Дисертації з теми "Cohorts Treatment"
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Davies, Mary-Ann. "Outcomes and effectiveness of antiretroviral therapy for HIV-infected children in South African treatment cohorts." Doctoral thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/9382.
Повний текст джерелаIncludes bibliographical references.
Since 2004, increasing numbers of children in sub-Saharan Africa have commenced antiretroviral therapy (ART). This thesis reviews the outcomes of published studies of paediatric ART cohorts in Africa, describes outcomes for children receiving ART in South Africa and examines determinants of mortality and generalizability across the Southern African region. Temporal trends in characteristics at ART initiation are also examined. The measurement of treatment success in resource-limited settings is reviewed, by examining virological failure, and assessing the diagnostic accuracy of immunological criteria for identifying virological failure.The results chapter is presented in the form of published or submitted papers based on data from the International epidemiologic Databases to Evaluate AIDS-Southern Africa (IeDEASA) collaboration. The first paper reviews paediatric ART studies from Africa published before 2008. Together with the literature review in chapter 1, it provides the background to this thesis. The second paper reports on mortality (8%) and retention in care (81%) by 3 years after ART start for > 6,000 children who initiated ART in South Africa. The generalizable prognostic models in the third paper suggest that mortality during the first year on ART ranges from <2% to >45%, with the majority of children being in the group with the best prognosis. The fourth paper reports that 1 in 5 children meet criteria for confirmed virological failure by 3 years on ART. The risk is greater with triple ART containing nevirapine or unboosted ritonavir (in comparison with lopinavir/ritonavir or efavirenz). The fifth and sixth papers demonstrate that immunological criteria have low sensitivity and positive predictive value for virological failure. Targeted viral load measurement reduces the number of false positive virological failure diagnoses. The final paper shows that increasing numbers of children have initiated ART with a decline in disease severity at therapy start from 2005-2010. However, even in 2010 a substantial number of children started ART with advanced disease. The thesis concludes that access to ART for children has increased, with good outcomes. HIV cohort research is important in evaluating the safety and effectiveness of different models of care, treatment and monitoring strategies.
Seleke, Rachel. "A comparison of treatment response in two cohorts of once daily HAART and twice daily HAART in a sample population in Gaborone, Botswana." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/80462.
Повний текст джерелаENGLISH ABSTRACT: Background Sub-Saharan Africa has been hard hit by the HIV/AIDS epidemic with an estimated 22.9 million adults infected in 2010. The advent of antiretroviral therapy (ART) has seen significant reduction in mortality from AIDS related illnesses. With the reduction of mortality and the indisputable positive results seen from the use of Anti-retroviral Treatment (ART), the demand both from people living with HIV and health care providers to phase in less toxic ARVs while maintaining simplified fixed-dose combinations has increased considerably. Botswana like most low-resource countries has adapted the WHO recommendation of daily ART as opposed to the previous twice daily HAART. No evidence from resource limited settings has been found that clearly indicates the superiority of regimens based on AZT, d4T or TDF. Aim The primary aim was to compare treatment response between two cohorts. The secondary aim was to compare any association of regimen to age or gender. Objectives To comparatively determine treatment response at 3 months based on immunological response (shown by an increase in CD4 above pre-therapy levels) and viral load response. Methods The study is a retrospective comparative cohort study. Three ART sites were selected from a total of 6 sites. A sample size of 263 was required to achieve a 90% effect power. An equal number of patient records were reviewed per site and each arm had an equal number of reviewed records. A total of 286 patient record files which fit the inclusion criteria were retrospectively analysed and data entered in Excel before being analysed using Statistica Version 10. A p <0.05 represents statistical significance whilst a 95% confidence interval was used for estimation of unknown variables. Results n=263. The overall sample was predominantly male (75.19%). An overwhelming majority (95.88%) of patients in both arms had undetectable viral loads (VL<400). A significant association was found between the regimen and viral load (p=0.0315-Pearson Chi Test). The difference in CD4 between the two arms was not statistically significant (p=0.655890-ANOVA). A positive association was found between the regimen and gender (p=0.03190-Pearson Chi Test). This was possibly owing to the high numbers of males and no statistical adjustment to gender made. No association was found in the difference in CD4 cell counts for regimen and gender (p=0.612191-Anova). Conclusion Treatment response at 3 months post initiation between once daily and twice daily HAART in Gaborone Botswana by use of virologic and immunologic response has been shown to be comparable. The use of one regimen over the other as first line as recommended by WHO and the subsequent adoption of the current first line regimen by the Botswana Ministry of Health may be justified. This study has therefore reinforced the applicability of previous findings in other settings of this recommendation. As part of the targeted audience and indeed as a partner in the care and management of HIV, the responsibility to ensure applicability of the recommendations set out for resource limited areas has been achieved through this study. However, bigger randomized trials in resource limited settings are needed to justify and accredit these findings as well as add to the evidence obtained in developed countries.
Groah, Joseph S. "Treatment of fourth class midshipmen : hazing and its impact on academic and military performance and psychological and physical health /." Thesis, access online version, 2005. http://www.usna.edu/IR/htmls/lead/database/cohort8/c08%5Foakes.pdf.
Повний текст джерелаLangwenya, Nontokozo. "Adherence to antiretroviral treatment (ART) among HIV-infected pregnant women starting treatment immediately vs delayed: a cohort study." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/22899.
Повний текст джерелаOlson, Karen. "Comparison of two treatments for fingertip amputation : a retrospective cohort study." [Tampa, Fla.] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0002164.
Повний текст джерелаPan, Yi-Ju. "Economic evaluations of antidepressant treatments : a national cohort study in Taiwan." Thesis, King's College London (University of London), 2014. https://kclpure.kcl.ac.uk/portal/en/theses/economic-evaluations-of-antidepressant-treatments(306d9beb-b8d9-4aa6-b41d-d11e570d41f9).html.
Повний текст джерелаMcNeil, Alexander John. "Statistical methods in AIDS progression studies with an analysis of the Edinburgh City Hospital Cohort." Thesis, University of Cambridge, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.307053.
Повний текст джерелаFeng, Lili. "Cocaine use among drug users in Methadone treatment: results from the Amsterdam cohort study." The Ohio State University, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=osu1406728675.
Повний текст джерелаAkin, Faith W., Kristal M. Riska, Laura Williams, Stephanie B. Rouse, and Owen D. Murnane. "Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1780.
Повний текст джерелаGilmore, Annette. "Feasibility and utility of a sickle cell disease registry for research and patient management." Thesis, Brunel University, 2009. http://bura.brunel.ac.uk/handle/2438/4445.
Повний текст джерелаZimmer, Andrea, Michael Coslovsky, Ivo Abraham, and Bernhard F. Décard. "Adherence to fingolimod in multiple sclerosis: an investigator-initiated, prospective, observational, single-center cohort study." DOVE MEDICAL PRESS LTD, 2017. http://hdl.handle.net/10150/626094.
Повний текст джерелаHarvard, Stephanie. "Economic evaluations in the context of treatment recommendations in spondyloarthritis : analyses from the DESIR cohort." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/63323.
Повний текст джерелаMedicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
Viney, Kerri. "Universal or selective directly observed treatment? : a clinical audit of directly observed treatment and tuberculosis in a North-East London (United Kingdom) cohort /." St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17920.pdf.
Повний текст джерелаMoeketsi, Ntshebo Mirriam. "Treatment and regimen change in a cohort of HIV positive patients in anti-retroviral treatment at Tshepang Wellness Clinic, Dr George Mukhari Hospital." Thesis, University of Limpopo ( Medunsa Campus ), 2010. http://hdl.handle.net/10386/218.
Повний текст джерелаBackground: Antiretroviral therapy led to a revolution in care of patients with HIV/AIDS in a developed world. Treatment is not a cure but it also presented with new challenges of side effects, drug resistance and it also dramatically reduces rate of mortality and morbidity and it also improves quality of life to people living with HIV/AIDS, and it also now considered as manageable chronic diseases. Aim: Aim of the study is to establish and describe reasons for treatment and regimen change in a cohort of HIV positive patients on ART enrolled in the pharmaco-epidemiological survey at Tshepang wellness clinic. Objectives: is to determine reasons for treatment and regimen change, types of treatment and regimen change among patients on ART who are enrolled in pharmacoepidemiological survey at Tshepang wellness clinic. Design and Methods: Study is a retrospective cohort study, and sample size of 301 medical records of a cohort of HIV positive patients on ARVs enrolled in a longitudinal pharmaco-epidemiological survey from November 2006-May 2007 reviewed. Data extraction tool used to collect data and software called SPSS 17.0 used to analyze data and relevant themes were extracted to determine distribution of variables. Results: Results of this study indicated that 91 (85%) were males and (87.8%) 191 were females. Age was grouped as teenagers (15-25yrs), young adults (26-49yrs) and adults (50- 70yrs). Results also shows reasons of treatment and regimen change of which majority of patients 134(44.8%) changed due toxicity followed by 16 (5.4%) who changed because of pregnancy, and the other 4(1.3%) changed because of resistance, and the last 2(0.7%) which are regarded as minorities change because of T.B. Conclusion and Recommendations: Results shows that majority of pharmacovigilance patients were initiated Regimen 1 compared to other regimens. Toxicity appear as the main reason of treatment and regimen change on this study as 140(46.4%) reported toxicities (peripheral neuropathy, lactic acidosis, lipodystrophy and lipoatrophy). Implementation of monitoring of adherence needed for prevention of resistance and virological failure.
Haerle, Darin R. "Recidivism Outcomes among a Cohort of Violent Institutionalized Juvenile Offenders." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9098/.
Повний текст джерелаTakuva, Simbarashe G. "A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland." Diss., University of Pretoria, 2010. http://hdl.handle.net/2263/30684.
Повний текст джерелаDissertation (MSc)--University of Pretoria, 2010.
Clinical Epidemiology
Unrestricted
Kantojärvi, L. (Liisa). "Personality disorders in the Northern Finland 1966 Birth Cohort Study." Doctoral thesis, University of Oulu, 2008. http://urn.fi/urn:isbn:9789514288487.
Повний текст джерелаTiivistelmä Persoonallisuushäiriöt ovat yleisiä mielenterveyden ongelmia, joihin liittyy usein psykiatrista oheissairastavuutta ja toimintakyvyn laskua. Tämän tutkimuksen tarkoituksena oli arvioida persoonallisuushäiriöiden yleisyyttä nuorilla aikuisilla. tehtävänä oli arvoida yhteyksiä lapsuuden perherakenteeseen ja yleisimpiin psykiatrisiin häiriöihin sekä arvioida persoonallisuushäiriöiden yhteyksiä temperamenttitekijöihin. Tutkimus on osa Pohjois-Suomen vuoden 1966 syntymäkohortin psykiatrista osaprojektia, Oulu Studyä. Tutkimusaineiston muodostivat Oulu Studyn otokseen kuuluvat kaikki 1. tammikuuta 1997 Oulussa asuneet kohortin jäsenet (N = 1 609) sekä sairaalahoidossa olleiden persoonallisuushäiriö- diagnoosin saaneiden osalta koko alkuperäisen syntymäkohortin (N = 12 058) jäsenet. Tutkimus koostui kaksivaiheisesta psykiatrisesta kenttätutkimuksesta, jossa tietoja tutkittavilta kerättiin sekä kyselylomakkeiden ja haastattelututkimuksen avulla. Lisäksi tutkittavilta kerättiin tiedot heidän elinaikanaan toteutuneesta julkisten psykiatristen sairaala- ja avohoitopalvelujen käytöstä sairauskertomustietojen perusteella. Niin kutsutun best-estimated -menetelmän avulla arvioitiin tutkittavien psykiatrista sairastavuutta mukaan lukien persoonallisuushäiriöt. Tutkittavien lapsuuden perherakennetta ja sosiodemografisia tekijöitä arvioitiin aiempien seurantatutkimusten tietojen avulla. Tutkimuksessa persoonallisuushäiriöt luokiteltiin DSM-III-R-diagnoosiluokituksen mukaisesti kolmeen eri pääryhmään ja niiden mukaisiin alaryhmiin: Ryhmä A (epävakaa, eristäytyvä ja psykoosipiirteinen persoonallisuus), ryhmä B (epäsosiaalinen, epävakaa, huomionhakuinen ja narsistinen persoonallisuus) ja ryhmä C (estynyt, riippuvainen, pakko-oireinen ja passiivis-aggressiivinen persoonallisuus). Oulu Studyn väestöotoksessa yleisimpiä näistä olivat ns. C-ryhmän persoonallisuushäiriöt, kun taas sairaalahoidetuilla henkilöillä B-ryhmän persoonallisuushäiriöt olivat yleisimpiä. Persoonallisuushäiriöiden todettiin liittyvän yleisesti masennus- ja ahdistuneisuushäiriöihin sekä päihteiden käyttöön. Vanhemman yksinhuoltajuuden todettiin liittyvän persoonallisuushäiriöihin, etenkin B-ryhmän persoonallisuushäiriöihin. Persoonallisuushäiriöryhmät erosivat toisistaan temperamenttiprofiilien perusteella. Eri persoonallisuushäiriöistä kärsivillä tutkittavilla ei todettu tyypillisiä temperamenttiprofiileja. Johtopäätöksenä voidaan todeta, että persoonallisuushäiriöiden ja niihin yleisesti liittyvän psykiatrisen oheissairastavuuden tunnistaminen on tärkeää. Havainnot korostavat perusterveydenhuollon ja erikoissairaanhoidon yhteistyön merkitystä persoonallisuushäiriöistä ja psykiatrisista häiriöistä kärsivien henkilöiden tutkimuksessa ja hoidossa. Persoonallisuushäiriöille altistavien lapsuuden tekijöiden tunnistaminen on tärkeää vaikeiden persoonallisuushäiriöiden ehkäisemiseksi. Persoonallisuushäiriöiden etiologian ja kehittymisen selvittämiseksi tarvitaan uusia tutkimuksia
Abdelrahman, Tamer. "Quasispecies dynamics and treatment outcome during early hepatitis C infection in a cohort of HIV-infected men." Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/7402/.
Повний текст джерелаDrogemoller, Britt Ingrid. "Investigation of genetic variation contributing to antipsychotic treatment response in a South African first episode schizophrenia cohort." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/95473.
Повний текст джерелаENGLISH ABSTRACT: Schizophrenia is a debilitating disorder that occurs the world over. Although antipsychotics are largely effective in treating the positive symptoms of schizophrenia, the outcomes are non-optimal in many patients. As antipsychotic treatment response has been shown to be heritable, it is expected that the implementation of antipsychotic pharmacogenomics should aid in the optimization of antipsychotic treatments, however to date clinically applicable results are limited. Therefore this study utilized exome sequencing in a cohort of well characterized first episode schizophrenia patients to identify the genetic factors contributing to antipsychotic treatment response. The utility of exome sequencing for antipsychotic pharmacogenomic applications in the African context was assessed through examination of the literature and publically available data. Thereafter, a cohort of 104 well characterized South African first episode schizophrenia patients who were treated with flupenthixol decanoate for twelve months was collected. From this cohort, subsets of patients on extreme ends of the treatment response spectrum were identified for exome sequencing. Thereafter a bioinformatics pipeline was used to call and annotate variants. These variants and those that have previously been associated with antipsychotic response, along with a panel of ancestry informative markers, were prioritized for genotyping in the entire cohort of patients. After genotyping of the 393 variants, statistical analyses were performed to identify associations with treatment response outcomes. Examination of the literature revealed a need for exome sequencing in Africa. However, critical analyses of next generation sequencing data demonstrated that complex regions of the genome may not be well suited to these technologies. Thus, it may be necessary to combine exome sequencing with knowledge obtained from past research, as was done in this study to identify the genetic factors contributing to antipsychotic treatment response. Using this strategy, the current study highlighted the potential role that rare variants play in antipsychotic treatment response and additionally detected 11 variants that were significantly associated with antipsychotic treatment response outcomes (P=2.19x10-5). Nine of these variants were predicted to alter the function of the genes in which they occurred; of which eight were novel with regards to antipsychotic treatment response. The remaining two variants have been associated with antipsychotic treatment outcomes in previous GWAS. Examination of the function of the genes in which the variants occurred revealed that the variants associated with (i) positive symptom improvement were involved in the folate metabolism pathway and (ii) negative and general pathological symptoms improvement had potential links to neuronal development and migration. To our knowledge this study is the first to utilize exome sequencing for antipsychotic pharmacogenomic purposes. The ability of this study to identify significant associations, even after correction for multiple testing, has highlighted the importance of combining genomic technologies with well characterized cohorts. The results generated from this study have served both to replicate results from previous antipsychotic pharmacogenetic studies and to identify novel genes and pathways involved in antipsychotic response. These results should aid in improving our understanding of the biological underpinnings of antipsychotic treatment response and may ultimately aid in the optimization of these treatments.
AFRIKAANSE OPSOMMING: Skisofrenie is ‘n siekte wat wêreldwyd voorkom en lei tot erge funksionele inkorting. Alhoewel antipsigotiese medikasie redelik effektief is in die behandeling van die positiewe simptome van skisofrenie, is die funksionele uitkomste in baie pasiënte nie optimaal nie. Die reaksie op antipsigotiese behandeling blyk oorerflik te wees. Die verwagting is dus dat die implementering van antipsigotiese farmakogenomika met die optimalisering van antipsigotiese behandeling sal help. Tot dusver het die resultate van farmakogenomika studies egter beperkte kliniese toepassings opgelewer. Hierdie studie het dus eksoomvolgordebepaling in 'n groep van goed-karakteriseerde eerste-episode skisofrenie pasiënte gebruik om die genetiese faktore wat bydra tot die antipsigotiese behandelings-reaksies te identifiseer. Die gebruik van eksoom-volgordebepaling vir antipsigotiese farmakogenomika in die Afrikakonteks is deur die ondersoek van literatuur en openbaar-beskikbare data geëvalueer. Daarna is 'n groep van 104 goed-gekarakteriseerde Suid-Afrikaanse eerste-episode skisofrenie pasiënte, wat met flupenthixol dekanoaat vir twaalf maande behandel is, versamel. Uit hierdie groep is subgroepe van pasiënte op die teenoorgestelde eindpunte van die behandelings-reaksiespektrum vir eksoom-volgordebepaling geïdentifiseer. Hierna is 'n bioinformatika pyplyn gebruik om variante te identifiseer en te annoteer. Hierdie variante, asook variante wat voorheen met antipsigotiese reaksie geassosieer is, is saam met 'n paneel van afkoms-informatiewe merkers vir genotipering in die hele groep pasiënte geprioritiseer vir genotipering. Na genotipering van die 393 variante, is statistiese analises uitgevoer om assosiasies met behandelings-reaksie uitkomste te identifiseer. ‘n Ondersoek van die literatuur het getoon dat daar 'n behoefte vir eksoomvolgordebepaling in Afrika is. ‘n Kritiese analise van volgende-generasie volgordebepalings data het egter getoon dat komplekse dele van die genoom nie geskik is vir die gebruik van hierdie tegnologie nie. Om die genetiese faktore wat bydra tot suksesvolle antipsigotiese behandeling te identifiseer, mag dit nodig wees om eksoom-volgordebepaling te kombineer met bevindings verkry uit vorige navorsing, soos gedoen in hierdie studie. In die huidige studie het die gebruik van hierdie strategie die potensiële rol van skaars variante in antipsigotiese behandelings-reaksies beklemtoon en ‘n bykomende 11 variante is geïdentifiseer wat beduidend met antipsigotiese behandelingsrespons geassosieer is (P=2.19x10-5). Daar is voorspel dat nege van hierdie variante die funksie van die gene waarin hulle voorkom sal verander en agt van hierdie variante is vir die eerste keer met antipsigotiese behandelingsrespons geassosieer. Die oorblywende twee variante is met antipsigotiese behandelingsrespons in vorige GWAS geassosieer. ‘n Ondersoek na die funksie van die gene waarin die variasies voorgekom het, toon dat die variante wat geassosieer is met (i) verbetering van positiewe simptome ‘n rol speel in folaatmetabolisme, terwyl variante wat geassosieer is met (ii) die verbetering in negatiewe en algemene patologiese simptome potensiële skakels met neuron ontwikkeling en migrasie het. Na ons wete is hierdie die eerste studie wat eksoom-volgordebepaling vir antipsigotiese farmakogenomika doeleindes gebruik. Die vermoë van hierdie studie om beduidende assosiasies te identifiseer, selfs na korreksie vir veelvoudige toetse, onderstreep die belangrikheid van die kombinering van genomiese tegnologie met goed-gekarakteriseerde pasiënte. Die bevindinge van hierdie studie het nie net die resultate van vorige antipsigotiese farmakogenetiese studies bevestig nie, maar ook nuwe gene en variante wat betrokke is in antipsigotiese reaksie geïdentifiseer. Hierdie resultate sal hopelik ons begrip van die onderliggende biologiese faktore wat antipsigotiese behandelingsrespons beïnvloed verbeter en uiteindelik ook met die optimalisering van behandeling help.
Leoo, Malin. "Childhood obesity treatment during the first wave of the Covid-19 pandemic : – a retrospective controlled cohort study." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-91059.
Повний текст джерелаManentsa, Mmatsie. "Stavudine-associated toxicity in patients on low-dose versus high-dose Stavudine in an HIV treatment cohort." Diss., University of Pretoria, 2015. http://hdl.handle.net/2263/53058.
Повний текст джерелаDissertation (MSc)--University of Pretoria, 2015.
School of Health Systems and Public Health (SHSPH)
MSc
Unrestricted
Bwalya, Clement Mudala. "Retention in HIV care among female sex workers on antiretroviral treatment in Lusaka, Zambia: A retrospective cohort study." University of the Western Cape, 2020. http://hdl.handle.net/11394/8045.
Повний текст джерелаBackground: HIV/AIDS remains a major public health issue that is affecting all population groups and communities in Zambia. Among the most affected groups are key populations (KPs) such as female sex workers. KPs are considered at high risk of contracting HIV but have limited access to HIV services and retention in care due to internalized stigma, discrimination, criminalization, and negative attitudes towards HIV treatment. Under the USAID Open Doors project in Zambia, KPs access comprehensive HIV prevention, care and treatment services. The test and treat strategy is implemented by the project in support of the UNAIDS 90-90-90 targets by 2020 to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load. Aim: This study aimed to determine retention in care among female sex workers (FSWs) in the first six months after ART initiation using the HIV care cascade. Methodology: A retrospective cohort study was conducted of all new HIV positive female sex workers (FSWs) initiated on ART between October 2018 and June 2019 (9 months period) based on the electronic records. Data were extracted from SmartCare, an electronic health record system used by the ART clinic. Microsoft Excel and Epi-Info 7 software were used for data entry and analysis. Kaplan–Meier survival analysis was conducted to examine differences in retention rates. Results: A total of 205 FSWs were initiated on ART, out of which 180 were active on ART (36 youths and 144 adults) and 25 were lost to follow-up (four youths and 21 adults) during the 9 months study period. Of the 180 FSWs active on ART, 36 were FSWs aged 18 – 24 years (youths) representing 90% retained in care while 144 were FSWs aged 25 – 42 years (adults) with 87% being retained on ART treatment. Retention in ART care was not significantly different in the survival curves between the age groups of FSW youths and FSW adults during the study period (p-value = 0.637). Retention in ART care was not statistically significant for education (p-value = 0.481), marital status (p-value = 0.545), and occupation (p-value = 0.169). Conclusion: Retention in ART care among FSWs was 88%. However, there were no significant differences by age group identified in this study. While this study shows 88% retention rate among FSWs, it will be used as a baseline in meeting the UNAIDS 90-90-90 goals.
Smith, Sean. "Trocantheric Femoral Fractures - a retrospective cohort study comparing reoperation rates before and after implementation of new treatment protocol." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-86763.
Повний текст джерелаBogefeldt, Johan. "Low back pain with special reference to prevalence, diagnosis, treatment and prognosis /." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl.[distributör], 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108070.
Повний текст джерелаWyl, Viktor von. "HIV-1 drug resistance in the Swiss HIV Cohort study : epidemiology and impact on treatment of HIV-infected patients /." Zürich : ETH, 2008. http://e-collection.ethbib.ethz.ch/show?type=diss&nr=17726.
Повний текст джерелаZhao, Ying. "Improved treatment outcomes with bedaquiline when substituted for second-line injectable agents in multidrug-resistant tuberculosis: A retrospective cohort study." Master's thesis, Faculty of Health Sciences, 2019. https://hdl.handle.net/11427/31777.
Повний текст джерелаIshida, Yoshihiro. "Killer immunoglobulin-like receptor genotype did not correlate with response to anti-PD-1 antibody treatment in a Japanese cohort." Kyoto University, 2020. http://hdl.handle.net/2433/253207.
Повний текст джерелаBaquerizo, Pamela, Camila Carbone, and Monica Giacchetti. "Abandono de la terapia nutricional y pérdida de peso en pacientes bariátricos: Cohorte retrospectiva en Lima-Perú." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2015. http://hdl.handle.net/10757/621812.
Повний текст джерелаbjectives: To determine the proportion of patients who meet international recommendations for bariatric surgery and to assess the impact of weight loss in the first, third and sixth month of nutritional treatment on it’s abandonment. Methods: A retrospective cohort study was performed using data from clinical records of patients who underwent sleeve gastrectomy in a private clinic of Lima, Peru. Two outcomes were evaluated, eligibility for bariatric surgery according to international recommendations (BMI ≥40 kg/m2 or ≥35 kg/m2 with comorbidities) and abandonment before and after starting nutritional management (no nutritional assessment after 60 days from the previous visit without achieving ideal BMI). The exposure was the percentage of weight lost in the first five weeks after surgery split into <10% and ≥10%. Poisson regression was used and relative risks and 95% confidence intervals (95%CI) were calculated. Results: Data from 423 medical records of bariatric patients, mean age 39.2 years (SD 12.3), 294 (69.5%) women, were analyzed. Only 117 (27.7%) patients met international recommendations for bariatric surgery. Before starting nutritional management, 48/117 (41%) abandoned treatment, whereas an additional 29/69 (42.0%) abandoned before six months of nutritional management. In multivariable model, a weight loss ≥10% in the first five weeks reduced the risk of abandoning nutritional management (RR = 0.10, 95% CI 0.01-0.68) in the first month. Conclusions: Despite of international recommendations, a great proportion of patients undergoing bariatric surgery did not meet the criteria. Rates of abandonment before and after starting nutritional management are high. Results highlight the urgency of having appropriate guidelines for managing bariatric surgery in our context.
Herdman, Susan J., Courtney D. Hall, and Lisa Heusel Gillig. "Factors Associated with Rehabilitation Outcomes in Patients with Unilateral Vestibular Hypofunction: A Prospective Cohort Study." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/7778.
Повний текст джерелаFrick, Ulrich, Jürgen Rehm, Daniele Zullino, Manrique Fernando, Gerhard Wiesbeck, Jeannine Ammann, and Ambros Uchtenhagen. "Long-Term Follow-Up of Orally Administered Diacetylmorphine Substitution Treatment." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133129.
Повний текст джерелаDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
Relton, Clare. "A new design for pragmatic randomised controlled trials : a 'Patient Cohort' RCT of treatment by a homeopath for menopausal hot flushes." Thesis, University of Sheffield, 2009. http://etheses.whiterose.ac.uk/6644/.
Повний текст джерелаFrick, Ulrich, Jürgen Rehm, Daniele Zullino, Manrique Fernando, Gerhard Wiesbeck, Jeannine Ammann, and Ambros Uchtenhagen. "Long-Term Follow-Up of Orally Administered Diacetylmorphine Substitution Treatment." Karger, 2010. https://tud.qucosa.de/id/qucosa%3A27490.
Повний текст джерелаDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
Sá, Edmundo José Bragança de. "How effective are brief interventions in smoking cessation: project of a cohort study in a family health care unit." Master's thesis, Faculdade de Ciências Médicas. UNL, 2012. http://hdl.handle.net/10362/9253.
Повний текст джерелаOliveira, Natasha van Schalkwyk Pimenta de. "Mental health care assessed based on structure, process and outcome : a retrospective cohort study." Master's thesis, Faculdade de Ciências Médicas, 2013. http://hdl.handle.net/10362/11455.
Повний текст джерелаDartois, Laureen. "Facteurs comportementaux et non-comportementaux associés au risque de cancer et de mortalité à partir des données de la cohorte de femmes françaises E3N." Thesis, Paris 11, 2014. http://www.theses.fr/2014PA11T081/document.
Повний текст джерелаBackground: Cancer is the second leading cause of mortality among women in France, and the leading cause of mortality among women aged between 35 and 84. Breast cancer is the most frequently diagnosed cancer, with 35% of cases among women in France in 2012. Multiple behavioural and non-Behavioural factors have been associated with increases in cancer incidence and mortality. However, the literature about their combined impact is scarce. Regarding breast cancer, some risk factors differed according to the menopausal status, suggesting a different etiology between premenopausal and postmenopausal breast cancers.Objectives: Data from the E3N prospective cohort of French women were used to evaluate the influence of behavioural and non-Behavioural factors on cancer risk before and after the menopause and on mortality. In addition, we aimed at estimating their relative impact on the population and identifying factors with the highest predictive power.Results: Our results suggest a modest influence of the lifestyle on cancer risk and mortality when adhering to only one public health recommendation. However, the influence is substantial with a combined adherence to several recommendations. Behavioural factors play a key role in the occurrence of cancer and mortality risk. Regarding breast cancer, these factors influence particularly the risk after the menopause, while before, their impact is lower than non-Behavioural factors. These observations were retrieved when aiming at predicting breast cancer risk according to menopausal status. Prediction was established by non-Behavioural factors in premenopause, while the prediction in postmenopause was driven by behavioural factors.Conclusion: We have shown that the etiology of breast cancer differs according to the nature of the tumour, and particularly according to the menopausal status of women. Whatever the age, lifestyle influence the risk of cancer and mortality, especially after the menopause when their impact is higher than the non-Behavioural factors’ one. New results from prospective study on younger women are warranted to confirm the results
Theunissen, Helene Cornelia. "Early infant breastfeeding practices, and predictors of breastfeeding cessation, in HIV-uninfected and HIV-infected mothers on antiretroviral treatment: a prospective cohort study." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33051.
Повний текст джерелаReichmuth, Kirsten Leah. "Virologic outcomes of HIV-infected children undergoing a single-class drug substitution from Lopinavir/Ritonavir- to Efavirenz-based antiretroviral treatment: A retrospective cohort study." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/14257.
Повний текст джерелаSinclair, Michael. "A qualitative exploration of coping and adhering with hepatitis C treatment amongst a cohort of gay men in London co-infected with HIV and hepatitis C." Thesis, University of Essex, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435559.
Повний текст джерелаMontvida, Olga. "Evaluation of cardio-metabolic effects of treatment with incretin-based therapies in patients with type 2 diabetes." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/122920/1/Olga_Montvida_Thesis.pdf.
Повний текст джерелаTravers, Andrew H. "Intravenous ߦ2-agonists in the treatment of patients who present to the Emergency Department with severe acute asthma, a meta analysis and prospective observational cohort study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0026/MQ40119.pdf.
Повний текст джерелаWorkman, Lesley. "Does helminth treatment reduce the risk of active tuberculosis in a cohort of children from high tuberculosis risk population who have been vaccinated with BCG at birth?" Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/9315.
Повний текст джерела[Background] Research in adults and older children has shown an association between Mycobacterium tuberculosis and helminth infection, with those infected with helminths at greater risk of tuberculosis. This association is believed to be on the basis that chronic helminth infection can result in a functional impairment of the immune response that is necessary to clear or control infection by Mycobacterium tuberculosis (Elias et al. 2001; Rook et al. 2006; Fincham 2001). It is thus possible that the introduction of regular deworming programmes in a vulnerable population of children under the age of five years could assist their immune systems to ward off tuberculosis infection and reduce the risk of tuberculosis disease in such a population. A randomised controlled trial to compare two methods of administering bacille Camlette-Guerin (BCG) vaccination to newborns from a high tuberculosis risk population provided an opportunity to test this hypothesis in a sub-study. [Objective] The objective of this study is to determine if young children in a high-risk tuberculosis population who have been vaccinated with BCG at birth and have been treated for helminth infection are at lower risk of tuberculosis disease than children who have been vaccinated with BCG at birth but not treated for helminth infection. [Method] A case control study nested within a cohort recruited for a separate randomised control trial to compare two methods of administering BCG vaccination was carried out. Children who presented to their local clinic or hospital with symptoms of tuberculosis or a history of exposure to tuberculosis were admitted to a case verification (CV) ward for investigation of tuberculosis. Investigation of tuberculosis included a detailed history, including past helminth treatment, physical examination, tuberculin skin test, chest radiograph, gastric washing and induced sputum for culture of tuberculosis and clinical examination. A diagnostic algorithm was developed by specialist physicians and biostatisticians to classify the children into one of five tuberculosis categories. A total of 510 children (median age 18.13 months) were included in the primary analysis of this case control study. Those defined as cases were the 328 classified as "definite or probable TB" and 182, classified as "not TB", comprised the control group. Those classified as "possible TB" or "unlikely TB" were excluded. A secondary analysis was performed that included the 337 children who had been classified as "unlikely TB" with the controls resulting in a total of 847 children (median age 18.37 months). The 328 children classified as "definite or probable TB" were defined as cases and the 519 classified as "unlikely or not TB" comprised the control group. Univariate analysis was used to explore a possible relationship between tuberculosis and helminth treatment using all the variables in the sub-study (n=510 primary analysis; n=847 secondary analysis). For both the primary and secondary analysis a multivariate logistic regression model was built using a reduced sample that had a complete set of data for all the variables: primary analysis (n=435); secondary analysis (n=724). This final model was then fitted on a more complete sample as the final variables selected had fewer missing data for the observations: primary analysis (n=493); secondary analysis (n=822). [Result] A total of 35.69% of the study sample in the primary analysis had been treated for helminth infection. The proportion of children who had been treated for helminth infection was similar in the cases and controls (35.98% and 35.16% respectively). Univariate logistic regression showed no association between tuberculosis and treatment for helminth infection: [odds ratio (OR) 1.04; 95% confidence interval (CI) 0.71 - 1.51]. Multivariate analysis adjusted for the effect of nutritional status, recorded as height for age z score (haz), number of occupants sharing the same dwelling as the child, gender and birth site showed a similar result: (OR 1.03; 95% CI 0.69 " 1.53). The OR is very close to 1 with a 95% CI that includes 1, which indicates that there is not a statistically significant association between tuberculosis and helminth treatment. In the secondary analysis, a total of 38.61% of the study sample had been treated for helminth infection. In this analysis the proportion of children who had been treated for helminth infection showed a difference between the cases and controls (35.98% and 40.27% respectively). Univariate logistic regression showed a 17% relative reduction in tuberculosis odds but this was not a statistically significant result: (OR 0.83; 95% CI 0.63 " 1.11). Multivariate analysis adjusted for the effect of haz, number of children sharing the same dwelling as the child and gender, showed a similar result: (OR 0.85; 95% CI 0.63 " 1.15). [Conclusion] The primary analysis of this observational study does not support the hypothesis that helminth treatment reduces the risk of tuberculosis disease in young children in a high-risk tuberculosis population. Although the secondary analysis showed a 15% relative reduction in tuberculosis odds after adjusting for the effect of haz, number of occupants sharing the same dwelling as the child and gender, this was not a statistically significant result. [Final Conclusion] This study does not support the hypothesis that helminth treatment reduces the risk of tuberculosis disease in young children in a high-risk tuberculosis population.
Härkin, P. (Pia). "Closure of patent ductus arteriosus in very preterm infants:potential role of paracetamol and consequences of current treatments." Doctoral thesis, Oulun yliopisto, 2018. http://urn.fi/urn:isbn:9789526220253.
Повний текст джерелаTiivistelmä Valtimotiehyt on sikiöaikana avoimena oleva suoni, joka yhdistää keuhkovaltimon laskevaan aorttaan ja ohjaa vähähappisen veren istukkaan. Yhdessä soikean aukon kanssa suoni takaa sikiön verenkierron normaalin toiminnan ennen keuhkojen avautumista. Mikäli valtimotiehyt jää syntymän jälkeen pitkittyneesti auki, muuttaa se keskosen verenkiertoa siten, että osa aortan verenkiertoa ohjautuu keuhkoverenkiertoon vaikeuttaen pienen keskosen toipumista. Nykyhoitoina käytetään joko lääkkeellistä (ibuprofeeni tai indometasiini) tai kirurgista sulkua. Lääkkeellinen hoito ei ole kovin tehokas kaikista epäkypsimmillä keskosilla ja hoitoihin liittyy vakaviakin sivuvaikutuksia. Väitöskirjassa tutkittiin parasetamolilääkityksen vaikutusta hyvin pienen keskosen avoimen valtimotiehyen sulkeutumiseen. Epidemiologisessa osiossa tutkittiin nykyhoitojen sivuvaikutuksia hyvin pienillä keskosilla. Osatyössä I todettiin, että avoimen valtimotiehyen hoidon tarve väheni merkittävästi sen jälkeen kun parasetamoli oli otettu käyttöön kivun hoidossa vastasyntyneiden teholla. Osatyö II oli satunnaistettu ja sokkoutettu hoitotutkimus, jossa todettiin alkuperäishavaintona, että parasetamolilla on biologinen vaikutus keskosen avoimeen valtimotiehyeen. Parasetamolia saaneilla keskosilla valtimotiehyt sulkeutui aikaisemmin kuin verrokeilla. Hoidolla ei todettu merkittäviä sivuvaikutuksia. Osatöissä III ja IV tutkittiin kaikkien vuosina 2005−2013 Suomessa syntyneiden hyvin pienten keskosten avoimen valtimotiehyen hoitoja. Lääkehoidolla (ibuprofeeni ja indometasiini) ja kirurgisella hoidolla todettiin olevan yhteys keskosen kroonisen keuhkotaudin (BPD) vaikeimpaan muotoon. Kirurgisella hoidolla oli yhteys keskosen vaikeaan suolitulehdukseen ja vaikeaan aivoverenvuotoon. Kuolleisuuden riskin ei kuitenkaan todettu lisääntyneen valtimotiehyen hoitoihin liittyen
Pillay, Vashini. "Short-term treatment outcomes of children starting ART in the ICU, general medical wards and outpatient HIV clinics at Red Cross War Memorial Children’s Hospital (RCWMCH): a retrospective cohort study." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/13245.
Повний текст джерелаShort-term treatment outcomes of children starting ART in the ICU, general medical wards and outpatient HIV clinics at Red Cross War Memorial Children’s Hospital (RCWMCH): A Retrospective Cohort Study. Background: Antiretroviral therapy (ART) has proven to decrease morbidity and mortality in HIV-infected children and improve immunologic, virologic and clinical outcomes. As clinical management policies evolved, an emphasis on early infant testing was adopted resulting in an increasing number of children being diagnosed and commenced on therapy before the onset of severe disease progression. However, a fair proportion still remain untested and subsequently present to hospital with advanced immunosuppression and severe disease. Since the advent of the 2013 national Standard Treatment Guidelines which encourage expedited initiation of ART within 7 days of HIV diagnosis in all children under the age of 12 months and in those with advanced immunosuppression, it is likely that many HIV-infected children are being initiated on ART during hospitalisation in South Africa. No local published data on these outcomes exist. We assessed the short-term outcomes of children initiated on ART in the intensive care unit (ICU), general medical wards (GMWs) and outpatient HIV clinics (OHCs) at RCWMCH. Methods: Structured Literature Review A Pubmed search looking at outcomes of treatment naïve HIV-infected children and adolescents up to 19 years of age living in South Africa commenced on 1st line ART regimens in accordance to the national guidelines presiding at the time, over a 10 year period was performed. This served to identify gaps in knowledge around paediatric ART in a South African context warranting further research. Retrospective Cohort Study We conducted a retrospective cohort study of HIV-infected children <13 years of age, commenced on first line ART between January 2008 and December 2011 at RCWMCH. Outcome measures included death, virologic suppression and changes in CD4 count and percentage. Kaplan-Meier estimates, multivariate Cox proportional hazard ratios and logistic regression were used to estimate outcomes 6 months after ART initiation. Results: Structured Literature Review This review identified several knowledge gaps. One of these gaps, the treatment outcomes of children started on ART at different service levels within tertiary health care settings was addressed in our retrospective cohort study and described in section C of this dissertation Retrospective Cohort Study Seven hundred and forty-nine children were included: 106 were commenced on ART in the ICU, 509 in the GMWs and 127 in the OHCs. Four hundred and ninety-two (65.7%) children were <12 months old. Children in the ICU and GMW cohorts were significantly younger than the OHC cohort (median ages: 3 and 5 months respectively vs. 22 months) and had lower WAZ scores (-2.48 and -2.33 respectively vs -1.14). Three hundred and eighty-five (51.4%) children qualified for rapid ART initiation within 7 days of HIV diagnosis or hospitalisation, based on CD4 criteria in the 2013 national Standard Treatment Guidelines. Overall mortality was 6.4% (CI: 4.9 - 8.4). Mortality was significantly higher in the ICU cohort i.e. 14 (13.2%) deaths compared to 28 (5.5%) and 5 (3.9%) deaths in the GMWs and OHCs cohorts, logrank p=0.004. Predictors of mortality included being moderately underweight HR 2.4 (CI: 1.1 – 5.2; p=0.02), severely underweight HR 3.2 (CI: 1.6 – 6.5; p=0.001), absence of caregiver counselling sessions HR 2.9 (CI: 1.4 – 6.0; p=0.005) and ART initiation in ICU HR 2.6 (CI: 1.4 – 4.9; p=0.003). Conclusion: The findings of our retrospective cohort study serve as a basis for understanding the implications of ART initiation in children during hospitalisation.
Bao, Yan [Verfasser], and Gerhard [Akademischer Betreuer] Jahn. "Dynamic and kinetic of HCV viral load under the new treatment with direct acting antivirals in a patient cohort of the University Clinic Tuebingen 2014-2017 / Yan Bao ; Betreuer: Gerhard Jahn." Tübingen : Universitätsbibliothek Tübingen, 2018. http://d-nb.info/1198972793/34.
Повний текст джерелаAbdel-Gadir, A. "B cell lipid presentation controls the homeostasis and immunoregulatory function of iNKT cells in healthy controls but not in SLE patients : analysis of a cohort of patients before and after rituximab treatment." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1322445/.
Повний текст джерелаAtanga, Pascal Nji [Verfasser], and Michael [Akademischer Betreuer] Hölscher. "Retention-in-care, adherence and treatment outcomes in a cohort of HIVpositive pregnant and breastfeeding women enrolled in a pilot project implementing “Option B+” in Cameroon / Pascal Nji Atanga ; Betreuer: Michael Hölscher." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2017. http://d-nb.info/113104035X/34.
Повний текст джерелаEze, Chukwuka [Verfasser], and Claus [Akademischer Betreuer] Belka. "Treatment response and prophylactic cranial irradiation are prognostic factors in a real-life limited-disease small-cell lung cancer patient cohort comprehensively staged with cranial magnetic resonance imaging / Chukwuka Eze ; Betreuer: Claus Belka." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2019. http://d-nb.info/1178323811/34.
Повний текст джерелаSpivey, Justin, Heather Sirek, Robert Wood, Kalpit Devani, Billy Brooks, and Jonathan Moorman. "Retrospective Cohort Study of the Efficacy of Azithromycin Vs. Doxycycline as Part of Combination Therapy in Non-Intensive Care Unit Veterans Hospitalized with Community-Acquired Pneumonia." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/3177.
Повний текст джерелаKrastinova, Evguenia. "Prise en charge du VIH au stade de la primo-infection." Thesis, Paris 11, 2015. http://www.theses.fr/2015PA11T013/document.
Повний текст джерелаIn France, since 2013, HIV treatment has been recommended for all HIV-infected patients independently of their CD4 count. However, when to start anti-retroviral (ARV) treatment is still an issue. This thesis aims to explore the therapeutic management of HIV at the stage of PHI in different aspects: 1) we explored how physicians in France have applied the evolving guidelines for ART initiation since 1996 2) the impact of a transient ARV treatment at PHI on immuno-virological response during 2nd treatment and 3) identification of new biomarkers prognostic of HIV progression.Most of the work presented in this thesis is based on data from the ongoing ANRS PRIMO cohort that enrolled more than 1 500 HIV infected patients enrolled at PHI since June 1996 in 94 French hospitals. All patients were antiretroviral therapy naive at baseline.The first part of the thesis analyzes the implementation of the recommendations of ARV treatment initiation between 1996 and 2010 by physicians in France, in two distinct situations: in the chronic HIV-1 infection and during primary HIV-1 infection. We have shown that the recommendations of ARV treatment initiation were widely followed. Nevertheless, there was inertia in guidelines application when changes in the recommendations took place. The time to treatment when CD4 cell counts reach the threshold to treat can be improved. 96% of the patients initiated ART when they had a CD4 cell count below the threshold to treat at entry, while treatment was less timely initiated when the CD4 threshold was reached during active follow-up (78%, p <0.001).We identified as risk factors for not being timely treated in chronic phase despite an indication for treatment: a viral load <5log (versus> 5), a lower education level and poor living conditions.The impact of ARV interruption after a first treatment initiated at PHI on the CD4 count restoration after resumption was explored by modeling the evolution of CD4 cells with linear mixed effects models with random intercept and slope. Patients who initiated ARV treatment during the chronic phase had a better immune response than patients who initiated a second course treatment after a transient ART at PHI: at 36 months, the gains in √CD4 cells / mm3 and CD4 percentage were significantly higher. However, this difference was clinically modest and further research on treatment interruptions seeking to induce post-treatment controllers is still an issue but only in research settings and under close medical surveillance. After an overview of the complex mechanisms of activation / inflammation of the immune system during primary infection we sought to identify new predictive biomarkers of disease progression. The level of sCD14 (marker of monocyte/macrophage activation and an indirect marker of microbial translocation) at the time of PHI was identified as predictive marker of CD4 decline and of risk of cardio-vascular mortality. In conclusion, although considerable progress has been made in the management of HIV, further studies are needed to optimize and adapt the treatment to the patient profile in the early stages of HIV infection
Novelli, Sophie. "Pronostic à long terme des personnes diagnostiquées en primo-infection VIH-1." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASS079.
Повний текст джерелаThis thesis focused on the long-term follow-up of individuals diagnosed with primary HIV-1 infection and the impact of early antiretroviral therapy (ART) initiation, particularly on chronic inflammation, which has been linked to the development of severe co-morbidities in people aging with HIV. Data came from the French ANRS CO6 PRIMO cohort. First, we confirmed the benefit of immediate ART initiation during primary infection, as recommended by international guidelines, to enhance the immune recovery and achieve long-term reduction of HIV reservoir size. However, we did not observe any effect of ART initiation in primary infection versus deferred in chronic infection on the levels of inflammation, nor immune activation or residual viral replication, after nearly 7 years of effective ART. Moreover, compared to two non HIV infected control groups, with respectively low and high frequency of health risk behaviours, HIV participants under long-term suppressive ART showed increased levels of markers associated with the mono-macrophagic and lymphocytic components of inflammation and intestinal mucosal integrity, even after taking into account major non-HIV related cofactors of inflammation. Besides, women, who already had more favourable immunovirological characteristics than men in primary infection, showed a better virological and immunological response than men following ART initiation in primary infection. However, the clinical benefit of these immunological advantages remains to be determined.This work focused on immunovirological parameters and will be continued with a better characterization of the health status of people living with HIV in France on common health parameters, compared to the general population