Papers by Anne-Mette Lebech
Open Forum Infectious Diseases, Sep 1, 2018
Background. People living with HIV (PLWH) appear to be at increased risk of cardiovascular diseas... more Background. People living with HIV (PLWH) appear to be at increased risk of cardiovascular disease (CVD), and this is possibly more pronounced in women living with HIV (WLWH). In the general population, men are more likely to develop obstructive coronary artery disease (CAD), and women often present with a nonobstructive pattern with cardiac microvascular dysfunction. We investigated cardiac microvascular function in men and women living with HIV and tested for association with cytomegalovirus (CMV) immunoglobulin G (IgG), as this has been associated with CVD in PLWH. Methods. In a cross-sectional study, 94 PLWH on antiretroviral therapy were scanned with 82 Rb positron emission tomography/ computed tomography at rest and during adenosine-induced stress, which enables the quantification of the myocardial flow reserve (MFR). CMV IgG was measured in plasma. Results. WLWH had significantly lower MFR compared with men living with HIV (MLWH; P = .003), and >45% of the women had an MFR indicative of cardiac microvascular dysfunction, whereas this was only true for 24% of men (P = .03). CMV IgG concentrations were inversely associated with MFR among WLWH but not MLWH (P = .05 for interaction). Conclusions. In this first study comparing MFR in women and men living with HIV, we found that WLWH had significantly lower MFR than MLWH and 45% of the women had cardiac microvascular dysfunction despite younger age and lower cardiovascular risk. Furthermore, CMV IgG was inversely associated with MFR among women but not men. This calls for attention to CVD among young WLWH even with low cardiovascular risk.
BMC Research Notes, Sep 7, 2017
Objective: Mycoplasma genitalium (M. genitalium) is a sexually transmitted pathogen associated wi... more Objective: Mycoplasma genitalium (M. genitalium) is a sexually transmitted pathogen associated with urethritis, cervicitis, and pelvic inflammatory disease. Previous studies have shown a strong association between M. genitalium and HIV infection, therefore screening and treatment for M. genitalium has been suggested as part of HIV prevention strategies. The objective of this study was to determine the prevalence of M. genitalium in women living with HIV (WLWH) in Denmark, and to compare the result with data on symptoms from the lower abdomen, sexual habits and immune status. 234 women, recruited from Danish HIV centres as part of a larger observational study on aspects of living with HIV as a woman (the SHADE study), were included. Results: We tested cervical samples for M. genitalium by specific PCR. We found three samples positive (1.3%). The women were between 30 and 50 years old, all were of Asian origin, sexually active, and on antiretroviral treatment with supressed HIV RNA and CD4 count >350 cells/µL. None reported symptoms from the lower abdomen. The prevalence of M. genitalium infection in WLWH in Denmark is low, thus systematic screening for M. genitalium in this group does not seem relevant.
Hiv Medicine, Sep 4, 2018
Coinfection with cytomegalovirus (CMV) may be involved in cardiovascular disease in HIVinfected p... more Coinfection with cytomegalovirus (CMV) may be involved in cardiovascular disease in HIVinfected patients. We found that higher level of CMV immunoglobulin G (IgG) was independently associated with an increased risk of coronary artery calcium and higher intima-media thickness in HIV-infected patients but not in healthy controls after adjustment for other cardiovascular risk factors and levels of herpes viridae IgG.
International Journal of Infectious Diseases, Apr 1, 2021
INTRODUCTION Outbreaks of invasive meningococcal disease (IMD) among men who have sex with men (M... more INTRODUCTION Outbreaks of invasive meningococcal disease (IMD) among men who have sex with men (MSM) caused by a hypervirulent, non-encapsulated Neisseria meningitidis (Nm) clone belonging to genogroup C have been described. We aimed to determine the oral and anal carriage rates and genogroups of Nm among MSM living with HIV. METHODS Sexually active MSM living with HIV were included. A questionnaire, an oral wash sample and an anal swab were collected at baseline and 12 months follow-up. Identification of Nm and genogrouping was performed using real-time polymerase chain reaction analysis. RESULTS Among 82 MSM, the Nm carriage rate was 31.7 % (95 % CI 21.9-42.9) at baseline. The oral carriage rate was 24.4 % (95 % CI 15.6-35.1) and the anal rate was 11.0 % (95 % CI 5.1-19.8). Non-groupable Nm were most prevalent followed by genogroup B and genogroup Y. Rates were similar at follow-up. CONCLUSION Strains of Nm were detected in both oral washes and anal samples in our study. Our results suggest that Nm may be transmitted sexually among MSM. Non-groupable Nm were predominant in our population and no genogroup C Nm were detected.
Journal of Acquired Immune Deficiency Syndromes, Aug 1, 2016
Hiv Medicine, May 24, 2017
We aimed to assess mode of delivery and predictors of emergency caesarean section (EmCS) in women... more We aimed to assess mode of delivery and predictors of emergency caesarean section (EmCS) in women living with HIV (WLWH) in a matched-pair setting with women from the general population (WGP) in Denmark. Further, we analysed birth plan in WLWH. Methods All WLWH giving birth to live-born children from 2002 to 2014 were included in the study. Data were retrieved from medical records and national registries. WLWH were matched 1:5 by age, birth year, parity and ethnicity to WGP. Multivariate logistic regression was used to estimate predictors. Results We included 389 WLWH and 1945 WGP in the study. At delivery, all WLWH were on antiretroviral therapy and 85.6% had HIV RNA <40 HIV-1 RNA copies/mL. Mean age was 32.7 years [95% confidence interval (CI) 32.1-33.2 years]. Mode of delivery differed significantly between WLWH and WGP [vaginal delivery, 33.4% versus 73.3%, respectively; elective caesarean section (ECS), 40.6% versus 9.7%, respectively; EmCS, 26% versus 17%, respectively; P < 0.0001]. Age > 40 years [adjusted odds ratio (aOR) 2.3; 95% CI 1.5-3.5], asphyxia (aOR 3.2; 95% CI 2.4-4.1), delivery during the evening and at night [aOR 2.3 (95% CI 1.7-3.0) and aOR 2.0 (95% CI 1.5-2.7), respectively], preterm delivery (aOR 3.8; 95% CI 2.6-5.6) and premature rupture of membranes (aOR 3.0; 95% CI 2.1-4.4) predicted EmCS. WLWH had a higher risk of EmCS compared with WGP [2002-2006, aOR 2.0 (95% CI 1.2-3.3); 2007-2008, aOR 2.9 (95% CI 1.4-5.9); 2009-2014, aOR 2.6 (95% CI 1.7-3.9)]. After 2007, more than half of WLWH planned to deliver vaginally. Prior caesarean section was associated with ECS (aOR 11.0; 95% CI 4.5-26.8). No mother-to-child transmission occurred. Conclusions Increasing numbers of WLWH deliver vaginally. Despite virological suppression, more WLWH plan and deliver by ECS than WGP. WLWH had a twofold higher risk of EmCS compared with WGP.
Hiv Medicine, Oct 11, 2019
We aimed to compare risk factors for adverse pregnancy outcomes in women living with HIV (WLWH) w... more We aimed to compare risk factors for adverse pregnancy outcomes in women living with HIV (WLWH) with women of the general population (WGP) in Denmark. Further, we estimated risk of pregnancy-or birth-related complications. Methods: A retrospective cohort study including all WLWH who delivered a live-born child from 2002-2014 and controls, matched by origin, age, year and parity. We compared risk factors during pregnancy and estimated risk of pregnancy-and birth-related complications using multivariate logistic regression. Results: A total of 2,334 pregnancies in 304 WLWH and 1,945 WGP were included. WLWH had more risk factors present during pregnancy: previous caesarean section (CS) (24.7% vs 16.3%; p=0.0001), smoking (14.2% vs 7.5%; p=0.0001) and previous perinatal/neonatal death (2.3% vs 0.9%; p=0.03). We found no difference between groups regarding gestational diabetes, hypertensive disorders, low birth weights or premature delivery. More children of WLWH had intrauterine-growth-retardation (IUGR) (aOR 1.9 95%CI; 1.1-3.2; p=0.02). Median gestational age and birth weights were lower in children born to WLWH. WLWH had higher risk of emergency CS (EmCS) (aOR 1.6 95%CI; 1.2-2.1; p=0.0005) and postpartum haemorrhage (aOR 1.4 95%CI; 1.0-1.9; p=0.02) but not infection, amniotomy, failure to progress, low APGAR scores or signs of asphyxia. Conclusion: WLWH had more risk factors present during pregnancy, similar risk of most pregnancyand birth-related complications but a higher risk of postpartum haemorrhage and EmCS than WGP. Children born by WLWH had lower median birth weights and gestational age and were at higher risk of IUGR.
Medicine, Oct 1, 2015
Studies have found HIV-infected patients to be at increased risk of myocardial infarction, which ... more Studies have found HIV-infected patients to be at increased risk of myocardial infarction, which may be caused by coronary microvascular dysfunction. For the first time among HIV-infected patients, we assessed the myocardial flow reserve (MFR) by Rubidium-82 (82 Rb) positron emission tomography (PET), which can quantify the coronary microvascular function. MFR has proved highly predictive of future coronary artery disease and cardiovascular events in the general population. In a prospective cross-sectional study, HIV-infected patients all receiving antiretroviral therapy (ART) with full viral suppression and HIV-uninfected controls were scanned using 82 Rb PET/computed tomography at rest and adenosine-induced stress, thereby obtaining the MFR (stress flow/rest flow), stratified into low 1.5, borderline >1.5 to 2.0, or normal >2.0. Fifty-six HIV-infected patients and 25 controls were included. The HIV-infected patients had a mean age of 53 years (range 37-68 years) with 23% active smokers. The controls had a mean age of 52 years (range 36-68 years) and 26% active smokers. In the HIV-infected group 73% had a normal MFR, 17% borderline, and 10% low values of MFR. Among controls these values were 71%, 19%, and 10%, respectively (P ¼ 0.99). However, the HIV-infected group had lower values of stress myocardial blood flow (MBF) (2.63 AE 0.09 mL/g/min vs 2.99 AE 0.14 mL/g/min; P ¼ 0.03). We found no evidence of decreased MFR as assessed by 82 Rb PET among HIV-infected patients on stable ART with full viral suppression compared with HIV-uninfected controls. We did notice a decreased MBF during stress. (Medicine 94(43):e1886) Abbreviations: 13 NH 3 = 13 N-ammonia, 82 Rb PET = 82 Rubidium positron emission tomography, ABC = abacavir, ART = antiretroviral therapy, CACS = coronary artery calcium score, CAD = coronary artery disease, CT = computed tomography, LVEF = left ventricular ejection fraction, MBF = myocardial blood flow, MFR = myocardial flow reserve, MPI = myocardial perfusion imaging, PI = protease inhibitor, RPP = rate pressure product.
Clinical Physiology and Functional Imaging, Mar 11, 2012
To investigate the development of lung function in HIV-infected patients. In a prospective cohort... more To investigate the development of lung function in HIV-infected patients. In a prospective cohort study, 88 HIV-infected patients had a lung function test performed and 63 patients (72%) had their LFT repeated with a median follow-up period of 4.4 years. Forty-eight per cent were smokers, and at the re-examination, 97% were on combination antiretroviral therapy. Carbon monoxide diffusion capacity was reduced and decreased over time in both smokers and non-smokers. Alveolar volume decreased and forced vital capacity increased similarly in both smokers and non-smokers. No changes were observed in forced expiratory volume or peak flow, but smokers had reduced values compared with those of the non-smokers at both examinations. FEV1/FVC was reduced especially in smokers and declined in both smokers and non-smokers. Carbon monoxide diffusion capacity is reduced in HIV-infected patients and seems to decline over time. Additionally, signs of obstructive lung disease are present in HIV-infected patients and seem to increase over time, although only modestly.
Future Virology, Apr 1, 2012
With the progressive increase in life expectancy of HIV-positive patient, thanks to "highly activ... more With the progressive increase in life expectancy of HIV-positive patient, thanks to "highly active antiretroviral therapy" (HAART), new comorbidities, and especially cardiovascular diseases (CVDs) are emerging as an important concern. An increased risk of coronary artery disease, often in a younger age, has been observed in this population. The underlying pathophysiology is complex and partially still unclear, with the interaction of viral infectionand systemic inflammation-antiretroviral therapy and traditional risk factors. After an accurate risk stratification, primary prevention should balance the optimal HAART to suppress the virus-avoiding side-effects-the intervention on lifestyle and the treatment of traditional risk factors (hypertension, dyslipidemia, diabetes). Also the management after a cardiovascular event is challenging: revascularization strategiesboth percutaneous and surgicalare valuable options, keeping in mind the higher rates of recurrent events, and caution is essential to avoid drug-drug interactions. Large evidence-based data on HIV-infected patients are still lacking, and recommendations often follow those of general population. Therefore we performed a comprehensive evaluation of the literature to analyze the current knowledge on CVD's prevalence, prevention and treatment in HIV-infected patients. 14 Crothers K, Griffith TA, McGinnis KA, Rodriguez-Barradas MC, Leaf DA, Weissman S et al, The impact of cigarette smoking on mortality, quality of life, and comorbid illness among HIV-positive veterans. J
Hiv Medicine, Jul 9, 2018
Smoking is a major contributor to mortality and morbidity in HIV-positive individuals. Our primar... more Smoking is a major contributor to mortality and morbidity in HIV-positive individuals. Our primary objective was to evaluate the association between smoking status determined by plasma cotinine (P-cotinine) concentration and inflammatory and endothelial biomarkers in HIV-positive versus HIV-negative individuals. Methods We studied eight inflammatory/endothelial biomarkers [high-sensitivity C-reactive protein (hsCRP), E-selectin, soluble vascular cell adhesion molecule 1 (sVCAM-1), soluble intercellular adhesion molecule 1 (sICAM-1), matrix metallopeptidase 9 (MMP-9), myeloperoxidase (MPO), tissue type plasminogen activator inhibitor 1 (tPAI) and endothelin] in 105 HIV-positive individuals and 105 HIV-negative individuals matched on age, sex and self-reported smoking status. Smoking status was determined using P-cotinine (a concentration > 14 ng/mL was defined as demonstrating exposure to smoke). We used linear regression models to (1) examine the association between smoking status and inflammatory/endothelial biomarkers in HIV-positive compared with HIVnegative individuals, and (2) to determine whether there was evidence to suggest that the impact of smoking status on the biomarkers differed between HIV-positive and HIV-negative individuals. Results Of the eight biomarkers, smokers had increased hsCRP, sICAM-1 and MMP-9 concentrations irrespective of HIV status and increasing P-cotinine concentration was associated with increasing hsCRP concentration. We found no interaction between smoking and HIV status. HIV infection was associated with increased hsCRP, E-selectin, sVCAM-1, sICAM-1 and MMP-9 concentrations. Selfreported smoking status differed substantially from smoking status assessed with P-cotinine. Conclusions Several biomarkers were associated with smoking status and HIV status. However, our data do not indicate that the effects of smoking on the biomarkers differ between HIV-positive and HIVnegative individuals.
Infectious diseases, Jun 26, 2015
All numeric variables are presented as mean (standard deviation), unless otherwise indicated. CDC... more All numeric variables are presented as mean (standard deviation), unless otherwise indicated. CDC indicates Centers for Disease Control and Prevention; NNRTI, nonnucleoside reverse transcriptase inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; HDL, high-density lipoprotein; LDL, low-density lipoprotein.
American Heart Journal, Mar 1, 2004
Background Cardiac dysfunction has been reported in a substantial part of patients infected with ... more Background Cardiac dysfunction has been reported in a substantial part of patients infected with the human immunodeficiency virus (HIV). However, most studies are from a time before the introduction of highly active antiretroviral treatment (HAART), which has significantly reduced HIV-associated morbidity and mortality rates. Accordingly, the prevalence of HIV-associated cardiac dysfunction may also have changed. The aim of the study was to establish the prevalence of right-and left-sided cardiac dysfunction in a Danish HIV population, most of whom were undergoing HAART, with radionuclide ventriculography. Methods Ninety-five consecutive patients with HIV infection were included. Mean HIV duration was 104 months, and 84% of the patients received HAART. All patients underwent radionuclide ventriculography, and plasma levels of atrial natriuetic peptide (ANP), brain natriuetic peptide (BNP), and endothelin-1 (ET-1) were measured. Thirty age-and sex-matched healthy volunteer subjects were included to establish reference values of radionuclide measurements of left and right ventricular ejection fraction and of left ventricular volume. Results Of 95 patients with HIV, 1 (1%) had a reduced left ventricular ejection fraction and 6 (7%) had a reduced right ventricle ejection fraction (0.35-0.42) compared with reference values from the age-and sex-matched reference population. Patients with HIV and reduced cardiac function did not differ in the duration of HIV, CD4 count, CD4 nadir, or HIV RNA load. No correlations were found between reduced cardiac function and levels of the 3 peptides measured. Conclusions No major dysfunction of the left ventricle is present in a developed world HIV population. However, a small but significant part of this population has modestly reduced right-sided systolic function.
Journal of Cardiovascular Magnetic Resonance, 2009
Introduction: Prophylactic implantation of a cardioverter/ defibrillator (ICD) has been shown to ... more Introduction: Prophylactic implantation of a cardioverter/ defibrillator (ICD) has been shown to reduce mortality in patients with chronic myocardial infarction (CMI) and an increased risk for life threatening ventricular arrhythmia (VA). The use of ICDs in this large patient population is still limited by high costs and possible adverse events including inappropriate discharges and progression of heart failure. VA is related to infarct size and seems to be related to infarct morphology. Contrast enhanced cardiovascular magnetic resonance imaging (ceCMR) can detect and quantify myocardial fibrosis in the setting of CMI and might therefore be a valuable tool for a more accurate risk stratification in this setting. Hypothesis: ceCMR can identify the subgroup developing VA in patients with prophylactic ICD implantation following MADIT criteria. Methods: We prospectively enrolled 52 patients (49 males, age 69 ± 10 years) with CMI and clinical indication for ICD therapy following MADIT criteria. Prior to implantation (36 ± 78 days) patients were investigated on a 1.5 T clinical scanner (Siemens Avanto © , Germany) to assess left ventricular function (LVEF), LV end-diastolic volume (LVEDV) and LV mass (sequence parameters: GRE SSFP, matrix 256 × 192, short axis stack; full LV coverage, no gap; slice thickness 6 mm). For quantitative assessment of infarct morphology late gadolinium enhancement (LGE) was performed including measurement of total and relative infarct mass (related to LV mass) and the degree of transmurality (DT) as defined by the percentage of transmurality in each scar. (sequence parameters: inversion recovery gradient echo; matrix 256 × 148, imaging 10 min after 0.2 μg/kg gadolinium DTPA; slice orientation equal to SSFP). MRI images were analysed using dedicated software (MASS © , Medis, Netherlands). LGE was defined as myocardial areas with signal intensity above the average plus 5 SD of the remote myocardium. After implantation, patients were followed up including ICD readout after 3 and than every 6 months for a mean of 945 ± 344 days. ICD data were evaluated by an experienced electrophysiologist. Primary endpoint was the occurrence of an appropriate discharge (DC), antitachycard pacing (ATP) or death from cardiac cause. Results: The endpoint occurred in 10 patients (3 DC, 6 ATP, 1 death). These patients had a higher relative infarct mass (28 ± 7% vs. 22 ± 11%, p = 0.03) as well as high degree of transmurality (64 ± 22% vs. 44 ± 25%, p = 0.05). Their LVEF (29 ± 8% vs. 30 ± 4%, p = 0.75), LV mass (148 ± 29 g vs. 154 ± 42 g, p = 0.60), LVEDV (270 ± 133 ml vs. 275 ± 83 ml, p = 0.90) or total infarct mass (43 ± 19 g vs. 37 ± 21 g, p = 0.43) were however not significant from the group with no events. In a cox proportional hazards regression model including LVEF, LVEDV, LV mass, DT and age, only degree of transmurality and relative infarct mass emerged as independent predictors of the primary end point (p = 0.009). Conclusion: In CMI-patients fulfilling MADIT criteria ceCMR could show that the extent and transmurality of myocardial scarring are independent predictors for life threatening ventricular arrhythmia or death. This additional information could lead to more precise risk stratification and might reduce adverse events and cost of ICD therapy in this patient population. Larger trials are needed to confirm this finding.
Diagnostics, May 31, 2017
After the introduction of antiretroviral therapy (ART) the life expectancy of patients infected w... more After the introduction of antiretroviral therapy (ART) the life expectancy of patients infected with human immunodeficiency virus (HIV) is now approaching that of the general population and the importance of non-AIDS co-morbidities is increasing. Specifically, the risk of coronary artery disease (CAD) seems to be higher in HIV-infected patients and an accurate risk prediction of CAD is of high importance for optimal long term treatment. In this study, we assessed the correlation of the endoPAT, which is an office-based CVD screening tool with the myocardial perfusion reserve by 82-rubidium PET/CT. We measured the reactive hyperemia index, which is a measure of the endothelial responsiveness, by the use of an endoPAT device (Itamar Medical, Caesarea, Israel) in 48 ART treated HIV-infected patients with high CD 4 cell counts and viral suppression (HIV-RNA < 20 copies/mL), who had previously undergone measurement of the myocardial perfusion reserve by 82-rubidium PET/CT for study purposes. We found an inverse correlation between the reactive hyperemia index and the myocardial perfusion reserve which most likely indicates different vascular physiology. This study did not find evidence to suggest the immediate implementation of the reactive hyperemia index as a screening tool for early coronary artery disease in well-treated HIV-infected patients pending further validation in larger prospective studies.
BMC Infectious Diseases, Nov 26, 2016
Background: Modern combination antiretroviral therapy (cART) has improved survival for people liv... more Background: Modern combination antiretroviral therapy (cART) has improved survival for people living with HIV (PLWHIV). Non-AIDS comorbidities have replaced opportunistic infections as leading causes of mortality and morbidity, and are becoming a key health concern as this population continues to age. The aim of this study is to estimate the prevalence and incidence of non-AIDS comorbidity among PLWHIV in Denmark in the cART era and to determine risk factors contributing to the pathogenesis. The study primarily targets cardiovascular, respiratory, and hepatic non-AIDS comorbidity. Methods/design: The Copenhagen comorbidity in HIV-infection (COCOMO) study is an observational, longitudinal cohort study. The study was initiated in 2015 and recruitment is ongoing with the aim of including 1500 PLWHIV from the Copenhagen area. Follow-up examinations after 2 and 10 years are planned. Uninfected controls are derived from the Copenhagen General Population Study (CGPS), a cohort study including 100,000 uninfected participants from the same geographical region. Physiological and biological measures including blood pressure, ankle-brachial index, electrocardiogram, spirometry, exhaled nitric oxide, transient elastography of the liver, computed tomography (CT) angiography of the heart, unenhanced CT of the chest and upper abdomen, and a number of routine biochemical analysis are uniformly collected in participants from the COCOMO study and the CGPS. Plasma, serum, buffy coat, peripheral blood mononuclear cells (PBMC), urine, and stool samples are collected in a biobank for future studies. Data will be updated through periodical linking to national databases. Discussion: As life expectancy for PLWHIV improves, it is essential to study long-term impact of HIV and cART. We anticipate that findings from this cohort study will increase knowledge on non-AIDS comorbidity in PLWHIV and identify targets for future interventional trials. Recognizing the demographic, clinical and pathophysiological characteristics of comorbidity in PLWHIV may help inform development of new guidelines and enable us to move forward to a more personalized HIV care.
Circulation, Nov 25, 2014
Introduction: HIV-infected patients are at increased risk of myocardial infarction and arterial i... more Introduction: HIV-infected patients are at increased risk of myocardial infarction and arterial inflammation has been suggested as an explanation. Vascular inflammation can be assessed in vivo by 18F-fluorodeoxyglucose (FDG) PET. Hypothesis: Well-treated HIV-infected patients without known cardiovascular disease will have increased uptake of FDG in different arterial regions as compared to healthy controls. Methods: We prospectively included 26 HIV-infected patients on stable antiretroviral therapy and 25 healthy volunteers. All underwent whole-body PET/CT 3 hours after injection of FDG. FDG uptake was assessed (SUV) in the carotid arteries, the ascending, descending, and abdominal aorta. Carotid intima-media thickness was determined by ultrasound. Soluble biomarkers of endothelial dysfunction and inflammation were measured by ELISA. Known cardiovascular risk factors were recorded for all included. Results: The HIV-infected patients were on stable antiretroviral therapy with full viral suppression. The HIV-infected group was older (50 vs 41 yrs; p = 0.01), had higher blood pressure and total cholesterol, and accordingly a higher Framingham risk score. FDG uptake was similar in the two groups quantified as SUVmax (figure) in the carotid region (1.67 ± 0.04 vs. 1.67 ± 0.04, p = 0.98), the ascending aorta (1.84 ± 0.06 vs. 1.97 ± 0.06, p = 0.15), the descending aorta (1.89 ± 0.08 vs. 1.93 ± 0.08, p = 0.70), and the abdominal aorta (1.70 ± 0.06 vs. 1.65 ± 0.06, p = 0.56) even when adjusting for differences in risk profile. No significant correlations between SUV, carotid intima-media thickness, known cardiovascular risk factors and soluble biomarkers were found. Conclusions: We found no evidence of increased arterial inflammation among HIV-infected patients with full viral suppression compared to controls. This may challenge the idea of chronic inflammation as the cause of cardiovascular disease among optimally treated HIV-infected patients.
Journal of Clinical Virology, Aug 1, 2018
Background: Women living with HIV (WLWH) have elevated risk of human papillomavirus (HPV) related... more Background: Women living with HIV (WLWH) have elevated risk of human papillomavirus (HPV) related cancers. Objectives: To assess prevalence, distribution and concordance of cervical, oral, and anal HPV infection, and predictors of oral and anal HPV in WLWH in Denmark. 3 39.3%. Most frequent i) cervical, ii) oral and iii) anal hrHPV genotypes were i) hrHPV58 (8.4%), 52 (5.1%), 16 (5.1%) and 51 (5.1%); ii) 52 (1.4%) and iii) 51 (9.3%), 58 (8.9%), 16 (7.0%) and 18 (7.0%). Among present cervical, oral, and anal hrHPV genotypes, 6.7%, 12.5% and 17.9% were targeted by the 2-or 4-valent HPV vaccines, whereas 50.0%, 50.0% and 42.9% of hrHPV genotypes were covered by the 9-valent HPV vaccine. Anal HPV infection was predicted by cervical HPV infection (adjusted OR 4.47 (95%CI 2.25-8.89)). Conclusion: Cervical and anal HPV infection were highly prevalent in WLWH. Non-16/18 hrHPV genotypes were predominant at all anatomical sites. Almost half of all hrHPV infections at the three anatomical sites could have been prevented by childhood/adolescent vaccination with the 9valent HPV vaccine.
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Papers by Anne-Mette Lebech