A5072673470- HIV/AIDS Research and Interventions
- HIV/AIDS drug development and treatment
- HIV Research and Treatment
- HIV-related health complications and treatments
- Long-Term Effects of COVID-19
- Stroke Rehabilitation and Recovery
- COVID-19 and Mental Health
- HIV, Drug Use, Sexual Risk
- Hepatitis C virus research
- Renal Transplantation Outcomes and Treatments
- Cytomegalovirus and herpesvirus research
- Medication Adherence and Compliance
- Polyomavirus and related diseases
- COVID-19 Clinical Research Studies
- Herpesvirus Infections and Treatments
- Intensive Care Unit Cognitive Disorders
- Statistical Methods in Clinical Trials
- Blood groups and transfusion
- Scientific Computing and Data Management
Colorado School of Public Health
2017-2024
University of Colorado Anschutz Medical Campus
2017-2024
University of Colorado Denver
2022
Emory Healthcare
2021
University of Illinois Chicago
2003
ABSTRACT Studies of daily emtricitabine-tenofovir disoproxil fumarate (FTC-TDF) for HIV preexposure prophylaxis (PrEP) in men who have sex with (MSM) modeled intracellular tenofovir-diphosphate (TFV-DP) dried blood spots (DBS) to assess adherence and corresponding PrEP outcomes. We conducted a prospective, randomized, crossover pharmacokinetic study TFV-DP DBS during 33%, 67%, or 100% dosing under directly observed therapy (DOT). Participants were assigned two 12-week regimens, separated by...
Objectives Determine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors. Design Pilot randomised study. Setting In-home telerehabilitation. Participants 44 participants (21 female, mean age 52 years) discharged home following hospitalisation with (with without intensive care unit (ICU) stay). Interventions were block 2:1 to receive 12 individual biobehaviourally informed, app-facilitated, sessions licenced physical therapist...
Abstract Background Although tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is a predictor of adherence and pre-exposure prophylaxis efficacy, its utility human immunodeficiency virus (HIV) treatment remains unknown. Methods DBS for TFV-DP were collected up to 3 times over 48 weeks persons living with HIV (PLWH) who receiving TFV disoproxil fumarate (TDF)-based therapy. Log-transformed baseline was compared using t-tests or analyses variance; generalized estimating equations used...
Abstract Background Tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is associated with viral suppression persons living HIV (PLWH) taking tenofovir disoproxil fumarate (TDF). However, its value as a predictor of future viremia remained unknown. Methods Blood for plasma load (VL) and TFV-DP DBS were collected (up to 3 visits within 48 weeks) PLWH on TDF. cut points selected using logistic prediction models maximizing the area under receiver operation characteristic curve, estimated...
Tenofovir alafenamide (TAF), in combination with FTC, was recently approved for PrEP the United States. The objective of this study to assess relationship between tenofovir-diphosphate (TFV-DP) and emtricitabine-triphosphate (FTC-TP) dried blood spots (DBS) adherence TAF/FTC.
Individuals with coronavirus disease 2019 (COVID-19) may have persistent symptoms following their acute illness. The prevalence and predictors of these symptoms, termed postacute sequelae severe respiratory syndrome 2 (SARS-CoV-2; PASC), not been fully described.Participants discharged from an outpatient telemedicine program for COVID-19 were emailed a survey (1-6 months after discharge) about ongoing illness severity, quality life. Standardized notes used covariates (comorbidities...
Abstract Background QUANTI-TAF aimed to establish tenofovir-diphosphate (TFV-DP)/emtricitabine-triphosphate (FTC-TP) adherence benchmarks in dried blood spots (DBS) for persons with human immunodeficiency virus (PWH) receiving tenofovir alafenamide/emtricitabine (TAF/FTC)–based antiretroviral therapy (ART). Methods For 16 weeks, PWH received TAF/FTC-based ART co-encapsulated an ingestible sensor directly measure cumulative (enrollment final visit) and 10-day adherence. At monthly visits,...
Residual systemic inflammation persists despite suppressive antiretroviral therapy (ART) and is associated with non-AIDS clinical outcomes. We aimed to evaluate the association between ART adherence in Ugandans living HIV who were predominantly receiving nevirapine-based a thymidine analog backbone virologically suppressed by conventional assays.Plasma concentrations of interleukin-6 (IL-6), D-dimer, soluble (s)CD14, sCD163, kynurenine/tryptophan ratio, addition CD8 T-cell activation,...
The drivers of low-level viremia (LLV) between 20 and 200 copies/mL remain unclear. In 1042 person-visits from 497 persons with HIV on tenofovir disoproxil fumarate-containing antiretroviral therapy (ART), the association LLV cumulative adherence (quantified using diphosphate [TFV-DP] in dried blood spots) was assessed. Lower TFV-DP levels were associated higher odds LLV. As (fmol/punch) categories decreased >1650 to 800-1650; 800-1650 <800; <800, adjusted ratios for vs VL <20 2.0 (95% CI,...
Objective: Tenofovir alafenamide (TAF) preferentially loads peripheral blood mononuclear cells (PBMCs), resulting in higher PBMC tenofovir-diphosphate (TFV-DP) vs. tenofovir disoproxil fumarate (TDF). No studies have yet compared TFV-DP from lower than daily dosing between prodrugs, which has potential implications for event-driven preexposure prophylaxis and pharmacologic forgiveness. Design: Two separate randomized, directly observed therapy (DOT) crossover (DOT-DBS TAF-DBS) were conducted...
Concentrations of tenofovir (TFV) in hair and diphosphate (TFV-DP) dried blood spots (DBSs) as measures cumulative exposure have been primarily studied younger, HIV-uninfected individuals taking preexposure HIV prophylaxis. Data on these among older HIV-infected are limited.We evaluated longitudinal TFV TFV-DP concentrations DBS, respectively, from adults. Multivariable model variables included age group (18-35 60 years older), creatinine clearance (CrCl), hematocrit (TFV-DP), gray color...
Tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is a strong predictor of viral suppression persons living with HIV (PLWH). Its association antiretroviral therapy (ART) resistance remains unknown.Blood was collected PLWH receiving TDF-containing ART enrolled 48-week study. diphosphate/emtricitabine triphosphate (FTC-TP) were quantified from the same sample as load (VL) who developed within ≤12 months.The study 807 participants, whom 10 had new resistance-conferring mutations. Among...
To determine factors associated with interindividual variability in tenofovir diphosphate (TFV-DP) concentrations dried blood spots (DBSs) among persons living HIV (PLWH).PLWH who were at least 18 years old and taking disoproxil fumarate-containing ART prospectively recruited enrolled from a clinical cohort followed longitudinally (up to three visits over 48 weeks). With log-transformed TFV-DP DBSs as the outcome, mixed-model regression analyses used assess associations between self-reported...
Abstract Background Hepatitis C virus treatment in persons who use drugs (PWUD) is often withheld due to adherence and reinfection concerns. In this study, we report outcomes, technology-based data, predictors PWUD and/or alcohol. Methods INCLUD was a prospective, open-label study of ledipasvir/sofosbuvir for 12 weeks aged 18–70 years. Participants were randomized wireless (wirelessly observed therapy) or video-based directly therapy (vDOT). Drug assessed every 2 weeks. Sustained virologic...
Emtricitabine triphosphate (FTC-TP), the phosphorylated anabolite of emtricitabine, can be quantified in dried blood spots (DBS). We evaluated FTC-TP DBS as a predictor viral suppression and self-reported adherence FTC-TP. Persons living with HIV (PLWH) on an FTC-containing regimen were prospectively recruited. A load obtained during routine clinical visits. Self-reported for 3 days, 30 days months was captured. Generalized estimating equations used to estimate adjusted odds ratio (aOR)...
Residual systemic inflammation, which is associated with non-AIDS clinical outcomes, may persist despite viral suppression. We assessed the effect of antiretroviral therapy (ART) adherence interruptions on inflammation among Ugandans living HIV who were virally suppressed.We evaluated adults initiating first-line ART at a regional referral hospital clinic in Mbarara, Uganda.Plasma concentrations interleukin-6 (IL-6), D-dimer, soluble sCD14, sCD163, kynurenine/tryptophan (K/T) ratio, and CD8...
Objectives: Women likely require higher adherence than men to preexposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) for similar efficacy. Pharmacologic metrics of predict efficacy better self-report, but expected drug levels (adherence benchmarks) must be established using directly observed therapy. We sought evaluate whether hair concentrations differ between women and receiving TDF/FTC. Methods: assessed in HIV-uninfected volunteers randomized receive...
Adherence to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC, Truvada®) is the primary determinant of HIV pre-exposure prophylaxis (PrEP) efficacy. Despite its importance, limitations exist in current methods adherence quantification, restricting their implementation clinic. Proteus Discover (Proteus Digital Health®) can measure time each dose using an ingestible sensor that coencapsulated with medication. In this study, bioequivalence TDF/FTC was compared relative unencapsulated drug....
From directly observed therapy studies, urine tenofovir (TFV) levels were 74% lower when taking alafenamide (TAF) vs disoproxil fumarate. Urine TFV remains quantifiable across a range of TAF adherence patterns, but separate point-of-care lateral flow immunoassay with threshold will be needed to support monitoring.
Abstract Background Incomplete antiretroviral therapy (ART) adherence has been linked to deleterious immunologic, inflammatory, and clinical consequences, even among virally suppressed (&lt;50 copies/mL) persons with human immunodeficiency virus (PWH). The impact of improving in the risk severe non-AIDS events (SNAEs) death this population is unknown. Methods We estimated reduction SNAEs or resulting from an increase ART by (1) applying existing data on association between high residual...
Abstract Background Ledipasvir/sofosbuvir increases tenofovir plasma exposures by up to 98% with disoproxil fumarate (TDF), and are highest boosted PIs. There currently no data on the combined use of newer prodrug, alafenamide (TAF), PIs ledipasvir/sofosbuvir. Objectives To compare intracellular pharmacokinetics renal safety TAF ledipasvir/sofosbuvir when co-administered Methods Persons HIV between 18 70 years a PI TDF were eligible. The study was comprised four phases: (1) 300 mg PI; (2) 25...
Objective: Emtricitabine triphosphate (FTC-TP) in dried blood spots (DBS), a measure of short-term antiretroviral therapy (ART) adherence, is associated with viral suppression persons HIV (PWH). However, its ability to predict future viremia remains unknown. Design: Prospective, observational cohort (up three visits 48 weeks). Methods: PWH receiving TDF/FTC-based ART had DBS and load obtained at routine clinical visits. FTC-TP was dichotomized into quantifiable vs. below the limit...
Knowledge on physical activity recovery after COVID-19 survival is limited. The AFTER (App-Facilitated Tele-Rehabilitation) program for survivors randomized participants, following hospital discharge, to either education and unstructured or a telerehabilitation program. Step count data were collected as secondary outcome, we found no significant differences in total step trajectories between groups at 6 weeks. Further not analyzed.The purpose of this analysis was examine correlates among all...
Objective: People living with HIV (PLWH) are longer and developing more non-AIDS comorbidities, which negatively impact antiretroviral therapy (ART) adherence. Tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is a novel pharmacologic measure of cumulative ART adherence that predictive viral suppression future viremia. However, the relationship between comorbidities this unknown. We aimed to evaluate association 3 (diabetes mellitus (DM), hypertension, hyperlipidemia) TFV-DP DBS...