Publications by authors named "Ole Kirk"
Introduction: HIV replication leads to a change in lymphocyte phenotypes that impairs immune protection against opportunistic infections. We examined current HIV replication as an independent risk factor for tuberculosis (TB).
Methods: We included people living with HIV from 25 European cohorts 1983-2015.
Objectives: Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/10 in the background population.
Methods: We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation.
Background: All-cause and AIDS-mortality in Europe has been decreasing between 1996 and 2020. However, regional differences as well as their drivers remain unclear. This study investigates mortality differences and their drivers, including usage of and response to antiretroviral therapy (ART) and active tuberculosis (TB), among people with HIV across Europe.
View Article and Find Full Text PDFObjectives: We aimed to assess the extent of integration of non-communicable disease (NCD) assessment and management in HIV clinics across Europe.
Methods: A structured electronic questionnaire with 41 multiple-choice and rating-scale questions assessing NCD assessment and management was sent to 88 HIV clinics across the WHO European Region during March-May 2023. One response per clinic was collected.
Article Synopsis
- - The study aimed to validate the Dutch Residency Educational Climate Test (D-RECT) for Danish medical trainees and assess their educational climate at Copenhagen University Hospital.
- - The process included translating D-RECT to Danish (DK-RECT), validating it psychometrically, and conducting a survey with a 68% response rate from 304 trainees across 31 specialties.
- - Results showed a generally positive educational climate with a median score of 4.0 out of 5, but highlighted lower ratings for feedback, while supervision and peer collaboration received higher scores.
Background: Eastern Europe has a high burden of tuberculosis (TB)/HIV coinfection with high mortality shortly after TB diagnosis. This study assesses TB recurrence, mortality rates and causes of death among TB/HIV patients from Eastern Europe up to 11 years after TB diagnosis.
Methods: A longitudinal cohort study of TB/HIV patients enrolled between 2011 and 2013 (at TB diagnosis) and followed-up until end of 2021.
Background: The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.
Methods: In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone.
Article Synopsis
- The study examined changes in the prognostic value of echocardiographic parameters for COVID-19 patients as treatment guidelines and SARS-CoV-2 variants evolved through the first and second waves of the pandemic.!* -
- Among 305 patients analyzed, those hospitalized during the second wave exhibited worse left ventricular function compared to those from the first wave, with significant decreases in ejection fraction and global longitudinal strain.!* -
- The analysis found that reduced global longitudinal strain was strongly linked to increased COVID-related mortality, highlighting its importance as a serious indicator of patient outcomes, regardless of treatment methods or viral variants.!*
Introduction: In recent years, HIV testing frequency has increased, resulting in more people being diagnosed during seroconversion with a temporarily low CD4 count. Using the current consensus definition of late HIV presentation ('presenting for care with a CD4 count < 350 cells/μL or an AIDS-defining event, regardless of CD4 count') these individuals would be incorrectly assigned as being diagnosed late.
Methods: In spring 2022, a European expert group convened to revise the current late HIV presentation consensus definition.
Article Synopsis
- * In a study of 305 COVID-19 patients, lower GWI was found in patients with high levels of cardiac biomarkers, such as troponin and NT-proBNP, indicating worse cardiac function and a higher need for oxygen.
- * GWI was linked to an increased risk of death among patients, but it did not provide additional predictive value beyond existing clinical parameters like troponin and NT-proBNP levels.
Objective: Age-related comorbidities, polypharmacy and thereby the risk of potential drug-drug interactions (PDDIs) among people living with HIV (PLWH) have increased over the years. We estimated the prevalence of comedications, including dietary supplements, and evaluated PDDIs among PLWH receiving antiretroviral therapy (ART) in Denmark in an outpatient setting.
Methods: Information on prescription medication, over-the-counter medication and dietary supplements was obtained from adult PLWH receiving ART attending two outpatient clinics in Denmark.
Aims: The aim was to report the prevalence of diabetes status in patients hospitalized with COVID-19 and assess the association between the glucometabolic status at admission and 90-day mortality.
Methods: Consecutive patients hospitalized with COVID-19 were included in the study. All participants included had an HbA measurement 60 days prior to or within 7 days after admission.
Article Synopsis
- - A study assessed lung ultrasound (LUS) in COVID-19 patients before hospitalization and again 2-3 months after discharge, focusing on changes in lung findings over time.
- - Out of 71 patients studied, LUS findings showed a significant reduction in pathologic results from 87% during hospitalization to 30% at follow-up, with a notable decrease in B-lines.
- - Although improvements were observed, 28% of patients still had abnormal LUS findings at follow-up, especially those who experienced acute respiratory distress syndrome (ARDS), suggesting LUS is a valuable tool for ongoing monitoring of lung health in COVID-19 survivors.
Background: The European AIDS Clinical Society (EACS) Guidelines were revised in 2021 for the 17th time with updates on all aspects of HIV care.
Key Points Of The Guidelines Update: Version 11.0 of the Guidelines recommend six first-line treatment options for antiretroviral treatment (ART)-naïve adults: tenofovir-based backbone plus an unboosted integrase inhibitor or plus doravirine; abacavir/lamivudine plus dolutegravir; or dual therapy with lamivudine or emtricitabine plus dolutegravir.
Tuberculosis (TB) is still a major challenge for global health, but in recent years there have been several important developments in treatment options. Shorter treatment regimens for latent TB, based on conventional drugs, offer better adherence and fewer side effects, while new and repurposed antibiotics have opened the door to more effective, shorter and less side effect-heavy treatments for drug susceptible TB and multidrug-resistant/extensively drug resistant TB as well as atypical mycobacterioses. This review investigates how these shorter and predominantly oral treatments, in the future, are expected to be used in combination with individualized precision medicine.
View Article and Find Full Text PDFArticle Synopsis
- The study explored the use of lung ultrasound (LUS) as a diagnostic tool for assessing COVID-19 patients, specifically looking at how LUS findings correlate with serious hospital outcomes like ARDS, ICU admissions, and mortality rates.
- A total of 215 patients with confirmed COVID-19 were enrolled, but only 168 had usable LUS data, revealing that 81% exhibited abnormal LUS findings despite not showing ARDS or being in ICU at the time.
- Although some disease severity markers were higher in patients with serious outcomes, the LUS findings and scores did not significantly differ between those who experienced serious complications and those who did not, indicating that LUS may not be a reliable predictor of these outcomes in this patient group.
Introduction: Antiretroviral therapy has reduced mortality and led to longer life expectancy in people living with HIV. These patients are now at an increased risk of non-communicable diseases (NCDs). Integration of care for HIV and NCDs has become a focus of research and policy.
View Article and Find Full Text PDFHypersensitivity reaction (HSR) and hepatotoxicity are rare, but potentially serious side-effects of antiretroviral use. To investigate discontinuations due to HSR, hepatotoxicity or other reasons among users of dolutegravir (DTG) vs. raltegravir (RAL) or elvitegravir (EVG) in the EuroSIDA cohort.
View Article and Find Full Text PDFBackground: Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH).
Methods: PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis.
Background: Weight gain effects of individual antiretroviral drugs are not fully understood. We investigated associations between a prespecified clinically significant increase (>7%) in body-mass index (BMI) and contemporary antiretroviral use.
Methods: The International Cohort Consortium of Infectious Diseases (RESPOND) is a prospective, multicohort collaboration, including data from 17 well established cohorts and over 29 000 people living with HIV.
Aims: The degree of cardiovascular sequelae following COVID-19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID-19.
Methods And Results: A consecutive sample of patients hospitalized with COVID-19 was prospectively included in this longitudinal study.
Objectives: In some eastern European countries, serious challenges exist to meet the HIV-, tuberculosis (TB)- and hepatitis-related target of the United Nations Sustainable Development Goals. Some of the highest incidence rates for HIV and the highest proportion of multi-drug-resistant (MDR) tuberculosis worldwide are found in the region. The purpose of this article is to review the challenges and important next steps to improve healthcare for people living with TB, HIV and hepatitis C (HCV) in eastern Europe.
View Article and Find Full Text PDFPurpose: Several studies have reported thromboembolic events to be common in severe COVID-19 cases. We sought to investigate the relationship between lung ultrasound (LUS) findings in hospitalized COVID-19 patients and the development of venous thromboembolic events (VTE).
Methods: A total of 203 adults were included from a COVID-19 ward in this prospective multi-center study (mean age 68.