Su Jin Jeong

Yonsei University Hospital, Sŏul, Seoul, South Korea

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Publications (74)102.68 Total impact

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    ABSTRACT: Although the proteasome inhibitor known as bortezomib can modulate the inflammatory process through the nuclear factor-kappa B signaling pathway, the immunomodulatory effect of pre-incubated bortezomib has not been fully evaluated for inflammation by infectious agents. Therefore, we evaluated the effect of bortezomib on the expression of inflammatory cytokines and mediators in macrophage cell lines and on survival in a murine peritonitis sepsis model. Bortezomib was applied 1 hr before lipopolysaccharide (LPS) stimulation in RAW 264.7 cells. The cecal ligation and puncture (CLP) experiments were performed in C57BL/6J mice. Pre-incubation with bortezomib (25 nM or 50 nM) prior to LPS (50 ng/mL or 100 ng/mL) stimulation significantly recovered the number of viable RAW 264.7 cells compared to those samples without pre-incubation. Bortezomib decreased various inflammatory cytokines as well as nitric oxide production in LPS-stimulated cells. The 7-day survival rate in mice that had received bortezomib at 0.01 mg/kg concentration 1 hr prior to CLP was significantly higher than in the mice that had only received a normal saline solution of 1 mL 1 hr prior to CLP. In addition, the administration of bortezomib at 0.01 mg/kg concentration 1 hr before CLP resulted in a significant decrease in inflammation of the lung parenchyma. Collectively, pretreatment with bortezomib showed an increase in the survival rate and changes in the levels of inflammatory mediators. These results support the possibility of pretreatment with bortezomib as a new therapeutic target for the treatment of overwhelming inflammation, which is a characteristic of severe sepsis.
    Yonsei medical journal. 01/2015; 56(1):112-23.
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    ABSTRACT: AimTo evaluate the relationship between human cytomegalovirus (HCMV) antibody status, and hypertension and functional status among elderly Koreans.Methods Patients aged ≥65 years were prospectively enrolled from March 2011 to February 2012 at a 2000-bed university hospital. We collected data including CD4+ and CD8+ T-lymphocyte count, and functional status by measuring basic activities of daily living and instrumental activities of daily living for all patients. In addition, HCMV immunoglobulin G levels were analyzed using enzyme-linked fluorescent assay.ResultsDuring the study period, 103 patients (51 men), who were admitted for treatment of infections or other diseases, were enrolled. Multivariate analysis showed that body mass index and HCMV immunoglobulin G antibody titers were independent factors associated with hypertension in elderly patients (OR 1.347, 95% CI 1.113–1.630, P = 0.002; OR 1.023, 95% CI 1.001–1.047, P = 0.042, respectively). In univariate linear correlations, HCMV antibody levels were positively correlated with systolic blood pressure levels (r = 0.303, P = 0.002), CD8+ T-lymphocyte count (r = 0.313, P = 0.001) and instrumental activities of daily living scores (r = 0.217, P = 0.028). In addition, HCMV immunoglobulin G titers were inversely associated with estimated glomerular filtration rate (r = −0.268, P = 0.006). These four variables remained independently significant in multivariate correlation analysis.Conclusion These findings could provide insight into the important role of HCMV in the pathogenesis of essential hypertension and decreased functional status in the elderly. Geriatr Gerontol Int 2014; ●●: ●●–●●.
    Geriatrics & Gerontology International 01/2015;
  • Su Jin Jeong
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    ABSTRACT: Background: Invasive mucormycosis is an uncommon but increasing, life-threatening fungal infection. Effective therapy is represented by the combination of surgery and antifungal agent administration and early initiation of the therapy is necessary for favorable outcome. However, the disease is difficult to diagnose and mortality reaches 40% even if treated adequately, and clinical data on clinical course are limited. Methods: We retrospectively reviewed histologically proven cases of invasive mucormycosis in two tertiary care referral hospitals from 2004 to 2013. The clinical and laboratory data were analyzed for all patients. Results: We reviewed total of 28 patients who were histologically diagnosed as invasive mucormycosis. Overall survival was 60% (n = 17). The time from onset of symptom to diagnostic procedure proved to be associated with mortality (P <0.001). In addition, time from onset of symptom to initiation of antifungal therapy was associated with a poor outcome in our study (P = 0.032). On multivariate regression analysis, delayed diagnostic procedure (more than 10 days after onset of symptom) was an independently significant predictor of mortality (odds ratio = 13.28, 95% confidence interval, 1.07-164.62; P= 0.044). Conclusion: Mucormycosis is a destructive fungal infection that is associated with a high mortality, ranging from 40 to 100 % depending on disease form. When a clinician suspects an invasive mucormycosis infection, early diagnostic procedure done within 10 days from the onset of symptom and early initiation of antifungal therapy will lead to successful management of the disease.
    IDWeek 2014 Meeting of the Infectious Diseases Society of America; 10/2014
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    ABSTRACT: The hypervirulent Clostridium difficile strains, most notably the BI/NAP1/027, have been increasingly emerging in Western countries as local epidemics. We performed a prospective multicenter observational study from December 2011 to May 2012 to identify recent incidences of toxigenic culture-confirmed hospital-onset CDI and their associated clinical characteristics in South Korea. The patients, suspected to have been suffering from CDI more than 48 hours after admission and aged ≥20 years, were prospectively enrolled and provided loose stool specimens. The toxigenic C. difficile culture (anaerobic culture + toxin A/B/binary gene PCR) and PCR ribotyping were performed in one central laboratory. We enrolled 98 toxigenic culture-confirmed CDI-infected patients and 250 toxigenic culture-negative participants from three hospitals. The incidence of toxigenic culture-confirmed hospital-onset CDI cases was 2.7 cases/10,000 patient-days. The percentage of severe CDI cases was relatively low at only 3.1%. UK ribotype 018 was the predominant type (48.1%). There were no hypervirulent BI/NAP1/027 isolates identified. The independent risk factors of toxigenic culture-confirmed hospital-onset CDI were the invasive procedure (OR 7.3, P=0.003) and past CDI history within three months (OR 28.5, P=0.003). In conclusion, the incidence and severity of CDI in our study were not higher than reported in Western countries.
    Journal of medical microbiology. 09/2014;
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    ABSTRACT: Fluoroquinolones, rapidly gaining prominence in treatment of Stenotrophomonas maltophilia (SMP), are noted for their potency and tolerability. However, SMP may rapidly acquire resistance to fluoroquinolones. We evaluated associations of clinical factors with acquisition of levofloxacin resistance (LFr) in SMP.
    Yonsei medical journal. 07/2014; 55(4):987-93.
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    ABSTRACT: Sepsis is a syndrome that results in high morbidity and mortality. We investigated the delta neutrophil index (DN) as a predictive marker of early mortality in patients with gram-negative bacteremia.
    Infection & chemotherapy. 06/2014; 46(2):94-102.
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    ABSTRACT: Carbapenem resistance among gram-negative bacilli is an emerging threat worldwide. The objective of this study was to identify risk factors for the acquisition of carbapenem-resistant Escherichia coli (CRE).
    American journal of infection control. 06/2014; 42(6):621-5.
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    ABSTRACT: Less costly but still accurate methods for monitoring HIV treatment response are needed. We prospectively evaluated if a qualitative polymerase chain reaction (PCR) amplification assay for virologic monitoring could maintain accuracy while reducing costs in Seoul, South Korea. We conducted the first prospective study comparing a qualitative PCR amplification of HIV-1 reverse transcriptase (RT) versus a commercial real time PCR assay (i.e. viral load) for virologic monitoring of 150 patients receiving antiretroviral therapy (ART) between November 2011 and August 2012 at an urban hospital in Seoul, South Korea. A total of 215 blood plasma samples from 150 patients receiving ART for more than 6 months were evaluated. Using the individual viral load assay, 12 of 215 (5.6%) plasma samples had more than 500 HIV RNAcopies/mL. The qualitative PCR amplification assay detected individual samples with ≥ 500 HIV RNA copies/mL with 100% sensitivity. The specificities of the qualitative PCR amplification of HIV-1 RT assay were 94.1%, 93.6%, and 93.2% compared to the real time PCR at 500, 1000, and 5000 threshold of HIV RNA copies/mL, respectively, and $24,940 USD would have been saved for 150 patients during 10 months. The qualitative PCR amplification of HIV-1 RT assay might be a useful approach to effectively monitor patients receiving ART and save resources.
    AIDS research and human retroviruses 04/2014; · 2.18 Impact Factor
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    ABSTRACT: The incidence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) bacteraemia has increased in recent years, and infections caused by CRPA result in higher mortality than those caused by susceptible strains. This study was performed to evaluate the risk factors for mortality, and to study the impact of virulence factors and bacterial strains on clinical outcomes in patients with CRPA bacteraemia. Data on 63 episodes of CRPA bacteraemia that have occurred between January 1, 2007 and December 31, 2009 in a teaching hospital (2000 beds) in Seoul, Korea were analyzed. The APACHE II score at the time of CRPA bacteraemia and the capacity of CRPA to form biofilm were independent predictive factors for mortality in patients with CRPA bacteraemia. In addition, the biofilm-forming ability and elastase activity of strains were correlated with APACHE II scores to measure the severity of disease and estimate predicted mortality in the patients.
    Diagnostic Microbiology and Infectious Disease. 01/2014;
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    ABSTRACT: Multiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation. We constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures. Overall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together. This model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM.
    PLoS ONE 01/2014; 9(3):e90080. · 3.53 Impact Factor
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    ABSTRACT: Background: Bacteremia with multidrug-resistant (MDR) Acinetobacter baumannii with carbapenem resistance is an important healthcare-associated infection that increases morbidity and mortality in immunocompromised patients. The aim of this study was to assess the annual incidence and clinical characteristics of such bacteremia and to identify the risk factors for infection in hematopoietic stem cell transplantation (HSCT) recipients. Methods: A retrospective cohort and case-control study was conducted in 483 HSCT recipients between January 2005 and December 2011 at a single tertiary center. Thirty-eight control HSCT patients without evidence of post-transplant infection were matched with 19 patients with bacteremia due to MDR A. baumannii in a 2:1 ratio. Results: The total incidence of carbapenem-resistant-MDR A. baumannii bacteremia was 0.52 cases/10,000 patient-days. In most cases (17 of 19, 89.5%), bacteremia developed after engraftment. Pneumonia was the origin of bacteremia in all patients. Eighteen (94.7%) patients with bacteremia and 3 (8.3%) without bacteremia died. In multivariate regression analyses, the duration between admission and HSCT (odds ratio (OR) 2.19 per 1-day increase, p = 0.030) and a history of care in an intensive care unit after HSCT (OR 32.2, p = 0.021) were independent risk factors for the development of carbapenem-resistant-MDR A. baumannii bacteremia. Conclusions: We report that carbapenem-resistant-MDR A. baumannii bacteremia in HSCT recipients is a fatal infectious complication and mainly develops after engraftment.
    Scandinavian Journal of Infectious Diseases 12/2013; · 1.71 Impact Factor
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    ABSTRACT: Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. While gastrointestinal surgery is relatively common in Korea, few studies have evaluated SSI in the context of gastric surgery. Thus, we performed a prospective cohort study to determine the incidence and risk factors of SSI in Korean patients undergoing gastric surgery. A prospective cohort study of 2,091 patients who underwent gastric surgery was performed in 10 hospitals with more than 500 beds (nine tertiary hospitals and one secondary hospital). Patients were recruited from an SSI surveillance program between June 1, 2010, and August 31, 2011 and followed up for 1 month after the operation. The criteria used to define SSI and a patient's risk index category were established according to the Centers for Disease Control and Prevention and the National Nosocomial Infection Surveillance System. We collected demographic data and potential perioperative risk factors including type and duration of the operation and physical status score in patients who developed SSIs based on a previous study protocol. A total of 71 SSIs (3.3%) were identified, with hospital rates varying from 0.0 - 15.7%. The results of multivariate analyses indicated that prolonged operation time (P = 0.002), use of a razor for preoperative hair removal (P = 0.010), and absence of laminar flow in the operating room (P = 0.024) were independent risk factors for SSI after gastric surgery. Longer operation times, razor use, and absence of laminar flow in operating rooms were independently associated with significant increased SSI risk after gastric surgery.
    Infection & chemotherapy. 12/2013; 45(4):422-30.
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    ABSTRACT: Background: There have been various efforts to identify less costly but still accurate methods for monitoring the response to HIV treatment. We evaluated a pooling method to determine if this could improve screening efficiency and reduce costs while maintaining accuracy in Seoul, South Korea. Methods: We conducted the first prospective study of pooled nucleic acid testing (NAT) using a 5 minipool + algorithm strategy versus individual viral load testing for patients receiving antiretroviral therapy (ART) between November 2011 and August 2012 at an urban hospital in Seoul, South Korea. The viral load assay used has a lower level of detection of 20 HIV RNA copies/ml, and the cost per assay is US$ 136. The 5 minipool +algorithm strategy was applied and 43 pooled samples were evaluated. The relative efficiency and accuracy of the pooled NAT were compared with those of individual testing. Results: Using the individual viral load assay, 15 of 215 (7%) plasma samples had more than 200 HIV RNA copies/ml. The pooled NAT using the 5 minipool + algorithm strategy was applied to 43 pooled samples; 111 tests were needed to test all samples when virologic failure was defined at HIV RNA ≥ 200 copies/ml. Therefore, 104 tests were saved over individual testing, with a relative efficiency of 0.48. When evaluating costs, a total of US$ 14,144 was saved for 215 individual samples during 10 months. The negative predictive value was 99.5% for all samples with HIV RNA ≥ 200 copies/ml. Conclusions: The pooled NAT with 5 minipool + algorithm strategy seems to be a very promising approach to effectively monitor patients receiving ART and to save resources.
    Scandinavian Journal of Infectious Diseases 11/2013; · 1.71 Impact Factor
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    ABSTRACT: Background: A novel therapeutic human cytomegalovirus (HCMV) DNA vaccine that includes glycoprotein B (gB) has recently undergone a successful phase 2 trial in allogenic hematopoietic stem cell transplantation recipients. However, a few studies have analyzed gB genotypes and their association with clinical outcome in patients with various underlying diseases. The aim of this study was to analyze the gB genotype distribution and its association with clinically significant factors such as survival rate and occurrence of tissue-invasive disease. Methods: This study was performed on 52 HCMV strains obtained from blood samples of immunocompromised patients presenting at a single tertiary center between January and April 2013. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing analysis were used to confirm the gB genotypes. Patients' clinical data were obtained from medical records. Results: Among the 52 patients, 26 (50%) had hematologic diseases including malignancy, 6 (12%) had solid organ cancers, 5 (10%) had autoimmune diseases, and the rest (28%) had infectious diseases. The prevalent genotypes of HCMV gB were type 1 (26, 50%) and 3 (24, 46%). No statistically significant difference was found between gB1 and gB3 distributions by disease among patients with and without hematologic disease (p=0.482). No statistically significant difference was noted between genotypes and all causes of in-hospital mortality (p=0.452). Among the 52 patients, 15 patients had HCMV disease, with HCMV pneumonitis being the most commonly identified (13/15, 86%). No statistically significant difference was found between the occurrence of HCMV disease and genotypes (p=0.879). Conclusion: In South Korea, HCMV gB1 and gB3 were both identified at similar levels. No significant difference was noted between gB1 and gB3 distributions with respect to underlying illness, survival, or occurrence of HCMV disease.
    IDWeek 2013 Meeting of the Infectious Diseases Society of America; 10/2013
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    ABSTRACT: Background: HIV-associated neurocognitive disorder (HAND) is an independent predictor of early mortality, and strongly predictive of a wide variety of difficulties in activities of daily living. We conducted a study to determine the prevalence and risk factors of HAND in HIV-infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological (NP) tests for diagnosing HAND. Methods: Two hundred HIV-infected patients were recruited consecutively from two different urban teaching hospitals in Seoul, South Korea between Mar 2012 and Sep 2012. Six subjects were excluded due to confounding comorbidity and withdrawing their agreement. Subjects completed a detailed neuropsychological assessment measuring their functioning in 6 cognitive domains known to be commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questionnaires, international dementia scale (IDS) and MOCA-K were assessed as a screening tool. Results: Among the 194 enrolled participants, the prevalence of HAND was 26.3%. Asymptomatic HAND and mild HAND accounted for 52.9% and 47.1% of the patients with HAND, respectively. In multivariate analysis, hemoglobin levels ≤13g/dL (p=0.046) and current use of PI-based regimen (p=0.031) were independent risk factors for HAND. The area under curves of key questionnaires, IDS and MOCA-K for diagnosing HAND were 0.584 (p=0.051), 0.678 (p<0.001) and 0.666 (p<0.001), respectively. Among NP tests, the Grooved Pegboard Test had the highest sensitivity and modest specificity (90.2% and 72.0%, respectively), and that of Wisconsin Card Sorting Test were 61.2% and 84.4%, respectively. Conclusion: The prevalence of HAND in HIV-infected Koreans was similar with those of western countries. IDS and MOKA-K as a screening tool for HAND had insufficiently better performance than key questionnaires. The Grooved Pegboard Test might be used as a screening tool for HAND in HIV infected Koreans.
    IDWeek 2013 Meeting of the Infectious Diseases Society of America; 10/2013
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    ABSTRACT: Background: Pseudomonas aeruginosa is recognized as the main pathogen responseible for the morbidity and mortality of cystic fibrosis (CF) patients. P. aeruginosa has also been found as a colonizer of lungs in a significant proportion of adults with chronic obstructive pulmonary disease (COPD). A hallmark of chronic infection of the CF airways is an event termed mucoid conversion, which is mediated by gene mutations in mucA. The clinical significance of mucA gene mutation in non-CF obstructive diseases is not clear. We evaluated the factors for prognosis and the influence of mucA gene mutation on clinical outcomes among COPD patients with P. aeruginosa pneumonia. Methods: This study prospectively enrolled COPD patients with P. aeruginosa pneumonia from November 2012 to February 2013 at a 2,000-bed university hospital. The clinical and laboratory data were collected for all patients. In addition, the mucA gene of P. aeruginosa isolates from COPD patients was analyzed. Results: There were 35 COPD patients with P. aeruginosa pneumonia. The APACHE II score and C-reactive protein/Albumin (CA) ratio at the time of P. aeruginosa pneumonia were independent predictive factor for mortality in COPD patients with P. aeruginosa pneumonia (odds ratio [OR] 1.46, 95% confidence intervals [CIs] 1.07-1.99, p = 0.016; and OR 1.05, 95% CIs 1.01-1.10, p = 0.044, respectively). In addition, mucA gene mutation of P. aeruginosa was independent predictors of mortality in COPD patients with P. aeruginosa pneumonia (OR 57.7, 95% CIs 1.2-2844.7, p = 0.041). Conclusion: Our results suggest that CA ratio and mucA gene mutation of P. aeruginosa could be used as predictors to identify COPD patients with P. aeruginosa pneumonia for poor prognosis.
    IDWeek 2013 Meeting of the Infectious Diseases Society of America; 10/2013
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    ABSTRACT: The clinical significance of humoral immune response to nosocomial pathogens and functional status in elderly patients with sepsis is not clear. We evaluated the humoral immune to nosocomial pathogens and the effect of functional dependencies on clinical outcomes among elderly patients with sepsis. This study prospectively enrolled patients aged ≥65 years with sepsis from September 2011 to May 2012 at a 2000-bed university hospital. The data including CD4 and CD8 T-cell count, functional status by measuring basic activities of daily living (ADL) and instrumental activities of daily living (IADL) were collected for all patients. In addition, the collected blood samples were analyzed for serum antibody levels against nosocomial pathogens using an ELISA. During the study period, 72 patients (38 males) treated with sepsis were enrolled. The all-cause in-hospital mortality rate was 16.7% (12/72). The mean CD4/CD8 T-cell ratio was significantly lower in nonsurvivors than in survivors (1.08±0.72 vs. 1.93±1.42, P=0.003). Serum antibody titers to Acinetobacter baumannii, Klebsiella pneumonia, Stenotrophomonas maltophilia, and Enterococcus faecalis were statistically higher in nonsurvivors than in survivors. On multivariate analysis, the IADL score was independently predictive of mortality in elderly patients with sepsis (odds ratio 1.410, 95% confidence interval 1.007-1.975, P=0.046). These results suggest that IADL scores could be used as predictors to identify elderly patients with a poor prognosis of nosocomial infections.
    Archives of gerontology and geriatrics 08/2013; · 1.36 Impact Factor
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    ABSTRACT: Background: The introduction of highly active antiretroviral therapy (HAART) has extended the life expectancy of persons infected with the human immunodeficiency virus type 1 (HIV-1). However, cardiovascular disease (CVD) is currently an increasing concern for HIV-infected persons. Methods: We conducted a cross-sectional case-control study to evaluate and compare the 10-y cardiovascular risk of HIV-infected Koreans who had been receiving HAART for over 6 months and age- and sex-matched uninfected persons who visited a health promotion center, by calculating Framingham risk scores (FRS). Results: The average 10-y risk for cardiovascular events (FRS) was 7.07% (2-45) in the HIV group and 6.87% (1-37) in the control group (p = 0.77), corresponding to the very low risk group. Among HIV patients, the FRS was above 10% (low to moderate cardiovascular risk) in 19.9% of the patients, and above 20% (high risk) in 1.7% of the patients. In the healthy control group, the FRS was above 10% in 16.8% and above 20% in 2.7% (p = 0.57). The FRS was not significantly different for HIV-infected patients treated with protease inhibitor (PI)-based HAART and those treated with non-nucleoside reverse transcriptase inhibitor (NNRTI)-based HAART (7.26 ± 6.3 and 6.81 ± 4.4, respectively, p = 0.69). Conclusions: The predicted cardiovascular risk of HIV-infected Koreans on HAART by FRS equation was low and similar to that of age- and sex-matched healthy control persons. However, the possibility remains that actual cardiovascular events could be underestimated. The next step for predicting the cardiovascular risk is to calculate the Data Collection of Adverse Events of Anti-HIV Drugs (D:A:D) equation risks.
    Scandinavian Journal of Infectious Diseases 08/2013; · 1.71 Impact Factor
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    ABSTRACT: The purpose of this study was to assess the prevalence and characteristics of HIV drug-resistance mutations among antiretroviral therapy (ART)-naïve and experienced patients in South Korea. A total of 50 ART-naïve and 34 ART-experienced Korean HIV-1 infected patients who visited an urban hospital from February 2007 to March 2011 were included. Most patients (86.9%) were infected with clade B HIV-1. Six (12%) ART-naïve and 22 (64.7%) ART-experienced patients had HIV strains with resistance mutations. Among ART-naïve patients, V179D was the most common mutation, being found in five ART naïve patients. Among ART-experienced patients, M184V was the most common mutation. Eight of 34 ART-experienced patients had thymidine analogue mutations (TAMs). The prevalence of drug-resistant HIV-1 in ART-naïve patients was higher than in previous reports, and 50% of patients with virologic failure harbored strains with multiple resistance mutations. HIV drug-resistance testing should be recommended to guide therapy of ART-naïve patients in South Korea.
    AIDS research and human retroviruses 08/2013; · 2.18 Impact Factor
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    ABSTRACT: Combined antiretroviral therapy (cART) has significantly improved the survival rate in HIV-infected individuals, but it contributes to the development of various metabolic complications. Klotho is a novel antiaging gene that encodes a protein with pleiotropic functions, including an emerging role in cardiovascular disease (CVD). The protective effect of higher plasma klotho levels against CVD was recently observed in non HIV-infected adults. We aimed to assess whether plasma secreted α-klotho is associated with subclinical carotid atherosclerosis in HIV-infected patients receiving cART. We prospectively examined the association of circulating plasma α-klotho in 120 HIV-infected patients who had received cART for ≥ 6 months with intima-media thickness (IMT) in the carotid artery and other metabolic variables. The subclinical carotid atherosclerosis was defined as increased mean-IMT level of ≥ 75th percentile for the matched age, sex and race and/or the presence of carotid plaque. Thirty-four (28.3%) of 120 had subclinical carotid atherosclerosis. The higher plasma levels of α-klotho had protective effect against subclinical carotid atherosclerosis (OR 0.006, p = 0.034) in multivariate regression analysis. Plasma α-klotho levels had a significantly negative correlation with fasting glucose levels (r = -0.216, p=0.018) and mean-IMT (r = -0.258, p = 0.004) in multiple stepwise regression analyses. The optimal cutoff values of plasma α-klotho levels for the greatest sensitivity and specificity was calculated as 2.83 log10[pg/mL] (sensitivity, 48.7%; specificity, 90.5%). These results show that plasma klotho levels were inversely associated with subclinical carotid atherosclerosis in HIV-infected patients receiving cART.
    AIDS research and human retroviruses 08/2013; · 2.18 Impact Factor

Publication Stats

172 Citations
102.68 Total Impact Points

Institutions

  • 2006–2014
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2011–2013
    • CHA University
      • Department of Pediatrics
      Seoul, Seoul, South Korea
    • Chonnam National University
      • Department of Radiology
      Gwangju, Gwangju, South Korea
  • 2012
    • Inha University Hospital
      Sinhyeon, South Gyeongsang, South Korea
  • 2011–2012
    • Chonnam National University Hospital
      Sŏul, Seoul, South Korea