Economic Outcomes of Patients Receiving Antiretroviral Therapy for HIV/AIDS in South Africa Are Sustained through Three Years on Treatment
Identifieur interne : 004959 ( Main/Exploration ); précédent : 004958; suivant : 004960Economic Outcomes of Patients Receiving Antiretroviral Therapy for HIV/AIDS in South Africa Are Sustained through Three Years on Treatment
Auteurs : Sydney Rosen [États-Unis, Afrique du Sud] ; Bruce Larson [États-Unis] ; Alana Brennan [États-Unis, Afrique du Sud] ; Lawrence Long [Afrique du Sud] ; Matthew Fox [États-Unis, Afrique du Sud] ; Constance Mongwenyana [Afrique du Sud] ; Mpefe Ketlhapile [Afrique du Sud] ; Ian Sanne [Afrique du Sud]Source :
- PLoS ONE [ 1932-6203 ] ; 2010.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Agents antiVIH (usage thérapeutique), Agents antiVIH (économie), Femelle, Humains, Infections à VIH (immunologie), Infections à VIH (traitement médicamenteux), Infections à VIH (économie), Jeune adulte, Mâle, République d'Afrique du Sud, Résultat thérapeutique, Syndrome d'immunodéficience acquise (traitement médicamenteux), Syndrome d'immunodéficience acquise (économie), Études de cohortes.
- MESH :
- immunologie : Infections à VIH.
- traitement médicamenteux : Infections à VIH, Syndrome d'immunodéficience acquise.
- usage thérapeutique : Agents antiVIH.
- économie : Agents antiVIH, Infections à VIH, Syndrome d'immunodéficience acquise.
- Adolescent, Adulte, Adulte d'âge moyen, Femelle, Humains, Jeune adulte, Mâle, République d'Afrique du Sud, Résultat thérapeutique, Études de cohortes.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Acquired Immunodeficiency Syndrome (drug therapy), Acquired Immunodeficiency Syndrome (economics), Adolescent, Adult, Anti-HIV Agents (economics), Anti-HIV Agents (therapeutic use), Cohort Studies, Female, HIV Infections (drug therapy), HIV Infections (economics), HIV Infections (immunology), Humans, Male, Middle Aged, South Africa, Treatment Outcome, Young Adult.
- MESH :
- chemical , economics : Anti-HIV Agents.
- geographic : South Africa.
- drug therapy : Acquired Immunodeficiency Syndrome, HIV Infections.
- economics : Acquired Immunodeficiency Syndrome, HIV Infections.
- immunology : HIV Infections.
- chemical , therapeutic use : Anti-HIV Agents.
- Adolescent, Adult, Cohort Studies, Female, Humans, Male, Middle Aged, Treatment Outcome, Young Adult.
Abstract
Although the medical outcomes of antiretroviral therapy (ART) for HIV/AIDS are well described, less is known about how ART affects patients' economic activities and quality of life, especially after the first year on ART. We assessed symptom prevalence, general health, ability to perform normal activities, and employment status among adult antiretroviral therapy patients in South Africa over three full years following ART initiation.
A cohort of 855 adult pre-ART patients and patients on ART for <6 months was enrolled and interviewed an average of 4.4 times each during routine clinic visits for up to three years after treatment initiation using an instrument designed for the study. The probability of pain in the previous week fell from 74% before ART initiation to 32% after three years on ART, fatigue from 66% to 12%, nausea from 28% to 4%, and skin problems from 55% to 10%. The probability of not feeling well physically yesterday fell from 46% to 23%. Before starting ART, 39% of subjects reported not being able to perform their normal activities sometime during the previous week; after three years, this proportion fell to 10%. Employment rose from 27% to 42% of the cohort. Improvement in all outcomes was sustained over 3 years and for some outcomes increased in the second and third year.
Improvements in adult ART patients' symptom prevalence, general health, ability to perform normal activities, and employment status were large and were sustained through the first three years on treatment. These results suggest that some of the positive economic and social externalities anticipated as a result of large-scale treatment provision, such as increases in workforce participation and productivity and the ability of patients to carry on normal lives, may indeed be accruing.
Url:
DOI: 10.1371/journal.pone.0012731
PubMed: 20856821
PubMed Central: 2939080
Affiliations:
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Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Brennan, Alana" sort="Brennan, Alana" uniqKey="Brennan A" first="Alana" last="Brennan">Alana Brennan</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Boston University Center for Global Health and Development, Boston, Massachusetts, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Boston University Center for Global Health and Development, Boston, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Long, Lawrence" sort="Long, Lawrence" uniqKey="Long L" first="Lawrence" last="Long">Lawrence Long</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Fox, Matthew" sort="Fox, Matthew" uniqKey="Fox M" first="Matthew" last="Fox">Matthew Fox</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Boston University Center for Global Health and Development, Boston, Massachusetts, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Boston University Center for Global Health and Development, Boston, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Mongwenyana, Constance" sort="Mongwenyana, Constance" uniqKey="Mongwenyana C" first="Constance" last="Mongwenyana">Constance Mongwenyana</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Ketlhapile, Mpefe" sort="Ketlhapile, Mpefe" uniqKey="Ketlhapile M" first="Mpefe" last="Ketlhapile">Mpefe Ketlhapile</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Sanne, Ian" sort="Sanne, Ian" uniqKey="Sanne I" first="Ian" last="Sanne">Ian Sanne</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Clinical HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Clinical HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acquired Immunodeficiency Syndrome (drug therapy)</term><term>Acquired Immunodeficiency Syndrome (economics)</term><term>Adolescent</term><term>Adult</term><term>Anti-HIV Agents (economics)</term><term>Anti-HIV Agents (therapeutic use)</term><term>Cohort Studies</term><term>Female</term><term>HIV Infections (drug therapy)</term><term>HIV Infections (economics)</term><term>HIV Infections (immunology)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>South Africa</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Agents antiVIH (usage thérapeutique)</term><term>Agents antiVIH (économie)</term><term>Femelle</term><term>Humains</term><term>Infections à VIH (immunologie)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Infections à VIH (économie)</term><term>Jeune adulte</term><term>Mâle</term><term>République d'Afrique du Sud</term><term>Résultat thérapeutique</term><term>Syndrome d'immunodéficience acquise (traitement médicamenteux)</term><term>Syndrome d'immunodéficience acquise (économie)</term><term>Études de cohortes</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>South Africa</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Acquired Immunodeficiency Syndrome</term><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Acquired Immunodeficiency Syndrome</term><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term><term>Syndrome d'immunodéficience acquise</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agents antiVIH</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Agents antiVIH</term><term>Infections à VIH</term><term>Syndrome d'immunodéficience acquise</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>République d'Afrique du Sud</term><term>Résultat thérapeutique</term><term>Études de cohortes</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Afrique du Sud</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Although the medical outcomes of antiretroviral therapy (ART) for HIV/AIDS are well described, less is known about how ART affects patients' economic activities and quality of life, especially after the first year on ART. We assessed symptom prevalence, general health, ability to perform normal activities, and employment status among adult antiretroviral therapy patients in South Africa over three full years following ART initiation.</p></sec><sec><title>Methodology/Principal Findings</title><p>A cohort of 855 adult pre-ART patients and patients on ART for <6 months was enrolled and interviewed an average of 4.4 times each during routine clinic visits for up to three years after treatment initiation using an instrument designed for the study. The probability of pain in the previous week fell from 74% before ART initiation to 32% after three years on ART, fatigue from 66% to 12%, nausea from 28% to 4%, and skin problems from 55% to 10%. The probability of not feeling well physically yesterday fell from 46% to 23%. Before starting ART, 39% of subjects reported not being able to perform their normal activities sometime during the previous week; after three years, this proportion fell to 10%. Employment rose from 27% to 42% of the cohort. Improvement in all outcomes was sustained over 3 years and for some outcomes increased in the second and third year.</p></sec><sec><title>Conclusions/Significance</title><p>Improvements in adult ART patients' symptom prevalence, general health, ability to perform normal activities, and employment status were large and were sustained through the first three years on treatment. These results suggest that some of the positive economic and social externalities anticipated as a result of large-scale treatment provision, such as increases in workforce participation and productivity and the ability of patients to carry on normal lives, may indeed be accruing.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Nash, D" uniqKey="Nash D">D Nash</name></author><author><name sortKey="Katyal, M" uniqKey="Katyal M">M Katyal</name></author><author><name sortKey="Brinkhof, Mw" uniqKey="Brinkhof M">MW Brinkhof</name></author><author><name sortKey="Keiser, O" uniqKey="Keiser O">O Keiser</name></author><author><name sortKey="May, M" uniqKey="May M">M May</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ivers, Lc" uniqKey="Ivers L">LC Ivers</name></author><author><name sortKey="Kendrick, D" uniqKey="Kendrick D">D Kendrick</name></author><author><name sortKey="Doucette, K" uniqKey="Doucette K">K Doucette</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boulle, A" uniqKey="Boulle A">A Boulle</name></author><author><name sortKey="Van Cutsem, G" uniqKey="Van Cutsem G">G Van Cutsem</name></author><author><name sortKey="Hilderbrand, K" uniqKey="Hilderbrand K">K Hilderbrand</name></author><author><name sortKey="Cragg, C" uniqKey="Cragg C">C Cragg</name></author><author><name sortKey="Abrahams, M" uniqKey="Abrahams M">M Abrahams</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bussmann, H" uniqKey="Bussmann H">H Bussmann</name></author><author><name sortKey="Wester, Cw" uniqKey="Wester C">CW Wester</name></author><author><name sortKey="Ndwapi, N" uniqKey="Ndwapi N">N Ndwapi</name></author><author><name sortKey="Grundmann, N" uniqKey="Grundmann N">N Grundmann</name></author><author><name sortKey="Gaolathe, T" uniqKey="Gaolathe T">T Gaolathe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Etard, Jf" uniqKey="Etard J">JF Etard</name></author><author><name sortKey="Ndiaye, I" uniqKey="Ndiaye I">I Ndiaye</name></author><author><name sortKey="Thierry Mieg, M" uniqKey="Thierry Mieg M">M Thierry-Mieg</name></author><author><name sortKey="Gueye, Nf" uniqKey="Gueye N">NF Gueye</name></author><author><name sortKey="Gueye, Pm" uniqKey="Gueye P">PM Gueye</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen, S" uniqKey="Rosen S">S Rosen</name></author><author><name sortKey="Fox, Mp" uniqKey="Fox M">MP Fox</name></author><author><name sortKey="Gill, Cj" uniqKey="Gill C">CJ Gill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Beard, J" uniqKey="Beard J">J Beard</name></author><author><name sortKey="Feeley, R" uniqKey="Feeley R">R Feeley</name></author><author><name sortKey="Rosen, S" uniqKey="Rosen S">S Rosen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jelsma, J" uniqKey="Jelsma J">J Jelsma</name></author><author><name sortKey="Maclean, E" uniqKey="Maclean E">E Maclean</name></author><author><name sortKey="Hughes, J" uniqKey="Hughes J">J Hughes</name></author><author><name sortKey="Tinise, X" uniqKey="Tinise X">X Tinise</name></author><author><name sortKey="Darder, M" uniqKey="Darder M">M Darder</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stangl, Al" uniqKey="Stangl A">AL Stangl</name></author><author><name sortKey="Wamai, N" uniqKey="Wamai N">N Wamai</name></author><author><name sortKey="Mermin, J" uniqKey="Mermin J">J Mermin</name></author><author><name sortKey="Awor, Ac" uniqKey="Awor A">AC Awor</name></author><author><name sortKey="Bunnell, Re" uniqKey="Bunnell R">RE Bunnell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen, S" uniqKey="Rosen S">S Rosen</name></author><author><name sortKey="Ketlhapile, M" uniqKey="Ketlhapile M">M Ketlhapile</name></author><author><name sortKey="Sanne, I" uniqKey="Sanne I">I Sanne</name></author><author><name sortKey="Bachman Desilva, M" uniqKey="Bachman Desilva M">M Bachman DeSilva</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen, S" uniqKey="Rosen S">S Rosen</name></author><author><name sortKey="Ketlhapile, M" uniqKey="Ketlhapile M">M Ketlhapile</name></author><author><name sortKey="Sanne, I" uniqKey="Sanne I">I Sanne</name></author><author><name sortKey="Bachman Desilva, M" uniqKey="Bachman Desilva M">M Bachman DeSilva</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen, S" uniqKey="Rosen S">S Rosen</name></author><author><name sortKey="Ketlhapile, M" uniqKey="Ketlhapile M">M Ketlhapile</name></author><author><name sortKey="Sanne, I" uniqKey="Sanne I">I Sanne</name></author><author><name sortKey="Bachman Desilva, M" uniqKey="Bachman Desilva M">M Bachman DeSilva</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bock, N" uniqKey="Bock N">N Bock</name></author><author><name sortKey="Lee, Cw" uniqKey="Lee C">CW Lee</name></author><author><name sortKey="Bechange, S" uniqKey="Bechange S">S Bechange</name></author><author><name sortKey="Moore, J" uniqKey="Moore J">J Moore</name></author><author><name sortKey="Khana, K" uniqKey="Khana K">K Khana</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fox, Mp" uniqKey="Fox M">MP Fox</name></author><author><name sortKey="Mccoy, K" uniqKey="Mccoy K">K McCoy</name></author><author><name sortKey="Larson, Ba" uniqKey="Larson B">BA Larson</name></author><author><name sortKey="Rosen, S" uniqKey="Rosen S">S Rosen</name></author><author><name sortKey="Bii, M" uniqKey="Bii M">M Bii</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Afrique du Sud</li><li>États-Unis</li></country><region><li>Gauteng</li><li>Massachusetts</li></region><settlement><li>Johannesbourg</li></settlement><orgName><li>Université du Witwatersrand</li></orgName></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Rosen, Sydney" sort="Rosen, Sydney" uniqKey="Rosen S" first="Sydney" last="Rosen">Sydney Rosen</name></region><name sortKey="Brennan, Alana" sort="Brennan, Alana" uniqKey="Brennan A" first="Alana" last="Brennan">Alana Brennan</name><name sortKey="Fox, Matthew" sort="Fox, Matthew" uniqKey="Fox M" first="Matthew" last="Fox">Matthew Fox</name><name sortKey="Larson, Bruce" sort="Larson, Bruce" uniqKey="Larson B" first="Bruce" last="Larson">Bruce Larson</name></country><country name="Afrique du Sud"><region name="Gauteng"><name sortKey="Rosen, Sydney" sort="Rosen, Sydney" uniqKey="Rosen S" first="Sydney" last="Rosen">Sydney Rosen</name></region><name sortKey="Brennan, Alana" sort="Brennan, Alana" uniqKey="Brennan A" first="Alana" last="Brennan">Alana Brennan</name><name sortKey="Fox, Matthew" sort="Fox, Matthew" uniqKey="Fox M" first="Matthew" last="Fox">Matthew Fox</name><name sortKey="Ketlhapile, Mpefe" sort="Ketlhapile, Mpefe" uniqKey="Ketlhapile M" first="Mpefe" last="Ketlhapile">Mpefe Ketlhapile</name><name sortKey="Long, Lawrence" sort="Long, Lawrence" uniqKey="Long L" first="Lawrence" last="Long">Lawrence Long</name><name sortKey="Mongwenyana, Constance" sort="Mongwenyana, Constance" uniqKey="Mongwenyana C" first="Constance" last="Mongwenyana">Constance Mongwenyana</name><name sortKey="Sanne, Ian" sort="Sanne, Ian" uniqKey="Sanne I" first="Ian" last="Sanne">Ian Sanne</name><name sortKey="Sanne, Ian" sort="Sanne, Ian" uniqKey="Sanne I" first="Ian" last="Sanne">Ian Sanne</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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