Publications by authors named "Petoumenos K"
Article Synopsis
- Australia struggles to effectively monitor the HIV epidemic due to insufficient population data, prompting this study to use incidence prevalence ratios (IPRs) to assess the epidemic trends among specific groups: men who have sex with men, women, and people who inject drugs.
- The study employed mathematical modeling to create IPRs from various data sources, comparing them against benchmarks based on life expectancy after HIV acquisition, illuminating trends from 2015 to 2022.
- The findings showed a significant decline in IPRs across all groups, with overall rates dropping by 80%, and many groups surpassing benchmarks, indicating a positive trend in managing HIV transmission in Australia.
While HIV infection and clonal hematopoiesis (CH) have been linked with inflammatory dysregulation and an increased risk of aging-related comorbidities, their relationship with clinical geriatric syndromes has not been well defined. In the Age-related Clonal Haematopoiesis in an HIV Evaluation Cohort (ARCHIVE) study (NCT04641013), we measure associations between HIV and CH and geriatric syndromes. Of 345 participants (176 with HIV and 169 without HIV), 23% had at least one mutation associated with CH: 27% with HIV and 18% without HIV (p = 0.
View Article and Find Full Text PDFObjective: Data on the impact of COVID-19 in people living with HIV (PWH) are lacking in resource-constrained settings. We utilised existingrandomised clinical trials (RCTs) on antiretroviral therapies (ART) in HIV-1 infection to conduct a SARS-CoV-2 serosurvey, between January and March 2021, while characterising participants' features.
Design: Cross-sectional serosurvey.
Background: The World Health Organization has endorsed single-dose human papillomavirus (HPV) vaccination, but data on the impact on HPV prevalence in high HIV burden settings are limited.
Methods: A single-dose bivalent HPV vaccine was delivered to adolescent girls in grade 10 in a schools-based campaign in 1 district in South Africa. Impact on HPV 16 and 18 prevalence was evaluated using repeat cross-sectional surveys.
Background: While people with HIV (PWH) start antiretroviral treatment (ART) regardless of CD4 count, CD4 measurement remains crucial for detecting advanced HIV disease and evaluating ART programmes. We explored CD4 measurement (proportion of PWH with a CD4 result available) and prevalence of CD4 <200 cells/µL at ART initiation within the International epidemiology Databases to Evaluate AIDS (IeDEA) global collaboration.
Methods: We included PWH at participating ART programmes who first initiated ART at age 15-80 years during 2005-2019.
Article Synopsis
- In 2014, South Africa launched an HPV vaccination program for girls aged 9 and older, but this study focused on 17-18 year old girls who weren't vaccinated, assessing HPV prevalence and related risk factors.
- From June to December 2019, the study surveyed adolescents at primary care clinics and collected data on HPV testing, HIV status, and sexual history from 900 participants, with a focus on understanding the link between these factors and HPV detection.
- Results showed that 56.5% had high-risk HPV, with a higher prevalence in those living with HIV, underscoring the need for increased HPV vaccination efforts in populations with high HIV rates.
Background: Increasing numbers of people with HIV have received prolonged antiretroviral therapy (ART). We assessed long-term immunological and survival outcomes among people with HIV from Asia (TREAT Asia HIV Observational Database) and Australia (Australian HIV Observational Database).
Methods: People with HIV receiving ART for ≥10 years were included.
Background: With integrase strand transfer inhibitor (INSTI) use associated with increased body mass index (BMI) and BMI increases associated with higher diabetes mellitus (DM) risk, this study explored the relationship between INSTI/non-INSTI regimens, BMI changes, and DM risk.
Methods: RESPOND participants were included if they had CD4, HIV RNA, and ≥ 2 BMI measurements during follow up. Those with prior DM were excluded.
Objective: To identify groups more likely to be referred for HIV testing because of symptomatic presentation rather than as part of asymptomatic screening.
Design: A retrospective analysis of Australian National HIV Registry (NHR) surveillance data including sociodemographic and clinical data, as well as reasons for HIV test.
Methods: Using notification records from 2017 to 2022, we summarised reasons for testing leading to an HIV diagnosis.
Background: Women with HIV are globally underrepresented in clinical research. Existing studies often focus on reproductive outcomes, seldom focus on older women, and are often underpowered to assess sex/gender differences. We describe CD4, HIV viral load (VL), clinical characteristics, comorbidity burden, and use of antiretroviral therapy (ART) among women with HIV in the RESPOND study and compare them with those of the men in RESPOND.
View Article and Find Full Text PDFIn this randomised, controlled study in 14 low- and middle-income countries, individuals taking dolutegravir with darunavir/ritonavir for 48 weeks had a greater increase in systolic and diastolic blood pressure than individuals taking two nucleoside reverse transcriptase with darunavir/ritonavir. The difference remained significant after controlling for confounding factors including weight gain.
View Article and Find Full Text PDFWe investigated factors associated with "worse than usual" anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human papillomavirus infection/lesions from September 2010 to August 2015.Among 616 participants (median age 49 years; 36% HIV-positive), 42 (6.8%) reported worse than usual anal health in the last 4 weeks.
View Article and Find Full Text PDFBackground: Human genetic contribution to HIV progression remains inadequately explained. The type 1 interferon (IFN) pathway is important for host control of HIV and variation in type 1 IFN genes may contribute to disease progression. This study assessed the impact of variations at the gene and pathway level of type 1 IFN on HIV-1 viral load (VL).
View Article and Find Full Text PDFArticle Synopsis
- Mortality rates among people with HIV significantly dropped after the introduction of combination antiretroviral therapy, particularly between 1999 and 2009, but remained stable from 2010 to 2020.
- The study analyzed data from over 55,000 participants, revealing that AIDS-related deaths were most common in the earlier period, while deaths from non-AIDS-related malignancies increased in the later years.
- Despite the decline in overall mortality, the reduction was not entirely attributed to better immune function or the presence of other risk factors, suggesting other contributing elements may be at play.
Associations between change in BMI and the risk of hypertension and dyslipidaemia in people receiving integrase strand-transfer inhibitors, tenofovir alafenamide, or both compared with other contemporary antiretroviral regimens: a multicentre, prospective observational study from the RESPOND consortium cohorts.
Lancet HIV
May 2024
Background: Integrase strand-transfer inhibitors (INSTIs) and tenofovir alafenamide have been associated with weight gain in several clinical trials and observational cohorts. However, whether weight gain associated with INSTIs and tenofovir alafenamide confers a higher risk of weight-related clinical events is unclear. We aimed to assess whether changes in BMI differentially increase hypertension or dyslipidaemia risk in people with HIV receiving INSTIs, tenofovir alafenamide, or both versus other contemporary regimens.
View Article and Find Full Text PDFObjective: To describe changes in atherosclerotic cardiovascular disease (ASCVD) risk over time among people living with HIV (PLHIV).
Methods: We used data from the TREAT Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD). Five-year ASCVD risk was calculated using the D:A:D equation.
Article Synopsis
- Australia is progressing toward UNAIDS's 95-95-95 targets for HIV management, but the study explores the prevalence of HIV viral blips, low-level viraemia (LLV), and virologic failure (VF) in a cohort from 2010-2021.
- The research included 2,544 participants on antiretroviral therapy and found that although the incidence of virologic failure decreased, rates of blips and LLV remained constant; those with blips or LLV were at higher risk for VF.
- Key risk factors for virologic failure included co-infection with Hepatitis B, younger age, and lower CD4 counts at the start of treatment, and understanding these predictors can
People with immunocompromising conditions are at increased risk of SARS-CoV-2 infection and mortality, however early in the pandemic it was challenging to collate data on this heterogenous population. We conducted a registry study of immunocompromised individuals with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection from March-October 2020 in Sydney, Australia to understand clinical and laboratory outcomes in this population prior to the emergence of the Delta variant. 27 participants were enrolled into the study including people with a haematologic oncologic conditions (n = 12), secondary immunosuppression (N = 8) and those with primary or acquired immunodeficiency (i.
View Article and Find Full Text PDFThe traditional trial paradigm is often criticized as being slow, inefficient, and costly. Statistical approaches that leverage external trial data have emerged to make trials more efficient by augmenting the sample size. However, these approaches assume that external data are from previously conducted trials, leaving a rich source of untapped real-world data (RWD) that cannot yet be effectively leveraged.
View Article and Find Full Text PDFDespite cancer being a leading comorbidity amongst individuals with HIV, there are limited data assessing cancer trends across different antiretroviral therapy (ART)-eras. We calculated age-standardised cancer incidence rates (IRs) from 2006-2021 in two international cohort collaborations (D:A:D and RESPOND). Poisson regression was used to assess temporal trends, adjusted for potential confounders.
View Article and Find Full Text PDFIntroduction: Australia has set the goal for the virtual elimination of HIV transmission by the end of 2022, yet accurate information is lacking on the level of HIV transmission occurring among residents. We developed a method for estimating the timing of HIV acquisition among migrants, relative to their arrival in Australia. We then applied this method to surveillance data from the Australian National HIV Registry with the aim of ascertaining the level of HIV transmission among migrants to Australia occurring before and after migration, and to inform appropriate local public health interventions.
View Article and Find Full Text PDFBackground: Although HIV treatment-as-prevention reduces individual-level HIV transmission, population-level effects are unclear. We aimed to investigate whether treatment-as-prevention could achieve population-level reductions in HIV incidence among gay, bisexual, and other men who have sex with men (GBM) in Australia's most populous states, New South Wales and Victoria.
Methods: TAIPAN was a longitudinal cohort study using routine health record data extracted from 69 health services that provide HIV diagnosis and care to GBM in New South Wales and Victoria, Australia.
Background: There are conflicting data regarding baseline determinants of virological nonsuppression outcomes in persons with human immunodeficiency virus (HIV) starting antiretroviral treatment (ART). We evaluated the impact of different baseline variables in the RESPOND cohort.
Methods: We included treatment-naive participants aged ≥18 who initiated 3-drug ART, in 2014-2020.
Article Synopsis
- The Omicron variant of COVID-19, which began in 2022, evolved from several lineages (BA.1, BA.2, BA.5) and developed mutations that help it evade neutralizing antibodies.
- Researchers evaluated the effectiveness of antibody responses by tracking over 420,000 U.S. plasma donors and studying blood samples from vaccinated and recovered individuals, along with testing clinically approved therapies.
- Findings indicated that antibody responses improved over time, but emerging variants like BQ.1.1 and XBF were increasingly resistant to treatments like Evusheld and Sotrovimab, suggesting that even dominant variants can evade antibodies while maintaining a persistent advantage in spreading.