Showing papers by "Anders Sönnerborg published in 2004"
TL;DR: It is concluded that reduction of memory B lymphocytes in HIV-1 infection correlates with defective humoral immunity and that hyperactivated naive B cells may represent the source of abnormal IgG production in HIV -1 infection.
311 citations
Katholieke Universiteit Leuven1, Karolinska Institutet2, GlaxoSmithKline3, University of Bergen4, Utrecht University5, University of Paris6, Catholic University of the Sacred Heart7, Goethe University Frankfurt8, Vertex Pharmaceuticals9, University of Copenhagen10, University College Dublin11, National and Kapodistrian University of Athens12, Abbott Laboratories13, George Washington University14, Hoffmann-La Roche15, Statens Serum Institut16, University of Zurich17, Istituto Superiore di Sanità18, University of Rome Tor Vergata19, University College London20, University of Barcelona21, National Institute for Health and Welfare22, Sheba Medical Center23, Centre Hospitalier de Luxembourg24, Celera Corporation25, Carlos III Health Institute26, Bayer Corporation27, University of Geneva28
TL;DR: The European HIV Drug Resistance Panel was established to make recommendations to clinicians and virologists on this topic and to propose quality control measures as mentioned in this paper, and the panel recommended resistance testing for the following indications: i) drug-naive patients with acute or recent infection; ii) therapy failure, including suboptimal treatment response, when treatment change is considered; iii) pregnant HIV-1-infected women and paediatric patients with detectable viral load when treatment initiation or change is considering; and iv) genotype source patient when post-exposure prophylaxis is considered
Abstract: In most European countries, HIV drug resistance testing has become a routine clinical tool. However, its practical implementation in a clinical context is demanding. The European HIV Drug Resistance Panel was established to make recommendations to clinicians and virologists on this topic and to propose quality control measures. The panel recommends resistance testing for the following indications: i) drug-naive patients with acute or recent infection; ii) therapy failure, including suboptimal treatment response, when treatment change is considered; iii) pregnant HIV-1-infected women and paediatric patients with detectable viral load when treatment initiation or change is considered; and iv) genotype source patient when post-exposure prophylaxis is considered. In addition, for drug-naive patients with chronic infection in whom treatment is to be started, the panel suggests that resistance testing should be strongly considered and recommends testing the earliest sample for drug resistance if suspicion of resistance is high or prevalence of resistance in this population exceeds 10%. The panel does not favour genotyping over phenotype, however it is anticipated that genotyping will be used more often because of its greater accessibility, lower cost and faster turnaround time. For the interpretation of resistance data, clinically validated systems should be used to the greatest extent possible. It is mandatory that laboratories performing HIV resistance tests take regular part in quality assurance programs. Similarly, it is necessary that HIV clinicians and virologists take part in continuous education and meet regularly to discuss problematic clinical cases. Indeed, resistance test results should be used in the context of all other clinically relevant information for predicting therapy response. The panel also encourages the timely collection of epidemiological information to estimate the impact of transmission of resistant HIV and the prevalence of HIV-1 non-B subtypes in the different European countries.
166 citations
TL;DR: It is concluded that efavirenz plasma concentration measurement gives reproducible results predictive of primary treatment failure, and a lower bound for the therapeutic level of 7 μmol/L is proposed, and data from other authors suggests that an upper level of 13 μ Mol/L may be applied.
Abstract: Efavirenz is a drug subject to extensive metabolism, mainly by the cytochrome P-450 isoenzyme CYP2B6, known to exhibit extensive interindividual variability. The aim of the present study was 2-fold: to investigate the relationship between plasma concentration and clinical effects of efavirenz and to investigate the extent of the inter- and intraindividual variability of the plasma concentration measurements. From an open clinic, 68 HIV-positive patients on efavirenz-containing treatment were recruited. From each patient 1 to 5 samples were collected; 43 had more than 1 sample taken. Most samples were taken 10-24 hours after the latest dose. Efavirenz was analyzed by high-performance liquid chromatography with UV detection. The data were analyzed by the variance component model analysis of variance. Efavirenz concentrations were reproducible, and intraindividual variability constituted only 16% of the total variance. Thus, 84% of the variance was attributed to interindividual variability. The incidence of primary treatment failure was related to low plasma concentrations with a geometric mean concentration of 6.1 micromol/L compared with 8.7 micromol/L in those responding to therapy (P < 0.05). If a cutoff of 7 micromol/L is used, 10 of 13 failing to respond were below this level compared with 15 of 45 in those responding. It is concluded that efavirenz plasma concentration measurement gives reproducible results predictive of primary treatment failure. A lower bound for the therapeutic level of 7 micromol/L is proposed, and data from other authors suggests that an upper level of 13 micromol/L may be applied.
126 citations
TL;DR: Effector CD8 T-cell subsets distinguished by lowered CD7 expression expand in a manner that correlates with the magnitude of HIV-1, EBV, and CMV antigenic challenge and contract in response to successful antiretroviral treatment.
28 citations