Pia Susanna Kivelä

Pia Susanna Kivelä
Helsinki University Central Hospital | HUCH · Division of Infectious Diseases

About

52
Publications
3,076
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
489
Citations
Citations since 2017
35 Research Items
323 Citations
2017201820192020202120222023020406080
2017201820192020202120222023020406080
2017201820192020202120222023020406080
2017201820192020202120222023020406080

Publications

Publications (52)
Article
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advan...
Article
Full-text available
Purpose The Finnish HIV Quality of Care Register (FINHIV) was created to: (1) estimate the number of people living with HIV (PLWH) in Finland, (2) evaluate the national level of antiretroviral medication use and viral suppression, (3) examine the change in the HIV epidemic in Finland to pinpoint issues to address and (4) enable evaluation of the he...
Article
Integrase inhibitors appear to increase body weight, but paradoxically some data indicate that raltegravir (RAL) may decrease liver fat. Our objective was to study the effects of switching from a protease inhibitor (PI) or efavirenz (EFV) to RAL on liver fat, body composition, and metabolic parameters among people living with HIV (PLWH) with high r...
Article
Full-text available
Objectives Comparative data on glucose disorders using fasting blood samples between people living with HIV (PLWH) and the general population are lacking. The objective of this study was to compare the prevalence and risk factors of obesity and disturbances in glucose homeostasis between PLWH treated with modern antiretroviral therapy and the gener...
Article
Tenofovir disoproxil fumarate (TDF) has increasingly been replaced by tenofovir alafenamide (TAF) because of reduced kidney and bone toxicity with TAF. This switch has, however, caused worsening of lipid concentrations in clinical trials, but data from any real-world setting are scarce. The objective of this study was to characterize the effect of...
Article
Background: Kaposi sarcoma (KS) age-standardized incidence rate is below 0.3 per 100,000 in Nordic countries. Data on KS in Finland have been sparse. Methods: A retrospective review of all the patients with KS cases managed in the Helsinki University Central Hospital between 2006 and 2018. Results: Forty patients (median age at diagnosis 45 ye...
Article
Full-text available
Background Tuberculosis (TB) is a major cause of death in HIV patients worldwide. Here we describe the epidemiology and outcome of HIV-TB co-infections in a high-income country with low TB incidence and integrated HIV and TB therapy according to European guidelines. Methods This study was based on the HIV cohort of the Helsinki University Hospital...
Article
Full-text available
Migrants are disproportionately affected by HIV in many European countries, including Finland. We aimed to compare the HIV-related knowledge, attitudes and practices (KAP) of young asylum seekers to those of the general young adult population. Two cross-sectional surveys were conducted among 20- to 25-year-old young adults: The TIE study among asyl...
Article
Full-text available
Studying the evolution of viruses and their molecular epidemiology relies on accurate viral sequence data, so that small differences between similar viruses can be meaningfully interpreted. Despite its higher throughput and more detailed minority variant data, next-generation sequencing has yet to be widely adopted for HIV. The difficulty of accura...
Article
HIV-positive children are still born in Europe despite low mother-to-child transmission (MTCT) rates. We aimed to clarify the remaining barriers to the prevention of MTCT. By combining the national registers, we identified all women living with HIV delivering at least one child during 1983–2013. Of the 212 women delivering after HIV diagnosis, 46%...
Article
Full-text available
Introduction Vaginal delivery has been recommended for more than ten years for women living with HIV (WLWH) with good virological control. However, in Europe most WLWH still deliver by cesarean section (CS). Our aim was to assess the rate of vaginal delivery and the indications for CS in WLWH over 20 years in a setting of low overall CS rate. Mate...
Article
Full-text available
Background: Migrants are considered a key population at risk for sexually transmitted and blood-borne diseases in Europe. Prevalence data to support the design of infectious diseases screening protocols are scarce. We aimed to estimate the prevalence of hepatitis B and C, human immunodefiency virus (HIV) infection and syphilis in specific migrant...
Poster
Full-text available
Poster display: https://academic.oup.com/eurpub/article/27/suppl_3/ckx186.229/4555844
Poster
Full-text available
Testing policy at a HIV testing service in Helsinki was changed to a more approach than earlier by offering test more frequently, doing outreach testing and using social media to reach the target group (MSM). After the change in policy, the median CD4 count for MSM was higher than before among MSM.
Article
Introduction: Cervical screening by means of annual Papanicolaou (PAP) smears has been recommended for all women living with HIV. We analysed the results of our annual PAP smear screening programme in order to identify low-risk subgroups for less rigorous screening MATERIAL AND METHODS: The study comprised 369 women followed at the Helsinki Univer...
Article
Full-text available
HIV-1 set-point viral load—the approximately stable value of viraemia in the first years of chronic infection—is a strong predictor of clinical outcome and is highly variable across infected individuals. To better understand HIV-1 pathogenesis and the evolution of the viral population, we must quantify the heritability of set-point viral load, whic...
Data
Estimated heritability as a function of sample size. Estimated heritability under the BM (top panel) and OU (bottom panel) models, as a function of sample size. We randomly sampled 40 subsets of the full dataset (subtype B only, N = 1581) and inferred maximum likelihood parameters and heritability in each subset. Bullets show the maximum likelihood...
Data
Schematic of a donor-recipient pair. On the left, the genealogy of a donor transmitting to a recipient. Arrows denote the time of sampling and measurement of each partner. We assume the donor is measured and sampled before the branching in the genealogy (which may be anterior to the transmission event because of within-host diversity). On the right...
Data
Analysis of temporal trends in GSVL and SPVL. (DOCX)
Data
Analysis of variance for three viral load measures, for the subset of patients infected by subtype B virus. (DOCX)
Data
The relationship between phylogenetic heritability and donor-recipient regression. (DOCX)
Data
Data for Figs 1B, 1C, 2, S2, S3 and S4. (ZIP)
Data
Linkage disequilibrium in the population as a function of the distance separating pairs of loci. We considered all subtype B sequences (N = 1581), and calculated the linkage disequilibrium for 100,000 pairs of positions where the two most common nucleotides have frequency greater than 0.01. Linkage disequilibrium was calculated as D = (XAB-pA pB)/√...
Data
Analysis of heritability stratified by country, gender, mode of transmission. (DOCX)
Data
Analysis of heritability for another viral load measure, for a linear model with country included as a covariate, and for other inclusion criteria for viral sequences. (DOCX)
Data
Maximum likelihood subtype B phylogeny. The maximum likelihood phylogeny of viral sequences of subtype B used for the estimation of heritability (N = 1581), with edges coloured by viral load value (in log10 copies/mL). Black points show nodes with bootstrap values greater than 90%. The data used in the figure is provided as supplementary informatio...
Data
Increase in phenotypic variance in the data and predicted increase in genetic variance in the phylogenetic models. Bullets show the variance in GSVL (black) and SPVL (gray) among subtype B samples as a function of the time of the sample, calculated over 2-years intervals. The corresponding lines show the linear regression, with a significant increa...
Data
Analysis of variance for GSVL and SPVL viral load measures, for patients infected by all subtypes (N = 2028). (DOCX)
Data
The relationship between SPVL and GSVL. (DOCX)
Preprint
Full-text available
Next-generation sequencing has yet to be widely adopted for HIV. The difficulty of accurately reconstructing the consensus sequence of a quasispecies from reads (short fragments of DNA) in the presence of rapid between- and within-host evolution may have presented a barrier. In particular, mapping (aligning) reads to a reference sequence leads to b...
Article
Background: Although infections represent the most common health problem of travellers abroad, data on morbidity and incidences of various infections are scarce. Method: Data on infections of Finnish travellers during 2010 to 2012 were retrieved from the database of SOS International, an assistance organization covering 95% of Finns requiring ai...
Article
Full-text available
As the human immunodeficiency virus (HIV)-positive population ages, issues concerning sexuality and fertility, among others, are becoming relevant. HIV is still surrounded by stigma and taboos, and there have been few studies conducted in industrialized settings concerning these questions. We therefore wanted to investigate the perception of sexual...
Article
Full-text available
The number of international tourist arrivals reached 1,000 million in 2012. Assessment of travellers' health problems has relied on proportionate morbidity data.Given the lack of data on number of visitors to each region, incidences have been impossible to calculate.This study, largest yet reporting travellers' health problems, is the first to pres...
Article
The aim of this study was to assess the acceptability of human immunodeficiency virus (HIV) testing among migrants in Finland and the factors contributing to non-acceptance. The Finnish Migrant Health and Wellbeing Study 'Maamu' was the first national population-based Health Interview and Examination Survey (HIS/HES) among migrants in Finland. A to...
Article
Full-text available
Background Although described in several reports, imported malaria in Europe has not been surveyed nationwide with overall coverage of patients and individually rechecked background information. Plasmodium falciparum infections have been reported despite regularly taken appropriate chemoprophylaxis, yet the reliability of such questionnaire-based r...
Article
Full-text available
An outbreak of HIV was detected amongst Finnish injecting-drug users (IDUs) in 1998. The outbreak was caused by CRF01-AE virus [1]. A comprehensive care programme including infectious diseases, addiction medicine, low threshold methadone program, needle exchange, accommodation and other social services started in December 2000. Funding was provided...
Article
Returning travelers with fever pose challenges for clinicians because of the multitude of diagnostic alternatives. Case data in a Finnish tertiary hospital were analyzed in order to define the causes of fever in returned travelers and to evaluate the current diagnostic approach. A retrospective study of patient records comprised 462 febrile adults...
Article
Full-text available
To determine the prevalence of parvovirus 4 infection and its clinical and sociodemographic correlations in Finland, we used virus-like particle-based serodiagnostic procedures (immunoglobulin [Ig] G, IgM, and IgG avidity) and PCR. We found 2 persons with parvovirus 4 primary infection who had mild or asymptomatic clinical features among hepatitis...
Article
Full-text available
Detailed phylogenetic analyses were performed to characterize an HIV-1 outbreak among injection drug users (IDUs) in Stockholm, Sweden, in 2006. This study investigated the source and dynamics of HIV-1 spread during the outbreak as well as associated demographic and clinical factors. Seventy Swedish IDUs diagnosed during 2004 to 2007 were studied....
Article
To study determinants of late HIV diagnosis in a low-HIV-prevalence (<0.1%) country where HIV spread among men who have sex with men (MSM) and heterosexuals in the 1980s, and among injecting drug users (IDUs) in the late 1990s. Newly diagnosed HIV cases referred to the Helsinki University Central Hospital between 1985 and 2005 were reviewed to iden...
Article
To study the prevalence of sexual risk behaviour and to identify factors associated with inconsistent condom use of Finnish injecting drug users (IDUs), and thus to examine the potential of sexual transmission of HIV within and from this population. HIV-positive (n = 89) and HIV-negative (n = 207) IDUs from the Helsinki metropolitan area were inter...
Article
Full-text available
Incidence of newly diagnosed HIV infections among injecting drug users (IDUs) in Helsinki rose from 0 per 100,000 inhabitants in 1997 to 2.9 in 1998 and to 11.1 in 1999. Thereafter incidence declined to 2.1 in 2003. Data were collected from interviews with HIV-positive IDUs who attended the University Hospital in Helsinki from 1998 until 2003. We s...
Article
An explosive outbreak of HIV-1 caused by the recombinant subtype AE (CRF01-AE) was detected in 1998 among Finnish injecting drug users (IDUs). These IDUs were compared with IDUs from the Amsterdam Cohort Study (ACS) infected with subtype B, to detect possible differences between 2 western IDU cohorts infected with different subtypes. Markers for pr...
Article
An HIV outbreak among Finnish injecting drug users (IDUs) occurred in 1998. By the end of 2005, 282 IDUs were in-fected, most of them by recombinant virus CRF01_AE of HIV. After a rapid spread, the outbreak subsided, and the prevalence of HIV among IDUs remained low (<2%). The purpose of the study was to describe the outbreak in order to recognise...

Network

Cited By

Projects

Project (1)
Archived project