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Juergen K. Rockstroh

Bio: Juergen K. Rockstroh is an academic researcher from University Hospital Bonn. The author has contributed to research in topics: Hepatitis C & Hepatitis C virus. The author has an hindex of 42, co-authored 250 publications receiving 9527 citations. Previous affiliations of Juergen K. Rockstroh include Hoffmann-La Roche & University of Bonn.


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Journal ArticleDOI
Daniel D Murray1, Kazuo Suzuki1, Matthew Law1, Jonel Trebicka2  +1486 moreInstitutions (9)
14 Oct 2015-PLOS ONE
TL;DR: No associations with mortality were found with any circulating miRNAs studied and these results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection.
Abstract: Introduction The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR-145 correlated with nadir CD4+ T cell count. Discussion No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection.

3,094 citations

Journal ArticleDOI
TL;DR: The simultaneous identification of cases outside areas where monkeypox has traditionally been endemic highlights the need for rapid identification and diagnosis of cases to contain further community spread.
Abstract: BACKGROUND Before April 2022, monkeypox virus infection in humans was seldom reported outside African regions where it is endemic. Currently, cases are occurring worldwide. Transmission, risk factors, clinical presentation, and outcomes of infection are poorly defined. METHODS We formed an international collaborative group of clinicians who contributed to an international case series to describe the presentation, clinical course, and outcomes of polymerase-chain-reaction-confirmed monkeypox virus infections. RESULTS We report 528 infections diagnosed between April 27 and June 24, 2022, at 43 sites in 16 countries. Overall, 98% of the persons with infection were gay or bisexual men, 75% were White, and 41% had human immunodeficiency virus infection; the median age was 38 years. Transmission was suspected to have occurred through sexual activity in 95% of the persons with infection. In this case series, 95% of the persons presented with a rash (with 64% having <10 lesions), 73% had anogenital lesions, and 41% had mucosal lesions (with 54 having a single genital lesion). Common systemic features preceding the rash included fever (62%), lethargy (41%), myalgia (31%), and headache (27%); lymphadenopathy was also common (reported in 56%). Concomitant sexually transmitted infections were reported in 109 of 377 persons (29%) who were tested. Among the 23 persons with a clear exposure history, the median incubation period was 7 days (range, 3 to 20). Monkeypox virus DNA was detected in 29 of the 32 persons in whom seminal fluid was analyzed. Antiviral treatment was given to 5% of the persons overall, and 70 (13%) were hospitalized; the reasons for hospitalization were pain management, mostly for severe anorectal pain (21 persons); soft-tissue superinfection (18); pharyngitis limiting oral intake (5); eye lesions (2); acute kidney injury (2); myocarditis (2); and infection-control purposes (13). No deaths were reported. CONCLUSIONS In this case series, monkeypox manifested with a variety of dermatologic and systemic clinical findings. The simultaneous identification of cases outside areas where monkeypox has traditionally been endemic highlights the need for rapid identification and diagnosis of cases to contain further community spread.

779 citations

Journal ArticleDOI
31 May 2007-AIDS
TL;DR: Eleven areas have been identified in which new recommendations are particu-larly needed: management of patients with persistently normalaminotransferasesliverrosis assessment: when and how predictors of response to anti-HCV therapy in coinfected patients, and interactions between HCV medications and antiretroviraldrugs.
Abstract: Chronic hepatitis C (HCV) infection is currently oneof the most clinically relevant comorbidities in theHIV population; overall, it affects one third of HIV-positive individuals [1]. Progression to end-stage liverdisease occurs faster in coinfected patients [2–4] anddecompensated cirrhosis is one of the main causes ofhospitalization and death in this population [5–8].However, the risk of hepatotoxicity using antiretroviraldrugs is increased in subjects with underlying HCVinfection [9,10]. Therefore, the optimal managementof chronic HCV in HIV-positive patients is currentlyapriority.Several guidelines for caring for HCV infection in HIV-positive individuals have been released [11–15]. Becausenew and relevant information has recently appeared, it isconvenient to update them. Eleven areas have beenidentified in which new recommendations are particu-larly needed:management of patients with persistently normalaminotransferasesliver fibrosis assessment: when and howpredictors of response to anti-HCV therapy in coinfectedpatientsoptimal dosages of pegylated interferon (pegIFN) andribavirin (RBV)optimal duration of anti-HCV therapytreatment of non-responders and/or relapserscare of patients with end-stage liver diseasetreatment of acute HCV infection in HIV-infectedindividualsmanagement of patients with multiple hepatitis virusesinteractions between HCV medications and antiretroviraldrugshepatotoxicity of antiretroviral drugs.

345 citations

Journal ArticleDOI
TL;DR: It is demonstrated that a subset of CD8+ T cell epitopes within HIV-1 are consistently targeted early after infection, while other epitopes subsequently targeted through the same HLA class I alleles are rarely recognized.
Abstract: Background Very little is known about the immunodominance patterns of HIV-1-specific T cell responses during primary HIV-1 infection and the reasons for human lymphocyte antigen (HLA) modulation of disease progression.

321 citations

Journal ArticleDOI
02 Jan 2008-AIDS
TL;DR: A universal standard for defining liver injury is proposed to enable comparisons between future studies and novel mechanisms for hepatotoxicity are discussed along with preventive measures to avoid the onset of ARLI.
Abstract: Antiretroviral drug-related liver injury (ARLI) is a common cause of morbidity, mortality and treatment discontinuation in HIV-infected patients [1]. Prevention and management of ARLI have emerged as major issues among HIV-infected patients in the era of HAART [2]. Virtually every licensed antiretroviral medication has been associated with liver enzyme elevations, although certain drugs may cause liver injury more frequently than others. In addition, certain comorbidities, such as chronic hepatitis B (HBV) or hepatitis C (HCV) infection, may predispose patients to ARLI [3]. Several major mechanisms of ARLI have been described, including metabolic host-mediated injury, hypersensitivity reactions, mitochondrial toxicity, and immune reconstitution phenomena. The management of ARLI should be based on its clinical severity and underlying pathogenic mechanism. Herein, we propose use of a universal standard for defining liver injury to enable comparisons between future studies. Novel mechanisms for hepatotoxicity are also discussed along with preventive measures to avoid the onset of ARLI.

219 citations


Cited by
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TL;DR: This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year, to survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks.

8,730 citations

Journal ArticleDOI
TL;DR: Recent progress on drug metabolism activity profiles, interindividual variability and regulation of expression, and the functional and clinical impact of genetic variation in drug metabolizing P450s are reviewed.

2,832 citations

Journal ArticleDOI
TL;DR: The 2009 update of the American Association for the Study of Liver Diseases (AASLD) Practice Guidelines for Management of Chronic Hepatitis B is now posted online at www.aasld.org, and the recommendation for first-line oral antiviral medications has been changed to tenofovir or entecavir, and adefovir has been moved to second-line Oral antiviral medication.

2,696 citations

Journal ArticleDOI
TL;DR: The optimal management of patients with acute and chronic HCV infections in 2018 and onwards is described, as well as developments in diagnostic procedures and improvements in therapy and prevention.

2,491 citations

Journal ArticleDOI
06 Aug 2008-JAMA
TL;DR: This report provides guidelines for when to initiate antiretroviral therapy, selection of appropriate initial regimens, patient monitoring, when to change therapy, and what regimens to use when changing.
Abstract: Context New trial data and drug regimens that have become available in the last 2 years warrant an update to guidelines for antiretroviral therapy (ART) in human immunodeficiency virus (HIV)–infected adults in resource-rich settings. Objective To provide current recommendations for the treatment of adult HIV infection with ART and use of laboratory-monitoring tools. Guidelines include when to start therapy and with what drugs, monitoring for response and toxic effects, special considerations in therapy, and managing antiretroviral failure. Data Sources, Study Selection, and Data Extraction Data that had been published or presented in abstract form at scientific conferences in the past 2 years were systematically searched and reviewed by an International Antiviral Society–USA panel. The panel reviewed available evidence and formed recommendations by full panel consensus. Data Synthesis Treatment is recommended for all adults with HIV infection; the strength of the recommendation and the quality of the evidence increase with decreasing CD4 cell count and the presence of certain concurrent conditions. Recommended initial regimens include 2 nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine or abacavir/lamivudine) plus a nonnucleoside reverse transcriptase inhibitor (efavirenz), a ritonavir-boosted protease inhibitor (atazanavir or darunavir), or an integrase strand transfer inhibitor (raltegravir). Alternatives in each class are recommended for patients with or at risk of certain concurrent conditions. CD4 cell count and HIV-1 RNA level should be monitored, as should engagement in care, ART adherence, HIV drug resistance, and quality-of-care indicators. Reasons for regimen switching include virologic, immunologic, or clinical failure and drug toxicity or intolerance. Confirmed treatment failure should be addressed promptly and multiple factors considered. Conclusion New recommendations for HIV patient care include offering ART to all patients regardless of CD4 cell count, changes in therapeutic options, and modifications in the timing and choice of ART in the setting of opportunistic illnesses such as cryptococcal disease and tuberculosis.

2,357 citations