david Haerry - Academia.edu (original) (raw)
Papers by david Haerry
Open Forum Infectious Diseases
Background Sexually transmitted infections (STIs) are common among people with human immunodefici... more Background Sexually transmitted infections (STIs) are common among people with human immunodeficiency virus (PWH), but there are limited data about risk factors and incidence of STIs in large, representative cohort studies. Methods We assessed incidence and risk factors of STIs reported by treating physicians within the Swiss HIV Cohort Study (SHCS). Sexually transmitted infections and demographic, clinical, and behavioral characteristics were prospectively collected at 6-month follow-up visits between October 2017 and November 2019. We used multilevel Poisson regression to assess incidence rate ratios of different STIs. Results Among 10 140 study participants, a total of 1634 STIs in 1029 SHCS participants were reported over 17 766 person-years of follow up (PYFUP). The overall incidence of any reported STI was 91.9 per 1000 PYFU (95% confidence interval [CI], 85.8 –98.5). Among the 1634 STI episodes, there were 573 (35.1%) incident cases of syphilis, 497 gonorrhea (30.4%), and 418...
HIV Medicine, 2019
Chemsex refers to the use of sex-enhancing drugs among men who have sex with men (MSM) in combina... more Chemsex refers to the use of sex-enhancing drugs among men who have sex with men (MSM) in combination with specific sexual and social behaviours. Longitudinal data on this development and the associated health risks are scarce. Methods Data on all recreational drugs reported in the Swiss HIV Cohort Study (SHCS) from 2007 to 2017 were collected. Drug use was analysed longitudinally for all drug classes. In addition, potential associations between patient characteristics and the consumption of methamphetamine, chydroxybutric acid/c-butyrolactone (GHB/GBL), 3,4-methylenedioxymethamphetamine (MDMA/ XTC), cocaine and amphetamine were analysed. Results We analysed 166 167 follow-up entries for 12 527 SHCS participants, including 7101 free text field entries containing information about recreational drugs other than cannabis, cocaine and heroin. Overall, we observed a stable percentage (9.0%) of recreational drug use (excluding cannabis, amyl nitrite and prescription drugs). For MSM, however, there was an increase in overall drug use from 8.8% in 2007 to 13.8% in 2017, with particularly large increases for methamphetamine (from 0.2 to 2.4%; P < 0.001) and GHB/GBL (from 1.0 to 3.4%; P < 0.001). The use of each of the potentially sex-enhancing drugs methamphetamine, GHB/GBL, cocaine, XTC/ MDMA and amphetamine was significantly associated with condomless sex with nonsteady partners, and higher prevalences of depression, syphilis and hepatitis C. Conclusions The significant increase in the use of chemsex drugs among MSM in the SHCS and the strong association with coinfections and depression highlights the need for harm reduction programmes tailored to MSM. According to our results, improving knowledge about recreational drugs is important for all health care professionals working with people living with HIV.
Clinical Infectious Diseases, May 9, 2023
Background: Integrase strand transfer inhibitors (INSTI) have been associated with an increased r... more Background: Integrase strand transfer inhibitors (INSTI) have been associated with an increased risk for cardiovascular disease (CVD) events. We investigated the impact of starting INSTIbased antiretroviral therapy (ART) on CVD events among treatment-naïve people with HIV
pairs of patient-and physician-questionnaires were completed. 426 (84 %) patients were male and 3... more pairs of patient-and physician-questionnaires were completed. 426 (84 %) patients were male and 39 (8 %), 138 (27 %), and 330 (65 %) were in the three stratified groups based on CD4 count, respectively. In the category 'Body and symptoms' the most commonly identified reason for patients not to start was: "As long as I feel good I don't have to take medication" (44 %). Less than 20 % of respondents indicated fears of side effects and toxicity or problems to manage pills. Most patients were in the lowest stage of treatment-readiness (N = 323, 68 %), especially patients with CD4 cells ≥500 cells/μL (N = 240, 79 %). Physicians answered in 92 (18 %) cases that ART was not indicated for CD4 cells <500 cells/μL. Main reasons for physicians not starting treatment for these patients were their perception that patients were 'too depressed' (13 %) or that they had not known them long enough (13 %). Conclusions Nowadays patient-barriers to ART are commonly related to health-and treatment-beliefs compared to fear of toxicity or ART manageability in the past. This new barrier pattern seems to reflect the era of well tolerated, easier ART regimens and has to be considered in light of the new recommendations to treat all HIV-infected individuals regardless of the CD4 cell count.
info:eu-repo/semantics/nonPublishe
Ultrasound and alpha-foetoprotein 6 months Controversial; persons with cirrhosis and persons with... more Ultrasound and alpha-foetoprotein 6 months Controversial; persons with cirrhosis and persons with HBV irrespective of fibrosis stage Others Controversial i Review all concomitant medicines which may potentially interact with ARVs or increase co-morbidities, see Drug-drug Interactions between DAAs and ARVs Drug-drug Interactions between Antidepressants and ARVs Drug-drug Interactions between Antihypertensives and ARVs Drug-drug Interactions between Analgesics and ARVs Drug-drug Interactions between Antimalarial Drugs and ARVs Drug-drug Interactions between Corticosteroids and ARVs Drug-drug Interactions between Contraceptives and ARVs and www.hiv-druginteractions.org ii If stable on ART with undetectable HIV-VL and CD4 count > 350 cells/ μL, suggest annual CD4 count. iii A risk equation developed from HIV populations is available, see http://www.hivpv.org/ Of note, if an individual receives medicines to control dyslipidaemia and/or hypertension, the estimation should be interpreted with caution. iv A calculator for LDL-cholesterol in cases where TG is not high can be found at http://www.hivpv.org/. v Risk factors for chronic liver disease include alcohol, viral hepatitis, obesity, diabetes, insulin resistance, hyperlipidaemia and hepatotoxic drugs. vi Risk factors for CKD: hypertension, diabetes, CVD, family history, black African ethnicity, viral hepatitis, low current CD4 count, smoking, older age, concomitant nephrotoxic drugs. vii eGFR: use CKD-EPI formula based on serum creatinine, gender, age and ethnicity because eGFR quantification is validated >60 mL/min. The abbreviated modification of diet in renal disease (aMDRD) or the Cockroft-Gault (CG) equation may be used as an alternative; see http:// www.hivpv.org viii Some experts recommend UA/C (urinary albumin creatinine ratio) or UP/C (urinary protein creatinine ratio) as a screening test for proteinuria in all persons. UA/C predominantly detects glomerular disease. Use in persons with diabetes. UP/C detects total protein secondary to glomerular and tubular disease. ix Different models have been developed for calculating a 5-year CKD risk score while using different nephrotoxic ARVs, integrating HIV independent and HIV-related risk factors [4], [5] x Classic risk factors: older age, female gender, hypogonadism, family history of hip fracture, low BMI (≤ 19 kg/m 2), vitamin D deficiency, smoking, physical inactivity, history of low impact fracture, alcohol excess (> 3 units/day), steroid exposure (minimum 5 mg for > 3 months). xi WHO fracture risk assessment (FRAX®) tool: www.shef.ac.uk/FRAX xii A diagnosis of COPD should be considered in persons over the age of 35 who have a risk factor (current or ex-smoker) and who present with exertional breathlessness, chronic cough, regular sputum production, frequent winter 'bronchitis' or wheeze.
HIV Medicine, 2021
ObjectivesThe aim of the study was to assess the feasibility of a national pre‐exposure prophylax... more ObjectivesThe aim of the study was to assess the feasibility of a national pre‐exposure prophylaxis (PrEP) programme using smartphone‐compatible data collection.MethodsThis was a multicentre cohort study (NCT03893188) enrolling individuals interested in PrEP in Switzerland. All centres participate in the SwissPrEPared programme, which uses smartphone‐compatible data collection. Feasibility was assessed after centres had enrolled at least one participant. Participants were HIV‐negative individuals presenting for PrEP counselling. Outcomes were participation (number enrolled/number eligible), enrolment rates (number enrolled per month), retention at first follow‐up (number with first follow‐up/number enrolled), and uptake (proportion attending first visit as scheduled). Participant characteristics were compared between those retained after baseline assessment and those who dropped out.ResultsBetween April 2019 and January 2020, 987 individuals were assessed for eligibility, of whom 96...
Research Involvement and Engagement
Background The role of patients in cancer research is undergoing a significant evolution as all s... more Background The role of patients in cancer research is undergoing a significant evolution as all stakeholders seek to enhance the level of direct patient involvement in the design and development of clinical trials. However, there are significant hurdles that patients, patient advocates, laboratory researchers, clinical investigators, and funding institutions must overcome to implement relevant patient involvement in all aspects of biomedical research. By using innovative grant funding models, philanthropic organizations can lead the field in overcoming these challenges. Rising Tide Foundation for Clinical Cancer Research (RTFCCR), a private philanthropy that funds academic research, has developed a novel approach for requiring and supporting partnerships among grantees and patients in designing and conducting research projects. This paper presents a reflective case study of efforts to advance the field of patient involvement in clinical research. Methods The decision to focus on pat...
Regulatory Affairs Watch
Patient and public involvement (PPI) in academic human research has been evolving in the United S... more Patient and public involvement (PPI) in academic human research has been evolving in the United States and Europe since the early 1980s, when it was jump-started by activists responding to the HIV pandemic. This article provides a brief look at the development of PPI in academic human research in the US and Europe, highlights the PPI initiatives of several US and European organisations, discusses how PPI is gaining momentum in health technology assessment bodies, and provides recommendations for various stakeholders on how to incorporate more PPI into academic human research.
Primary and hospital care, Dec 7, 2022
Les chlamydias peuvent provoquer des complications graves telles que des grossesses extra-utérine... more Les chlamydias peuvent provoquer des complications graves telles que des grossesses extra-utérines et de l'infertilité, mais ceci arrive beaucoup moins souvent qu'on ne le pensait auparavant. Un dépistage de routine de la chlamydia chez les femmes sexuellement actives n'est pas recommandé. La chlamydiose anale et pharyngée est traitée par la doxycycline. La gonorrhée et la syphilis sont en augmentation, surtout chez les hommes qui ont des rapports sexuels avec des hommes (HSH). La gonorrhée peut désormais être traitée par voie intraveineuse (ceftriaxone 1 g en une seule fois). Chlamydia Les chlamydias sont de plus en plus fréquentes en Suisse. Cette épidémie de chlamydia fait peur. Avec >12 000 cas déclarés (2019) et une multiplication par cinq au cours des 20 dernières années, les chlamydias sont la maladie sexuellement transmissible (MST) la plus fréquemment diagnostiquée en Suisse [31, 73]. Une étude menée à Bâle suggère toutefois qu'il s'agit d'une pseudo-augmentation [77]; sur l'ensemble des échantillons envoyés, chaque année, de manière constante, seuls environ 5% étaient positifs chez les femmes (environ 10% chez les hommes), alors que le nombre d'échantillons envoyés lui a fortement augmenté. Il y a donc nettement plus de tests effectués, entre autres lors des contrôles gynécologiques annuels de femmes asymptomatiques [77].
Primary and Hospital Care: Allgemeine Innere Medizin
The Journal of Infectious Diseases
We assessed changes in sexual behavior among people with human immunodeficiency virus (HIV) over ... more We assessed changes in sexual behavior among people with human immunodeficiency virus (HIV) over 20 years. Condom use with stable partners steadily declined from over 90% to 29% since the Swiss U = U statement, with similar trajectories between men who have sex with men (MSM) and heterosexuals. Occasional partnership remained higher among MSM compared to heterosexuals even during coronavirus disease 2019 (COVID-19) social distancing.
Primary and hospital care: médecine interne générale
Primary and Hospital Care: Allgemeine Innere Medizin
Swiss Medical Weekly
BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SA... more BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SARS-CoV-2 pandemic remain unclear. METHODS: Design: Longitudinal analysis of an ongoing, multicentre, pre-exposure prophylaxis (PrEP) cohort (NCT03893188) in Switzerland. Participants: HIV-negative MSM aged ≥18 who completed at least one questionnaire before and one after the start of the SARS-CoV-2 pandemic. Outcomes: Primary: mental health, defined as anxiety and depression scores assessed by the Patient Health Questionnaire-4. Secondary: sexual behaviour, well-being, PrEP use and disruption of care. Outcomes were assessed over seven periods corresponding to different SARS-CoV-2 prevention measures in Switzerland. We performed pairwise comparisons between periods (Wilcoxon signed rank test). RESULTS: Data from 1,043 participants were included. Whilst anxiety scores remained stable over time, depression scores worsened in the second wave and the second lockdown period compared to pre-pan...
Clinical Infectious Diseases, 2020
Background Using data from the COHERE collaboration, we investigated whether primary prophylaxis ... more Background Using data from the COHERE collaboration, we investigated whether primary prophylaxis for Pneumocystis Pneumonia (PcP) might be withheld in all patients on antiretroviral therapy with suppressed plasma HIV RNA (≤ 400c/mL) irrespective of CD4 count. Methods We implemented an established causal inference approach whereby observational data is used to emulate a randomised trial. Patients taking PcP prophylaxis were eligible for the emulated trial if their CD4 count was ≤ 200 cells/µL in line with existing recommendations. We compared the following two strategies for stopping prophylaxis: i.) when CD4 count was above 200 cells/µL for more than 3 months, or ii.) when the patient was virologically suppressed (two consecutive HIV RNA ≤ 400c/mL). Patients were artificially censored if they did not comply with these stopping rules. We estimated the risk of primary PcP in patients on ART, using the hazard ratio to compare the stopping strategies by fitting a pooled logistic model, ...
Nature Communications, 2019
The HIV-1 reservoir is the major hurdle to a cure. We here evaluate viral and host characteristic... more The HIV-1 reservoir is the major hurdle to a cure. We here evaluate viral and host characteristics associated with reservoir size and long-term dynamics in 1,057 individuals on suppressive antiretroviral therapy for a median of 5.4 years. At the population level, the reservoir decreases with diminishing differences over time, but increases in 26.6% of individuals. Viral blips and low-level viremia are significantly associated with slower reservoir decay. Initiation of ART within the first year of infection, pretreatment viral load, and ethnicity affect reservoir size, but less so long-term dynamics. Viral blips and low-level viremia are thus relevant for reservoir and cure studies.
Primary and Hospital Care: Allgemeine Innere Medizin
Primary and hospital care: médecine interne générale
Primary and Hospital Care: Allgemeine Innere Medizin
Open Forum Infectious Diseases
Background Sexually transmitted infections (STIs) are common among people with human immunodefici... more Background Sexually transmitted infections (STIs) are common among people with human immunodeficiency virus (PWH), but there are limited data about risk factors and incidence of STIs in large, representative cohort studies. Methods We assessed incidence and risk factors of STIs reported by treating physicians within the Swiss HIV Cohort Study (SHCS). Sexually transmitted infections and demographic, clinical, and behavioral characteristics were prospectively collected at 6-month follow-up visits between October 2017 and November 2019. We used multilevel Poisson regression to assess incidence rate ratios of different STIs. Results Among 10 140 study participants, a total of 1634 STIs in 1029 SHCS participants were reported over 17 766 person-years of follow up (PYFUP). The overall incidence of any reported STI was 91.9 per 1000 PYFU (95% confidence interval [CI], 85.8 –98.5). Among the 1634 STI episodes, there were 573 (35.1%) incident cases of syphilis, 497 gonorrhea (30.4%), and 418...
HIV Medicine, 2019
Chemsex refers to the use of sex-enhancing drugs among men who have sex with men (MSM) in combina... more Chemsex refers to the use of sex-enhancing drugs among men who have sex with men (MSM) in combination with specific sexual and social behaviours. Longitudinal data on this development and the associated health risks are scarce. Methods Data on all recreational drugs reported in the Swiss HIV Cohort Study (SHCS) from 2007 to 2017 were collected. Drug use was analysed longitudinally for all drug classes. In addition, potential associations between patient characteristics and the consumption of methamphetamine, chydroxybutric acid/c-butyrolactone (GHB/GBL), 3,4-methylenedioxymethamphetamine (MDMA/ XTC), cocaine and amphetamine were analysed. Results We analysed 166 167 follow-up entries for 12 527 SHCS participants, including 7101 free text field entries containing information about recreational drugs other than cannabis, cocaine and heroin. Overall, we observed a stable percentage (9.0%) of recreational drug use (excluding cannabis, amyl nitrite and prescription drugs). For MSM, however, there was an increase in overall drug use from 8.8% in 2007 to 13.8% in 2017, with particularly large increases for methamphetamine (from 0.2 to 2.4%; P < 0.001) and GHB/GBL (from 1.0 to 3.4%; P < 0.001). The use of each of the potentially sex-enhancing drugs methamphetamine, GHB/GBL, cocaine, XTC/ MDMA and amphetamine was significantly associated with condomless sex with nonsteady partners, and higher prevalences of depression, syphilis and hepatitis C. Conclusions The significant increase in the use of chemsex drugs among MSM in the SHCS and the strong association with coinfections and depression highlights the need for harm reduction programmes tailored to MSM. According to our results, improving knowledge about recreational drugs is important for all health care professionals working with people living with HIV.
Clinical Infectious Diseases, May 9, 2023
Background: Integrase strand transfer inhibitors (INSTI) have been associated with an increased r... more Background: Integrase strand transfer inhibitors (INSTI) have been associated with an increased risk for cardiovascular disease (CVD) events. We investigated the impact of starting INSTIbased antiretroviral therapy (ART) on CVD events among treatment-naïve people with HIV
pairs of patient-and physician-questionnaires were completed. 426 (84 %) patients were male and 3... more pairs of patient-and physician-questionnaires were completed. 426 (84 %) patients were male and 39 (8 %), 138 (27 %), and 330 (65 %) were in the three stratified groups based on CD4 count, respectively. In the category 'Body and symptoms' the most commonly identified reason for patients not to start was: "As long as I feel good I don't have to take medication" (44 %). Less than 20 % of respondents indicated fears of side effects and toxicity or problems to manage pills. Most patients were in the lowest stage of treatment-readiness (N = 323, 68 %), especially patients with CD4 cells ≥500 cells/μL (N = 240, 79 %). Physicians answered in 92 (18 %) cases that ART was not indicated for CD4 cells <500 cells/μL. Main reasons for physicians not starting treatment for these patients were their perception that patients were 'too depressed' (13 %) or that they had not known them long enough (13 %). Conclusions Nowadays patient-barriers to ART are commonly related to health-and treatment-beliefs compared to fear of toxicity or ART manageability in the past. This new barrier pattern seems to reflect the era of well tolerated, easier ART regimens and has to be considered in light of the new recommendations to treat all HIV-infected individuals regardless of the CD4 cell count.
info:eu-repo/semantics/nonPublishe
Ultrasound and alpha-foetoprotein 6 months Controversial; persons with cirrhosis and persons with... more Ultrasound and alpha-foetoprotein 6 months Controversial; persons with cirrhosis and persons with HBV irrespective of fibrosis stage Others Controversial i Review all concomitant medicines which may potentially interact with ARVs or increase co-morbidities, see Drug-drug Interactions between DAAs and ARVs Drug-drug Interactions between Antidepressants and ARVs Drug-drug Interactions between Antihypertensives and ARVs Drug-drug Interactions between Analgesics and ARVs Drug-drug Interactions between Antimalarial Drugs and ARVs Drug-drug Interactions between Corticosteroids and ARVs Drug-drug Interactions between Contraceptives and ARVs and www.hiv-druginteractions.org ii If stable on ART with undetectable HIV-VL and CD4 count > 350 cells/ μL, suggest annual CD4 count. iii A risk equation developed from HIV populations is available, see http://www.hivpv.org/ Of note, if an individual receives medicines to control dyslipidaemia and/or hypertension, the estimation should be interpreted with caution. iv A calculator for LDL-cholesterol in cases where TG is not high can be found at http://www.hivpv.org/. v Risk factors for chronic liver disease include alcohol, viral hepatitis, obesity, diabetes, insulin resistance, hyperlipidaemia and hepatotoxic drugs. vi Risk factors for CKD: hypertension, diabetes, CVD, family history, black African ethnicity, viral hepatitis, low current CD4 count, smoking, older age, concomitant nephrotoxic drugs. vii eGFR: use CKD-EPI formula based on serum creatinine, gender, age and ethnicity because eGFR quantification is validated >60 mL/min. The abbreviated modification of diet in renal disease (aMDRD) or the Cockroft-Gault (CG) equation may be used as an alternative; see http:// www.hivpv.org viii Some experts recommend UA/C (urinary albumin creatinine ratio) or UP/C (urinary protein creatinine ratio) as a screening test for proteinuria in all persons. UA/C predominantly detects glomerular disease. Use in persons with diabetes. UP/C detects total protein secondary to glomerular and tubular disease. ix Different models have been developed for calculating a 5-year CKD risk score while using different nephrotoxic ARVs, integrating HIV independent and HIV-related risk factors [4], [5] x Classic risk factors: older age, female gender, hypogonadism, family history of hip fracture, low BMI (≤ 19 kg/m 2), vitamin D deficiency, smoking, physical inactivity, history of low impact fracture, alcohol excess (> 3 units/day), steroid exposure (minimum 5 mg for > 3 months). xi WHO fracture risk assessment (FRAX®) tool: www.shef.ac.uk/FRAX xii A diagnosis of COPD should be considered in persons over the age of 35 who have a risk factor (current or ex-smoker) and who present with exertional breathlessness, chronic cough, regular sputum production, frequent winter 'bronchitis' or wheeze.
HIV Medicine, 2021
ObjectivesThe aim of the study was to assess the feasibility of a national pre‐exposure prophylax... more ObjectivesThe aim of the study was to assess the feasibility of a national pre‐exposure prophylaxis (PrEP) programme using smartphone‐compatible data collection.MethodsThis was a multicentre cohort study (NCT03893188) enrolling individuals interested in PrEP in Switzerland. All centres participate in the SwissPrEPared programme, which uses smartphone‐compatible data collection. Feasibility was assessed after centres had enrolled at least one participant. Participants were HIV‐negative individuals presenting for PrEP counselling. Outcomes were participation (number enrolled/number eligible), enrolment rates (number enrolled per month), retention at first follow‐up (number with first follow‐up/number enrolled), and uptake (proportion attending first visit as scheduled). Participant characteristics were compared between those retained after baseline assessment and those who dropped out.ResultsBetween April 2019 and January 2020, 987 individuals were assessed for eligibility, of whom 96...
Research Involvement and Engagement
Background The role of patients in cancer research is undergoing a significant evolution as all s... more Background The role of patients in cancer research is undergoing a significant evolution as all stakeholders seek to enhance the level of direct patient involvement in the design and development of clinical trials. However, there are significant hurdles that patients, patient advocates, laboratory researchers, clinical investigators, and funding institutions must overcome to implement relevant patient involvement in all aspects of biomedical research. By using innovative grant funding models, philanthropic organizations can lead the field in overcoming these challenges. Rising Tide Foundation for Clinical Cancer Research (RTFCCR), a private philanthropy that funds academic research, has developed a novel approach for requiring and supporting partnerships among grantees and patients in designing and conducting research projects. This paper presents a reflective case study of efforts to advance the field of patient involvement in clinical research. Methods The decision to focus on pat...
Regulatory Affairs Watch
Patient and public involvement (PPI) in academic human research has been evolving in the United S... more Patient and public involvement (PPI) in academic human research has been evolving in the United States and Europe since the early 1980s, when it was jump-started by activists responding to the HIV pandemic. This article provides a brief look at the development of PPI in academic human research in the US and Europe, highlights the PPI initiatives of several US and European organisations, discusses how PPI is gaining momentum in health technology assessment bodies, and provides recommendations for various stakeholders on how to incorporate more PPI into academic human research.
Primary and hospital care, Dec 7, 2022
Les chlamydias peuvent provoquer des complications graves telles que des grossesses extra-utérine... more Les chlamydias peuvent provoquer des complications graves telles que des grossesses extra-utérines et de l'infertilité, mais ceci arrive beaucoup moins souvent qu'on ne le pensait auparavant. Un dépistage de routine de la chlamydia chez les femmes sexuellement actives n'est pas recommandé. La chlamydiose anale et pharyngée est traitée par la doxycycline. La gonorrhée et la syphilis sont en augmentation, surtout chez les hommes qui ont des rapports sexuels avec des hommes (HSH). La gonorrhée peut désormais être traitée par voie intraveineuse (ceftriaxone 1 g en une seule fois). Chlamydia Les chlamydias sont de plus en plus fréquentes en Suisse. Cette épidémie de chlamydia fait peur. Avec >12 000 cas déclarés (2019) et une multiplication par cinq au cours des 20 dernières années, les chlamydias sont la maladie sexuellement transmissible (MST) la plus fréquemment diagnostiquée en Suisse [31, 73]. Une étude menée à Bâle suggère toutefois qu'il s'agit d'une pseudo-augmentation [77]; sur l'ensemble des échantillons envoyés, chaque année, de manière constante, seuls environ 5% étaient positifs chez les femmes (environ 10% chez les hommes), alors que le nombre d'échantillons envoyés lui a fortement augmenté. Il y a donc nettement plus de tests effectués, entre autres lors des contrôles gynécologiques annuels de femmes asymptomatiques [77].
Primary and Hospital Care: Allgemeine Innere Medizin
The Journal of Infectious Diseases
We assessed changes in sexual behavior among people with human immunodeficiency virus (HIV) over ... more We assessed changes in sexual behavior among people with human immunodeficiency virus (HIV) over 20 years. Condom use with stable partners steadily declined from over 90% to 29% since the Swiss U = U statement, with similar trajectories between men who have sex with men (MSM) and heterosexuals. Occasional partnership remained higher among MSM compared to heterosexuals even during coronavirus disease 2019 (COVID-19) social distancing.
Primary and hospital care: médecine interne générale
Primary and Hospital Care: Allgemeine Innere Medizin
Swiss Medical Weekly
BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SA... more BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SARS-CoV-2 pandemic remain unclear. METHODS: Design: Longitudinal analysis of an ongoing, multicentre, pre-exposure prophylaxis (PrEP) cohort (NCT03893188) in Switzerland. Participants: HIV-negative MSM aged ≥18 who completed at least one questionnaire before and one after the start of the SARS-CoV-2 pandemic. Outcomes: Primary: mental health, defined as anxiety and depression scores assessed by the Patient Health Questionnaire-4. Secondary: sexual behaviour, well-being, PrEP use and disruption of care. Outcomes were assessed over seven periods corresponding to different SARS-CoV-2 prevention measures in Switzerland. We performed pairwise comparisons between periods (Wilcoxon signed rank test). RESULTS: Data from 1,043 participants were included. Whilst anxiety scores remained stable over time, depression scores worsened in the second wave and the second lockdown period compared to pre-pan...
Clinical Infectious Diseases, 2020
Background Using data from the COHERE collaboration, we investigated whether primary prophylaxis ... more Background Using data from the COHERE collaboration, we investigated whether primary prophylaxis for Pneumocystis Pneumonia (PcP) might be withheld in all patients on antiretroviral therapy with suppressed plasma HIV RNA (≤ 400c/mL) irrespective of CD4 count. Methods We implemented an established causal inference approach whereby observational data is used to emulate a randomised trial. Patients taking PcP prophylaxis were eligible for the emulated trial if their CD4 count was ≤ 200 cells/µL in line with existing recommendations. We compared the following two strategies for stopping prophylaxis: i.) when CD4 count was above 200 cells/µL for more than 3 months, or ii.) when the patient was virologically suppressed (two consecutive HIV RNA ≤ 400c/mL). Patients were artificially censored if they did not comply with these stopping rules. We estimated the risk of primary PcP in patients on ART, using the hazard ratio to compare the stopping strategies by fitting a pooled logistic model, ...
Nature Communications, 2019
The HIV-1 reservoir is the major hurdle to a cure. We here evaluate viral and host characteristic... more The HIV-1 reservoir is the major hurdle to a cure. We here evaluate viral and host characteristics associated with reservoir size and long-term dynamics in 1,057 individuals on suppressive antiretroviral therapy for a median of 5.4 years. At the population level, the reservoir decreases with diminishing differences over time, but increases in 26.6% of individuals. Viral blips and low-level viremia are significantly associated with slower reservoir decay. Initiation of ART within the first year of infection, pretreatment viral load, and ethnicity affect reservoir size, but less so long-term dynamics. Viral blips and low-level viremia are thus relevant for reservoir and cure studies.
Primary and Hospital Care: Allgemeine Innere Medizin
Primary and hospital care: médecine interne générale
Primary and Hospital Care: Allgemeine Innere Medizin