Jürgen Rockstroh

Jürgen Rockstroh
University of Bonn | Uni Bonn · Medizinische Klinik und Poliklinik I

MD

About

1,002
Publications
60,562
Reads
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31,068
Citations
Citations since 2017
130 Research Items
9361 Citations
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201720182019202020212022202305001,0001,500
201720182019202020212022202305001,0001,500
201720182019202020212022202305001,0001,500
Additional affiliations
July 1989 - present
University of Bonn - Medical Center
Position
  • Consultant
May 1989 - present
University of Bonn
Position
  • Professor

Publications

Publications (1,002)
Article
Full-text available
Background and aims Liver-associated complications still frequently lead to mortality in people with HIV (PWH), even though combined antiretroviral treatment (cART) has significantly improved overall survival. The quantification of circulating collagen fragments released during collagen formation and degradation correlate with the turnover of extra...
Article
Background & aims: Hepatitis B virus (HBV) coinfection is common among people living with HIV (PLWH) and the most important cause of hepatocellular carcinoma (HCC). Whereas risk prediction tools for HCC exist for patients with HBV monoinfection, they have not been evaluated in PLWH. We performed an external validation of PAGE-B in people with HIV/...
Article
Background and aims: A high prevalence of hepatitis delta virus (HDV) infection, the most severe form of viral hepatitis, has been reported among persons living with HIV (PLWH) in Europe. We analyzed data from a large HIV cohort collaboration to characterize HDV epidemiological trends across Europe, as well as its impact on clinical outcomes. Met...
Article
Getting to Zero is a commonly cited strategic aim to reduce mortality due to both HIV and avoidable deaths among people with HIV. However, no clear definitions are attached to these aims with regard to what constitutes HIV-related or preventable mortality, and their ambition is limited. This Position Paper presents consensus recommendations to defi...
Article
The mechanisms involved in HIV-associated NK cell impairment are still incompletely understood. We observed HIV infection to be associated with increased plasma levels of IFABP, a marker for gut epithelial barrier dysfunction, and LBP, a marker for microbial translocation. Both IFABP and LBP plasma concentrations were inversely correlated with NK c...
Article
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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 individ...
Article
Background: The ongoing COVID-19 pandemic has been impeding HIV diagnosis and treatment worldwide. Data on the impact of COVID-19 on late diagnosis (LD) in Germany are lacking. Here we present novel data of a single-centre German HIV cohort assessing LD during COVID-19. Methods: This is a non-interventional, single-centre retrospective cohort as...
Article
Objectives: Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study. Methods:...
Article
Background Data on the long-term persistence of HCV resistance-associated substitutions (RASs) after treatment with direct acting antivirals (DAAs) are limited. This study evaluated the persistence of NS3, NS5A and NS5B RASs for up to 5 years after the end of treatment (EOT). Methods We included samples from n=678 patients with a HCV GT (genotype)...
Article
We present the outcomes of the HepHIV 2021 Lisbon & virtual conference held on 5-7 May 2021, including a Call to Action addressing policy and practice implications in the field of earlier and integrated testing for HIV, viral hepatitis, STI and TB and in light of lessons learned from the COVID-19 pandemic. Conference presentations showed that combi...
Article
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Objective: To compare the incidence of hypertension in people living with HIV receiving integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) versus non-nucleoside reverse transcriptase inhibitors (NNRTIs) or boosted protease inhibitors (PIs) in the RESPOND consortium of HIV cohorts. Methods: Eligible people with HIV wer...
Article
Background: Following the introduction of direct-acting antiviral therapy in 2013, WHO launched the first Global Health Sector Strategy on Viral Hepatitis. We describe a hepatitis C virus (HCV) cascade of care in people with HIV (PWH) across Europe in terms of reaching the WHO elimination targets of diagnosing 90% and treating 80% of HCV-infected...
Article
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Introduction: Pangenotypic, all-oral direct-acting antivirals, such as glecaprevir/pibrentasvir (G/P), are recommended for treatment of hepatitis C virus (HCV) infection. Concerns exist about the impact on efficacy in patients with suboptimal adherence, particularly with shorter treatment durations. These post hoc analyses evaluated adherence (bas...
Article
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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 l...
Research
Full-text available
Health systems have improved their abilities to identify, diagnose, treat and, increasingly, achieve viral suppression among people living with HIV (PLHIV). Despite these advances, a higher burden of multimorbidity and poorer health-related quality of life are reported by many PLHIV in comparison to people without HIV. Stigma and discrimination fur...
Article
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Late presentation for care in chronic viral hepatitis has been estimated to occur in approximately 25% of patients initiating treatment with direct acting antivirals. We evaluated the extent of late presentation since the implementation of direct acting antivirals and established differences between HCV monoinfected and HIV/HCV coinfected patients....
Article
Full-text available
Health systems have improved their abilities to identify, diagnose, treat and, increasingly, achieve viral suppression among people living with HIV (PLHIV). Despite these advances, a higher burden of multimorbidity and poorer health-related quality of life are reported by many PLHIV in comparison to people without HIV. Stigma and discrimination fur...
Article
Background We sought to identify factors associated with weight gain in randomized clinical trials of antiretroviral (ART) switch. Methods We explored the effects of demographic factors, clinical characteristics, and ART on weight gain in a pooled analysis of 12 prospective clinical trials, wherein virologically-suppressed people with HIV (PWH) we...
Article
Background and aims Shortened duration therapy for acute and recent hepatitis C virus (HCV) infection has been shown to be highly effective in several small non-randomised studies with direct-acting antiviral regimens, however large randomised studies are lacking. Methods REACT was an NIH-funded multicentre international, open-label, randomised, p...
Article
Full-text available
Acute‐on‐chronic liver failure (ACLF) is a syndrome associated with organ failure and high short‐term mortality. Presence of ACLF at interventions, such as surgery or transjugular intrahepatic portosystemic shunt (TIPS), has been shown to determine outcome, but those interventions have also been attributed to precipitate ACLF in different studies....
Article
Full-text available
Rabies post-exposure prophylaxis (R-PEP) including wound treatment, vaccination and application of rabies immunoglobulin (RIG) is essential in preventing rabies mortality. Today, Germany is officially declared free from terrestrial rabies and rabies is only found in bats. However, physicians in A&E Departments are frequently consulted on the need f...
Article
Background The ongoing global SARS-CoV-2 pandemic has caused over 4.7 million infections greatly challenging healthcare workers (HCW) and medical institutions worldwide. The SARS-CoV-2 pandemic has shown to significantly impact mental and physical health of HCW. Thus, implementation of testing facilities supporting HCW are urgently needed. Methods...
Article
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HLA-B*57 affects the course of HIV infection. Under antiretroviral therapy, its effects cannot be explained by outstandingly efficient T cell responses alone but may also involve cells of innate immunity. Studying in vitro stimulation with Pam3CSK4, E. coli LPS-B5 and CpG-ODN-2216, we observed greater induction of IL-6/IL-1beta double-positive CD14...
Article
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The COVID-19 pandemic is an unprecedented global challenge that substantially risks reversing the progress in ending HIV. At the same time, it may offer the opportunity for a new era of HIV management. This viewpoint presents the impact of COVID-19 on HIV care, including the Joint United Nations Programme on HIV/AIDS (UNAIDS) “three 90s” targets. I...
Article
Since 2002, a global epidemic of acute hepatitis C virus (HCV) infection has been noted in men who have sex with men (MSM). Transmission of HCV, particularly in the context of traumatic sex practices that increase the risk of blood-blood contacts (eg, anal sex and fisting), was initially found in human immunodeficiency virus (HIV)–coinfected and mo...
Article
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Transjugular intrahepatic portosystemic shunt (TIPS) can treat portal hypertensive complications and modifies hepatic hemodynamics. Modification of liver perfusion can alter contrast enhancement dynamics of liver nodules. This study investigated the diagnostic performance of contrast-enhanced ultrasound (CEUS) to diagnose hepatocellular carcinoma (...
Article
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Objectives Non‐treponemal serological tests are used to monitor treatment response during syphilis infection. Syphilis‐ and HIV‐coinfected patients may experience incomplete resolution in non‐treponemal titres, which is referred to as the serofast state. The goal of this study was to evaluate risk factors for serofast state in HIV‐infected patients...
Article
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Background The role of HCV-coinfection and HCV-RNA on development of diabetes mellitus (DM) in HIV-positive persons remains unclear. Methods Poisson regression was used to compare incidence rates of DM (blood glucose >11.1 mmol/L, HbA1C >6.5% or >48 mmol/mol, starting antidiabetic medicine or physician reported date of DM onset) between current HI...
Article
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Background: the International Cohort Consortium of Infectious Disease (RESPOND) is a collaboration dedicated to research on HIV and other infectious diseases. Methods: RESPOND is a flexible organization, with several independent substudies operating under one shared governance. HIV-related variables, including full antiretroviral therapy (ART) hist...
Article
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Background: Bictegravir/emtricitabine/and tenofovir alafenamide (B/F/TAF) is guideline-recommended treatment for HIV-1. We evaluated whether people receiving dolutegravir (DTG) plus F/TAF or F/tenofovir disoproxil fumarate (TDF) with viral suppression can switch to B/F/TAF without compromising safety or efficacy, regardless of pre-existing NRTI re...
Article
5053 Background: Previous studies showed that men with HIV-associated germ cell cancer (HIV-GCC) have a similar cancer-free outcome compared with their HIV-negative counterparts. However, the overall survival (OS) was inferior and little data is available on treatment and outcome of HIV-GCC in the era of combined antiretroviral therapy (cART). Meth...
Article
Data on the prevalence of resistance‐associated substitutions (RASs) and their implications for treatment with direct acting antivirals (DAAs) is sparse in European patients with HCV genotype 4. This study investigated RASs before and after DAA failure in different genotype 4 subtypes and evaluated retreatment efficacies. Samples of 195 genotype 4‐...
Article
Objectives The objective of the paper is to present the outcomes of the HepHIV 2019 conference, held in Bucharest under the Romanian EU Presidency and focusing on challenges of timely and integrated testing and care. Methods The conference programme was put together by the organizing committee. It consisted of invited talks and peer‐reviewed abstr...
Article
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Objectives: Development of novel antiretrovirals aims at reducing long-term toxicities. Tenofovir disoproxil fumarate (TDF) has been associated with potential nephrotoxicity. The aim of our study was to assess the impact of switching from TDF to tenofovir alafenamide (TAF) on functional nephropathy and lipid parameters in a real-life setting. Met...
Article
There is an ongoing global hepatitis C virus (HCV) epidemic mainly related to high risk behaviour in persons who inject drugs (PWID) and in HIV‐infected men who have sex with men (MSM) which continues to fuel the HCV epidemic. Treatment of HCV infection with direct antiviral therapy (DAA) has been very successful in the last decade. Main obstacles...
Article
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The EuroSIDA study was initiated in 1994 and follows adult people living with HIV (PLHIV) in 100 collaborating clinics across 35 countries covering all European regions, Israel and Argentina. The study aims to study the long‐term virological, immunological and clinical outcomes of PLHIV and to monitor temporal changes and regional differences in ou...
Article
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HIV/HCV infection is supposed to substantially reduce survival as compared to HIV mono-infection. Here, we compared longtime-survival and causes of death in a cohort of HIV- and HIV/HCV-co-infected patients on combined antiretroviral therapy (cART), before introduction of HCV direct acting antivirals (DAA). 322 Caucasian patients with HIV (n = 176)...
Article
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Background: It is cost-effective to perform an HIV test in people with specific indicator conditions (IC) with an undiagnosed HIV prevalence of at least 0.1%. Our aim was to determine the HIV prevalence for 14 different conditions across 20 European countries. Methods: Individuals aged 18-65 years presenting for care with one of 14 ICs between J...
Article
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Background and aims: Although combined antiretroviral treatment (cART) has improved overall survival of HIV infected patients, liver fibrosis and liver related-mortality still constitute major challenges in HIV positive patients. Collagen accumulates in the liver during fibrogenesis. Recent studies showed that circulating levels of extracellular m...
Article
Background Severe hepatic steatosis shows a high prevalence and contributes to morbidity and mortality in human immunodeficiency virus (HIV) infected patients. Known risk factors include obesity, dyslipidemia and features of metabolic syndrome. Fibroblast growth factor 21 (FGF‐21) is involved with hepatic glucose and lipid metabolism. This study ai...
Article
Objectives The aim of the study was to assess the regression of liver stiffness after successful direct‐acting antiviral (DAA) treatment in patients with hepatitis C virus (HCV) monoinfection and HCV/‐HIV coinfection. In addition, we aimed to identify factors associated with liver stiffness regression. Methods We studied patients treated with inte...
Article
Zusammenfassung Einleitung Mehr als 50% der rund 37 Mio. Menschen, die weltweit mit HIV leben, sind Frauen. Heutzutage kann die MTCT (Mother-to-child Transmission) auf<1% reduziert werden. Intention der vorliegenden Untersuchung war es, die Entwicklung (1) des Schwangerschaftsverlaufs HIV-positiver Frauen, (2) des Entbindungsmodus und (3) der Poste...
Article
Was ist neu? Zerebrale Toxoplasmose Als intravenöse Therapie ist die Gabe von Trimethoprim und Sulfamethoxazol möglich. Auch als orale Prophylaxe können sie nun schon ab einer CD4-T-Helferzellzahl von < 200/µl eingesetzt werden. Pneumocystis jiroveci Zur Prophylaxe und Therapie der Pneumocystis-jiroveci-Pneumonie ist die Kombination aus Trimethopri...
Article
Full-text available
Direct acting antivirals (DAA) represent a breakthrough in the treatment of chronic HCV-infections with cure rates (sustained virologic response, SVR) of up to 99%. However, for interferon-free treatment regimens less is known about their impact on clinical endpoints, especially in case of HCV-HIV co-infection. One of the most compromising issues i...
Article
In the February issue of the American Journal of Public Health, Zibbell et al. report on a relationship between increases in acute hepatitis C virus (HCV) infections and the rising opiod injection epidemic in the United States. The authors base their report on acute HCV case data from the National Notifiable Disease Surveillance System (NNDSS) and...
Article
The introduction of efficacious new hepatitis C virus (HCV) treatments galvanized the World Health Organization to define ambitious targets for eliminating HCV as a public health threat by 2030. Formidable obstacles to reaching this goal can best be overcome through a micro-elimination approach, which entails pursuing elimination goals in discrete...
Article
Background: Switching from therapy based on a boosted protease inhibitor to bictegravir, emtricitabine, and tenofovir alafenamide could avoid drug interactions and unwanted side-effects in virologically suppressed adults with HIV-1 infection, while maintaining a high barrier to resistance and providing a simplified once-daily, single-tablet regime...
Article
Full-text available
Prevalence and risk factors for hepatic steatosis (HS) in the human immunodeficiency virus (HIV)-positive population of western countries are controversially discussed and potentially confounded by coinfection with viral hepatitis. Significant HS (more than 10% of hepatocytes) can be accurately assessed using controlled attenuation parameter (CAP)...
Article
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Background: Once-daily glecaprevir coformulated with pibrentasvir (glecaprevir/pibrentasvir) has demonstrated high rates of sustained virologic response 12 weeks post-treatment (SVR12) in patients with hepatitis C virus (HCV) genotype 1-6 infection. This phase 3 study evaluated the efficacy and safety of glecaprevir/pibrentasvir in patients with c...
Article
Background Twelve weeks of the pangenotypic direct‐acting antiviral (DAA) combination sofosbuvir/velpatasvir (SOF/VEL) was highly efficient in patients with hepatitis C virus (HCV) genotype 3 (GT3) infection in the ASTRAL‐3 approval study. However, presence of resistance‐associated substitutions (RASs) in the HCV nonstructural protein 5A (NS5A) was...
Article
Background: Doravirine is a novel non-nucleoside reverse transcriptase inhibitor (NNRTI) with a pharmacokinetic profile supporting once-daily dosing, and potent in-vitro activity against the most common NNRTI-resistant HIV-1 variants. We compared doravirine with ritonavir-boosted darunavir, when both were given with two nucleoside reverse transcri...
Article
Just published - an opinion piece on scaling up HIV self-testing and self-sampling, by the HIV in Europe Initiative (a European civil society, policy makers, health professionals and public health institutions platform to advance early diagnosis and care of HIV and viral hepatitis). The initiative highlights a few steps to be taken to ensure the q...
Article
Objectives: The objective of the article is to provide an overview of the results of the HepHIV 2017 Conference organized by the HIV in Europe initiative under the Maltese EU Presidency in January 2017. Methods: A thourough review of all conference presentations (oral and poster presentations) was performed to retrieve the key outcomes of the co...
Article
Objectives: With persisting high numbers of new HIV diagnoses in Europe, HIV testing remains an important aspect of HIV prevention. The traditional centralized and medicalized HIV testing approach has been complemented with newly developed and evaluated non-traditional approaches. Two important factors guided this process: technological innovation...
Article
Objectives: The European Association for the Study of the Liver (EASL) treatment recommendations for hepatitis C no longer discriminate between HIV/hepatitis C virus (HCV)-coinfected and HCV-monoinfected patients. However, recent data from Spain are questioning these recommendations on the basis of the findings of higher relapse rates and lower cu...
Article
Full-text available
Introduction Combined antiretroviral therapy (cART) has improved survival in HIV-patients. While the first antiretrovirals, which became available in particular D-drugs (especially didanosine and stavudine) and unboosted protease inhibitors, may impair liver function, the modern cART seems to decrease liver fibrosis. This study assessed the influen...
Article
Introduction: Direct-acting antivirals (DAA) have revolutionized the modern treatment of chronic hepatitis C (HCV). These highly efficacious, well-tolerated, all-oral HCV regimens allow cure of HCV in over 95% of HCV-monoinfected as well as HIV/HCV-co-infected patients with short treatment durations of 8-12 weeks. Areas covered: This review will ad...