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  1. Article: Clinical parameters, selected HLA and chemokine gene variants associated with late presentation into care of people living with HIV/AIDS

    Aksak-Wąs, Bogusz Jan / Urbańska, Anna / Leszczyszyn-Pynka, Magdalena / Chober, Daniel / Parczewski, Miłosz

    Infection, genetics, and evolution. 2022 Jan., v. 97

    2022  

    Abstract: Late presentation into care remains a significant problem in the diagnosis of HIV infection, and may negatively impact the Joint United Nations Program HIV/AIDS elimination targets. Host genetics affects the tempo of HIV disease progression and therefore ...

    Abstract Late presentation into care remains a significant problem in the diagnosis of HIV infection, and may negatively impact the Joint United Nations Program HIV/AIDS elimination targets. Host genetics affects the tempo of HIV disease progression and therefore may influence clinical status at care entry. Longitudinal data were collected for 863 Caucasian patients followed up at Pomeranian Medical University, Szczecin, Poland. Single nucleotide polymorphisms in CCR2 (rs1799864), CX3CR1 (rs3732378), HLAC-35 (rs9264942), CCR5 promoter (rs1799988) as well as 32 base pair CCR5 mutation and HLA-B*5701 genotypes were correlated with the clinical and immunologic patient status at care entry. Late presentation was defined as baseline CD4 lymphocyte count <350 cells/μL or history of AIDS-defining illness, while advanced HIV disease as baseline CD4 lymphocyte count <200 cells/μL or AIDS. Of the analyzed gene variants, the CCR2 (rs1799864) GG genotype was more frequent among patients presenting for care with a CD4 lymphocyte count <200/μL (82.6% for GG homozygotes vs. 74.5% for allele A carriers, p = 0.01). The presence of the heterozygous wt/Δ32 genotype at the CCR5 gene was associated with a higher frequency of asymptomatic infection (18.9% for wt/Δ32 heterozygotes vs. 12% for wt/wt homozygotes, p = 0.03). As expected, this association was also observed among late presenters compared to patients presenting for care earlier (13.7% vs. 19,7%, respectively, p = 0.04). Finally, HLA-B*5701 was less common among late presenters (5%) compared to patients who entered care early (9.6%, p = 0.01) or patients with advanced HIV disease (8.9% vs. 5.2%, p = 0.02). Late presentation was associated with the GG homozygous genotype at the CCR2 rs1799864 SNP, while both the HLA-B*5701 variant and the CCR5 wt/Δ32 were associated with more favorable clinical profile at care entry.
    Keywords CD4 lymphocyte count ; HIV infections ; alleles ; chemokines ; disease progression ; evolution ; heterozygosity ; homozygosity ; infection ; patients ; people ; Poland
    Language English
    Dates of publication 2022-01
    Publishing place Elsevier B.V.
    Document type Article
    ZDB-ID 2037068-4
    ISSN 1567-1348
    ISSN 1567-1348
    DOI 10.1016/j.meegid.2021.105180
    Database NAL-Catalogue (AGRICOLA)

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  2. Article ; Online: Clinical parameters, selected HLA and chemokine gene variants associated with late presentation into care of people living with HIV/AIDS.

    Aksak-Wąs, Bogusz Jan / Urbańska, Anna / Leszczyszyn-Pynka, Magdalena / Chober, Daniel / Parczewski, Miłosz

    Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases

    2021  Volume 97, Page(s) 105180

    Abstract: Introduction: Late presentation into care remains a significant problem in the diagnosis of HIV infection, and may negatively impact the Joint United Nations Program HIV/AIDS elimination targets. Host genetics affects the tempo of HIV disease ... ...

    Abstract Introduction: Late presentation into care remains a significant problem in the diagnosis of HIV infection, and may negatively impact the Joint United Nations Program HIV/AIDS elimination targets. Host genetics affects the tempo of HIV disease progression and therefore may influence clinical status at care entry.
    Materials and methods: Longitudinal data were collected for 863 Caucasian patients followed up at Pomeranian Medical University, Szczecin, Poland. Single nucleotide polymorphisms in CCR2 (rs1799864), CX3CR1 (rs3732378), HLAC-35 (rs9264942), CCR5 promoter (rs1799988) as well as 32 base pair CCR5 mutation and HLA-B*5701 genotypes were correlated with the clinical and immunologic patient status at care entry. Late presentation was defined as baseline CD4 lymphocyte count <350 cells/μL or history of AIDS-defining illness, while advanced HIV disease as baseline CD4 lymphocyte count <200 cells/μL or AIDS.
    Results: Of the analyzed gene variants, the CCR2 (rs1799864) GG genotype was more frequent among patients presenting for care with a CD4 lymphocyte count <200/μL (82.6% for GG homozygotes vs. 74.5% for allele A carriers, p = 0.01). The presence of the heterozygous wt/Δ32 genotype at the CCR5 gene was associated with a higher frequency of asymptomatic infection (18.9% for wt/Δ32 heterozygotes vs. 12% for wt/wt homozygotes, p = 0.03). As expected, this association was also observed among late presenters compared to patients presenting for care earlier (13.7% vs. 19,7%, respectively, p = 0.04). Finally, HLA-B*5701 was less common among late presenters (5%) compared to patients who entered care early (9.6%, p = 0.01) or patients with advanced HIV disease (8.9% vs. 5.2%, p = 0.02).
    Conclusions: Late presentation was associated with the GG homozygous genotype at the CCR2 rs1799864 SNP, while both the HLA-B*5701 variant and the CCR5 wt/Δ32 were associated with more favorable clinical profile at care entry.
    MeSH term(s) Acquired Immunodeficiency Syndrome/genetics ; Adult ; Chemokines/genetics ; Disease Progression ; Female ; Genetic Variation ; HIV Infections/genetics ; HLA Antigens/genetics ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Poland ; Polymorphism, Single Nucleotide ; Young Adult
    Chemical Substances Chemokines ; HLA Antigens
    Language English
    Publishing date 2021-12-09
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2037068-4
    ISSN 1567-7257 ; 1567-1348
    ISSN (online) 1567-7257
    ISSN 1567-1348
    DOI 10.1016/j.meegid.2021.105180
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Differences in the integrase and reverse transcriptase transmitted resistance patterns in Northern Poland.

    Parczewski, Miłosz / Leszczyszyn-Pynka, Magdalena / Urbańska, Anna

    Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases

    2016  Volume 49, Page(s) 122–129

    Abstract: Introduction: With the widespread introduction of the integrase (In) inhibitors into clinical practice, transmission of drug resistance to this class of antiretroviral medications may expand. The aim of this study was to analyze the recent patterns of ... ...

    Abstract Introduction: With the widespread introduction of the integrase (In) inhibitors into clinical practice, transmission of drug resistance to this class of antiretroviral medications may expand. The aim of this study was to analyze the recent patterns of In resistance in treatment naive individuals in Northern Poland and its association with transmitted protease (PR) and reverse transcriptase (RT) mutations.
    Methods: Study included 172 PR, RT and InI sequences from antiretroviral treatment naive HIV-1 infected patients linked to care in Northern Poland from 2010 to 2015. Drug resistance was interpreted based on the WHO surveillance and IAS-USA mutation lists. For phylogeny maximum likelihood and Bayesian Monte Carlo Markov Chain analyses were used.
    Results: Overall rate of transmitted drug resistance was 12.21%. Nucleoside reverse transcriptase inhibitor (NRTI) resistance associated substitutions were found in 11.05% of cases and non-nucleoside reverse transcriptase inhibitor resistance variants in 1.16%. In multivariate models transmitted resistance strongly associated with subtype D infections [66.67% compared to the 3.84% for subtype B (p=0.001)]. No transmission of major protease or integrase mutations were observed. Polymorphisms associated with resistance against integrase inhibitor, mostly E157Q, were found in 21.5% sequences and associated with female (31.91% vs. 15.2% for male, p=0.01), injection drug use (84.21% compared to 22.08% for heterosexual and 1.39% for men-who-have-sex-with-men transmissions, p<0.0001) as well as hepatitis C coinfection [63.64% for positive, versus 8.57% for HCV antibody negative, p<0.0001]. Clusters of nucleoside reverse transcriptase mutations in subtype D and integrase E157Q variants in subtype B were observed.
    Conclusions: Transmitted drug resistance frequency was high in subtype D but limited to clustered NRTI mutations, being infrequent among subtype B infected cases. Despite lack of major integrase resistance in treatment naive patients, variants potentially affecting susceptibility to this class were common, which indicates the potential need for extended surveillance in the near future.
    MeSH term(s) Adult ; Anti-HIV Agents/therapeutic use ; Bayes Theorem ; Drug Resistance, Viral/genetics ; Female ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; HIV Infections/virology ; HIV Integrase/genetics ; HIV Integrase/metabolism ; HIV Reverse Transcriptase/antagonists & inhibitors ; HIV Reverse Transcriptase/genetics ; HIV Reverse Transcriptase/metabolism ; HIV-1/classification ; HIV-1/drug effects ; HIV-1/genetics ; HIV-1/isolation & purification ; Humans ; Male ; Markov Chains ; Middle Aged ; Monte Carlo Method ; Mutation Rate ; Phylogeny ; Poland/epidemiology ; Sex Factors
    Chemical Substances Anti-HIV Agents ; HIV Integrase (EC 2.7.7.-) ; HIV Reverse Transcriptase (EC 2.7.7.49)
    Language English
    Publishing date 2016-12-23
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2037068-4
    ISSN 1567-7257 ; 1567-1348
    ISSN (online) 1567-7257
    ISSN 1567-1348
    DOI 10.1016/j.meegid.2016.12.019
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  4. Article ; Online: Clinical Perspective on Human Immunodeficiency Virus Care of Ukrainian War Refugees in Poland.

    Parczewski, Miłosz / Jabłonowska, Elżbieta / Wójcik-Cichy, Kamila / Zhyvytsia, Dmytro / Witak-Jędra, Magdalena / Leszczyszyn-Pynka, Magdalena / Aksak-Wąs, Bogusz / Siwak, Ewa / Cielniak, Iwona / Olczak, Anita / Szymczak, Aleksandra / Szetela, Bartosz / Bociąga-Jasik, Monika / Kalinowska-Nowak, Anna / Mularska, Elżbieta / Witor, Adam / Jakubowski, Paweł / Hlebowicz, Maria / Rozpłochowski, Błażej /
    Łojewski, Władysław / Scheibe, Kaja / Serwin, Karol

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2024  Volume 76, Issue 10, Page(s) 1708–1715

    Abstract: Background: The Russian invasion of Ukraine forced migration for safety, protection, and assistance. Poland is the primary sheltering country for Ukrainian refugees, providing support including medical care, which resulted in the rapid ∼15% increase in ... ...

    Abstract Background: The Russian invasion of Ukraine forced migration for safety, protection, and assistance. Poland is the primary sheltering country for Ukrainian refugees, providing support including medical care, which resulted in the rapid ∼15% increase in the number of followed-up people with human immunodeficiency virus (HIV) (PWH) in the country. Here, we present the national experience on HIV care provided for refugees from Ukraine.
    Methods: Clinical, antiretroviral, immunological, and virologic data from 955 Ukrainian PWH entering care in Poland since February 2022 were analyzed. The dataset included both antiretroviral-treated (n = 851) and newly diagnosed (n = 104) patients. In 76 cases, protease/reverse transcriptase/integrase sequencing was performed to identify drug resistance and subtype.
    Results: Most (70.05%) of the patients were female, with a predominance of heterosexual (70.3%) transmissions. Anti-hepatitis C antibody and hepatitis B antigen were present in 28.7% and 2.9% of the patients, respectively. A history of tuberculosis was reported in 10.1% of cases. Among previously treated patients, the viral suppression rate was 89.6%; 77.3% of newly HIV diagnosed cases were diagnosed late (with lymphocyte CD4 count <350 cells/μL or AIDS). The A6 variant was observed in 89.0% of sequences. Transmitted mutations in the reverse transcriptase were found in 15.4% treatment-naive cases. Two patients with treatment failure exhibited multiclass drug resistance.
    Conclusions: Migration from Ukraine influences the characteristics of HIV epidemics in Europe, with an increase in the proportion of women and hepatitis C coinfected patients. Antiretroviral treatment efficacy among previously treated refugees was high, with new HIV cases frequently diagnosed late. The A6 subtype was the most common variant.
    MeSH term(s) Humans ; Female ; Male ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Anti-HIV Agents/therapeutic use ; Poland/epidemiology ; Refugees ; HIV-1/genetics ; Anti-Retroviral Agents/therapeutic use ; RNA-Directed DNA Polymerase/therapeutic use ; Drug Resistance, Viral/genetics
    Chemical Substances Anti-HIV Agents ; Anti-Retroviral Agents ; RNA-Directed DNA Polymerase (EC 2.7.7.49)
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciad116
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Factors Influencing Immune Restoration in People Living with HIV/AIDS.

    Aksak-Wąs, Bogusz Jan / Urbańska, Anna / Scheibe, Kaja / Serwin, Karol / Leszczyszyn-Pynka, Magdalena / Rafalska-Kosior, Milena / Gołąb, Joanna / Chober, Daniel / Parczewski, Miłosz

    Journal of clinical medicine

    2022  Volume 11, Issue 7

    Abstract: Introduction: Immune restoration is a key clinical aspect that is pursued in the care of human immunodeficiency virus (HIV)-infected patients. Despite effective antiretroviral treatment and undetectable viremia, immune recovery is often incomplete. ... ...

    Abstract Introduction: Immune restoration is a key clinical aspect that is pursued in the care of human immunodeficiency virus (HIV)-infected patients. Despite effective antiretroviral treatment and undetectable viremia, immune recovery is often incomplete. Materials and methods: Data from 311 Caucasian patients were collected. SNP in CCR2(rs1799864), CX3CR1(rs3732378), HLAC-35(rs9264942), and CCR5(promoter, rs1799988); a 32bp deletion(Δ32) in CCR5; and HLA-B*5701 genotypes were correlated with clinical data and selected endpoints. Kaplan−Meier and Cox proportional hazards models were used to analyze the effects of genetic factors over time. Results: For HLA-B*5701, the effect on the CD4+/CD8+ >0.8 cell ratio was lost within 48 months (HR = 2.04, 95% CI: 1.04−4.03), and the effect on the CD4+ cell count >500 cells/µL was lost within 12 months (HR = 2.12, CI: 1.11−4.04). The effect of CCR2 GG on the CD4+/CD8+ >0.8 cell ratio was lost within 36 months (HR = 1.7, CI: 1.05−2.75). For CCR5 wt/Δ32, the effect on the CD4+/CD8+ >1.0 cell ratio was lost within 24 months (HR = 2.0, CI: 1.08−3.69), and the effect on the CD4+ >800 cells/µL cell count was lost within 18 months (HR = 1.98, CI: 1.14−4.73). Conclusions: Selected genetic polymorphisms, namely CCR2 GG and CCR5 Δ32, and the presence of the HLA-B*5701 allele positively influenced immune restoration in cART-treated patients with HIV/AIDS.
    Language English
    Publishing date 2022-03-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11071887
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  6. Article ; Online: Protective Effect of HLA-B*5701 and HLA-C -35 Genetic Variants in HIV-Positive Caucasians from Northern Poland.

    Leszczyszyn-Pynka, Magdalena / Aksak-Wąs, Bogusz / Urbańska, Anna / Parczewski, Miłosz

    PloS one

    2015  Volume 10, Issue 6, Page(s) e0127867

    Abstract: Aim of the study: Association of two HLA class I variants with HIV-1 pretreatment viremia, CD4+ T cell count at the care-entry and CD4+ T cell nadir.: Methods: 414 HIV-positive Caucasians (30% women) aged 19-73 years were genotyped for HLA-C -35 ( ... ...

    Abstract Aim of the study: Association of two HLA class I variants with HIV-1 pretreatment viremia, CD4+ T cell count at the care-entry and CD4+ T cell nadir.
    Methods: 414 HIV-positive Caucasians (30% women) aged 19-73 years were genotyped for HLA-C -35 (rs9264942) and HLA-B*5701 variants. HIV-1 viral load, as well as CD4+ T cell count at care-entry and nadir, were compared across alleles, genotypes and haplotypes.
    Results: HLA-C -35 C/C genotype was found in 17.6% patients, C/T genotype in 48.1%, and T/T genotype in 34.3% patients. HLA-B*5701 variant was present in 5.8% of studied population. HIV plasma viremia in the group with C allele was significantly lower (p=0.0002) compared to T/T group [mean:4.66 log (SD:1.03) vs. 5.07 (SD:0.85) log HIV-RNA copies/ml, respectively], while CD4+ T cell count at baseline was notably higher among C allele carriers compared to T/T homozygotes [median: 318 (IQR:127-537) cells/μl vs. median: 203 (IQR:55-410) cells/μl, respectively] (p=0.0007). Moreover, CD4+ T cell nadir among patients with C allele [median: 205 (IQR:83.5-390) cells/μl] was significantly higher compared to T/T group [median: 133 (IQR:46-328) cells/μl] (p=0.006). Among cases with HLA-B*5701 allele, significantly lower pretreatment viremia and higher baseline CD4+ T cell count were found (mean: 4.08 [SD: 1.2] vs. mean: 4.84 [SD:0.97] log HIV-RNA copies/ml, p=0.003 and 431 vs. 270 cells/μl, p=0.04, respectively) compared to HLA-B*5701 negative individuals. The lowest viremia (mean: 3.85 log [SD:1.3]) HIV-RNA copies/ml and the highest baseline and nadir CD4+ T cell [median: 476 (IQR:304-682) vs. median: 361 (IQR: 205-574) cells/μl, respectively) were found in individuals with HLA-B*5701(+)/HLA-C -35 C/C haplotype.
    Conclusions: HLA-C -35 C and HLA-B*5701 allele exert a favorable effect on the immunological (higher baseline and nadir CD4+ T cell count) and virologic (lower pretreatment HIV viral load) variables. This protective effect is additive for the compound HLA-B*5701(+)/HLA-C -35 C/C haplotype.
    MeSH term(s) Adult ; Aged ; Alleles ; CD4 Lymphocyte Count ; CD4-Positive T-Lymphocytes/cytology ; CD4-Positive T-Lymphocytes/immunology ; European Continental Ancestry Group/genetics ; Female ; Genotype ; HIV Infections/genetics ; HIV Infections/pathology ; HIV-1/genetics ; HLA-B Antigens/genetics ; HLA-C Antigens/genetics ; Homozygote ; Humans ; Male ; Middle Aged ; Poland ; RNA, Viral/analysis ; Viral Load ; Young Adult
    Chemical Substances HLA-B Antigens ; HLA-B*57:01 antigen ; HLA-C Antigens ; RNA, Viral
    Language English
    Publishing date 2015
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0127867
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The temporal increase in HIV-1 non-R5 tropism frequency among newly diagnosed patients from northern Poland is associated with clustered transmissions.

    Parczewski, Miłosz / Leszczyszyn-Pynka, Magdalena / Witak-Jędra, Magdalena / Maciejewska, Katarzyna / Myślińska, Sławomira / Urbańska, Anna

    Journal of the International AIDS Society

    2015  Volume 18, Page(s) 19993

    Abstract: Introduction: CCR5 (R5) tropic viruses are associated with early stages of infection, whereas CXCR4 (X4) HIV-1 tropism has been associated with severe immunodeficiency. We investigated the temporal changes in the genotype-predicted tropism frequency and ...

    Abstract Introduction: CCR5 (R5) tropic viruses are associated with early stages of infection, whereas CXCR4 (X4) HIV-1 tropism has been associated with severe immunodeficiency. We investigated the temporal changes in the genotype-predicted tropism frequency and the phylogenetic relationships between the R5 and non-R5 clades.
    Methods: A cohort of 194 patients with a newly diagnosed HIV infection that was linked to their care from 2007 to 2014 was analyzed. Baseline plasma samples were used to assess the HIV-1 genotypic tropism with triplicate V3-loop sequencing. The non-R5 tropism prediction thresholds were assigned using a false positive rate (FPR) of 10 and 5.75% and associated with clinical and laboratory data. The transmission clusters were analyzed using pol sequences with a maximum likelihood and Bayesian inference.
    Results: The overall non-R5 tropism frequency for 5.75% FPR was 15.5% (n=30) and 27.8% (n=54) for 10% FPR. The frequency of the non-R5 tropism that was predicted using 5.75% FPR increased significantly from 2007 (0%) to 2014 (n=5/17, 29.4%) (p=0.004, rough slope +3.73%/year) and from 0% (2007) to 35.3% (2014, n=6/17) (p=0.071, rough slope +2.9%/year) using 10% FPR. Increase in the asymptomatic diagnoses over time was noted (p=0.05, rough slope +3.53%/year) along with a tendency to increase the lymphocyte CD4 nadir (p=0.069). Thirty-two clusters were identified, and non-R5 tropic viruses were found for 26 (30.95%) sequences contained within 14 (43.8%) clusters. Non-R5 tropism was associated with subtype D variants (p=0.0001) and the presence of CCR5 Δ32/wt genotype (p=0.052).
    Conclusions: R5 tropism predominates among the treatment of naive individuals, but the increases in the frequency of non-R5 tropic variants may limit the clinical efficacy of the co-receptor inhibitors. The rising prevalence of non-R5 HIV-1 may indicate transmission of X4 clades.
    MeSH term(s) Adult ; Cohort Studies ; Female ; Genotype ; HIV Infections/transmission ; HIV-1/genetics ; HIV-1/physiology ; Humans ; Male ; Middle Aged ; Poland ; Receptors, CCR5/physiology ; Viral Tropism
    Chemical Substances CCR5 protein, human ; Receptors, CCR5
    Language English
    Publishing date 2015
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2467110-1
    ISSN 1758-2652 ; 1758-2652
    ISSN (online) 1758-2652
    ISSN 1758-2652
    DOI 10.7448/IAS.18.1.19993
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  8. Article ; Online: Hypertension, dyslipidemia and cardiovascular risk in HIV infected adults in Poland.

    Rogalska-Płońska, Magdalena / Rogalski, Paweł / Leszczyszyn-Pynka, Magdalena / Stempkowska, Justyna / Kocbach, Piotr / Kowalczuk-Kot, Aldona / Janczarek, Małgorzata / Grzeszczuk, Anna

    Kardiologia polska

    2017  

    Abstract: Background: Prevalence of cardiovascular diseases (CVD) in HIV infected patients increases with aging and duration of the disease. Hypertension (HA), high cholesterol level obesity, diabetes, tobacco exposure and use of alcohol are among the traditional ...

    Abstract Background: Prevalence of cardiovascular diseases (CVD) in HIV infected patients increases with aging and duration of the disease. Hypertension (HA), high cholesterol level obesity, diabetes, tobacco exposure and use of alcohol are among the traditional risk factors that contribute to CVD.
    Aim: was to determinate the incidence of HA, lipid disturbances and CVD risk in dependence on clinical, viral and biochemical factors.
    Methods: Four hundred and seventeen HIV infected Caucasian adult patients from the four clinical centers in Poland were enrolled and analyzed on the basis of available medical data from the years 2013-2015.
    Results: HA was diagnosed in 28% of all patients and in age ranges: < 40, between 41-60 and > 60 in 18%, 43% and 53% respectively. Percentage of optimal, normal and high normal blood pressure was: 28%, 14% and 30% respectively. Hypertension grade I, II and III was observed in 58%, 35% and 7% of patients, respectively. Factors associated with HA were: increasing age, male sex, increased BMI, hypercholesterolemia, hypo-HDL, hypertriglyceridemia and duration of HIV infection more than 10 years. Hypercholesterolemia, suboptimal level of HDL, elevated LDL and hypertriglyceridemia were observed in 37%, 20.5%, 31% and 52% respectively. Hypertriglyceridemia was associated with protease inhibitors based highly active antiretroviral therapy. HCV infection was negatively associated with hypercholesterolemia. Cigarette smoking was reported in 55% of cases.
    Conclusions: Incidence of HA in particular age groups of HIV infected people is higher than in general Polish population. Hypertension is influenced by traditional risk factors and duration of HIV infection but not antiretroviral treatment. HIV/HCV coinfection appears to be protective against hypercholesterolemia.
    Language English
    Publishing date 2017-07-17
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 411492-9
    ISSN 1897-4279 ; 0022-9032
    ISSN (online) 1897-4279
    ISSN 0022-9032
    DOI 10.5603/KP.a2017.0148
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  9. Article ; Online: Transmitted drug resistance to rilpivirine among antiretroviral-naïve patients living with HIV from northern Poland.

    Parczewski, Miłosz / Urbańska, Anna / Maciejewska, Katarzyna / Witak-Jȩdra, Magdalena / Leszczyszyn-Pynka, Magdalena

    Journal of the International AIDS Society

    2014  Volume 17, Page(s) 18929

    Abstract: Introduction: Rilpivirine (RPV) is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) that was recently approved for the treatment of antiretroviral-naïve individuals with HIV-1 viral load of <100,000 copies/ml. As transmission ... ...

    Abstract Introduction: Rilpivirine (RPV) is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) that was recently approved for the treatment of antiretroviral-naïve individuals with HIV-1 viral load of <100,000 copies/ml. As transmission of the drug resistance mutations to this NNRTI may affect treatment outcomes, the frequency of primary, RPV-associated drug resistance mutations was assessed in this study.
    Methods: For the study, 244 viral genome sequences from antiretroviral-naïve individuals were obtained by bulk sequencing. RPV-associated mutations were divided into RPV resistance mutations (K101E/P, E138A/G/K/Q/R, V179L, Y181C/I/V, Y188L, H221Y, F227C and M230I/L) according to the International AIDS Society-USA (IAS-USA) mutation list and variants potentially affecting RPV susceptibility (L100I, K101H/T, E138S, V179F/D/G/T, G190A/E/S, F227L and M230V) based on the in vitro and in vivo data.
    Results: IAS-USA RPV drug resistance mutations were found in 5.3% sequences, with E138A and E138G being the most common (3.7 and 0.8%, respectively), followed by K101E (0.4%) and Y181C (0.4%), with no significant differences in the frequency between subtype B and non-B clades. Mutations potentially reducing RPV susceptibility were found in 2.5% of sequences, and they included V179D (1.6%) and G190A (0.8%), with equal distribution among non-B (n=2, 2.5%) and subtype B (n=4, 2.5%) clades. Clustering of RPV mutations was infrequent.
    Conclusions: Prevalence of RPV-associated drug resistance mutations was low in the analysed sample and did not vary across the subtypes. The frequency of variants with potential influence on RPV susceptibility was similar among non-B variants if compared to B clades. Transmitted drug resistance to RPV is uncommon, which makes this a good option for the treatment of ARV-naïve patients; however, genotype resistance testing should remain compulsory before starting an RPV-based regimen.
    MeSH term(s) Adult ; Anti-HIV Agents/therapeutic use ; Drug Resistance, Viral/genetics ; Female ; HIV/genetics ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; HIV Infections/transmission ; HIV Infections/virology ; Humans ; Male ; Middle Aged ; Mutation/genetics ; Nitriles/therapeutic use ; Poland/epidemiology ; Prevalence ; Pyrimidines/therapeutic use ; Rilpivirine
    Chemical Substances Anti-HIV Agents ; Nitriles ; Pyrimidines ; Rilpivirine (FI96A8X663)
    Language English
    Publishing date 2014-04-17
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2467110-1
    ISSN 1758-2652 ; 1758-2652
    ISSN (online) 1758-2652
    ISSN 1758-2652
    DOI 10.7448/IAS.17.1.18929
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  10. Article ; Online: Temporal increase in HIV-1 non-R5 tropism frequency among antiretroviral-naive patients from northern Poland.

    Parczewski, Milosz / Leszczyszyn-Pynka, Magdalena / Witak-Jêdra, Magdalena / Maciejewska, Katarzyna / Urbañska, Anna

    Journal of the International AIDS Society

    2014  Volume 17, Issue 4 Suppl 3, Page(s) 19687

    Abstract: Introduction: Sequencing of the third hypervariable loop allows to identify genotype-based HIV tropism. R5-tropic viruses associated with early stages of infection are preferentially transmitted, while non-R5 HIV-1 tropism has been associated with ... ...

    Abstract Introduction: Sequencing of the third hypervariable loop allows to identify genotype-based HIV tropism. R5-tropic viruses associated with early stages of infection are preferentially transmitted, while non-R5 HIV-1 tropism has been associated with severe immunodeficiency and lower lymphocyte CD4 nadir and may reflect delayed HIV diagnosis. In this study, we investigate the changes in tropism frequency from 2007 to 2013.
    Materials and methods: Study included 194 patients with confirmed HIV infection linked to care in 2007-2013. Baseline plasma samples from treatment naive patients were used for HIV-1 genotypic tropism assessment based on triplicate V3 loop sequencing. Non-R5 tropism prediction thresholds were assigned using a false positive rate (FPR) of 10% and 5.75% FPR and associated with clinical and laboratory data (age, gender, date of HIV diagnosis, route of transmission, CDC clinical category at diagnosis, pretreatment HIV viral load, baseline and nadir lymphocyte CD4 counts). For statistics, chi-square and Mann-Whitney U tests were used, time trends were examined using logistic regression (R statistical platform, v. 3.1.0) for binary variables and linear regression for continuous ones.
    Results: Overall non-R5 tropism frequency for the 5.75% FPR was 15.5% and 27.8% for 10% FPR. Frequency of the non-R5 tropism predicted using 5.75% FPR increased significantly from 2007 (0%) to 2013 (25%) [OR: 1.44 (95% CI 1.14-1.86), p=0.003, rough slope +3.89%/year] (Figure 1a). With 10% FPR, the frequency changed from 7% (2007) to 33% (2013) [OR: 1.17 (95% CI 0.99-1.39), p=0.054, rough slope +3.0%/year] (Figure 1b). Baseline lymphocyte CD4 count and nadir, as well as pretreatment HIV-1 viral loads were stable over time of observation (r=0.014, p=0.84; r=0.13, p=0.085; r=0.016, p=0.83 for CD4 baseline, nadir and HIV load, respectively). Frequency of AIDS at HIV diagnosis increased from 21.4% in 2007 to 38.0% in 2013, however trend over time was insignificant [OR: 1.1 (95% CI 0.95-1.31), p=0.19]. Temporal trends for HIV transmission route, gender, non-B variant frequencies also were not significant.
    Conclusions: R5 tropism predominates among the treatment naive individuals but increase in the frequency of non-R5 tropic variants may limit clinical efficacy of the coreceptor inhibitors. Increased prevalence of non-R5 HIV-1 may be related to late care entry and higher number of AIDS diagnoses in the recent years.
    Language English
    Publishing date 2014
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2467110-1
    ISSN 1758-2652 ; 1758-2652
    ISSN (online) 1758-2652
    ISSN 1758-2652
    DOI 10.7448/IAS.17.4.19687
    Database MEDical Literature Analysis and Retrieval System OnLINE

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