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Erschienen in: Der Internist 10/2012

01.10.2012 | Schwerpunkt

Morbidität und Mortalität der HIV-Infektion

verfasst von: M. Stöckle, L. Elzi, J.K. Rockstroh, Prof. Dr. M. Battegay

Erschienen in: Die Innere Medizin | Ausgabe 10/2012

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Zusammenfassung

Morbidität und Mortalität von HIV-infizierten Menschen haben seit 1996 aufgrund der antiretroviralen Kombinationstherapie (cART) dramatisch abgenommen. Die HIV-Infektion wurde somit zu einer chronischen, ambulant behandelbaren und meist asymptomatischen Krankheit mit praktisch normaler Lebenserwartung. Ein Hauptgrund der verbleibenden Morbidität und Sterblichkeit ist, dass die HIV-Infektion in etwa 20% der Fälle spät diagnostiziert bzw. therapiert wird. Oft liegt zu diesem Zeitpunkt die CD4-Zellzahl bereits unter der Schwelle von 200 Zellen/µl und/oder AIDS-definierende Krankheiten haben sich manifestiert. Weitere Gründe für die verbleibende Morbidität und Mortalität sind Komorbiditäten, insbesondere die Koinfektion mit einer viralen Hepatitis und Tumoren bei älteren Patienten. Durch die verbesserte Prognose nimmt das Alter HIV-infizierter Menschen zu. Dies bedeutet aufgrund von Komorbiditäten und sozioökonomischen Kosten eine erhebliche Herausforderung für die Zukunft.
Literatur
1.
Zurück zum Zitat Antiretroviral Therapy Cohort Collaboration (2008) Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet 372:293–299CrossRef Antiretroviral Therapy Cohort Collaboration (2008) Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet 372:293–299CrossRef
2.
Zurück zum Zitat Egger M et al (2002) Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet 360:119–129PubMedCrossRef Egger M et al (2002) Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet 360:119–129PubMedCrossRef
3.
Zurück zum Zitat Ledergerber B et al (1999) AIDS-related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA 282:2220–2226PubMedCrossRef Ledergerber B et al (1999) AIDS-related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA 282:2220–2226PubMedCrossRef
4.
Zurück zum Zitat Ledergerber B et al (1999) Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study. Swiss HIV Cohort Study. Lancet 353:863–868PubMedCrossRef Ledergerber B et al (1999) Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study. Swiss HIV Cohort Study. Lancet 353:863–868PubMedCrossRef
5.
Zurück zum Zitat Ledergerber B, Egger M, Telenti A (2000) AIDS-related opportunistic illness and potent antiretroviral therapy. JAMA 283:2653–2654PubMedCrossRef Ledergerber B, Egger M, Telenti A (2000) AIDS-related opportunistic illness and potent antiretroviral therapy. JAMA 283:2653–2654PubMedCrossRef
6.
Zurück zum Zitat May M et al (2007) Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies. AIDS 21:1185–1197PubMedCrossRef May M et al (2007) Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies. AIDS 21:1185–1197PubMedCrossRef
7.
Zurück zum Zitat Hammer SM et al (1997) A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team. N Engl J Med 337:725–733 Hammer SM et al (1997) A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team. N Engl J Med 337:725–733
8.
Zurück zum Zitat Egger M et al (1997) Impact of new antiretroviral combination therapies in HIV infected patients in Switzerland: prospective multicentre study. Swiss HIV Cohort Study. BMJ 315:1194–1199PubMedCrossRef Egger M et al (1997) Impact of new antiretroviral combination therapies in HIV infected patients in Switzerland: prospective multicentre study. Swiss HIV Cohort Study. BMJ 315:1194–1199PubMedCrossRef
9.
Zurück zum Zitat Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord et al (2012) All-cause mortality in treated HIV-infected adults with CD4 ≥ 500/mm3 compared with the general population: evidence from a large European observational cohort collaboration. Int J Epidemiol 41:433–445CrossRef Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord et al (2012) All-cause mortality in treated HIV-infected adults with CD4 ≥ 500/mm3 compared with the general population: evidence from a large European observational cohort collaboration. Int J Epidemiol 41:433–445CrossRef
10.
Zurück zum Zitat Strategies for Management of Antiretroviral Therapy (SMART) Study Group et al (2006) CD4 + count-guided interruption of antiretroviral treatment. N Engl J Med 355:2283–2296 Strategies for Management of Antiretroviral Therapy (SMART) Study Group et al (2006) CD4 + count-guided interruption of antiretroviral treatment. N Engl J Med 355:2283–2296
11.
Zurück zum Zitat Kaufmann GR et al (2011) Interruptions of cART limits CD4 T-cell recovery and increases the risk for opportunistic complications and death. AIDS 25:441–451PubMedCrossRef Kaufmann GR et al (2011) Interruptions of cART limits CD4 T-cell recovery and increases the risk for opportunistic complications and death. AIDS 25:441–451PubMedCrossRef
12.
Zurück zum Zitat Wolbers M et al (2008) Delayed diagnosis of HIV infection and late initiation of antiretroviral therapy in the Swiss HIV Cohort Study. HIV Med 9:397–405PubMedCrossRef Wolbers M et al (2008) Delayed diagnosis of HIV infection and late initiation of antiretroviral therapy in the Swiss HIV Cohort Study. HIV Med 9:397–405PubMedCrossRef
13.
Zurück zum Zitat Weber R et al (2006) Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med 166:1632–1641PubMedCrossRef Weber R et al (2006) Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med 166:1632–1641PubMedCrossRef
14.
Zurück zum Zitat Data Collection on Adverse Events of Anti-HIV drugs (D:A:D) Study Group et al (2010) Factors associated with specific causes of death amongst HIV-positive individuals in the D:A:D Study. AIDS 24:1537–1548 Data Collection on Adverse Events of Anti-HIV drugs (D:A:D) Study Group et al (2010) Factors associated with specific causes of death amongst HIV-positive individuals in the D:A:D Study. AIDS 24:1537–1548
15.
Zurück zum Zitat Murray M et al (2012) The effect of injecting drug use history on disease progression and death among HIV-positive individuals initiating combination antiretroviral therapy: collaborative cohort analysis. HIV Med 13:89–97PubMedCrossRef Murray M et al (2012) The effect of injecting drug use history on disease progression and death among HIV-positive individuals initiating combination antiretroviral therapy: collaborative cohort analysis. HIV Med 13:89–97PubMedCrossRef
16.
Zurück zum Zitat Study Group on Death Rates at High CD4 Count in Antiretroviral Naive Patients et al (2010) Death rates in HIV-positive antiretroviral-naive patients with CD4 count greater than 350 cells per μl in Europe and North America: a pooled cohort observational study. Lancet 376:340–345CrossRef Study Group on Death Rates at High CD4 Count in Antiretroviral Naive Patients et al (2010) Death rates in HIV-positive antiretroviral-naive patients with CD4 count greater than 350 cells per μl in Europe and North America: a pooled cohort observational study. Lancet 376:340–345CrossRef
17.
Zurück zum Zitat Monforte A et al (2008) HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies. AIDS 22:2143–2153PubMedCrossRef Monforte A et al (2008) HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies. AIDS 22:2143–2153PubMedCrossRef
18.
Zurück zum Zitat Lacombe K, Rockstroh J (2012) HIV and viral hepatitis coinfections: advances and challenges. Gut 61(Suppl 1):i47–58PubMedCrossRef Lacombe K, Rockstroh J (2012) HIV and viral hepatitis coinfections: advances and challenges. Gut 61(Suppl 1):i47–58PubMedCrossRef
19.
Zurück zum Zitat Hasse B et al (2011) Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis 53:1130–1139PubMedCrossRef Hasse B et al (2011) Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis 53:1130–1139PubMedCrossRef
20.
Zurück zum Zitat Fux CA et al (2007) Tenofovir use is associated with a reduction in calculated glomerular filtration rates in the Swiss HIV Cohort Study. Antivir Ther 12:1165–1173PubMed Fux CA et al (2007) Tenofovir use is associated with a reduction in calculated glomerular filtration rates in the Swiss HIV Cohort Study. Antivir Ther 12:1165–1173PubMed
21.
Zurück zum Zitat Grinspoon S, Carr A (2005) Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med 352:48–62 Grinspoon S, Carr A (2005) Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med 352:48–62
22.
Zurück zum Zitat Kowalska JD et al (2012) Long-term exposure to combination antiretroviral therapy and risk of death from specific causes: no evidence for any previously unidentified increased risk due to antiretroviral therapy. AIDS 26:315–323PubMedCrossRef Kowalska JD et al (2012) Long-term exposure to combination antiretroviral therapy and risk of death from specific causes: no evidence for any previously unidentified increased risk due to antiretroviral therapy. AIDS 26:315–323PubMedCrossRef
23.
Zurück zum Zitat Ledergerber B et al (2007) Factors associated with the incidence of type 2 diabetes mellitus in HIV-infected participants in the Swiss HIV Cohort Study. Clin Infect Dis 45:111–119PubMedCrossRef Ledergerber B et al (2007) Factors associated with the incidence of type 2 diabetes mellitus in HIV-infected participants in the Swiss HIV Cohort Study. Clin Infect Dis 45:111–119PubMedCrossRef
24.
Zurück zum Zitat Palella FJ Jr et al (1998) Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 338:853–860 Palella FJ Jr et al (1998) Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 338:853–860
25.
Zurück zum Zitat Mocroft A et al (2003) Decline in the AIDS and death rates in the EuroSIDA study: an observational study. Lancet 362:22–29PubMedCrossRef Mocroft A et al (2003) Decline in the AIDS and death rates in the EuroSIDA study: an observational study. Lancet 362:22–29PubMedCrossRef
26.
Zurück zum Zitat Mocroft A et al (2010) Serious fatal and nonfatal non-AIDS-defining illnesses in Europe. J Acquir Immune Defic Syndr 55:262–270 Mocroft A et al (2010) Serious fatal and nonfatal non-AIDS-defining illnesses in Europe. J Acquir Immune Defic Syndr 55:262–270
27.
Zurück zum Zitat May M et al (2007) Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies. AIDS 21:1185–1197PubMedCrossRef May M et al (2007) Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies. AIDS 21:1185–1197PubMedCrossRef
28.
Zurück zum Zitat d’Arminio Monforte A et al (2005) The changing incidence of AIDS events in patients receiving highly active antiretroviral therapy. Arch Intern Med 165:416–423CrossRef d’Arminio Monforte A et al (2005) The changing incidence of AIDS events in patients receiving highly active antiretroviral therapy. Arch Intern Med 165:416–423CrossRef
29.
Zurück zum Zitat Khanna N et al (2009) Incidence and outcome of progressive multifocal leukoencephalopathy over 20 years of the Swiss HIV Cohort Study. Clin Infect Dis 48:1459–1466PubMedCrossRef Khanna N et al (2009) Incidence and outcome of progressive multifocal leukoencephalopathy over 20 years of the Swiss HIV Cohort Study. Clin Infect Dis 48:1459–1466PubMedCrossRef
30.
Zurück zum Zitat Sugar EA et al (2012) Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Am J Ophthalmol 153:1016–1024.e5PubMedCrossRef Sugar EA et al (2012) Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Am J Ophthalmol 153:1016–1024.e5PubMedCrossRef
31.
Zurück zum Zitat Porter K et al (2008) Changes in outcome of persons initiating highly active antiretroviral therapy at a CD4 count less than 50 cells/mm3. J Acquir Immune Defic Syndr 47:202–205 Porter K et al (2008) Changes in outcome of persons initiating highly active antiretroviral therapy at a CD4 count less than 50 cells/mm3. J Acquir Immune Defic Syndr 47:202–205
32.
Zurück zum Zitat Bhaskaran K et al (2008) Changes in the risk of death after HIV seroconversion compared with mortality in the general population. JAMA 300:51–59PubMedCrossRef Bhaskaran K et al (2008) Changes in the risk of death after HIV seroconversion compared with mortality in the general population. JAMA 300:51–59PubMedCrossRef
33.
Zurück zum Zitat Deeks SG, Phillips AN (2009) HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity. BMJ 338:a3172PubMedCrossRef Deeks SG, Phillips AN (2009) HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity. BMJ 338:a3172PubMedCrossRef
34.
Zurück zum Zitat Ruppik M, Ledergerber B, Rickenbach M et al (2011) Changing patterns of causes of death: the Swiss HIV Cohort Study 2005–2009. CROI, Poster 156 Ruppik M, Ledergerber B, Rickenbach M et al (2011) Changing patterns of causes of death: the Swiss HIV Cohort Study 2005–2009. CROI, Poster 156
35.
Zurück zum Zitat Ledergerber B et al (2004) Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes. Lancet 364:51–62PubMedCrossRef Ledergerber B et al (2004) Predictors of trend in CD4-positive T-cell count and mortality among HIV-1-infected individuals with virological failure to all three antiretroviral-drug classes. Lancet 364:51–62PubMedCrossRef
36.
Zurück zum Zitat Mocroft A et al (2010) Estimated average annual rate of change of CD4(+) T-cell counts in patients on combination antiretroviral therapy. Antivir Ther 15:563–570PubMedCrossRef Mocroft A et al (2010) Estimated average annual rate of change of CD4(+) T-cell counts in patients on combination antiretroviral therapy. Antivir Ther 15:563–570PubMedCrossRef
37.
Zurück zum Zitat Kaufmann GR et al (2005) Characteristics, determinants, and clinical relevance of CD4 T cell recovery to < 500 cells/microL in HIV type 1-infected individuals receiving potent antiretroviral therapy. Clin Infect Dis 41:361–372PubMedCrossRef Kaufmann GR et al (2005) Characteristics, determinants, and clinical relevance of CD4 T cell recovery to < 500 cells/microL in HIV type 1-infected individuals receiving potent antiretroviral therapy. Clin Infect Dis 41:361–372PubMedCrossRef
38.
Zurück zum Zitat Kaufmann GR et al (2003) CD4 T-lymphocyte recovery in individuals with advanced HIV-1 infection receiving potent antiretroviral therapy for 4 years: the Swiss HIV Cohort Study. Arch Intern Med 163:2187–2195PubMedCrossRef Kaufmann GR et al (2003) CD4 T-lymphocyte recovery in individuals with advanced HIV-1 infection receiving potent antiretroviral therapy for 4 years: the Swiss HIV Cohort Study. Arch Intern Med 163:2187–2195PubMedCrossRef
39.
Zurück zum Zitat Zoufaly A et al (2011) Clinical outcome of HIV-infected patients with discordant virological and immunological response to antiretroviral therapy. J Infect Dis 203:364–371 Zoufaly A et al (2011) Clinical outcome of HIV-infected patients with discordant virological and immunological response to antiretroviral therapy. J Infect Dis 203:364–371
40.
Zurück zum Zitat Opportunistic Infections Project Team of the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) in EuroCoord (2012) CD4 cell count and the risk of AIDS or death in HIV-infected adults on combination antiretroviral therapy with a suppressed viral load: a longitudinal cohort study from COHERE. PLoS Med 9:e1001194CrossRef Opportunistic Infections Project Team of the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) in EuroCoord (2012) CD4 cell count and the risk of AIDS or death in HIV-infected adults on combination antiretroviral therapy with a suppressed viral load: a longitudinal cohort study from COHERE. PLoS Med 9:e1001194CrossRef
41.
Zurück zum Zitat Sendi P et al (2004) Productivity costs and determinants of productivity in HIV-infected patients. Clin Ther 26:791–800PubMedCrossRef Sendi P et al (2004) Productivity costs and determinants of productivity in HIV-infected patients. Clin Ther 26:791–800PubMedCrossRef
42.
Zurück zum Zitat Waters L, Sabin CA (2011) Late HIV presentation: epidemiology, clinical implications and management. Expert Rev Anti Infect Ther 9:877–889PubMedCrossRef Waters L, Sabin CA (2011) Late HIV presentation: epidemiology, clinical implications and management. Expert Rev Anti Infect Ther 9:877–889PubMedCrossRef
43.
Zurück zum Zitat Battegay M et al (2007) Late presentation of HIV-infected individuals. Antivir Ther 12:841–851PubMed Battegay M et al (2007) Late presentation of HIV-infected individuals. Antivir Ther 12:841–851PubMed
44.
Zurück zum Zitat Phillips A, Pezzotti P, CASCADE Collaboration (2004) Short-term risk of AIDS according to current CD4 cell count and viral load in antiretroviral drug-naive individuals and those treated in the monotherapy era. AIDS 18:51–58PubMedCrossRef Phillips A, Pezzotti P, CASCADE Collaboration (2004) Short-term risk of AIDS according to current CD4 cell count and viral load in antiretroviral drug-naive individuals and those treated in the monotherapy era. AIDS 18:51–58PubMedCrossRef
45.
Zurück zum Zitat Elzi L et al (2010) Treatment modification in human immunodeficiency virus-infected individuals starting combination antiretroviral therapy between 2005 and 2008. Arch Intern Med 170:57–65PubMedCrossRef Elzi L et al (2010) Treatment modification in human immunodeficiency virus-infected individuals starting combination antiretroviral therapy between 2005 and 2008. Arch Intern Med 170:57–65PubMedCrossRef
46.
Zurück zum Zitat Marzolini C et al (2010) Prevalence of comedications and effect of potential drug-drug interactions in the Swiss HIV Cohort Study. Antivir Ther 15:413–423PubMedCrossRef Marzolini C et al (2010) Prevalence of comedications and effect of potential drug-drug interactions in the Swiss HIV Cohort Study. Antivir Ther 15:413–423PubMedCrossRef
47.
Zurück zum Zitat Battegay M et al (2006) Immunological recovery and antiretroviral therapy in HIV-1 infection. Lancet Infect Dis 6:280–287PubMedCrossRef Battegay M et al (2006) Immunological recovery and antiretroviral therapy in HIV-1 infection. Lancet Infect Dis 6:280–287PubMedCrossRef
48.
Zurück zum Zitat Hirsch HH et al (2004) Immune reconstitution in HIV-infected patients. Clin Infect Dis 38:1159–1166PubMedCrossRef Hirsch HH et al (2004) Immune reconstitution in HIV-infected patients. Clin Infect Dis 38:1159–1166PubMedCrossRef
49.
Zurück zum Zitat Kelley CF et al (2009) Incomplete peripheral CD4 + cell count restoration in HIV-infected patients receiving long-term antiretroviral treatment. Clin Infect Dis 48:787–794PubMedCrossRef Kelley CF et al (2009) Incomplete peripheral CD4 + cell count restoration in HIV-infected patients receiving long-term antiretroviral treatment. Clin Infect Dis 48:787–794PubMedCrossRef
50.
Zurück zum Zitat Antiretroviral Therapy Cohort Collaboration (2007) Importance of baseline prognostic factors with increasing time since initiation of highly active antiretroviral therapy: collaborative analysis of cohorts of HIV-1-infected patients. J Acquir Immune Defic Syndr 46:607–615 Antiretroviral Therapy Cohort Collaboration (2007) Importance of baseline prognostic factors with increasing time since initiation of highly active antiretroviral therapy: collaborative analysis of cohorts of HIV-1-infected patients. J Acquir Immune Defic Syndr 46:607–615
51.
Zurück zum Zitat Delta Coordinating Committee (1996) Delta: a randomised double-blind controlled trial comparing combinations of zidovudine plus didanosine or zalcitabine with zidovudine alone in HIV-infected individuals. Delta Coordinating Committee. Lancet 348:283–291CrossRef Delta Coordinating Committee (1996) Delta: a randomised double-blind controlled trial comparing combinations of zidovudine plus didanosine or zalcitabine with zidovudine alone in HIV-infected individuals. Delta Coordinating Committee. Lancet 348:283–291CrossRef
52.
Zurück zum Zitat Hammer SM et al (1996) A trial comparing nucleoside monotherapy with combination therapy in HIV-infected adults with CD4 cell counts from 200–500 per cubic millimeter. AIDS Clinical Trials Group Study 175 Study Team. N Engl J Med 335:1081–1090 Hammer SM et al (1996) A trial comparing nucleoside monotherapy with combination therapy in HIV-infected adults with CD4 cell counts from 200–500 per cubic millimeter. AIDS Clinical Trials Group Study 175 Study Team. N Engl J Med 335:1081–1090
53.
Zurück zum Zitat Sterne JA et al (2005) Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study. Lancet 366:378–384PubMedCrossRef Sterne JA et al (2005) Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study. Lancet 366:378–384PubMedCrossRef
54.
Zurück zum Zitat Lohse N et al (2007) Survival of persons with and without HIV infection in Denmark, 1995–2005. Ann Intern Med 146:87–95PubMed Lohse N et al (2007) Survival of persons with and without HIV infection in Denmark, 1995–2005. Ann Intern Med 146:87–95PubMed
Metadaten
Titel
Morbidität und Mortalität der HIV-Infektion
verfasst von
M. Stöckle
L. Elzi
J.K. Rockstroh
Prof. Dr. M. Battegay
Publikationsdatum
01.10.2012
Verlag
Springer-Verlag
Erschienen in
Die Innere Medizin / Ausgabe 10/2012
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI
https://doi.org/10.1007/s00108-011-2990-5

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