PYFU). After adjustment for baseline confounders, there was a significantly increased incidence of nonliver malignancies in HBV-positive versus HBV-negative individuals [adjusted incidence rate ratio (aIRR) 1.23; 95% CI 1.00-1.51]. Compared to HBV-negative individuals, HBsAg-positive/HBV-DNA-positive individuals had significantly increased incidences of nonliver malignancies (aIRR 1.37; 95% CI 1.00-1.89) and NHL (aIRR 2.57; 95% CI 1.16-5.68). There was no significant association between HBV and lung or anal cancer. Conclusions: We found increased rates of nonliver malignancies in HBsAg-positive participants, the increases being most pronounced in those who were HBV DNA positive and for NHL. If confirmed, these results may have implications for increased cancer screening in HIV-positive subjects with chronic HBV infection.
    2021-07Journal article Open access Show more