排序方式: 共有81条查询结果,搜索用时 447 毫秒
71.
Wyl Vv Gianella S Fischer M Niederoest B Kuster H Battegay M Bernasconi E Cavassini M Rauch A Hirschel B Vernazza P Weber R Joos B Günthard HF;Swiss HIV Cohort Study-SHCS 《PloS one》2011,6(11):e27463
Background
Long-term benefits of combination antiretroviral therapy (cART) initiation during primary HIV-1 infection are debated.Methods
The evolution of plasma HIV-RNA (432 measurements) and cell-associated HIV-DNA (325 measurements) after cessation of cART (median exposure 18 months) was described for 33 participants from the Zurich Primary HIV Infection Study using linear regression and compared with 545 measurements from 79 untreated controls with clinically diagnosed primary HIV infection, respectively a known date for seroconversion.Results
On average, early treated individuals were followed for 37 months (median) after cART cessation; controls had 34 months of pre-cART follow-up. HIV-RNA levels one year after cART interruption were −0.8 log10 copies/mL [95% confidence interval −1.2;−0.4] lower in early treated patients compared with controls, but this difference was no longer statistically significant by year three of follow-up (−0.3 [−0.9; 0.3]). Mean HIV-DNA levels rebounded from 2 log10 copies [1.8; 2.3] on cART to a stable plateau of 2.7 log10 copies [2.5; 3.0] attained 1 year after therapy stop, which was not significantly different from cross-sectional measurements of 9 untreated members of the control group (2.8 log10 copies [2.5; 3.1]).Conclusions
The rebound dynamics of viral markers after therapy cessation suggest that early cART may indeed limit reservoir size of latently infected cells, but that much of the initial benefits are only transient. Owing to the non-randomized study design the observed treatment effects must be interpreted with caution. 相似文献72.
73.
74.
75.
76.
Radoslaw Panczak Marcel Zwahlen Adrian Spoerri Kali Tal Martin Killias Matthias Egger for the Swiss National Cohort 《PloS one》2013,8(1)
Background
Homicide–suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland.Methods
The study identified homicide–suicide events 1991–2008 in persons from the same household in the Swiss National Cohort, which links census and mortality records. The analysis examined the association of the risk of dying in a homicide–suicide event with socio-demographic variables, measured at the individual-level, household composition variables and area-level variables. Proportional hazards regression models were calculated for male perpetrators and female victims. Results are presented as age-adjusted hazard ratios (HR) with 95% confidence intervals (95%CI).Results
The study identified 158 deaths from homicide–suicide events, including 85 murder victims (62 women, 4 men, 19 children and adolescents) and 68 male and 5 female perpetrators. The incidence was 3 events per million households and year. Firearms were the most prominent method for both homicides and suicides. The risk of perpetrating homicide-suicide was higher in divorced than in married men (HR 3.64; 95%CI 1.56–8.49), in foreigners without permanent residency compared to Swiss citizens (HR 3.95; 1.52–10.2), higher in men without religious affiliations than in Catholics (HR 2.23; 1.14–4.36) and higher in crowded households (HR 4.85; 1.72–13.6 comparing ≥2 with <1 persons/room). There was no association with education, occupation or nationality, the number of children, the language region or degree of urbanicity. Associations were similar for female victims.Conclusions
This national longitudinal study shows that living conditions associated with psychological stress and lower levels of social support are associated with homicide-suicide events in Switzerland. 相似文献77.
Viktor von Wyl Thomas Klimkait Sabine Yerly Dunja Nicca Hansjakob Furrer Matthias Cavassini Alexandra Calmy Enos Bernasconi Jürg B?ni Vincent Aubert Huldrych F. Günthard Heiner C. Bucher Tracy R. Glass and the Swiss HIV Cohort Study 《PloS one》2013,8(10)
Background
Non-adherence is one of the strongest predictors of therapeutic failure in HIV-positive patients. Virologic failure with subsequent emergence of resistance reduces future treatment options and long-term clinical success.Methods
Prospective observational cohort study including patients starting new class of antiretroviral therapy (ART) between 2003 and 2010. Participants were naïve to ART class and completed ≥1 adherence questionnaire prior to resistance testing. Outcomes were development of any IAS-USA, class-specific, or M184V mutations. Associations between adherence and resistance were estimated using logistic regression models stratified by ART class.Results
Of 314 included individuals, 162 started NNRTI and 152 a PI/r regimen. Adherence was similar between groups with 85% reporting adherence ≥95%. Number of new mutations increased with increasing non-adherence. In NNRTI group, multivariable models indicated a significant linear association in odds of developing IAS-USA (odds ratio (OR) 1.66, 95% confidence interval (CI): 1.04-2.67) or class-specific (OR 1.65, 95% CI: 1.00-2.70) mutations. Levels of drug resistance were considerably lower in PI/r group and adherence was only significantly associated with M184V mutations (OR 8.38, 95% CI: 1.26-55.70). Adherence was significantly associated with HIV RNA in PI/r but not NNRTI regimens.Conclusion
Therapies containing PI/r appear more forgiving to incomplete adherence compared with NNRTI regimens, which allow higher levels of resistance, even with adherence above 95%. However, in failing PI/r regimens good adherence may prevent accumulation of further resistance mutations and therefore help to preserve future drug options. In contrast, adherence levels have little impact on NNRTI treatments once the first mutations have emerged. 相似文献78.
In general, optimal reaction norms in heterogeneous populations can be obtained only by iterative numerical procedures (McNamara,
1991; Kawecki and Stearns, 1993). We consider two particular, but biologically plausible and analytically tractable cases
of individual optimization to gain insight into the mechanisms which shape the optimal reaction norm of fecundity in relation
to an environmental variable or an individual trait. In the first case, we assume that the quality of the environment (e.g.
food abundance) or the quality of the individual (e.g. body size) is fixed during its entire life; it may also be a heritable
individual trait. In the second case, individual quality is assumed to change randomly such that the probability distribution
of quality in the next year is the same for the parent and for her offspring. For these two cases, we obtain analytical expressions
for the shape of the optimal reaction norm, which are heuristically interpretable in terms of underlying selective mechanisms.
It is shown that better quality may reduce the optimal fecundity. This outcome is particularly likely if better quality increases
a fecundity-independent factor of parental survival in a long-lived species with fixed quality.
This revised version was published online in July 2006 with corrections to the Cover Date. 相似文献
79.
80.
Katharina Kusejko Huldrych F. Günthard Gregory S. Olson Kyra Zens Katharine Darling Nina Khanna Hansjakob Furrer Pauline Vetter Enos Bernasconi Pietro Vernazza Matthias Hoffmann Roger D. Kouyos Johannes Nemeth the Swiss HIV Cohort Study 《PLoS biology》2020,18(12)
Approximately 28% of the human population have been exposed to Mycobacterium tuberculosis (MTB), with the overwhelming majority of infected individuals not developing disease (latent TB infection (LTBI)). While it is known that uncontrolled HIV infection is a major risk factor for the development of TB, the effect of underlying LTBI on HIV disease progression is less well characterized, in part because longitudinal data are lacking. We sorted all participants of the Swiss HIV Cohort Study (SHCS) with at least 1 documented MTB test into one of the 3 groups: MTB uninfected, LTBI, or active TB. To detect differences in the HIV set point viral load (SPVL), linear regression was used; the frequency of the most common opportunistic infections (OIs) in the SHCS between MTB uninfected patients, patients with LTBI, and patients with active TB were compared using logistic regression and time-to-event analyses. In adjusted models, we corrected for baseline demographic characteristics, i.e., HIV transmission risk group and gender, geographic region, year of HIV diagnosis, and CD4 nadir. A total of 13,943 SHCS patients had at least 1 MTB test documented, of whom 840 (6.0%) had LTBI and 770 (5.5%) developed active TB. Compared to MTB uninfected patients, LTBI was associated with a 0.24 decreased log HIV SPVL in the adjusted model (p < 0.0001). Patients with LTBI had lower odds of having candida stomatitis (adjusted odds ratio (OR) = 0.68, p = 0.0035) and oral hairy leukoplakia (adjusted OR = 0.67, p = 0.033) when compared to MTB uninfected patients. The association of LTBI with a reduced HIV set point virus load and fewer unrelated infections in HIV/TB coinfected patients suggests a more complex interaction between LTBI and HIV than previously assumed.Surprisingly little is known about how latent tuberculosis infection alters human physiology and immune function. Extensive statistical analyses of the large Swiss HIV Cohort Study suggests that latent tuberculosis infection can be protective in individuals with HIV. 相似文献