A5042882515- HIV/AIDS drug development and treatment
- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- Sepsis Diagnosis and Treatment
- HIV-related health complications and treatments
- Nosocomial Infections in ICU
- COVID-19 diagnosis using AI
- Global Maternal and Child Health
- SARS-CoV-2 and COVID-19 Research
- SARS-CoV-2 detection and testing
- Hepatitis C virus research
- Cultural Competency in Health Care
- Adipose Tissue and Metabolism
- Myasthenia Gravis and Thymoma
- Machine Learning in Healthcare
- Folate and B Vitamins Research
- Peroxisome Proliferator-Activated Receptors
- HIV, Drug Use, Sexual Risk
- Service-Learning and Community Engagement
- Artificial Intelligence in Healthcare and Education
- Pleural and Pulmonary Diseases
- Hepatitis B Virus Studies
- Vaccine Coverage and Hesitancy
- Athletic Training and Education
- COVID-19 Clinical Research Studies
Massachusetts General Hospital
2016-2025
Harvard University
2017-2025
Mbarara University of Science and Technology
2023-2025
Africa Health Research Institute
2023
May Institute
2023
Pontificia Universidad Católica de Chile
2023
University of the Witwatersrand
2022
Museum of Heilongjiang Province
2021
Kantonsspital Aarau
2021
Johns Hopkins University Center for AIDS Research
2017
Background: Dolutegravir (DTG) is a cornerstone of global antiretroviral (ARV) therapy (ART) due to its high efficacy and favorable tolerability. However, limited data exist regarding the risk emergent integrase strand transfer inhibitor (INSTI) drug-resistance mutations (DRMs) in individuals receiving DTG-containing ART. Methods: We performed PubMed search using term “Dolutegravir”, last updated 18 December 2023, estimate prevalence VF with INSTI DRMs people living HIV (PLWH) without...
ABSTRACT Background Dolutegravir (DTG) is a cornerstone of global antiretroviral (ARV) therapy (ART) due to its high efficacy and favorable tolerability. However, limited data exist regarding the risk virological failure (VF) with emergent integrase strand transfer inhibitor (INSTI) drug-resistance mutations (DRMs) in individuals receiving DTG-containing ART. Methods We performed PubMed search using term “Dolutegravir” last updated December 18, 2023, estimate prevalence VF INSTI DRMs...
Abstract Background Lenacapavir, a novel HIV-1 capsid inhibitor, shows promise for treating MDR HIV-1, as well pre-exposure prophylaxis (PrEP) in prevention of HIV infection. Its unique mechanism and lack cross-resistance with other antiretroviral classes make lenacapavir significant addition to therapy. The clinical trials CALIBRATE CAPELLA have demonstrated high viral suppression rates both ART-naive individuals HIV-1. Lenacapavir-associated resistance mutations, such M66I Q67H, rarely...
Objective: We sought to evaluate the utility of a point-of-care (POC) urine tenofovir (TFV) assay, developed objectively assess adherence, predict HIV drug resistance (HIVDR) in people failing first-line antiretroviral therapy (ART). Design: retrospectively analyzed TFV levels as biomarker adherence specimens collected during clinical trial that enrolled adults with virologic failure on ART Uganda and South Africa. Methods: Urine were from participants TFV-containing regimens who had viral...
Background: People with HIV (PWH) on integrase inhibitor-based regimens may be at risk of excess weight gain, but it is unclear if this consistent across settings. We assessed change over 48 weeks among PWH who were transitioned to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD). Design: conducted a prospective cohort study public-sector clinics in Uganda and South Africa. Methods: Eligible participants adults TLD. Weight was measured enrollment, 24-, 48-weeks post TLD...
Procalcitonin (PCT) is a prohormone that rises in bacterial pneumonia and has promise reducing antibiotic use. Despite these attributes, there are inconclusive data on its use for clinical prognostication. We hypothesize serial PCT measurements can predict mortality, intensive care unit (ICU) admission, bacteremia.A prospective cohort study of inpatients diagnosed with was performed at large tertiary center Boston, Massachusetts. measured days 1 through 4. The primary endpoint composite...
Abstract Background Isolation of hospitalized persons under investigation (PUIs) for coronavirus disease 2019 (COVID-19) reduces nosocomial transmission risk. Efficient evaluation PUIs is needed to preserve scarce healthcare resources. We describe the development, implementation, and outcomes an inpatient diagnostic algorithm clinical decision support system (CDSS) evaluate PUIs. Methods conducted a pre-post study CORAL (COvid Risk cALculator), CDSS that guides frontline clinicians through...
Virologic failure in HIV predicts the development of drug resistance and mortality. Genotypic testing (GRT), which is standard care after virologic high-income settings, rarely implemented sub-Saharan Africa.
Objective: Dolutegravir (DTG) is now a preferred component of first-line antiretroviral therapy (ART). However, prevalence data on natural resistance to integrase inhibitors [integrase strand transfer (INSTIs)] in circulating non-subtype B HIV-1 sub-Saharan Africa scarce. Our objective report pre-treatment polymorphisms associated with INSTIs an ART-naive cohort diverse subtypes. Design: We retrospectively examined sequences from Uganda. Methods: Plasma samples were derived the Uganda AIDS...
Background: The World Health Organization defines HIV virologic failure as 2 consecutive viral loads >1000 copies/mL, measured 3–6 months apart, with interval adherence support. We sought to empirically evaluate these guidelines using data from an observational cohort. Setting: Uganda AIDS Rural Treatment Outcomes study observed adults in southwestern the time of antiretroviral therapy (ART) initiation and monitored electronic pill bottles. Methods: included participants on ART a...
Tenofovir/lamivudine/dolutegravir (TLD) is the preferred first-line antiretroviral therapy (ART) regimen for people with HIV (PWH), including those who were previously virologically suppressed on nonnucleoside reverse transcriptase inhibitors (NNRTIs). We sought to estimate real-world effectiveness of TLD transition in Ugandan public-sector clinics.
The prevalence of HIV pretreatment drug resistance (PDR) is increasing in sub-Saharan Africa. We sought to describe correlates PDR and evaluate effects on clinical outcomes rural Uganda. analyzed data from the Uganda AIDS Rural Treatment Outcomes study, a cohort antiretroviral therapy (ART)-naive adults with (2005–2015). performed testing pre-ART specimens. defined as any World Health Organization (WHO) 2009 surveillance mutation classified level using Stanford algorithm. fit unadjusted...
Abstract Background The long-acting injectable regimen of cabotegravir plus rilpivirine (CAB/RPV) emerged as an alternative to oral standard care integrase strand transfer inhibitor (INSTI)-based regimens for individuals with adherence challenges or preference reduced dosing schedules. Although INSTI have a high barrier emergent resistance, less is known about the potency and durability CAB/RPV. Methods We reviewed clinical trial registries, PubMed, EMBASE, conference abstract databases...
HIV virological failure remains a major threat to programme success in sub-Saharan Africa. While drug resistance (HIVDR) and inadequate adherence are the main drivers of failure, individual, clinical health system characteristics that lead poor outcomes not well understood. The objective this paper is identify those among people failing first-line antiretroviral therapy (ART).
Despite a poor toxicity profile, zidovudine supersedes abacavir (ABC) as an alternative first-line agent in most international treatment guidelines because of concerns about HLA-B*57:01-related ABC-hypersensitivity. We detected one case HLA-B*57:01 carriage among 513 HIV-infected individuals Uganda, which, combination with previous reports, supports the safety ABC region.
Abstract We describe an approach to the evaluation and isolation of hospitalized persons under investigation (PUIs) for coronavirus disease 2019 (COVID-19) at a large US academic medical center. Only small proportion (2.9%) PUIs with 1 or more repeated severe acute respiratory virus 2 (SARS-CoV-2) nucleic acid amplification tests (NAATs) after negative NAAT were diagnosed COVID-19.
A 34-year-old woman presented with hypercortisolism resulting from a metastatic pancreatic neuroendocrine tumor. Chest CT revealed patchy consolidation cavitation and tree-in-bud opacities. Management decisions were made.
To examine if point-of-care urine tenofovir testing-informed counseling could be used to improve virologic suppression (VS) among participants with failure (VF) after ≥1 prior round of enhanced adherence (EAC).