Lene Ryom

Lene Ryom

PhD

About

95
Publications
6,709
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2,851
Citations
Citations since 2016
52 Research Items
2352 Citations
20162017201820192020202120220100200300
20162017201820192020202120220100200300
20162017201820192020202120220100200300
20162017201820192020202120220100200300

Publications

Publications (95)
Article
Objective: Deaths due to suicide, substance use and violence/accidental may reflect similar risk factors and be overlapping in their classification. This study aimed to investigate incidence and risk factors of mortality among people with HIV (PWH) due to these three related causes. Design: Prospectively collected data from PWH ≥18 years old and...
Article
Objective: Assessing whether the previously reported association between abacavir (ABC) and cardiovascular disease (CVD) remained amongst contemporarily treated people living with HIV (PLWH). Design: Multinational cohort collaboration. Methods: RESPOND participants were followed from latest of 01/01/2012 or cohort enrolment until the first of...
Article
Background Although associations between older antiretroviral drug classes and cardiovascular disease in people living with HIV are well described, there is a paucity of data regarding a possible association with integrase strand-transfer inhibitors (INSTIs). We investigated whether exposure to INSTIs was associated with an increased incidence of c...
Article
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 ou...
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Full-text available
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...
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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...
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Background Limited data exist examining the association between incident cancer and cumulative integrase inhibitor (INSTI) exposure. Methods Participants were followed from baseline (latest of local cohort enrolment or 01.01.2012) until the earliest of first cancer, final follow-up, or 31.12.2019. Negative binomial regression was used to assess as...
Article
BACKGROUND: Limited data exist comparing clinical outcomes of two-drug regimens (2DRs) and three-drug regimens (3DRs) in people living with HIV. METHODS: Antiretroviral treatment-experienced individuals in RESPOND switching to a new 2DR or 3DR from 1/1/12-1/10/18 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular...
Article
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, multicohor...
Article
Introduction: Cumulative use of some first-generation protease inhibitors has been associated with higher rates of dyslipidemia and increased risk of cardiovascular disease. The protease inhibitors most commonly in use are atazanavir and darunavir, which have fewer detrimental lipid effects and greater tolerability. This paper aims to review the ev...
Article
Objective: To evaluate time trends in pregnancies and pregnancy outcomes among women living with HIV in Europe. Design: European multicentre prospective cohort study. Methods: EuroSIDA has collected annual cross-sectional audits of pregnancies between 1996 and 2015. Pregnancy data were extracted and described. Odds of pregnancy were modelled,...
Article
BACKGROUND It is unknown if the carcinogenic effect of smoking is influenced by CD4+ cell count and viral load in persons living with HIV. MATERIAL AND METHODS RESPOND participants with known smoking status were included. Poisson regression adjusting for baseline confounders investigated the interaction between current CD4+/viral load strata [good...
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Background: Expanding statin use may help to alleviate the excess burden of atherosclerotic cardiovascular disease in people living with HIV (PLHIV). Pravastatin and pitavastatin are preferred agents due to their lack of substantial interaction with antiretroviral therapy. We aimed to evaluate the cost-effectiveness of pravastatin and pitavastatin...
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Full-text available
Objectives To compare virologic and immunologic outcomes of integrase inhibitor (INSTI)-containing, contemporary boosted protease inhibitor (PI/b)-containing and non-nucleotide reverse transcriptase inhibitor (NNRTI)-containing regimens in a real-life setting.Methods Using logistic regression, virologic and immunologic outcomes of INSTI use were co...
Article
Background Limited data exist comparing clinical outcomes of two-drug regimens (2DRs) and three-drug regimens (3DRs) in people living with HIV. Methods Antiretroviral treatment-experienced individuals in RESPOND switching to a new 2DR or 3DR from 1/1/12-1/10/18 were included. The incidence of clinical events (AIDS, non-AIDS cancer, cardiovascular...
Article
Background: Weight gain is common among people with HIV once antiretroviral treatment (ART) is commenced. We assess the effect of changes in body mass index (BMI), from different baseline BMI levels, on the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Methods: D:A:D participants receiving ART were followed from their first BM...
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Background: Hepatitis C virus (HCV) infection has been associated with increased risk of chronic kidney disease (CKD). We investigated the impact of HCV cure on CKD in HIV-positive persons in the EuroSIDA study. Methods: HIV-positive persons with known HCV status and at least three serum creatinine measurements after 1/1/2004 were compared based...
Article
Background: Despite increased INSTI use, limited large-scale, real-life data exists on INSTI uptake and discontinuation. Setting: International multicohort collaboration. Methods: RESPOND participants starting dolutegravir (DTG), elvitegravir (EVG) or raltegravir (RAL) after 1/1/2012 were included. Predictors of INSTI used were assessed using...
Article
Objectives: Predictors of chronic kidney disease (CKD) amongst HIV-positive persons are well established, but insights into the prognosis after CKD including the role of modifiable risk factors are limited. Design: Prospective cohort study METHODS:: D:A:D participants developing CKD (confirmed, >3 months apart, eGFR ≤ 60 mL/min/1.73 m or 25% eGF...
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Full-text available
Background: Hypertension is a stronger predictor of hemorrhagic than ischemic strokes in the general population. We aimed to identify whether hypertension or other risk factors, including HIV-related factors, differ in their associations with stroke subtypes in people living with HIV (PLWHIV). Methods: HIV-1-positive individuals from the Data co...
Article
Background: It is unclear if use of contemporary protease inhibitors (PIs) pose a similar chronic kidney disease (CKD) risk as older PIs. Methods: D:A:D participants were followed to CKD, last visit or 2016. Adjusted Poisson regression assessed associations between CKD and boosted atazanavir (ATV/r) and darunavir (DRV/r). Results: CKD incidenc...
Article
Objective: To assess the use of two-drug antiretroviral regimens (2DR) and virologic and immunologic outcomes compared to three-drug regimens (3DR) in the EuroSIDA cohort. Design: Multicentre, prospective cohort study. Methods: Logistic regression was used to analyse the uptake and outcomes among HIV-positive individuals who started or switche...
Article
Objectives: To describe changes in the prevalence of comorbidities and risk factors among HIV-positive individuals in the EuroSIDA study. Design: Comparison of two cross-sectional cohorts of HIV-positive adults under active follow-up in 2006 and 2014. Methods: Baseline demographics and prevalence of comorbidities were described. Factors associ...
Article
Background: Cancers are a major source of morbidity and mortality for HIV-positive persons on combination antiretroviral therapy, while the clinical benefits of smoking cessation are not well established. Methods: Participants were followed from 1 January 2004 until first cancer diagnosis, death, or 1 February 2016. Smoking status was defined as...
Article
Background: Although earlier protease inhibitors have been associated with increased risk of cardiovascular disease, whether this increased risk also applies to more contemporary protease inhibitors is unknown. We aimed to assess whether cumulative use of ritonavir-boosted atazanavir and ritonavir-boosted darunavir were associated with increased i...
Article
Background: The relationship between body mass index (BMI) (weight (kg)/ height(m)) and serious non-AIDS events is not well understood. Methods: We followed D:A:D study participants on antiretroviral therapy from their first BMI measurement to the first occurrence of the endpoint or end of follow-up (N=41,149 followed for 295,147 person-years)....
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Full-text available
Introduction: There is paucity of data related to potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) among HIV-positive individuals. We investigated whether such differences exist in the observational D:A:D cohort study. Methods: Participants were followed from study enrolment until the ear...
Article
Background: Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) are increased in populations with immune dysfunction, including people living with HIV; however, there is little evidence for to what degree immunological and virological factors differently affect NHL and HL risk. Methods: Data from the Data Collection on Adverse events of Anti-HI...
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Purpose of review: To review the evidence linking use of HIV protease inhibitors with excess risk of cardiovascular disease (CVD) in HIV+ populations. Recent findings: For the two contemporary most frequently used protease inhibitors, darunavir and atazanavir [both pharmacologically boosted with ritonavir (/r)], darunavir/r has been shown to be...
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Full-text available
Background: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study has developed predictive risk scores for cardiovascular disease (CVD) and chronic kidney disease (CKD, defined as confirmed estimated glomerular filtration rate [eGFR] ≤ 60 ml/min/1.73 m2) events in HIV-positive people. We hypothesized that participants in D:A:D at h...
Data
CVD event rates according to predicted Framingham CVD and CKD risk strata. (DOCX)
Data
CKD event rates by predicted Framingham CVD and CKD risk strata. (DOCX)
Data
Full list of members of the D:A:D Steering Committee and Study Group. (DOCX)
Data
D:A:D concept study sheet. (DOC)
Article
Objective: To investigate the association between abacavir (ABC) use and recurrent myocardial infarction (MI) among HIV-positive people with a prior MI. Design: International multi-cohort collaboration with follow-up from 1999-2016. Methods: The rate of recurrent MI was described among D:A:D participants who experienced an index MI whilst in t...
Article
Purpose of review: The aim of this study was to discuss the most recent research in the management of cardiovascular disease (CVD) in people living with HIV (PLWHIV) with a focus on screening, primary and secondary prevention. Recent findings: The cause of CVD in PLWHIV is complex and multifactorial and creates a demand for a multifaceted approa...
Article
Objectives: The objectives of this analysis were to investigate predictors of progression, stabilisation or improvement in eGFR after development of chronic renal impairment (CRI) in HIV-positive individuals. Design: Prospective observational study. Methods: D:A:D study participants progressing to CRI defined as confirmed, ?3 months apart, eGF...
Article
Background While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in HIV-positive individuals. Methods Individuals with >2 estimated glomerular filtration rate (eGFRs) after 1/2/2004 were followed until CVD, death, last visit plus six...
Article
OBJECTIVE Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen. DESIGN Prospective cohort study. METHODS Demograph...
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Full-text available
Chronic kidney disease (CKD) has emerged as an important health concern in HIV-positive individuals. Preventing long-term kidney toxicity from an antiretroviral therapy is therefore critical. Selected antiretroviral agents, especially tenofovir disoproxil fumarate (TDF) and some ritonavir-boosted protease inhibitors (PI/rs), have been associated wi...
Article
Background: Antiretroviral (ART) drugs have been associated with higher triglycerides (TG), higher total cholesterol (TC) and lower high density lipoprotein cholesterol (HDL-C) levels. Associations between lipid levels with HIV viraemia and immunosuppression in the presence of ART remain unclear. Methods: Participants from the D:A:D study with a...
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Full-text available
Background In March 2008, the D:A:D study published results demonstrating an increased risk of myocardial infarction (MI) for patients on abacavir (ABC). We describe changes to the use of ABC since this date, and investigate changes to the association between ABC and MI with subsequent follow-up. Methods A total of 49,717 D:A:D participants were f...
Article
Objective: Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen. Design: Prospective cohort study. Methods: D...
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Full-text available
Background Although human immunodeficiency virus (HIV)-positive persons on antiretroviral therapy (ART) frequently have chronic liver enzyme elevation (cLEE), the underlying cause is often unclear. Methods Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study participants without chronic viral hepatitis were observed to the earliest of...
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Full-text available
Objective: Nelfinavir exhibits potent anti-cancer properties against a range of tumours. However, in 2006/07, nelfinavir supplies were accidently contaminated with a carcinogen. This analysis investigated the association between nelfinavir use and cancer risk in HIV-positive persons. Design: Observational cohort study. Methods: D:A:D study dat...
Article
Objectives: Whilst several antiretroviral drugs (ARVs), including the d-drugs stavudine (d4T) and didanosine (ddI), may cause biomarker-defined hepatotoxicity, their association with clinically defined end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) remains unknown. Design: Prospective cohort study METHODS:: D:A:D participants...
Article
Background: Whether or not the association between some antiretrovirals used in HIV infection and chronic kidney disease is cumulative is a controversial topic, especially in patients with initially normal renal function. In this study, we aimed to investigate the association between duration of exposure to antiretrovirals and the development of c...
Article
With the aging of the population living with HIV, the absolute risk of cardiovascular disease (CVD) is increasing. There is a need to further facilitate the identification of persons at elevated risk in routine practice. Prospective information was collected on 32,663 HIV-positive persons from 20 countries in Europe and Australia, who were free of...
Article
The association between combination antiretroviral therapy (cART) and cancer risk, especially regimens containing protease inhibitors (PIs) or nonnucleoside reverse transcriptase inhibitors (NNRTIs), is unclear. Participants were followed from the latest of D:A:D study entry or January 1, 2004, until the earliest of a first cancer diagnosis, Februa...
Article
HIV infection has been associated with an increased risk of chronic kidney disease (CKD). Little is known about the prevalence of CKD in individuals with high CD4 cell counts prior to initiation of antiretroviral therapy (ART). We sought to address this knowledge gap. We describe the prevalence of CKD among 4637 ART-naïve adults (mean age 36.8 year...
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Full-text available
Background: Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify t...
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Full-text available
Introduction: Proteinuria (PTU) is an important marker for the development and progression of renal disease, cardiovascular disease and death, but there is limited information about the prevalence and factors associated with confirmed PTU in predominantly white European HIV+ persons, especially in those with an estimated glomerular filtration rate...
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Introduction: Development of a simple, widely applicable risk score for chronic kidney disease (CKD) allows comparisons of risks or benefits of starting potentially nephrotoxic antiretrovirals (ARVs) as part of a treatment regimen. Materials and methods: A total of 18,055 HIV-positive persons from the Data on Adverse Drugs (D:A:D) study with >3...
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Introduction There is a lack of data on potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) in HIV-positive individuals. We investigated whether such differences exist in the D:A:D study. Materials and Methods Follow-up was from 01/02/99 until the earliest of death, 6 months after last visit o...
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Full-text available
Introduction A recent meta-analysis of 4 RCTs showed an increased rate of suicidality events (suicidal ideation or attempted/completed suicide) associated with efavirenz (EFV) compared to other regimens, but only a trend towards a higher rate of completed/attempted suicides, as only 17 events occurred. We investigated the association between EFV us...
Article
Background: With the advent of effective antiretroviral treatment, the life expectancy for people with HIV is now approaching that seen in the general population. Consequently, the relative importance of other traditionally non-AIDS-related morbidities has increased. We investigated trends over time in all-cause mortality and for specific causes o...
Article
Objectives The aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations.Methods We analysed three endpoints: myoc...
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Full-text available
No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90 ml/min/1.73 m(2) (using Cockcroft Gault) in the Data Collection on Adverse Events of Anti-HIV Drugs (D: A: D...
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Objectives: To determine the relationship between measures of renal function [current estimated glomerular filtration rate (eGFR) and proportion of follow-up with a low eGFR (%FU ≤60 ml/min)] and fatal/ nonfatal AIDS, non-AIDS events and all-cause mortality. Design: An observational, longitudinal cohort study of 12 155 persons from EuroSIDA. Me...
Article
Whilst several antiretroviral drugs have been associated with moderate chronic kidney disease (CKD), their contribution to advanced CKD and end-stage renal disease (ESRD) remain unknown. D:A:D participants with at least three estimated glomerular filtration rates (eGFR) after February 2004 were followed until the first of advanced CKD (confirmed eG...
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The purpose of this article is to review recent literature on antiretroviral treatment (ART) and immune suppression as risk factors for renal impairment in HIV-positive persons, and to discuss pending research questions within this field. Several individual antiretroviral agents (ARVs) including tenofovir and several protease inhibitors have, in di...
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Full-text available
The aim of this study was to determine whether the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)- or Cockcroft-Gault (CG)-based estimated glomerular filtration rates (eGFRs) performs better in the cohort setting for predicting moderate/advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD). A total of 9521 persons in...
Article
To consider associations between the latest/nadir CD4 count, and time spent with CD4 count < 200 cells/mm (duration of immune depression), and myocardial infarction (MI), coronary heart disease (CHD), stroke or CVD (CHD or stroke) in 33,301 HIV-positive individuals. Longitudinal cohort study METHODS:: Analyses were undertaken using Poisson regressi...
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Background: Several antiretroviral agents (ARVs) are associated with chronic renal impairment, but the extent of such adverse events among human immunodeficiency virus (HIV)-positive persons with initially normal renal function is unknown. Methods: D:A:D study participants with an estimated glomerular filtration rate (eGFR) of ≥ 90 mL/min after...
Article
Background: An inverse association between serum alanine aminotransferase (ALT) levels and the risk of myocardial infarction (MI) has been reported in the general population. We investigated associations between ALT levels and the risk of various cardiovascular and cerebrovascular outcomes in a large cohort study of HIV-positive individuals. Meth...