scholarly journals Secondary attack rate among high-risk contacts of COVID-19 paediatric index cases: a study at the beginning of the pandemic in Pune city of Western Maharashtra, India

2021 ◽  
Vol 8 (12) ◽  
pp. 1920
Author(s):  
Ganesh R. Jagadale ◽  
Muralidhar P. Tambe ◽  
Yallapa Jadhav ◽  
Pradip S. Borle ◽  
Malangori A. Parande ◽  
...  
Keyword(s):  
Attack Rate ◽  
Family Background ◽  
Demographic Data ◽  
Pediatric Case ◽  
Unexplored Area ◽  
The Mean ◽  
Isolation Facilities ◽  
Written Informed Consent ◽  
Efficient Transmission ◽  
Index Cases

Background: The COVID-19 was the emerging disease caused by SARS-COV2. Efficient transmission of this disease occurs through droplets and fomites. The susceptibility of children to coronavirus disease-19 (COVID-19) and transmission of COVID-19 from children to others is a relatively unexplored area. The aim of this study was to understand the transmission dynamics of severe acute respiratory syndrome coronavirus 2 in children. Study objectives were to estimate secondary attack rate of COVID-19 from paediatric index case during the early phase of pandemic in Pune city and to identify factors associated with transmission and development of the COVID-19 disease.Methods: This was a retrospective cohort study conducted in the month of June 2020. The sample includes 58 contacts of 11 laboratory confirmed pediatric index cases of COVID-19 from Pune municipal corporation after written informed consent. A confidential telephonic interview of parents was taken by using a prestructured questionnaire which includes socio-demographic data, family background, type of house, development of symptoms, outcome etc.Results: The mean age of primary pediatric case was 12.7±5.1 years. All of them were symptomatic. The SAR estimated was 55.2%. The factors significantly affecting SAR were comorbidity, no. of family members, type of family, overcrowding, no. of rooms, bedroom attached with toilet.Conclusions: The household SAR from paediatric patients is high and is closely associated with family size and other household characteristics. Hence, home quarantine should be advocated in smaller families with appropriate isolation facilities; more emphasis is given to co-morbid individuals.

scholarly journals Secondary Attack Rate among the Contacts of COVID-19 Patients at the Beginning of the Pandemic in Pune City of WesternMaharashtra, India

2021 ◽  
Vol 53 (03) ◽  
pp. 51-59
Author(s):  
Malangori A Parande ◽  
Keyword(s):  
High Risk ◽  
Attack Rate ◽  
Family Background ◽  
Close Contact ◽  
Demographic Data ◽  
Family Type ◽  
Primary Case ◽  
Disease Study ◽  
Outcome Type ◽  
Efficient Transmission

Introduction: The COVID-19 was the emerging disease caused by SARS-COV 2. Efficient transmission of this disease occurs through droplets and fomites. As COVID-19 has high transmission and hence susceptible household & non-household close contacts are at high risk of developing disease. Study Objectives: 1) To estimate secondary attack rate of COVID-19 among the contacts during the pandemic in Pune city; 2) To identify factors associated with transmission and development of COVID-19 disease. Material & Methods: This was a retrospective cohort study conducted in the month of June 2020. The sample includes 741 contacts of 119 Laboratory confirmed cases for COVID-19, resides in 15 ward offices areas of Pune Municipal Corporation after written informed consent. A confidential telephonic interview was taken by using a prestructured questionnaire which includes socio demographic data, duration of stay, family background, outcome, type of house, development of symptoms etc. Results: The overall Secondary Attack Rate estimated to be 32.5%, 33.7% among the high risk contacts while 13.3% among the low risk contacts. In this city, 6 wards (40%) out of 15 wards showed SAR of more than 40%. The characteristics of primary cases associated with spread of disease were presence of symptoms and duration between onset of disease and isolation of primary case. The factors significantly affecting SAR were age, comorbidity, no. of family members, type of family, type of house, overcrowding, no. of rooms, bedroom attached with toilet, type of contact & containment zone. Conclusion: Higher SAR was seen in the household contacts. It is necessary to adopt rigorous measures to cut the transmission chain in this area of close contact.

scholarly journals Epidemiology of mumps in the Netherlands

1980 ◽  
Vol 85 (3) ◽  
pp. 313-326 ◽  
Author(s):  
J. H. T. Wagenvoort ◽  
M. Harmsen ◽  
Barry J. Khader Boutahar-Trouw ◽  
C. A. Kraaijeveld ◽  
K. C. Winkler
Keyword(s):  
Attack Rate ◽  
Neutralizing Antibodies ◽  
Family Study ◽  
Neutralizing Antibody ◽  
Population Group ◽  
Significant Rise ◽  
First Year ◽  
The Family ◽  
The Mean ◽  
Index Cases

SUMMARYIn a Dutch population group neutralizing antibodies against mumps virus were determined by a plaque reduction technique, which proved reproducible, sensitive and specific. The results with sera of about 800 suburban children show that mumps is acquired at an early age with peak acquisition rates between the ages of four and six years. Over 90% have acquired mumps before the age of 14 years. More than 95% of about 1000 adults (18–05 years) have neutralizing antibodies. The relatively constant median titre suggests that antibodies persist during life.During a family study 77 clinical and 18 subclinical cases were observed. In families with index cases the attack rate was 26/37 = 0·71. Eleven children (excluding six babies) esćaped infection. The mean attack rate during the epidemic was 0·30. The mean titre of mumps neutralizing antibody is maximal during the first year after the disease but declines during childhood. Mothers exposed to mumps in the family occasionally showed a significant rise in titre. Some seronegative mothers remained seronegative after exposure.

scholarly journals High Rate of SARS-CoV-2 Transmission due to Choir Practice in France at the Beginning of the COVID-19 Pandemic

2020 ◽  
Author(s):  
Nathalie CHARLOTTE
Keyword(s):  
Attack Rate ◽  
Transmission Rate ◽  
High Rate ◽  
Individual Risk ◽  
High Transmission ◽  
The Mean ◽  
The Individual ◽  
Practice Methods ◽  
Index Cases ◽  
Close Contacts

Background: There has been little focus on the individual risk of acquiring COVID-19 related to choir practice. Methods: We report the case of a high transmission rate of SARS-CoV-2 linked to an indoor choir rehearsal in France in March 2020 at the beginning of the COVID-19 pandemic. Results: A total of 27 participants, including 25 male singers, a conductor and an accompanist attended a choir practice on March 12, 2020. The practice was indoor and took place in a non-ventilated space of 45 m2. No choir member reported having been symptomatic for COVID-19 between March 2 and March 12.The mean age of the participants was 66.9 (range 35-86) years. 70% of the participants (19 of 27) were diagnosed with COVID-19 from 1 to 12 days after the rehearsal with a median of 5.1 days. 36% of the cases needed a hospitalization (7/19), and 21% (4/19) were admitted to an ICU. The index cases were possibly multiple. Discussion: The choir practice was planned in March 2020 at a period when the number of new cases of COVID-19 began to grow exponentially in France because SARS-CoV-2 was actively circulating. The secondary attack rate (70%) was much higher than it is described within households (10-20%) and among close contacts made outside households (0-5%). Singing might have contributed to enhance SARS-CoV-2 person-to-person transmission through emission of droplets and aerosolization in a closed non ventilated space with a relative high number of people including multiple pre-symptomatic suspected index cases. Conclusion: Indoor choir practice should be suspended during SARS-CoV-2 outbreaks. Further studies are necessary to test the spread of the virus by the act of singing. As the benefits of the barrier measures and social distancing are known to be effective in terms of a reduction in the incidence of the COVID-19, experts recommendations concerning the resuming of choir practice are necessary.

scholarly journals Flow diverter stents in the treatment of recanalized intracranial aneurysms

2021 ◽  
pp. 159101992199050
Author(s):  
Erol Akgul ◽  
Hasan Bilen Onan ◽  
Irem Islek ◽  
Mehmet Tonge ◽  
Yavuz Durmus ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Demographic Data ◽  
Previous Treatment ◽  
Flow Diverter ◽  
Serious Adverse Events ◽  
Clinical Complications ◽  
Tertiary Hospitals ◽  
The Mean ◽  
Technical Complication

Background We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly. Materials & Methods Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients’ demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded. Results Eighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3–6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero. Conclusion The drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.

scholarly journals POS0548 OPTIMAL ASSESSMENT OF THE RHEUMATOID ARTHRITIS ANKLE AND HINDFOOT: A COMPARATIVE STUDY BETWEEN CLINICAL EXAMINATION AND ULTRASONOGRAPHY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 508.2-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
M. Habechi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Examination ◽  
Demographic Data ◽  
Power Doppler ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Therapeutic Decisions ◽  
The Mean ◽  
Foot Disease

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared

scholarly journals AB0189 LIPOPROTEIN ABNORMALITIES IN RHEUMATOID ARTHRITIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1119.1-1119
Author(s):  
L. Nacef ◽  
Y. Besbes ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Demographic Data ◽  
Calcium Score ◽  
Healthy Person ◽  
Mean Value ◽  
Immunological Parameters ◽  
American College Of Rheumatology ◽  
Patient Consent ◽  
The Mean ◽  
High Level

Background:The lipid paradox is termed the decreased cholesterol level in rheumatoid arthritis (RA). Nevertheless, the apolipoprotein levels are usually higher than a healthy person and are predictors of cardiovascular events.Objectives:We aimed to describe lipid abnormalities in RA patients and to look for predictor factors of these changes.Methods:The prospective study was carried out on patients with RA who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria. These patients were followed in the rheumatology department of the Kassab Institute.We collected the socio-demographic data, biological and immunological parameters.The lipid assessment included: a measurement of total cholesterol (TC), HDL, LDL, and triglycerides (TG). Lipoproteins APOA1 and APOB were measured. All data were collected after patient consent.Results:Of the 47 patients recruited, 78.7% were female. The mean age was 52.5 ±11.06 [32-76]. The average RA progressed from 86.25 ±63 months [5-288] and was erosive in 81.6% of cases. The rheumatoid factor (RF) was positive in 57.8% of patients, and citrullinated antipeptide antibodies (ACPA) were present in 62.2%. Eight patients had a previous CV history.Mean TC was 4.42 ±1.3 [1.2-7.58], mean HDL was 1.38 ±0.73 [0.18-4.10], mean LDL was 2.55 ±1.16 [0.24-5.54]. The mean TG value was 1.28 ±0.6 [0.24-5.54]. TC elevation was found in 9.1% of cases, HDL in 21.3% of cases, LDL in 5.5% of cases, and TG in 16.4% of cases. Mean APOB/APOA1 ratio was 0.67 ±0.18 [0,46-1,11]. LDL elevation was associated to a high DAS28 (p=0.06, r=0.512). APOA1 was associated to a low DAS28 (p=0.04, r=-0.642).The mean value of APO A1 was 1.36 ±0.21 [0.84-1.81], that of APOB was 0.90 ±0.22 [0.58-1.40]. APOA1 values were lower in patients with high-level LDL (p=0.767). The APOB value was associated with lipid disturbance without significant correlation (p=0.291).Conclusion:Lipid test abnormalities can be found in RA patients outside of any known CV risk factors. APOA1 seems to have a protective effect. Screening and treatment of these abnormalities can prevent CV risk.References:[1]Miguel Bernardes and al. Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers. Int J Rheum Dis. 2019;00:1–16.[2]Anna So dergren and al. Biomarkers associated with cardiovascular disease in patients with early rheumatoid arthritis. PLOS ONE. August 5, 2019.Disclosure of Interests:None declared

scholarly journals Investigation of Four Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Rwanda, 2020

2021 ◽  
Vol 18 (13) ◽  
pp. 7018
Author(s):  
Olivier Nsekuye ◽  
Edson Rwagasore ◽  
Marie Aime Muhimpundu ◽  
Ziad El-Khatib ◽  
Daniel Ntabanganyimana ◽  
...  
Keyword(s):  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Symptom Onset ◽  
Attack Rate ◽  
Positive Sample ◽  
Contact Tracing ◽  
Face To Face ◽  
Laboratory Confirmation ◽  
Closed Environment ◽  
Index Cases

We reported the findings of the first Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) four clusters identified in Rwanda. Case-investigations included contact elicitation, testing, and isolation/quarantine of confirmed cases. Socio-demographic and clinical data on cases and contacts were collected. A confirmed case was a person with laboratory confirmation of SARS-CoV-2 infection (PCR) while a contact was any person who had contact with a SARS-CoV-2 confirmed case within 72 h prior, to 14 days after symptom onset; or 14 days before collection of the laboratory-positive sample for asymptomatic cases. High risk contacts were those who had come into unprotected face-to-face contact or had been in a closed environment with a SARS-CoV-2 case for >15 min. Forty cases were reported from four clusters by 22 April 2020, accounting for 61% of locally transmitted cases within six weeks. Clusters A, B, C and D were associated with two nightclubs, one house party, and different families or households living in the same compound (multi-family dwelling). Thirty-six of the 1035 contacts tested were positive (secondary attack rate: 3.5%). Positivity rates were highest among the high-risk contacts compared to low-risk contacts (10% vs. 2.2%). Index cases in three of the clusters were imported through international travelling. Fifteen of the 40 cases (38%) were asymptomatic while 13/25 (52%) and 8/25 (32%) of symptomatic cases had a cough and fever respectively. Gatherings in closed spaces were the main early drivers of transmission. Systematic case-investigations contact tracing and testing likely contributed to the early containment of SARS-CoV-2 in Rwanda.

scholarly journals Autologous Matrix-Induced Chondrogenesis for Treatment of Focal Cartilage Defects in the Knee: A Follow-up Study

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098187
Author(s):  
Justus Gille ◽  
Ellen Reiss ◽  
Moritz Freitag ◽  
Jan Schagemann ◽  
Matthias Steinwachs ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Demographic Data ◽  
Case Series ◽  
Defect Size ◽  
Lysholm Score ◽  
Outcome Analysis ◽  
Cartilage Defects ◽  
Chondral Defects ◽  
The Mean

Background: Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects. Purpose: To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee. Study Design: Case series; Level of evidence, 4. Methods: A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm2. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points. Results: The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( P < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes. Conclusion: AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.

scholarly journals A hospital-based study on clinical data, demographic data and visual function of keratoconus patients in Central China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kaili Yang ◽  
Liyan Xu ◽  
Qi Fan ◽  
Yuwei Gu ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Clinical Data ◽  
Rural Areas ◽  
Visual Function ◽  
Urban Areas ◽  
Demographic Data ◽  
Corneal Thickness ◽  
Positive Family History ◽  
Education Level ◽  
Central China ◽  
The Mean

AbstractChina is a populous country but lacks epidemiological data on keratoconus (KC). The present study aimed to investigate the clinical data, demographic data, and visual function (VF) data of KC patients in Central China. A total of 524 KC eyes in 307 KC patients (217 bilateral and 90 unilateral) from Henan Eye Hospital were included in the current study. Demographic and VF data were assessed with questionnaires administered by well-trained staff during face-to-face interviews. Visual acuity value was examined by a qualified optometrist, and the clinical data were measured by professional clinicians. The distributions of sex, residence and education level of KC patients were compared by Chi-square tests, and the ratios of people wearing glasses and rigid gas permeable (RGP) lenses were compared by McNemar tests. General linear models/Chi-squared tests were used to compare the clinical and demographic data according to KC severity. Spearman’s correlation analysis was used to test the associations between the data and KC severity. The mean age at diagnosis was 20.98 ± 6.06 years, and males had a higher ratio of KC than females (P < 0.001). Patients in rural areas had a higher rate of KC than those in urban areas (P = 0.039), and the proportion of KC patients with a higher education level (above high school) was high (P < 0.001). A total of 68.40% of the patients reported eye rubbing and 3.52% had a positive family history. The percentage of people wearing glasses was higher than that of patients wearing RGP lenses (P < 0.001). The total VF score of KC patients was 69.35 ± 15.25. The thinnest corneal thickness (TCT) and stiffness parameter at the first applanation (SP-A1) values were inversely correlated with KC severity (P < 0.05). The mean, steep, and max keratometry (Km, Ks and Kmax) values, the RGP lens use and keratoplasty were positively correlated with KC severity (all P < 0.05). The total VF score of the eye with better VA decreased as the severity increased (r = − 0.21, P = 0.002). The present study comprehensively describes various associated features of KC patients from a tertiary hospital in Central China, providing a reference for understanding the characteristics of KC patients in China.

scholarly journals Influence ofABCC2andABCC4Polymorphisms on Tenofovir Plasma Concentrations in Thai HIV-Infected Patients

2015 ◽  
Vol 59 (6) ◽  
pp. 3240-3245 ◽  
Author(s):  
Kanokrat Rungtivasuwan ◽  
Anchalee Avihingsanon ◽  
Narukjaporn Thammajaruk ◽  
Siwaporn Mitruk ◽  
David M. Burger ◽  
...  
Keyword(s):  
Body Weight ◽  
Multivariate Analysis ◽  
Plasma Concentration ◽  
Protease Inhibitors ◽  
Demographic Data ◽  
Plasma Concentrations ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Mean

ABSTRACTTenofovir (TFV) is eliminated by renal excretion, which is mediated through multidrug-resistant protein 2 (MRP2) and MRP4, encoded byABCC2andABCC4, respectively. Genetic polymorphisms of these transporters may affect the plasma concentrations of tenofovir. Therefore, the aim of this study was to investigate the influence of genetic and nongenetic factors on tenofovir plasma concentrations. A cross-sectional study was performed in Thai HIV-infected patients aged ≥18 years who had been receiving tenofovir disoproxil fumarate at 300 mg once daily for at least 6 months. A middose tenofovir plasma concentration was obtained. Multivariate analysis was performed to investigate whether there was an association between tenofovir plasma concentrations and demographic data, including age, sex, body weight, estimated glomerular filtration rate (eGFR), hepatitis B virus coinfection, hepatitis C virus coinfection, duration of tenofovir treatment, concomitant use of ritonavir-boosted protease inhibitors, and polymorphisms ofABCC2andABCC4. A total of 150 Thai HIV-infected patients were included. The mean age of the patients was 43.9 ± 7.2 years. The mean tenofovir plasma concentration was 100.3 ± 52.7 ng/ml. In multivariate analysis, a low body weight, a low eGFR, the concomitant use of ritonavir-boosted protease inhibitors, and theABCC44131T → G variation (genotype TG or GG) were independently associated with higher tenofovir plasma concentrations. After adjusting for weight, eGFR, and the concomitant use of ritonavir-boosted protease inhibitors, a 30% increase in the mean tenofovir plasma concentration was observed in patients having theABCC44131 TG or GG genotype. Both genetic and nongenetic factors affect tenofovir plasma concentrations. These factors should be considered when adjusting tenofovir dosage regimens to ensure the efficacy and safety of a drug. (This study has been registered at ClinicalTrials.gov under registration no. NCT01138241.)

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