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Characterising HIV-Indicator conditions among two nationwide long-term cohorts of people living with HIV in Germany (1999–2023)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年10月30日

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  • Amrei Krings,
  • Christian Kollan,
  • Daniel Schmidt,
  • Barbara Gunsenheimer-Bartmeyer,
  • Frederik Valbert,
  • Anja Neumann,
  • Jürgen Wasem,
  • Georg M. N. Behrens,
  • Markus Bickel,
  • Christoph Boesecke,
  • Stefan Esser,
  • Patrik Dröge,
  • Thomas Ruhnke,
  • Uwe Koppe,
  • Heribert Knechten,
  • Petra Panstrugart,
  • Keikawus Arasteh,
  • Michael Rittweger,
  • Hans Wesselmann,
  • Nikolai Menner,
  • Dirk Schürmann,
  • Marianne Warncke,
  • Ulrich Bohr,
  • Heiko Jessen,
  • Arne B. Jessen,
  • Hubert Schulbin,
  • Sascha Brand,
  • Jan Gumprecht,
  • Beate Weninger,
  • Heribert Hillenbrand,
  • Heiko Karcher,
  • Klaus Fischer,
  • Dietmar Schranz,
  • Mathias Vallée,
  • Jukka Hartikainen,
  • Stephan Grunwald,
  • Jörg A. Claus,
  • Claudia Thomas,
  • Roland Grimm,
  • Sarah Schoor,
  • Christiane Cordes,
  • Reinhold Schröder,
  • Tobias Glaunsinger,
  • Michael Rausch,
  • Thomas Reineke,
  • Gordon Weinberg,
  • Manuel Bruhy,
  • Siegfried Köppe,
  • Peter Kreckel,
  • Andreas Berger,
  • Sinah Lindemann,
  • Norbert H. Brockmeyer,
  • Anja Potthoff,
  • Kathrin van Bremen,
  • Jürgen Rockstroh,
  • Jan-Christian Wasmuth,
  • Svetlana Hass,
  • Martin Hower,
  • Claudia Bachmann,
  • Petra Spornraft-Ragaller,
  • Dieter Teichmann,
  • Björn-Erik Ole Jensen,
  • Falk Hüttig,
  • Cecilie Feind,
  • Pia Schenk-Westkamp,
  • Annette Haberl,
  • Christoph Stephan,
  • Peter Schott,
  • Susanne Usadel,
  • Matthias Müller,
  • Janina Trauth,
  • Alan Chavez-Valladares,
  • Gerd Deutschinoff,
  • Burkhard Kreft,
  • Danica Lange,
  • Olaf Degen,
  • Guido Schäfer,
  • Andreas Plettenberg,
  • Frieder Kuhlendahl,
  • Thore Lorenzen,
  • Dorothea Wiemer,
  • Lavinia Biemann,
  • Axel Adam,
  • Thomas Buhk,
  • Stephan Fenske,
  • Stefan Hansen,
  • Michael Sabranski,
  • Knud Schewe,
  • Christian Hoffmann,
  • Hans-Jürgen Stellbrink,
  • Dennis Radzuweit,
  • Alexander Mainka,
  • Constantin Rickassel,
  • Olaf Degen,
  • Guido Schäfer,
  • Robin Scheiter,
  • Georg Behrens,
  • Matthias Stoll,
  • Steve Gerschmann,
  • Renate Beider,
  • Benjamin T. Schleenvoigt,
  • Mathias W. Pletz,
  • Heinz-August Horst,
  • Silke Trautmann,
  • Ansgar Rieke,
  • Stephan Schneeweiß,
  • Stefan Scholten,
  • Mark Oette,
  • Gerd Fätkenheuer,
  • Jörg Janne Vehreschild,
  • Laura Hamacher,
  • Lennart Nicksch,
  • Peter A. Arbter,
  • Thomas Grünewald,
  • Jeannine Weidemann,
  • Ines Ruck,
  • Bernd Claus,
  • Martin Sprinzl,
  • Peter R. Galle,
  • Matthias P. Ebert,
  • Roger Vogelmann,
  • Johannes Bogner,
  • Ulrike Hellerer,
  • Barbara Sonntag,
  • Oliver Pullen,
  • Antoniya Todorova,
  • Claudia Traidl-Hoffmann,
  • Birgit Mück,
  • Ramona Pauli,
  • Christoph D. Spinner,
  • Jochen Schneider,
  • Birgit Mück,
  • Robert Baumann,
  • Niels Schübel,
  • Christiane Berning,
  • Franz Audebert,
  • Carlos Fritzsche,
  • A Trein,
  • E Schnaitmann,
  • Clemens Roll,
  • Simone Marquardt,
  • Georg Härter,
  • Beate Grüner,
  • Cengiz Güler,
  • Steve Rößler

摘要

Background/Objective

Information about occurrence and affected groups of symptoms/diagnoses indicative of an HIV infection (so-called HIV indicator conditions; HIV-ICs) is lacking. We analyse HIV-IC incidence, transmission risks and immune status among people living with HIV (PLWH) antiretroviral therapy (ART) naive.

Methods

Diagnoses reported for ART-naive PLWH from two multicentre observational, prospective cohort studies between 1999–2023 were analysed. Incidence rates per 1,000 person-years (PYs) were calculated for the overall study period and time periods defined by ART treatment recommendations. For further description, CD4 counts around HIV-IC diagnosis (+ -30 days) and HIV-transmission routes were collected.

Results

In total 15,940 diagnoses of 18,534 PLWH in Germany were included. Of those 81% were male (median age: 36 years) and 56% reported being men, who have sex with men as the likely HIV-transmission route. Incidence rates varied between the different HIV-ICs. Syphilis had the highest incidence rate (34 per 1,000 PYs; 95% confidence interval [CI] 29–40) for sexually transmitted infections (STIs), hepatitis B was highest for viral hepatitis diagnoses (18 per 1,000 PYs; 95% CI 17–20); according to CDC-classification herpes zoster for HIV-associated diagnoses (22 per 1,000; 95% CI 20–24) and candidiasis for AIDS-defining diagnoses (30 per 1,000 PYs; 95% CI 29–32). Most PLWH with HIV-ICs (hepatitis, HIV-associated diagnoses and AIDS-defining conditions) had CD4 cell counts < 350.

Conclusion

This analysis characterizes HIV-ICs regarding the incidence, HIV-transmission route and patients’ immune status. The results underline the importance of HIV-IC-based screening to detect PLWH with already partially impaired immune status and in need of timely ART initiation.