Publications by authors named "Markus Bickel"

Article Synopsis
  • The study analyzes the occurrence, transmission risks, and immune status related to HIV indicator conditions (HIV-ICs) among treatment-naive individuals living with HIV in Germany from 1999 to 2023.
  • It includes data from 15,940 diagnoses and found that the majority of participants were male, with a notable incidence rate for syphilis (34 per 1,000 person-years) and high rates for other conditions linked to HIV.
  • The findings emphasize the need for targeted screening based on HIV-ICs to identify individuals with weakened immune systems, highlighting the importance of early antiretroviral therapy (ART) initiation.
View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on improving early diagnosis of HIV among individuals with specific conditions known as indicator conditions (ICs), which are associated with higher rates of undiagnosed HIV infections.
  • Using data from over 513,000 German healthcare records from 2016 to 2021, the researchers analyzed the HIV prevalence among people with 26 selected ICs, finding notable rates especially in conditions like pneumocystosis and Kaposi's sarcoma.
  • The findings indicated significant gender and age disparities, revealing that while many ICs showed high HIV prevalence in younger and middle-aged adults, some female patients had lower prevalence rates in certain conditions compared to males.
View Article and Find Full Text PDF

Introduction: Direct-acting antivirals (DAAs) are key to eliminating hepatitis C virus (HCV). In men who have sex with men (MSM) with HIV co-infection, recently acquired HCV infection is common. Sexual practices and reinfection rates may hamper micro-elimination despite high treatment rates.

View Article and Find Full Text PDF
Article Synopsis
  • * A 32-year-old woman with multiple sclerosis and immunosuppressed due to medication developed symptoms typical of vaccine-associated yellow fever after vaccination.
  • * The use of sofosbuvir as an antiviral treatment helped her recover, highlighting the need for careful patient evaluation before live vaccinations and potential treatment strategies for such cases.
View Article and Find Full Text PDF
Article Synopsis
  • A significant number of people living with HIV are diagnosed late, and identifying HIV indicator diseases could facilitate earlier diagnosis through improved testing.
  • The HeLP study aims to validate existing HIV indicator diseases for Germany by reviewing literature, consulting experts, and analyzing various health data to create guidelines for better HIV testing.
  • By examining physician awareness and barriers related to HIV testing in practice, the study seeks to enhance understanding and implementation of HIV testing recommendations in clinical settings.
View Article and Find Full Text PDF
Article Synopsis
  • Recent studies show that ongoing HCV infections are mainly transmitted through drug use and sexual behaviors, particularly among men who have sex with men (MSM), but the details of transmission and infection progression remain unclear.
  • After following 161 patients with recently acquired HCV infections over 10 years, it was found that most were male MSM, many of whom were also HIV-positive, and their main transmission risks were sexual behavior and drug use.
  • The findings indicate low spontaneous clearance rates of the infection, significant phylogenetic clustering among MSM cases, and a rise in specific HCV genotypes over time, highlighting the need for targeted interventions in high-risk groups.
View Article and Find Full Text PDF

Delayed HIV diagnosis at advanced stages of disease remains common (33%-64%). This analysis of the multi-center FindHIV study including newly diagnosed HIV-infected adults in Germany, focused on the potential role of socio-demographic and psychological factors on late diagnosis (formerly "late presentation", AIDS diagnosis or CD4 cells <350/µL). These data were collected from patient profiles, physician-patient interviews and questionnaires.

View Article and Find Full Text PDF
Article Synopsis
  • - The study investigates how hematopoietic stem and progenitor cells (HSPCs) may serve as reservoirs for HIV-1, which complicates finding a cure for the virus.
  • - Experiments showed that various HSPC subpopulations could be infected by HIV-1, mainly through the CXCR4 and CCR5 entry pathways, indicating their vulnerability to the virus.
  • - Analysis of bone marrow samples from HIV-positive individuals revealed the presence of HIV-1 genetic material in some CD34+ cells, supporting the idea that these primitive HSPCs contribute to the HIV-1 reservoir.
View Article and Find Full Text PDF

Introduction: Objectives of this study, as part of a nation-wide HIV pre-exposure prophylaxis (PrEP) evaluation project, were to determine the incidence of infections with HIV, chlamydia, gonorrhea, syphilis, hepatitis A/B/C in persons using PrEP, and to describe the health care funded PrEP use in Germany. Additionally, factors associated with chlamydia/gonorrhea and syphilis infections were assessed.

Methods: Anonymous data of PrEP users were collected at 47 HIV-specialty centers from 09/2019-12/2020.

View Article and Find Full Text PDF

Background: Since May 2022, increasing numbers of monkeypox virus (MPXV) infections have been reported from across Europe and North America. Studies, mainly from Africa, have suggested a higher risk for severe MPXV cases in people living with HIV.

Methods: This was a retrospective study of all confirmed MPXV infections observed in the participating centres since 19 May 2022.

View Article and Find Full Text PDF

Ukraine is one of the countries in Europe most affected by HIV. The escalation of open war on the European continent has affected HIV care in Ukraine in an unprecedented way. Treating physicians in Europe have little experience on how to handle HIV-specific care under these circumstances.

View Article and Find Full Text PDF

IntroductionDespite increased use of pre-exposure prophylaxis (PrEP) in Germany, HIV infection rates are not declining and little is known about how this prevention method affects the prevalence of sexually transmitted infections (STI) among men who have sex with men (MSM).AimWe studied, in a large multicentre cohort, STI point prevalence, co-infection rates, anatomical location and influence of PrEP.MethodsThe BRAHMS study was a prospective cohort study conducted at 10 sites in seven major German cities that enrolled MSM reporting increased sexual risk behaviour.

View Article and Find Full Text PDF

Background: Information on testing units in health care is scarce, particularly the group of late-presenters among the HIV-first diagnoses is still a challenge in Germany.

Aim: Analysis of the impact of testing units on and reasons for the prevalence of HIV-first diagnoses and late presentation, taking 2014 for illustrative purposes.

Material And Methods: Cross-sectional analysis of all individuals, treated in the Network HIV-Regional who were first diagnosed with HIV in 2014; patient characteristics, demographic and clinical data, including information on HIV testing were collected retrospectively and in a decentralised manner, pseudonymized and statistically evaluated.

View Article and Find Full Text PDF

Background: Previous studies have shown that men with HIV and germ cell cancer (HIV-GCC) have inferior overall survival (OS) in comparison with their HIV-negative counterparts. However, little information is available on treatments and outcomes of HIV-GCC in the era of combination antiretroviral therapy (cART).

Methods: This study examined men living with HIV who were 18 years old or older and had a diagnosis of histologically proven germ cell cancer (GCC).

View Article and Find Full Text PDF

Background: HIV and hepatitis C virus (HCV) have shared routes of transmission among men who have sex with men (MSM). Routine testing facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We evaluated factors associated with HIV and HCV testing in a behaviorally vulnerable cohort of predominantly MSM.

View Article and Find Full Text PDF

Background: HIV-infected patients with Pneumocystis-pneumonia (PCP) may develop paradoxical immune reconstitution inflammatory syndrome (IRIS), when combination antiretroviral therapy (cART) is started early during the course of PCP-treatment (PCPT). The aim of this study was to identify risk factors and predictors for PCP-IRIS and to improve individualized patient care.

Methods: An ICD-10 code hospital database query identified all Frankfurt HIV Cohort patients being diagnosed with PCP from January 2010 - June 2016.

View Article and Find Full Text PDF

Anogenital and oropharyngeal infections with human papilloma viruses (HPV) are common. Clinically manifest disease may significantly impact quality of life; the treatment of HPV-associated lesions is associated with a high rate of recurrence and invasive neoplasms, such as cervical, anal, vulvar, penile, and oropharyngeal cancers, which are characterized by significant morbidity and mortality. Vaccination against HPV is an effective and safe measure for the primary prevention of HPV-associated lesions, but immunization rates are still low in Germany.

View Article and Find Full Text PDF

Background: In the primary analysis of the DRIVE-SHIFT trial, switching to doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) maintained suppression of HIV-1 through week 48. Here, we present long-term efficacy and safety outcomes through week 144 of the DRIVE-SHIFT trial.

Methods: This phase 3, randomized, open-label trial evaluated switching from a stable antiretroviral regimen to once-daily DOR/3TC/TDF in adults with HIV-1 suppressed for ≥6 months and no previous virologic failure.

View Article and Find Full Text PDF

Background: Dolutegravir (DTG) and boosted darunavir (bDRV) are potent antiretrovirals with a high resistance barrier and might be valuable switch options for people with HIV (PWH).

Methods: DUALIS, a randomized, open-label, phase 3b, noninferiority clinical trial, compared the switch to DTG + bDRV (2DR) with continuation of 2 nucleoside reverse transcriptase inhibitors (2NRTI) + bDRV (3DR). PWH with HIV RNA <50 copies/mL taking 2NRTI + bDRV (3DR) for ≥24 weeks (1 accepted blip <200 copies/mL) were randomized to either switch to DTG 50 mg + DRV 800 mg (boosted with 100 mg of ritonavir) or continue taking 3DR.

View Article and Find Full Text PDF

Purpose: Current German/Austrian antiretroviral treatment guidelines recommend more than 20 combination regimens for first-line therapy, without a preference. Regimens include two nucleoside reverse transcriptase inhibitors (NRTIs) plus either an integrase strand transfer inhibitor (INSTI), a non-NRTI (NNRTI) or a boosted protease inhibitor (PI). The objective was to examine the outcomes of recommended first-line ART in Germany.

View Article and Find Full Text PDF

Introduction: Data on people living with human immunodeficiency virus (PLWH) in the current SARS-CoV-2 pandemic are still scarce. This case series of 33 PLWH patients with COVID-19 reveals symptoms and outcome in this special population.

Methods: Retrospective analysis of anonymized data including age, gender, HIV-associated parameters, symptoms, and outcome.

View Article and Find Full Text PDF

Background: Doravirine is a novel, nonnucleoside reverse transcriptase inhibitor with demonstrated efficacy in treatment-naive adults with HIV-1.

Methods: In this open-label, active-controlled, noninferiority trial, adults with HIV-1 virologically suppressed for ≥6 months on 2 nucleoside reverse transcriptase inhibitors plus a boosted protease inhibitor, boosted elvitegravir, or a non-nucleoside reverse transcriptase inhibitor were randomized (2:1) to switch to once-daily, single-tablet doravirine 100 mg with lamivudine 300 mg and tenofovir disoproxil fumarate 300 mg (DOR/3TC/TDF) or to continue their current therapy (Baseline Regimen) for 24 weeks. The primary endpoint was the proportion of participants with HIV-1 RNA <50 copies/mL (defined by the FDA Snapshot approach), with the primary comparison between DOR/3TC/TDF at week 48 and Baseline Regimen at week 24 and a secondary comparison between the groups at week 24 (noninferiority margin, -8%).

View Article and Find Full Text PDF