Lucas E. Hermans
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View article: Causes of death in adults living with HIV in South Africa: A single-centre postmortem study
Causes of death in adults living with HIV in South Africa: A single-centre postmortem study Open
Background: Mortality among people living with HIV (PLWH) in developing settings remains elevated, despite high coverage with antiretroviral therapy (ART), with 70% – 80% being virally suppressed (VS). Objectives: This study aimed to deter…
View article: Long COVID prevalence and risk factors in adults residing in middle- and high-income countries: secondary analysis of the multinational Anti-Coronavirus Therapies (ACT) trials
Long COVID prevalence and risk factors in adults residing in middle- and high-income countries: secondary analysis of the multinational Anti-Coronavirus Therapies (ACT) trials Open
Background During the recent COVID-19 pandemic, reports of long-term persistence or recurrence of symptoms after SARS-CoV-2 infection emerged, which are now collectively referred to as ‘long COVID’. Most descriptions of long COVID originat…
View article: Defective proviruses significantly impact viral transcription and immune activation in men and women with HIV-1 subtype C in rural South Africa
Defective proviruses significantly impact viral transcription and immune activation in men and women with HIV-1 subtype C in rural South Africa Open
Introduction The main obstacle to achieving an HIV-1 cure is the proviral reservoir. To promote equity in HIV cure strategies, it is crucial to study the viral reservoir of the predominant HIV-1 subtype C in both women and men. Therefore, …
View article: Final 192-Week Efficacy and Safety Results of the ADVANCE Trial, Comparing 3 First-line Antiretroviral Regimens
Final 192-Week Efficacy and Safety Results of the ADVANCE Trial, Comparing 3 First-line Antiretroviral Regimens Open
Background ADVANCE compared 3 World Health Organization–recommended first-line regimens in participants with HIV who were antiretroviral naive. Methods This randomized, open-label, noninferiority trial enrolled participants living with HIV…
View article: Point-of-care diagnostics for infection and antimicrobial resistance in sub-Saharan Africa: A narrative review
Point-of-care diagnostics for infection and antimicrobial resistance in sub-Saharan Africa: A narrative review Open
View article: Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa
Changing character and waning impact of COVID-19 at a tertiary centre in Cape Town, South Africa Open
BACKGROUND: The emergence of genetic variants of SARS-CoV-2 was associated with changing epidemiological characteristics throughout coronavirus disease 2019 (COVID-19) pandemic in population-based studies. Individual-level data on the clin…
View article: Equid trypanosomiasis: A systematic review of the global impact of a neglected veterinary disease: Prevalence, morbidity and mortality
Equid trypanosomiasis: A systematic review of the global impact of a neglected veterinary disease: Prevalence, morbidity and mortality Open
presented to all clinics included in the study during the study period.The relationship between selected epidemiological factors and outcome was analysed statistically using a Pearson Chi-Square Test with a significance level of p < 0.05.A…
View article: Predictors of Treatment Adherence and Virological Failure Among People Living with HIV Receiving Antiretroviral Therapy in a South African Rural Community: A Sub-study of the ITREMA Randomised Clinical Trial
Predictors of Treatment Adherence and Virological Failure Among People Living with HIV Receiving Antiretroviral Therapy in a South African Rural Community: A Sub-study of the ITREMA Randomised Clinical Trial Open
View article: Unmasking a silent killer: Prevalence of diagnosed and undiagnosed diabetes mellitus among people living with <scp>HIV</scp> in rural South Africa
Unmasking a silent killer: Prevalence of diagnosed and undiagnosed diabetes mellitus among people living with <span>HIV</span> in rural South Africa Open
Objectives To document the prevalence of impaired glucose tolerance (IGT) and undiagnosed diabetes mellitus (DM) and to identify factors associated with undiagnosed DM in people living with HIV (PLWH). Methods Cross‐sectional study perform…
View article: Prevalence, incidence and recurrence of sexually transmitted infections in <scp>HIV</scp>‐negative adult women in a rural South African setting
Prevalence, incidence and recurrence of sexually transmitted infections in <span>HIV</span>‐negative adult women in a rural South African setting Open
Objective Sexually transmitted infections (STIs), including syphilis, chlamydia, gonorrhoea and trichomoniasis, are of global public health concern. While STI incidence rates in sub‐Saharan Africa are high, longitudinal data on incidence a…
View article: Utility of a machine-guided tool for assessing risk behaviour associated with contracting HIV in three sites in South Africa
Utility of a machine-guided tool for assessing risk behaviour associated with contracting HIV in three sites in South Africa Open
View article: HIV Treatment Monitoring in Resource-Limited Settings
HIV Treatment Monitoring in Resource-Limited Settings Open
The human immunodeficiency virus (HIV) has a profound impact on global health and severely affects many low- and middle-income countries in sub-Saharan Africa. Antiretroviral therapy (ART) has transformed HIV infection from a deadly diseas…
View article: Point-of-Care Tenofovir Urine Testing for the Prediction of Treatment Failure and Drug Resistance During Initial Treatment for Human Immunodeficiency Virus Type 1 (HIV-1) Infection
Point-of-Care Tenofovir Urine Testing for the Prediction of Treatment Failure and Drug Resistance During Initial Treatment for Human Immunodeficiency Virus Type 1 (HIV-1) Infection Open
Background Viral rebound during antiretroviral treatment (ART) is most often driven by suboptimal adherence in the absence of drug resistance. We assessed the diagnostic performance of point-of-care (POC) tenofovir (TFV) detection in urine…
View article: A randomized study of intensified antiretroviral treatment monitoring versus standard-of-care for prevention of drug resistance and antiretroviral treatment switch
A randomized study of intensified antiretroviral treatment monitoring versus standard-of-care for prevention of drug resistance and antiretroviral treatment switch Open
Introduction: Standard-of-care antiretroviral treatment (ART) monitoring in low and middle-income countries consists of annual determination of HIV-RNA viral load with confirmatory viral load testing in case of viral rebound. We evaluated …
View article: Utility of a Machine-Guided Tool for Assessing Risk Behaviour Associated with Contracting HIV in Three Sites in South Africa: A field evaluation (Preprint)
Utility of a Machine-Guided Tool for Assessing Risk Behaviour Associated with Contracting HIV in Three Sites in South Africa: A field evaluation (Preprint) Open
BACKGROUND Digital data collection and the associated mobile health technologies have allowed for the recent exploration of machine learning (ML) as a tool for combatting the HIV epidemic. Machine learning has been found to be useful both…
View article: Differentiated service delivery for people using second‐line antiretroviral therapy: clinical outcomes from a retrospective cohort study in KwaZulu‐Natal, South Africa
Differentiated service delivery for people using second‐line antiretroviral therapy: clinical outcomes from a retrospective cohort study in KwaZulu‐Natal, South Africa Open
Introduction Evidence is needed to guide the inclusion of broader groups of people living with HIV (PLHIV) in differentiated service delivery (DSD) programmes. We assessed treatment outcomes among PLHIV on second‐line regimens in a communi…
View article: Guidelines are needed for studies of pre-treatment HIV drug resistance: a methodological study
Guidelines are needed for studies of pre-treatment HIV drug resistance: a methodological study Open
Background The expansion of access to antiretroviral therapy (ART) has been accompanied by an increase in pre-treatment drug resistance (PDR). While it is critical to monitor the increasing prevalence of PDR across countries and population…
View article: Clinical Impact of Pretreatment Human Immunodeficiency Virus Drug Resistance in People Initiating Nonnucleoside Reverse Transcriptase Inhibitor–Containing Antiretroviral Therapy: A Systematic Review and Meta-analysis
Clinical Impact of Pretreatment Human Immunodeficiency Virus Drug Resistance in People Initiating Nonnucleoside Reverse Transcriptase Inhibitor–Containing Antiretroviral Therapy: A Systematic Review and Meta-analysis Open
Background Increased access to antiretroviral therapy (ART) has resulted in rising levels of pretreatment human immunodeficiency virus drug resistance (PDR). This is the first systematic review and meta-analysis to assess the impact of PDR…
View article: Immune activation correlates with and predicts CXCR4 co-receptor tropism switch in HIV-1 infection
Immune activation correlates with and predicts CXCR4 co-receptor tropism switch in HIV-1 infection Open
View article: Guidelines are Needed for Studies of Pre-Treatment HIV Drug Resistance: A Methodological Study
Guidelines are Needed for Studies of Pre-Treatment HIV Drug Resistance: A Methodological Study Open
Background: The expansion of access to antiretroviral therapy (ART) has been accompanied by an increase in pre-treatment drug resistance (PDR). While it is critical to monitor the increasing prevalence of PDR across countries and populatio…
View article: Drug level testing as a strategy to determine eligibility for drug resistance testing after failure of ART: a retrospective analysis of South African adult patients on second‐line ART
Drug level testing as a strategy to determine eligibility for drug resistance testing after failure of ART: a retrospective analysis of South African adult patients on second‐line ART Open
Introduction When protease inhibitor (PI)‐based second‐line ART fails, guidelines recommend drug resistance testing and individualized third‐line treatment. However, PI‐resistant viral strains are rare and drug resistance testing is costly…
View article: Virological suppression and clinical management in response to viremia in South African HIV treatment program: A multicenter cohort study
Virological suppression and clinical management in response to viremia in South African HIV treatment program: A multicenter cohort study Open
In this study, 90% virological suppression below the threshold of 1,000 copies/mL was observed in on-treatment analysis. However, this target was not met at the 50-copies/mL threshold or in intention-to-treat analysis. Clinical management …
View article: Immune-escape mutations and stop-codons in HBsAg develop in a large proportion of patients with chronic HBV infection exposed to anti-HBV drugs in Europe
Immune-escape mutations and stop-codons in HBsAg develop in a large proportion of patients with chronic HBV infection exposed to anti-HBV drugs in Europe Open
View article: Combined Analysis of the Prevalence of Drug-Resistant Hepatitis B Virus in Antiviral Therapy–Experienced Patients in Europe (CAPRE)
Combined Analysis of the Prevalence of Drug-Resistant Hepatitis B Virus in Antiviral Therapy–Experienced Patients in Europe (CAPRE) Open
These findings support resistance testing in cases of apparent NA therapy failure. This survey highlights the impact of exposure to lamivudine and adefovir on development of drug resistance and cross-resistance. Continued use of these NAs …