Characterizing trends in HIV infection among men who have sex with men in Australia by birth cohorts: results from a modified back-projection method

<p>Abstract</p> <p>Background</p> <p>We set out to estimate historical trends in HIV incidence in Australian men who have sex with men with respect to age at infection and birth cohort.</p> <p>Methods</p> <p>A modified back-projection technique is applied to data from the HIV/AIDS Surveillance System in Australia, including "<it>newly diagnosed HIV infections</it>", "<it>newly acquired HIV infections</it>" and "<it>AIDS diagnoses</it>", to estimate trends in HIV incidence over both calendar time and age at infection.</p> <p>Results</p> <p>Our results demonstrate that since 2000, there has been an increase in new HIV infections in Australian men who have sex with men across all age groups. The estimated mean age at infection increased from ~35 years in 2000 to ~37 years in 2007. When the epidemic peaked in the mid 1980s, the majority of the infections (56%) occurred among men aged 30 years and younger; 30% occurred in ages 31 to 40 years; and only ~14% of them were attributed to the group who were older than 40 years of age. In 2007, the proportion of infections occurring in persons 40 years or older doubled to 31% compared to the mid 1980s, while the proportion of infections attributed to the group younger than 30 years of age decreased to 36%.</p> <p>Conclusion</p> <p>The distribution of HIV incidence for birth cohorts by infection year suggests that the HIV epidemic continues to affect older homosexual men as much as, if not more than, younger men. The results are useful for evaluating the impact of the epidemic across successive birth cohorts and study trends among the age groups most at risk.</p

Initiative zur Leitlinienerstellung für die Berichterstattung von EbM-Inhalten in Apps

Gonnermann A, von Jan U, Albrecht U-V. Initiative zur Leitlinienerstellung für die Berichterstattung von EbM-Inhalten in Apps. In: GMDS 2013: 58. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS). Düsseldorf: German Medical Science GMS Publishing House; 2013

Appropriate Reporting of EbM Content In Electronic Media -- APPRECIEM

von Jan U, Gonnermann A, Albrecht U-V. Appropriate Reporting of EbM Content In Electronic Media -- APPRECIEM. Presented at the Medicine 2.0. World Congress on Social Media, Mobile Apps, Internet / Web 2.0 in Health, Medicine and Biomedical Research, London, United Kingdom

Draft Guideline for the Development of Evidence Based Medicine-Related Apps

Gonnermann A, von Jan U, Albrecht U-V. Draft Guideline for the Development of Evidence Based Medicine-Related Apps. In: Cornet R, Stoicu-Tivadar L, Hörbst A, Parra Calderón CL, Kjær Andersen S, Hercigonja-Szekeres M, eds. Digital Healthcare Empowering Europeans. Studies in Health Technology and Informatics. Vol 210. Amsterdam: IOS Press; 2015: 637-641.Evidence based recommendations can significantly aid decision processes in medicine and mobile apps are starting to enter this domain. Considering the rapid access to and quick processing of information made possible by such apps, it is especially important to ensure the quality and structure of the provided data and to also keep the limitations of the information sources in mind. A draft guideline meant for implementing appropriate standards for such apps is outlined in this contribution

Treatment Extension of Pegylated Interferon Alpha and Ribavirin Does Not Improve SVR in Patients with Genotypes 2/3 without Rapid Virological Response (OPTEX Trial): A Prospective, Randomized, Two-Arm, Multicentre Phase IV Clinical Trial

Although sofosbuvir has been approved for patients with genotypes 2/3 (G2/3), many parts of the world still consider pegylated Interferon alpha (P) and ribavirin (R) as standard of care for G2/3. Patients with rapid virological response (RVR) show response rates >80%. However, SVR (sustained virological response) in non-RVR patients is not satisfactory. Longer treatment duration may be required but evidence from prospective trials are lacking. A total of 1006 chronic HCV genotype 2/3 patients treated with P/R were recruited into a German HepNet multicenter screening registry. Of those, only 226 patients were still HCV RNA positive at week 4 (non-RVR). Non-RVR patients with ongoing response after 24 weeks P-2b/R qualified for OPTEX, a randomized trial investigating treatment extension of additional 24 weeks (total 48 weeks, Group A) or additional 12 weeks (total 36 weeks, group B) of 1.5 $\mu$g/kg P-2b and 800-1400 mg R. Due to the low number of patients without RVR, the number of 150 anticipated study patients was not met and only 99 non-RVR patients (n=50 Group A, n=49 Group B) could be enrolled into the OPTEX trial. Baseline factors did not differ between groups. Sixteen patients had G2 and 83 patients G3. Based on the ITT (intention-to-treat) analysis, 68% [55%; 81%] in Group A and 57% [43%; 71%] in Group B achieved SVR (p=0.31). The primary endpoint of better SVR rates in Group A compared to a historical control group (SVR 70%) was not met. In conclusion, approximately 23% of G2/3 patients did not achieve RVR in a real world setting. However, subsequent recruitment in a treatment-extension study was difficult. Prolonged therapy beyond 24 weeks did not result in higher SVR compared to a historical control group

Historical control group.

<p>* Patients who were HCV-RNA positive (>29 IU/mL) at week 4 but HCV-RNA negative at week 12</p><p>** Patients who were HCV-RNA positive (>50 IU/mL) at week 4 but HCV-RNA negative at week 12</p><p>Historical control group.</p

Severe adverse events.

<p>Severe adverse events.</p

SF-36 Physical and Mental Health.

<p>SF-36 Physical and Mental Health.</p

Multivariate logistic regression model.

<p>Multivariate logistic regression model.</p

Virological response rates at EOT, FU12 and FU24 in the ITT, mITT and completer population.

<p>Virological response rates at EOT, FU12 and FU24 in the ITT, mITT and completer population.</p