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Telaprevir for Retreatment of HCV Infection

Identifieur interne : 006670 ( Main/Exploration ); précédent : 006669; suivant : 006671

Telaprevir for Retreatment of HCV Infection

Auteurs : Stefan Zeuzem [Allemagne] ; Pietro Andreone [Italie] ; Stanislas Pol [France] ; Eric Lawitz [États-Unis] ; Moises Diago [Espagne] ; Stuart Roberts [Australie] ; Roberto Focaccia [Brésil] ; Zobair Younossi [États-Unis] ; Graham R. Foster [Royaume-Uni] ; Andrzej Horban [Pologne] ; Peter Ferenci [Autriche] ; Frederik Nevens [Belgique] ; Beat Müllhaupt [Suisse] ; Paul Pockros [États-Unis] ; Ruben Terg [Argentine] ; Daniel Shouval [Israël] ; Bart Van Hoek [Pays-Bas] ; Ola Weiland [Suède] ; Rolf Van Heeswijk [Belgique] ; Sandra De Meyer [Belgique] ; Don Luo [Belgique] ; Griet Boogaerts [Belgique] ; Ramon Polo [Belgique] ; Gaston Picchio [Belgique] ; Maria Beumont [Belgique]

Source :

RBID : Pascal:11-0444849

Descripteurs français

English descriptors

Abstract

BACKGROUND Up to 60% of patients with hepatitis C virus (HCV) genotype 1 infection do not have a sustained virologic response to therapy with peginterferon alfa plus ribavirin. METHODS In this randomized, phase 3 trial, we evaluated the addition of telaprevir to peginterferon alfa-2a plus ribavirin in patients with HCV genotype 1 infection who had no response or a partial response to previous therapy or who had a relapse after an initial response. A total of 663 patients were assigned to one of three groups: the T12PR48 group, which received telaprevir for 12 weeks and peginterferon plus ribavirin for a total of 48 weeks; the lead-in T12PR48 group, which received 4 weeks of peginterferon plus ribavirin followed by 12 weeks of telaprevir and peginterferon plus ribavirin for a total of 48 weeks; and the control group (PR48), which received peginterferon plus ribavirin for 48 weeks. The primary end point was the rate of sustained virologic response, which was defined as undetectable HCV RNA 24 weeks after the last planned dose of a study drug. RESULTS Rates of sustained virologic response were significantly higher in the two telaprevir groups than in the control group among patients who had a previous relapse (83% in the T12PR48 group, 88% in the lead-in T12PR48 group, and 24% in the PR48 group), a partial response (59%, 54%, and 15%, respectively), and no response (29%, 33%, and 5%, respectively) (P<0.001 for all comparisons). Grade 3 adverse events (mainly anemia, neutropenia, and leukopenia) were more frequent in the telaprevir groups than in the control group (37% vs. 22%). CONCLUSIONS Telaprevir combined with peginterferon plus ribavirin significantly improved rates of sustained virologic response in patients with previously treated HCV infection, regardless of whether there was a lead-in phase. (Funded by Tibotec and Vertex Pharmaceuticals ; REALIZE ClinicalTrials.gov number, NCT00703118.).


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Le document en format XML

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<name sortKey="De Meyer, Sandra" sort="De Meyer, Sandra" uniqKey="De Meyer S" first="Sandra" last="De Meyer">Sandra De Meyer</name>
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<name sortKey="Luo, Don" sort="Luo, Don" uniqKey="Luo D" first="Don" last="Luo">Don Luo</name>
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<name sortKey="Diago, Moises" sort="Diago, Moises" uniqKey="Diago M" first="Moises" last="Diago">Moises Diago</name>
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<name sortKey="Roberts, Stuart" sort="Roberts, Stuart" uniqKey="Roberts S" first="Stuart" last="Roberts">Stuart Roberts</name>
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<country>Brésil</country>
<wicri:noRegion>Emilio Ribas Infectious Diseases Institute</wicri:noRegion>
</affiliation>
</author>
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<name sortKey="Younossi, Zobair" sort="Younossi, Zobair" uniqKey="Younossi Z" first="Zobair" last="Younossi">Zobair Younossi</name>
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<country>États-Unis</country>
<wicri:noRegion>Falls Church, VA </wicri:noRegion>
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<settlement type="city">Londres</settlement>
</placeName>
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<name sortKey="Horban, Andrzej" sort="Horban, Andrzej" uniqKey="Horban A" first="Andrzej" last="Horban">Andrzej Horban</name>
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</inist:fA14>
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</affiliation>
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<name sortKey="Ferenci, Peter" sort="Ferenci, Peter" uniqKey="Ferenci P" first="Peter" last="Ferenci">Peter Ferenci</name>
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<s1>Medical University of Vienna, Internal Medicine III, Department of Gastroenterology and Hepatology</s1>
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<sZ>11 aut.</sZ>
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<sZ>12 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
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</author>
<author>
<name sortKey="Mullhaupt, Beat" sort="Mullhaupt, Beat" uniqKey="Mullhaupt B" first="Beat" last="Müllhaupt">Beat Müllhaupt</name>
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<s1>Swiss Hepato-Pancreato-Biliary Center and Division of Gastroenterology and Hepatology, University Hospital Zurich</s1>
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<country>Suisse</country>
<wicri:noRegion>Zurich</wicri:noRegion>
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<name sortKey="Pockros, Paul" sort="Pockros, Paul" uniqKey="Pockros P" first="Paul" last="Pockros">Paul Pockros</name>
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<inist:fA14 i1="14">
<s1>Scripps Clinic and Scripps Research Institute</s1>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Scripps Clinic and Scripps Research Institute</wicri:noRegion>
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</author>
<author>
<name sortKey="Terg, Ruben" sort="Terg, Ruben" uniqKey="Terg R" first="Ruben" last="Terg">Ruben Terg</name>
<affiliation wicri:level="1">
<inist:fA14 i1="15">
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<s2>Capital Federal</s2>
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<wicri:noRegion>Hospital Municipal de Gastroenterologia Dr. Bonorino Udaondo</wicri:noRegion>
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<name sortKey="Shouval, Daniel" sort="Shouval, Daniel" uniqKey="Shouval D" first="Daniel" last="Shouval">Daniel Shouval</name>
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<s1>Liver Unit, Hadassah-Hebrew University Hospital, Ein-Kerem</s1>
<s2>Jerusalem</s2>
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<sZ>16 aut.</sZ>
</inist:fA14>
<country>Israël</country>
<wicri:noRegion>Jerusalem</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Van Hoek, Bart" sort="Van Hoek, Bart" uniqKey="Van Hoek B" first="Bart" last="Van Hoek">Bart Van Hoek</name>
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<inist:fA14 i1="17">
<s1>Department of Gastroenterology and Hepatology, Leiden University Medical Center</s1>
<s2>Leiden</s2>
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<sZ>17 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Weiland, Ola" sort="Weiland, Ola" uniqKey="Weiland O" first="Ola" last="Weiland">Ola Weiland</name>
<affiliation wicri:level="3">
<inist:fA14 i1="18">
<s1>Karolinska Institutet, Karolinska University Hospital Huddinge</s1>
<s2>Stockholm</s2>
<s3>SWE</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Suède</country>
<placeName>
<settlement type="city">Stockholm</settlement>
<region nuts="2">Svealand</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Van Heeswijk, Rolf" sort="Van Heeswijk, Rolf" uniqKey="Van Heeswijk R" first="Rolf" last="Van Heeswijk">Rolf Van Heeswijk</name>
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<inist:fA14 i1="19">
<s1>Tibotec</s1>
<s2>Beerse</s2>
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<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>25 aut.</sZ>
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<country>Belgique</country>
<wicri:noRegion>Tibotec</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="De Meyer, Sandra" sort="De Meyer, Sandra" uniqKey="De Meyer S" first="Sandra" last="De Meyer">Sandra De Meyer</name>
<affiliation wicri:level="1">
<inist:fA14 i1="19">
<s1>Tibotec</s1>
<s2>Beerse</s2>
<s3>BEL</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Tibotec</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Luo, Don" sort="Luo, Don" uniqKey="Luo D" first="Don" last="Luo">Don Luo</name>
<affiliation wicri:level="1">
<inist:fA14 i1="20">
<s1>Tibotec</s1>
<s2>Titusville, NJ </s2>
<s3>BEL</s3>
<sZ>21 aut.</sZ>
<sZ>23 aut.</sZ>
<sZ>24 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Tibotec</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Boogaerts, Griet" sort="Boogaerts, Griet" uniqKey="Boogaerts G" first="Griet" last="Boogaerts">Griet Boogaerts</name>
<affiliation wicri:level="1">
<inist:fA14 i1="19">
<s1>Tibotec</s1>
<s2>Beerse</s2>
<s3>BEL</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Tibotec</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Polo, Ramon" sort="Polo, Ramon" uniqKey="Polo R" first="Ramon" last="Polo">Ramon Polo</name>
<affiliation wicri:level="1">
<inist:fA14 i1="20">
<s1>Tibotec</s1>
<s2>Titusville, NJ </s2>
<s3>BEL</s3>
<sZ>21 aut.</sZ>
<sZ>23 aut.</sZ>
<sZ>24 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Tibotec</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Picchio, Gaston" sort="Picchio, Gaston" uniqKey="Picchio G" first="Gaston" last="Picchio">Gaston Picchio</name>
<affiliation wicri:level="1">
<inist:fA14 i1="20">
<s1>Tibotec</s1>
<s2>Titusville, NJ </s2>
<s3>BEL</s3>
<sZ>21 aut.</sZ>
<sZ>23 aut.</sZ>
<sZ>24 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Tibotec</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Beumont, Maria" sort="Beumont, Maria" uniqKey="Beumont M" first="Maria" last="Beumont">Maria Beumont</name>
<affiliation wicri:level="1">
<inist:fA14 i1="19">
<s1>Tibotec</s1>
<s2>Beerse</s2>
<s3>BEL</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Tibotec</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">The New England journal of medicine</title>
<title level="j" type="abbreviated">N. Engl. j. med.</title>
<idno type="ISSN">0028-4793</idno>
<imprint>
<date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">The New England journal of medicine</title>
<title level="j" type="abbreviated">N. Engl. j. med.</title>
<idno type="ISSN">0028-4793</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Antiviral</term>
<term>Medicine</term>
<term>Retreatment</term>
<term>Telaprevir</term>
<term>Viral hepatitis C</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Télaprévir</term>
<term>Reprise traitement</term>
<term>Médecine</term>
<term>Hépatite virale C</term>
<term>Antiviral</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Médecine</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">BACKGROUND Up to 60% of patients with hepatitis C virus (HCV) genotype 1 infection do not have a sustained virologic response to therapy with peginterferon alfa plus ribavirin. METHODS In this randomized, phase 3 trial, we evaluated the addition of telaprevir to peginterferon alfa-2a plus ribavirin in patients with HCV genotype 1 infection who had no response or a partial response to previous therapy or who had a relapse after an initial response. A total of 663 patients were assigned to one of three groups: the T12PR48 group, which received telaprevir for 12 weeks and peginterferon plus ribavirin for a total of 48 weeks; the lead-in T12PR48 group, which received 4 weeks of peginterferon plus ribavirin followed by 12 weeks of telaprevir and peginterferon plus ribavirin for a total of 48 weeks; and the control group (PR48), which received peginterferon plus ribavirin for 48 weeks. The primary end point was the rate of sustained virologic response, which was defined as undetectable HCV RNA 24 weeks after the last planned dose of a study drug. RESULTS Rates of sustained virologic response were significantly higher in the two telaprevir groups than in the control group among patients who had a previous relapse (83% in the T12PR48 group, 88% in the lead-in T12PR48 group, and 24% in the PR48 group), a partial response (59%, 54%, and 15%, respectively), and no response (29%, 33%, and 5%, respectively) (P<0.001 for all comparisons). Grade 3 adverse events (mainly anemia, neutropenia, and leukopenia) were more frequent in the telaprevir groups than in the control group (37% vs. 22%). CONCLUSIONS Telaprevir combined with peginterferon plus ribavirin significantly improved rates of sustained virologic response in patients with previously treated HCV infection, regardless of whether there was a lead-in phase. (Funded by Tibotec and Vertex Pharmaceuticals ; REALIZE ClinicalTrials.gov number, NCT00703118.).</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Argentine</li>
<li>Australie</li>
<li>Autriche</li>
<li>Belgique</li>
<li>Brésil</li>
<li>Espagne</li>
<li>France</li>
<li>Israël</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>Pologne</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>Suède</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>District de Darmstadt</li>
<li>Grand Londres</li>
<li>Hesse (Land)</li>
<li>Hollande-Méridionale</li>
<li>Svealand</li>
<li>Vienne (Autriche)</li>
<li>Émilie-Romagne</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Bologne</li>
<li>Francfort-sur-le-Main</li>
<li>Leyde</li>
<li>Londres</li>
<li>Paris</li>
<li>Stockholm</li>
<li>Vienne (Autriche)</li>
</settlement>
<orgName>
<li>Université Paris-Descartes</li>
<li>Université de Bologne</li>
<li>Université de Londres</li>
</orgName>
</list>
<tree>
<country name="Allemagne">
<region name="Hesse (Land)">
<name sortKey="Zeuzem, Stefan" sort="Zeuzem, Stefan" uniqKey="Zeuzem S" first="Stefan" last="Zeuzem">Stefan Zeuzem</name>
</region>
</country>
<country name="Italie">
<region name="Émilie-Romagne">
<name sortKey="Andreone, Pietro" sort="Andreone, Pietro" uniqKey="Andreone P" first="Pietro" last="Andreone">Pietro Andreone</name>
</region>
</country>
<country name="France">
<region name="Île-de-France">
<name sortKey="Pol, Stanislas" sort="Pol, Stanislas" uniqKey="Pol S" first="Stanislas" last="Pol">Stanislas Pol</name>
</region>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Lawitz, Eric" sort="Lawitz, Eric" uniqKey="Lawitz E" first="Eric" last="Lawitz">Eric Lawitz</name>
</noRegion>
<name sortKey="Pockros, Paul" sort="Pockros, Paul" uniqKey="Pockros P" first="Paul" last="Pockros">Paul Pockros</name>
<name sortKey="Younossi, Zobair" sort="Younossi, Zobair" uniqKey="Younossi Z" first="Zobair" last="Younossi">Zobair Younossi</name>
</country>
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<noRegion>
<name sortKey="Diago, Moises" sort="Diago, Moises" uniqKey="Diago M" first="Moises" last="Diago">Moises Diago</name>
</noRegion>
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<country name="Australie">
<noRegion>
<name sortKey="Roberts, Stuart" sort="Roberts, Stuart" uniqKey="Roberts S" first="Stuart" last="Roberts">Stuart Roberts</name>
</noRegion>
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<country name="Brésil">
<noRegion>
<name sortKey="Focaccia, Roberto" sort="Focaccia, Roberto" uniqKey="Focaccia R" first="Roberto" last="Focaccia">Roberto Focaccia</name>
</noRegion>
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<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Foster, Graham R" sort="Foster, Graham R" uniqKey="Foster G" first="Graham R." last="Foster">Graham R. Foster</name>
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</country>
<country name="Pologne">
<noRegion>
<name sortKey="Horban, Andrzej" sort="Horban, Andrzej" uniqKey="Horban A" first="Andrzej" last="Horban">Andrzej Horban</name>
</noRegion>
</country>
<country name="Autriche">
<region name="Vienne (Autriche)">
<name sortKey="Ferenci, Peter" sort="Ferenci, Peter" uniqKey="Ferenci P" first="Peter" last="Ferenci">Peter Ferenci</name>
</region>
</country>
<country name="Belgique">
<noRegion>
<name sortKey="Nevens, Frederik" sort="Nevens, Frederik" uniqKey="Nevens F" first="Frederik" last="Nevens">Frederik Nevens</name>
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<name sortKey="Beumont, Maria" sort="Beumont, Maria" uniqKey="Beumont M" first="Maria" last="Beumont">Maria Beumont</name>
<name sortKey="Boogaerts, Griet" sort="Boogaerts, Griet" uniqKey="Boogaerts G" first="Griet" last="Boogaerts">Griet Boogaerts</name>
<name sortKey="De Meyer, Sandra" sort="De Meyer, Sandra" uniqKey="De Meyer S" first="Sandra" last="De Meyer">Sandra De Meyer</name>
<name sortKey="Luo, Don" sort="Luo, Don" uniqKey="Luo D" first="Don" last="Luo">Don Luo</name>
<name sortKey="Picchio, Gaston" sort="Picchio, Gaston" uniqKey="Picchio G" first="Gaston" last="Picchio">Gaston Picchio</name>
<name sortKey="Polo, Ramon" sort="Polo, Ramon" uniqKey="Polo R" first="Ramon" last="Polo">Ramon Polo</name>
<name sortKey="Van Heeswijk, Rolf" sort="Van Heeswijk, Rolf" uniqKey="Van Heeswijk R" first="Rolf" last="Van Heeswijk">Rolf Van Heeswijk</name>
</country>
<country name="Suisse">
<noRegion>
<name sortKey="Mullhaupt, Beat" sort="Mullhaupt, Beat" uniqKey="Mullhaupt B" first="Beat" last="Müllhaupt">Beat Müllhaupt</name>
</noRegion>
</country>
<country name="Argentine">
<noRegion>
<name sortKey="Terg, Ruben" sort="Terg, Ruben" uniqKey="Terg R" first="Ruben" last="Terg">Ruben Terg</name>
</noRegion>
</country>
<country name="Israël">
<noRegion>
<name sortKey="Shouval, Daniel" sort="Shouval, Daniel" uniqKey="Shouval D" first="Daniel" last="Shouval">Daniel Shouval</name>
</noRegion>
</country>
<country name="Pays-Bas">
<region name="Hollande-Méridionale">
<name sortKey="Van Hoek, Bart" sort="Van Hoek, Bart" uniqKey="Van Hoek B" first="Bart" last="Van Hoek">Bart Van Hoek</name>
</region>
</country>
<country name="Suède">
<region name="Svealand">
<name sortKey="Weiland, Ola" sort="Weiland, Ola" uniqKey="Weiland O" first="Ola" last="Weiland">Ola Weiland</name>
</region>
</country>
</tree>
</affiliations>
</record>

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