Luba Tau

Tel Aviv University

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Amos Adler

Tel Aviv Sourasky Medical Center

Tomer Ziv‐Baran

Tel Aviv University

Ronen Ben‐Ami

Tel Aviv Sourasky Medical Center

David Shasha

Tel Aviv Sourasky Medical Center

Justyna D. Kowalska

Medical University of Warsaw

Israel Nissan

Israel Ministry of Health

Efrat Rorman

Israel Ministry of Health

Arjan Harxhi

University of Tirana

Gil Bornstein

Tel Aviv Sourasky Medical Center

Zeev Dveyrin

Israel Ministry of Health

Cooperative Institutions

University of Copenhagen

Rigshospitalet

Tel Aviv University

University College London

Tel Aviv Sourasky Medical Center

Odense University Hospital

Centre of Excellence for Health, Immunity and Infections

Poznan University of Medical Sciences

Hebrew University of Jerusalem

Fundació Lluita contra les Infeccions

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Prevalence and Outcomes for Heavily Treatment-Experienced Individuals Living With Human Immunodeficiency Virus in a European Cohort

JAIDS Journal of Acquired Immune Deficiency Syndromes (2021)

Annegret Pelchen‐Matthews Álvaro H. Borges Joanne Reekie Line Dahlerup Rasmussen Lothar Wiese

Although antiretroviral treatments have improved survival of persons living with HIV, their long-term use may limit available drug options. We estimated the prevalence of heavily treatment-experienced (HTE) status and the potential clinical consequences of becoming HTE.EuroSIDA, a European multicenter prospective cohort study.A composite definition for HTE was developed, based on estimates of antiretroviral resistance and prior exposure to specific antiretroviral regimens. Risks of progressing to clinical outcomes were assessed by Poisson regression, comparing every HTE individual with 3 randomly selected controls who never became HTE.Of 15,570 individuals under follow-up in 2010-2016, 1617 (10.4%, 95% CI: 9.9% to 10.9%) were classified as HTE. 1093 individuals became HTE during prospective follow-up (HTE incidence rate 1.76, CI: 1.66 to 1.87 per 100 person-years of follow-up). The number of HTE individuals was highest in West/Central Europe (636/4019 persons, 15.7%) and lowest in East Europe (26/2279 persons, 1.1%). Although most HTE individuals maintained controlled viral loads (<400 copies/mL), many had low CD4 counts (≤350 cells/µL). After controlling for age, immunological parameters and pre-existing comorbidities, HTE status was not associated with the risk of new AIDS (adjusted incidence rate ratio, aIRR 1.44, CI: 0.86 to 2.40, P = 0.16) or non-AIDS clinical events (aIRR 0.96, CI: 0.74 to 1.25, P = 0.77).HTE prevalence increased with time. After adjusting for key confounding factors, there was no evidence for an increased risk of new AIDS or non-AIDS clinical events in HTE. Additional therapeutic options and effective management of comorbidities remain important to reduce clinical complications in HTE individuals.

Rate ratio

10.1097/qai.0000000000002635

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Citations (18)

Viremia does not independently predict cardiovascular disease in people with HIV: a RESPOND cohort study

Open Forum Infectious Diseases (2025)

Olof Elvstam Lene Ryom Bastian Neesgaard Luba Tau Huldrych F. Günthard

Abstract Background HIV viremia has been considered a cardiovascular disease (CVD) risk factor, but many studies have had insufficient data on potential confounders. We explored the association between viremia and CVD after adjusting for established risk factors and analyzed whether consideration of viremia would improve CVD prediction. Methods Adults from RESPOND were followed from the first date with available data until the first of rigorously defined CVD, loss to follow-up, death, or administrative censoring. We first analyzed the associations between 6 measures of viremia (time-updated, before antiretroviral therapy [ART], viremia category, and measures of cumulative viremia) and CVD after adjusting for the variables in the D:A:D CVD score (age, sex/gender, smoking, family history, diabetes, recent abacavir, CD4 count, blood pressure, cholesterol, high-density lipoprotein, cumulative use of stavudine, didanosine, indinavir, lopinavir, and darunavir). We subsequently compared predictive performance with and without viremia in 5-fold internal cross-validation. Results A total of 547 events were observed in 17 497 persons (median follow-up, 6.8 years). Although some viremia variables were associated with CVD in univariable analyses, there were no statistically significant associations after adjusting for potential confounders, neither for measures of current viral load, pre-ART viral load, highest viremia category during ART, nor cumulative viremia (modeled both as total cumulative viremia, cumulative viremia during ART, and recent cumulative viremia). Consistently, none of the viremia variables improved prediction capacity. Conclusions In this large international cohort, HIV viremia was not associated with CVD when adjusting for established risk factors. Our results did not show viremia to be predictive of CVD among people with HIV.

Viremia

10.1093/ofid/ofaf016

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Single Dose of Doxycycline for the Prevention of Tick-borne Relapsing Fever

Clinical Infectious Diseases (2020)

Yoav Binenbaum Ronen Ben‐Ami Gad Baneth Boaz Langford Yoav Negev

Abstract The current postexposure prophylaxis regimen for tick-borne relapsing fever (TBRF) consists of 5 days’ doxycycline. In this observational study of 77 spelunkers at high risk for TBRF, a single dose of 100 mg doxycycline taken up to 72 hours after exposure to ticks was 100% effective in preventing the disease.

Regimen

10.1093/cid/ciaa034

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Influence of Hepatitis C Coinfection and Treatment on Risk of Diabetes Mellitus in HIV-Positive Persons

Open Forum Infectious Diseases (2020)

Amanda Mocroft Jens Lundgren Juergen Rockstroh Inka Aho Gilles Wandeler

The role of hepatitis C virus (HCV) coinfection and HCV-RNA in the development of diabetes mellitus (DM) in HIV-positive persons remains unclear.Poisson regression was used to compare incidence rates of DM (blood glucose >11.1 mmol/L, HbA1C >6.5% or >48 mmol/mol, starting antidiabetic medicine or physician reported date of DM onset) between current HIV/HCV groups (anti-HCV-negative, spontaneously cleared HCV, chronic untreated HCV, successfully treated HCV, HCV-RNA-positive after HCV treatment).A total of 16 099 persons were included; at baseline 10 091 (62.7%) were HCV-Ab-negative, 722 (4.5%) were spontaneous clearers, 3614 (22.4%) were chronically infected, 912 (5.7%) had been successfully treated, and 760 (4.7%) were HCV-RNA-positive after treatment. During 136 084 person-years of follow-up (PYFU; median [interquartile range], 6.9 [3.6-13.2]), 1108 (6.9%) developed DM (crude incidence rate, 8.1/1000 PYFU; 95% CI, 7.7-8.6). After adjustment, there was no difference between the 5 HCV strata in incidence of DM (global P = .33). Hypertension (22.2%; 95% CI, 17.5%-26.2%) and body mass index >25 (22.0%; 95% CI, 10.4%-29.7%) had the largest population-attributable fractions for DM.HCV coinfection and HCV cure were not associated with DM in this large study. The biggest modifiable risk factors were hypertension and obesity, and continued efforts to manage such comorbidities should be prioritized.

Hepatitis C

Interquartile range

10.1093/ofid/ofaa470

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Citations (2)

Prolonged survival of a patient with active MDR-TB HIV co-morbidity: Insights from a Mycobacterium tuberculosis strain with a unique genomic deletion

medRxiv (Cold Spring Harbor Laboratory) (2023)

Mor Rubinstein Andrei Makhon Yelena Losev Gal Zizelski Valenci Yair E. Gatt

Abstract Coinfection of HIV and multidrug-resistant tuberculosis (MDR-TB) presents significant challenges in terms of the treatment and prognosis of tuberculosis, leading to complexities in managing the disease and impacting the overall outcome for TB patients. This study presents a remarkable case of a patient with MDR-TB and HIV coinfection who survived for over eight years, despite poor treatment adherence and comorbidities. Whole genome sequencing (WGS) of the infecting Mycobacterium tuberculosis ( Mtb ) strain revealed a unique genomic deletion, spanning 18 genes, including key genes involved in hypoxia response, intracellular survival, immunodominant antigens and dormancy. This deletion, that we have called “Del-X”, potentially exerts a profound influence on the bacterial physiology and its virulence. Only few similar deletions were detected in other non-related Mtb genomes worldwide. In vivo evolution analysis identified drug resistance and metabolic adaptation mutations and their temporal dynamics during the patient’s treatment course.

10.1101/2023.08.28.23294468

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Clinical features and outcomes of bacteremic and non-bacteremic Campylobacteriosis: a case–control study

Infection (2022)

Luba Tau Amos Adler Ohad Shalom Yael Paran Ronit Cohen Poradosu

Blood Culture

Bacteremia

Campylobacteriosis

10.1007/s15010-022-01798-8

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Citations (1)

The Effect of Reflexology on Immunological Parameters of People Living with HIV

Integrative Medicine Reports (2024)

Elena Nison Dan Turner Tomer Ziv‐Baran Luba Tau

Reflexology

10.1089/imr.2024.0011

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C-reactive protein serum levels as an early predictor of outcome in patients with pandemic H1N1 influenza A virus infection

BMC Infectious Diseases (2010)

Ofer Zimmerman Ori Rogowski Galit Aviram Michal Mizrahi David Zeltser

Data for predicting which patients with pandemic influenza A (H1N1) infection are likely to run a complicated course are sparse. We retrospectively studied whether the admission serum C-reactive protein (CRP) levels can serve as a predictor of illness severity. Included were all consecutive adult patients who presented to the emergency department (ED) between May-December, 2009 with a flu-like illness, a confirmed diagnosis of pandemic influenza A (H1N1) infection and a serum CRP level measured within 24 hours of presentation. Patients with a proven additional concurrent acute illness (e.g., bacteremia) were excluded. We used the ROC curve analysis, Kaplan-Meier curves and the Cox proportional hazard model to evaluate the predictive ability of CRP as a prognostic factor. Seventeen (9%) of the 191 enrolled patients were admitted to the intensive care unit (ICU), of whom eight (4%) required mechanical ventilation and three (2%) died. The median admission serum CRP levels were significantly higher among patients who required subsequent ICU care and mechanical ventilation than among patients who did not (123 mg/L and 112 mg/L vs. 40 mg/L, p < .001 and 43 mg/L, p = .017, respectively). A Cox proportional hazard model identified admission serum CRP levels and auscultatory findings over the lungs as independent prognostic factors for ICU admission. Admission serum CRP levels were the only independent prognostic factor for mechanical ventilation. Thirty days after presenting to the ED, none of the patients with admission serum CRP level <28 mg/L (lower tertile) required either ICU admission or mechanical ventilation. At the same time point, 19% of the patients with admission serum CRP level ≥70 mg/L (upper tertile) needed to be admitted to the ICU and 8% of the same upper tertile group required mechanical ventilation. The differences in the rates between the lower vs. upper tertile groups were significant (Log-Rank p < .001 for ICU and p < .024 for mechanical ventilation). In our study group, serum CRP levels obtained in the early ED admission stage from patients presenting with pandemic H1N1 influenza A infection were found to serve as a useful gauge for predicting disease course and assisting in patient management.

Medical microbiology

Bacteremia

10.1186/1471-2334-10-288

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Citations (57)

Rate and predictors of blood culture positivity after antibiotic administration: a prospective single-center study

Infection (2023)

Lior Zornitzki Lana Anuk Shir Frydman Nira Morag‐Koren David Zahler

Blood Culture

Single Center

10.1007/s15010-023-02105-9

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Citations (4)

Associations of vaccine status with characteristics and outcomes of hospitalized severe COVID-19 patients in the booster era

PLoS ONE (2022)

Ophir Freund Luba Tau Tali Weiss Lior Zornitzki Shir Frydman

The resurgence of COVID-19 cases since June 2021, referred to as the fourth COVID-19 wave, has led to the approval and administration of booster vaccines. Our study aims to identify any associations between vaccine status with the characteristics and outcomes of patients hospitalized with severe COVID-19 disease.We retrospectively reviewed all COVID-19 patients admitted to a large tertiary center between July 25 and October 25, 2021 (fourth wave in Israel). Univariant and multivariant analyses of variables associated with vaccine status were performed.Overall, 349 patients with severe or critical disease were included. Patients were either not vaccinated (58%), had the first two vaccine doses (35%) or had the booster vaccine (7%). Vaccinated patients were significantly older, male predominant, and with a higher number of comorbidities including diabetes, hyperlipidemia, ischemic heart disease, heart failure, immunodeficient state, kidney disease and cognitive decline. Time from the first symptom to hospital admission was longer among non-vaccinated patients (7.2 ± 4.4 days, p = 0.002). Critical disease (p<0.05), admissions to the intensive care unit (p = 0.01) and advanced oxygen support (p = 0.004) were inversely proportional to the number of vaccines given, lowest among the booster vaccine group. Death (20%, p = 0.83) and hospital stay duration (8.05± 8.47, p = 0.19) were similar between the groups.Hospitalized vaccinated patients with severe COVID-19 had significantly higher rates of most known risk factors for COVID-19 adverse outcomes. Still, all disease outcomes were similar or better compared with the non-vaccinated patients.

Hyperlipidemia

Booster dose

Booster (rocketry)

10.1371/journal.pone.0268050

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Citations (28)