A5029003024- HIV-related health complications and treatments
- Diabetes, Cardiovascular Risks, and Lipoproteins
- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- Atherosclerosis and Cardiovascular Diseases
- Cardiovascular Disease and Adiposity
- Adipokines, Inflammation, and Metabolic Diseases
- Atrial Fibrillation Management and Outcomes
- Tuberculosis Research and Epidemiology
- Acute Myocardial Infarction Research
- Immune Cell Function and Interaction
- Lipoproteins and Cardiovascular Health
- Chronic Disease Management Strategies
- Cardiac Health and Mental Health
- Global Public Health Policies and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- Osteoarthritis Treatment and Mechanisms
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Cardiovascular Function and Risk Factors
- Systemic Lupus Erythematosus Research
- Cardiac Arrhythmias and Treatments
- Diagnosis and treatment of tuberculosis
- Inflammasome and immune disorders
- Cardiac Imaging and Diagnostics
- Bone Metabolism and Diseases
University of Washington
2018-2025
Harvard University
2024
University of Nairobi
2017-2023
University of Washington Medical Center
2022-2023
Seattle University
2022-2023
Johns Hopkins Hospital
2019
Duke University
2019
University of California, San Diego
2019
Kenyatta National Hospital
2017
Brown University
2010-2015
People living with HIV have a 1.5- to 2-fold increased risk of developing cardiovascular disease. Despite treatment highly effective antiretroviral therapy, people chronic inflammation that makes them susceptible multiple comorbidities. Several factors, including the reservoir, coinfections, clonal hematopoiesis indeterminate potential (CHIP), microbial translocation, and may contribute state inflammation. Within innate immune system, macrophages harbor latent are among prominent cells...
The burden of cardiovascular disease (CVD) is increasing in sub-Saharan Africa with untreated hypertension being a major contributing factor. Understanding the magnitude problem and risk factors associated HIV long-term antiretroviral therapy (ART) critically important for designing effective programs diagnosing treating Kenya.In this cross-sectional study, we enrolled 300 persons (PWH) on long term ART (≥6 months) 298 HIV-negative adults seeking care at Kisumu County Hospital between...
Persistent systemic inflammation is associated with an elevated risk of cardiometabolic diseases. However, the characteristics innate and adaptive immune systems in individuals who develop these conditions remain poorly defined. Doublets, or cell-cell complexes, are routinely eliminated from flow cytometric other phenotyping analyses, which limits our understanding their relationship to disease states. Using well-characterized clinical cohorts, including participants controlled human...
The ATDC5 cell line exhibits a multistep process of chondrogenic differentiation analogous to that observed during endochondral bone formation. Previous investigators have induced cells differentiate by exposing them insulin at high concentrations. We spontaneous maintained in ascorbic acid-containing α-MEM. A comparison the events response high-dose vs. acid showed similar expression patterns key genes, including collagen II, Runx2, Sox9, Indian hedgehog, and X. took advantage action...
Traditional cardiovascular disease (CVD) risk factors contribute to increase of CVD in people living with HIV (PLWH). Of all world regions, sub-Saharan Africa has the highest prevalence yet little is known about PLWH's knowledge and self- perceived for coronary heart (CHD). In this study, we assessed knowledge, perception attitude towards diseases their prevention.We conducted a cross-sectional study largest care program western Kenya. Trained research assistants used validated...
Background: Acute coronary syndrome (ACS) is understudied in sub-Saharan Africa despite its increasing disease burden.We sought to create an ACS registry at Kenyatta National Hospital evaluate the presentation, management and outcomes of patients.Methods: From November 2016 April 2017, we conducted a retrospective review cases managed between 2013 2016, with primary discharge diagnosis ACS, based on International Classification Diseases (ICD) 10 coding (I20-I24).We compared by subtype using...
Metabolic syndrome (MetS), a cluster of cardiovascular disease risk factors, is increasingly common in people living with HIV; however, data on prevalence and the role antiretroviral therapy (ART) as factor for MetS sub-Saharan Africa are lacking. We conducted cross-sectional study to assess factors among ART-naive ART-experienced HIV-infected adults without preexisting cardiometabolic disorders Western Kenya using validated questionnaires laboratory tests after overnight fasting. used...
Abstract To determine the prevalence and correlates of metabolic syndrome (MetS) compare 10-year cardiovascular disease (CVD) risk among Kenyan adults with without HIV infection. We conducted a cross-sectional study ≥30 years age infection seeking care at Kisumu County Hospital. Participants completed health questionnaire vital signs, anthropomorphic measurements, fasting blood were obtained. MetS was defined using 2009 Consensus Criteria Atherosclerotic CVD (ASCVD) score calculated....
Background: Persons with HIV (PWH) on antiretroviral therapy (ART) have persistent immune activation associated increased risk for non-AIDS related diseases. Latent tuberculosis infection (LTBI), endemic in Africa, may contribute to this dysregulation. We evaluated the impact of and TB co-infection plasma pro- anti-inflammatory cytokines among Kenyan adults. Methods: compared data from 221 PWH long-term ART 177 HIV-negative adults examining biomarkers pro-[sCD14, interleukin (IL)-2, IL-6,...
Persons with HIV (PWH) on long-term antiretroviral therapy (ART) have a higher incidence and prevalence of cardiometabolic diseases attributed, in part, to persistent inflammation despite viral suppression. In addition traditional risk factors, immune responses co-infections such as cytomegalovirus (CMV) may play an unappreciated role comorbidities offer new potential therapeutic targets subgroup individuals. We assessed the relationship CX3CR1 + , GPR56 CD57 +/- T cells (termed CGC )...
Abstract Background Residual monocyte activation may contribute to increased risk for endothelial dysfunction and subsequent atherosclerotic cardiovascular diseases (CVDs) among people with HIV (PWH) on antiretroviral therapy (ART). We examined the relationship between in PWH Kenya. Methods Serum levels of markers (soluble/circulating intercellular [sICAM-1] vascular [sVCAM-1] cell adhesion molecule–1), intestinal barrier (intestinal fatty acid binding protein [I-FABP]), (soluble CD14...
Objective: Persons with HIV have double the risk of developing cardiovascular disease compared general population. A persistent and heightened immune response to cytomegalovirus coinfection may be one contributing factor, but relationship between replication, virus-specific cells, plaque burden is unclear. Approach Results: We assessed CD4 + T-cell subsets carotid in a cohort 70 HIV-positive participants sustained viral suppression on single antiretroviral regimen without known disease....
Objective: Chronic inflammation contributes to the high burden of cardiovascular disease (CVD) in persons with HIV (PWH). has broad effects on innate and adaptive immune cells, including lymphoid cells (ILCs) CD4 + T-helper cells. At present, relationship between CVD plasma cytokines reflecting ILC/T-helper responses PWH is not well defined. We investigated relationships subclinical atherosclerosis. Design: A cross-sectional study. Methods: recruited 70 a single antiretroviral regimen...
Objective Hypertension affects 23% of Kenyans and is the most prevalent modifiable risk factor for cardiovascular disease. Despite this, hypertension awareness treatment adherence very low. We conducted a qualitative study to explore lay beliefs about among HIV-infected adults inform development culture sensitive prevention control program. Methods Eight focus group discussions were held 53 at HIV clinic in Kenya. Results Respondents had difficulties describing hypertension. was considered...
Background Atrial fibrillation (AF) is a major contributor to the global cardiovascular disease burden. The clinical profile and outcomes of AF patients with valvular heart diseases in sub-Saharan Africa (SSA) have not been adequately described. We assessed features 12-month (vAF) comparison without (nvAF) western Kenya. Methods performed cohort study retrospective data gathering characterize risk factors prospective collection their hospitalization, stroke mortality rates. Results included...
Objectives Diastolic dysfunction (DD) has been reported to be highly prevalent in people living with HIV (PLWH) on antiretroviral therapy (ART) leading the hypothesis that it may an early marker of myocardial disease. Our objective was evaluate prevalence DD human immunodeficiency virus without known history diabetes or hypertension Western Kenya. Methods In this cross-sectional study western Kenya, 110 PLWH ART and were matched for age ±5 years sex HIV-uninfected controls. Study...
Objective: Inflammation is key in the pathogenesis of atherosclerotic coronary artery disease (CAD). Distinct sex-specific inflammatory mechanisms may contribute to CAD sub-Saharan Africa (SSA), where environmental and biological determinants systemic inflammation differ from those high-income settings. Approach results: We investigated sex differences markers a 2-year prospective cohort Ugandan adults enriched for cardiometabolic risk factors (RFs) HIV. Seven plasma biomarkers were...
Markers of monocyte/macrophage activation and vascular inflammation are associated with HIV-related cardiovascular diseases (CVD) mortality. We compared these markers among African people living HIV (PLWH) HIV-negative adults, examined risk factors elevated biomarkers (>75th percentile) in PLWH on antiretroviral therapy (ART).Cross-sectional study.We measured serum concentrations a gut integrity biomarker (intestinal-fatty acid binding protein), (soluble CD14 CD163), [soluble intercellular...
Abstract Background Systemic inflammation independently predicts future cardiovascular events and is associated with a 2-fold increase in disease (CVD) risk among persons living human immunodeficiency virus (PLHIV). We examined the association between inflammatory markers, HIV status, traditional CVD factors. Methods conducted cross-sectional study of Kenyan adults without seeking care at Kisumu County Hospital. Using multiplex immunoassay, we measured interleukin (IL) 1β, IL-6, tumor...
Background The prevalence of ischaemic heart disease and its acute manifestation, coronary syndrome (ACS), is growing throughout sub-Saharan Africa, including Kenya. To address this increasing problem, we sought to understand the facilitators, context barriers ACS care at Kenyatta National Hospital, with aim improving quality ACS. Methods We conducted in-depth interviews healthcare providers involved in management patients from January February 2017 Hospital Nairobi, selected an initial...
Background Persons with HIV have a higher prevalence of coronary artery disease compared their HIV-negative counterparts. Earlier identification subclinical atherosclerosis may provide greater opportunity for cardiovascular risk reduction. We investigated cross-sectional area (CorCSA) by noncontrasted computed tomography imaging as noninvasive measure arterial remodeling among virally suppressed persons HIV. Methods and Results assessed 105 spectrum cardiometabolic health. All participants...