A5008162121- HIV/AIDS drug development and treatment
- HIV Research and Treatment
- HIV/AIDS Research and Interventions
- Opioid Use Disorder Treatment
- HIV, Drug Use, Sexual Risk
- SARS-CoV-2 and COVID-19 Research
- Vaccine Coverage and Hesitancy
- Infective Endocarditis Diagnosis and Management
- Antibiotic Use and Resistance
- Pneumocystis jirovecii pneumonia detection and treatment
- Infectious Diseases and Tuberculosis
- Viral gastroenteritis research and epidemiology
- Pharmaceutical Practices and Patient Outcomes
- Orthopedic Infections and Treatments
- Forensic Toxicology and Drug Analysis
- HIV-related health complications and treatments
- SARS-CoV-2 detection and testing
- COVID-19 epidemiological studies
- Cardiac pacing and defibrillation studies
- Dermatological and COVID-19 studies
- IL-33, ST2, and ILC Pathways
- Parasitic Infections and Diagnostics
- Bacillus and Francisella bacterial research
- Otolaryngology and Infectious Diseases
- Infection Control and Ventilation
Beth Israel Deaconess Medical Center
2012-2024
Betsi Cadwaladr University Health Board
2023
Harvard University
2010-2022
Hadassah Medical Center
2013-2020
Botswana Harvard AIDS Institute Partnership
2010-2020
Boston University
2013-2020
Washington University in St. Louis
2014
A large, ongoing multicountry outbreak of human monkeypox has the potential to cause considerable morbidity and mortality. Therapeutics for treatment smallpox, a related Orthopoxvirus, may be used affect natural history monkeypox. We present 3 patients from our hospitals treated with tecovirimat, pan-Orthopoxvirus inhibitor currently available under an expanded access investigational new drug protocol
After BNT162b2 messenger RNA vaccination, antibody levels to spike, receptor-binding domain, and virus neutralization were examined in 149 nursing home residents 110 healthcare worker controls. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-naive residents' median post-second vaccine dose titers are one-quarter that of SARS-CoV-2-naive workers.
Abstract Background In the context of opioid epidemic, injection drug use (IDU)–related infections are an escalating health issue for infectious diseases (ID) physicians in United States. Methods We conducted a mixed methods survey Infectious Diseases Society America’s Emerging Infections Network between February and April 2017 to evaluate perspectives relating care persons who inject drugs (PWID). Topics included frequency management strategies IDU-related infection, availability addiction...
Hospitalizations for individuals with injection drug use-related infective endocarditis (IDU-IE) represent an increasing portion of all patients endocarditis. This study describes the evolving trends in demographics, clinical characteristics, rates surgical intervention, and mortality among hospitalized IE, comparing those without use.This is a retrospective cohort admitted between January 1, 2007 to June 30, 2015 at tertiary care center Boston, Massachusetts. Endocarditis was defined by...
ABSTRACT Cytotoxic-T-lymphocyte (CTL) escape mutations in human immunodeficiency viruses encode amino acid substitutions positions that disrupt CTL targeting, thereby increasing virus survival and conferring a relative fitness benefit. However, it is now clear can also confer cost, there evidence to suggest some cases, e.g., from HLA-B*57/B*5801-restricted responses, the costs may affect clinical course of infection. To quantify magnitude HLA-B*57/B*5801 escape, highly sensitive...
Antibody decline occurred from 2 weeks to 6 months post-BNT162b2 mRNA vaccination in nursing home (NH) residents and healthcare workers. Antispike, receptor-binding domain, neutralization levels dropped >81% irrespective of prior infection. Notably, 69% infection-naive NH had neutralizing antibodies at or below the assay's limit detection.
Abstract Background The BNT162b2 SARS-CoV-2 mRNA vaccination has mitigated the burden of COVID-19 among residents long-term care facilities considerably, despite being excluded from vaccine trials. Data on reactogenicity (vaccine side effects) in this population are limited. Aims To assess nursing home (NH) residents. provide a plausible proxy for predicting response population. Methods We enrolled and sampled NH community-dwelling healthcare workers who received vaccine, to local or...
Seeing growing numbers of life-threatening infections arising from injection drug use, a group ID physicians began offering patients with opioid use disorder counseling, naloxone, buprenorphine induction therapy, and essential referrals for long-term treatment.
The aim of the study was to evaluate for presence drug resistance HIV medications in treatment-naive individuals Botswana. Two different populations were evaluated evidence at three geographical locations In first population, consisting pregnant females diagnosed with during pregnancy, participants enrolled time their diagnosis. second population included pre-ART enrollees Infectious Diseases Care Clinics (IDCCs) who had a CD4 T cell count >350 cells/μL. A total 422 genotypes determined: 234...
The SARS-CoV-2 pandemic impact on nursing home (NH) residents prompted their prioritization for early vaccination. To fill the data gap vaccine immunogenicity in NH residents, we examined antibody levels after BNT162b2 mRNA to spike, receptor binding domain (RBD) and virus neutralization 149 111 health care worker controls. SARS-CoV-2-naive mount responses with nearly 4-fold lower median titers half anti-spike level compared healthcare workers. By contrast, SARS-CoV-2-recovered vaccinated...
Abstract High COVID-19 mortality among nursing home (NH) residents led to their prioritization for SARS-CoV-2 vaccination; most NH received BNT162b2 mRNA vaccination under the Emergency Use Authorization due first market and its availability. With residents’ poor initial vaccine response, rise of breakthrough infections outbreaks, characterization durability immunity inform public health policy on need boosting is needed. We report humoral from 2 weeks 6-months post-vaccination in 120 92...
HIV-1 drug resistance mutations have been detected at low frequencies after single-dose nevirapine (sdNVP) for prevention of mother-to-child transmission (PMTCT). We investigated the relationship between these "minor variant" NVP-resistant viruses and clinical outcome with NVP-containing antiretroviral therapy (ART). An allele-specific quantitative PCR (ASPCR) assay was used to quantify pre-ART frequency K103N Y181C in 26 women who had received sdNVP. The cohort composed 7 patients...
There are limited data on the effectiveness of dolutegravir (DTG)-based combination antiretroviral therapy (ART) in real-life settings southern Africa where HIV-1 subtype C predominates. We report a patient infected with DTG-based ART previously exposed to raltegravir who developed multidrug resistance mutations four classes. is need for drug monitoring and clinical vigilance ensure HIV treatment programs even era ART.
Despite escalating opioid overdose death rates, addiction medicine is underrepresented in residency curricula. Providing naloxone to at-risk patients, relatives, and first responders reduces deaths, but rates of prescribing remain low. The goal this study examine the impact a brief curricular intervention for internal residents on knowledge, attitudes.Internal (N = 160) at an urban, tertiary care medical center received two 1-hour didactic sessions addressing prevention, including intranasal...
We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50 - 1000 copies/mL for more than 12 months. Subjects were followed from time first detectable viral load (VL). In total, 102 episodes LLV detected among 80 individuals. The median (mean, range) HIV copy number at genotyping was 250 (486, 3900) after 14 (17.9, 0 58) months LLV. Few patients maintained the entire 9 years...
Background: Individuals living with human immunodeficiency virus (HIV) who experience virological failure (VF) after combination antiretroviral therapy (cART) initiation may have had low-frequency drug resistance mutations (DRMs) at cART initiation. There are no data on DRMs among cART-naïve HIV-positive individuals in Botswana. Methods: We evaluated the prevalence of previously sequenced using Sanger sequencing. The generated pol amplicons were by next-generation Results: observed (detected...
Effective therapies are limited for patients with parenteral nutrition-dependent short bowel syndrome. We previously showed that intestinal expression of the transcriptional coregulator tetradecanoyl phorbol acetate-induced sequence 7 (tis7) is markedly increased during adaptive response following massive small resection and tis7 plays a role in normal gut lipid metabolism. Here, we further explore functional implications deletion metabolism resection. Intestinal transgenic (tis7(tg)),...
Background Roll-out of Integrase Strand Transfer Inhibitors (INSTIs) such as dolutegravir for HIV combination antiretroviral therapy (cART) in sub-Saharan Africa necessitates the development affordable drug resistance (HIVDR) assays targeting gene. We optimised and evaluated an in-house integrase HIV-1 assay (IH-Int) compared it to a commercially available assay, ViroSeq™ Genotyping kit (VS-Int) amongst clade C infected individuals. Methods used 54 plasma samples from treatment naïve...
Clusters of patients who obtain cosmetic surgeries abroad have developed surgical site infections due to rapid growing non-tuberculous mycobacteria (NTM). These are usually treated with a combination surgery and months anti-mycobacterial therapy, but poor outcomes, including permanent scarring common. We present case 36-year-old female clarithromycin-resistant M. chelonae (CRMC) infection after undergoing breast augmentation in the Dominican Republic. She underwent debridement explant her...