A5003568343- Hepatitis C virus research
- HIV, Drug Use, Sexual Risk
- Opioid Use Disorder Treatment
- Liver Disease Diagnosis and Treatment
- Hepatitis B Virus Studies
- HIV/AIDS Research and Interventions
- HIV/AIDS drug development and treatment
- Substance Abuse Treatment and Outcomes
- LGBTQ Health, Identity, and Policy
- Systemic Lupus Erythematosus Research
- Intramuscular injections and effects
- Pharmacovigilance and Adverse Drug Reactions
- HIV-related health complications and treatments
- Chronic Lymphocytic Leukemia Research
- Schizophrenia research and treatment
- Botulinum Toxin and Related Neurological Disorders
- HIV Research and Treatment
- Blood groups and transfusion
- Cervical Cancer and HPV Research
- Alcohol Consumption and Health Effects
- Liver Diseases and Immunity
- Forensic Toxicology and Drug Analysis
- Clostridium difficile and Clostridium perfringens research
- Suicide and Self-Harm Studies
- Drug-Induced Adverse Reactions
University of Maryland, Baltimore
2016-2025
AIDS United
2019-2025
Institute of Human Virology
2016-2022
Gilead Sciences (United States)
2015-2021
National Institutes of Health
2016-2021
Family and Medical Counseling Service
2017
National Institute of Allergy and Infectious Diseases
2015-2016
St. Joseph's Hospital
2016
Creighton University
2016
National Institutes of Health Clinical Center
2015-2016
Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has resulted in high rates of disease cure; however, not enough specialists currently are available to provide care.
Abstract Background People who inject drugs have a high prevalence of hepatitis C virus (HCV) and significant disease associated with drug use; however, HCV treatment often occurs in absence interventions to address opioid use disorder use–related harms. The impact concurrent initiation agonist therapy (OAT) on outcomes is unknown. Methods In this prospective, open-label, observational trial at harm reduction organization’s drop-in center Washington, DC, 100 patients chronic infection,...
A converging public health crisis is emerging because the opioid epidemic fueling a surge in infectious diseases, such as human immunodeficiency virus infection with or without AIDS, viral hepatitides, infective endocarditis, and skin soft-tissue infections. An integrated strategy needed to tailor preventive therapeutic approaches toward diseases people who misuse and/or are addicted opioids concurrently address underlying predisposing factor for infections-opioid use disorder. This...
Treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs) for 6 weeks achieves sustained virologic response (SVR) rates 95% in some patients. If effective, shorter therapeutic courses could improve adherence and treatment costs.
<h3>Importance</h3> The demand for medications opioid use disorder (MOUD) in rural US counties far outweighs their availability. Novel approaches to extend treatment capacity include telemedicine (TM) and mobile on demand; however, combined has not been reported or evaluated. <h3>Objective</h3> To evaluate the of a TM unit (TM-MTU) improve access MOUD individuals living an underserved area. <h3>Design, Setting, Participants</h3> This quality improvement study evaluated data collected from...
In a cohort of transgender women (TGW) with abnormal anal cytology (AAC) in Washington, DC, we determined the rates and factors associated completion high-resolution anoscopy (HRA). This mixed-methods study used sequential design. an academic-community clinic, recruited TGW who provided blood samples, swabs for cytology, completed surveys. For quantitative phase this study, χ2 test to compare HRA among AAC. From that cohort, purposive sampling recruit 16 qualitative interviews, based on...
Abstract Background Injection-related skin ulcers (IRSU) are a cause of acute bacterial infection among people who inject drugs (PWID). We aimed to measure the prevalence, characteristics, and risk factors for IRSU, readmission, cohort PWID hospitalized infections. Table 1 SD, standard deviation. Methods CHOICE+ is multisite retrospective study adults at four healthcare systems with infections due injection opioid use between 1/1/2018 3/31/2022. Data were collected by abstraction electronic...
Abstract Background People who inject drugs hospitalized with severe injection-related infections (SIRI) face barriers to antibiotic treatment completion and remain at risk for new due ongoing injection drug use. We explored factors SIRI readmission whether readmissions were caused by the index or a SIRI. Methods CHOICE+ is retrospective cohort study of adults opioid use 4 hospital systems between 1/1/2018 3/31/2022. Data collected abstraction medical record. Primary outcomes within 1 year...
Abstract Background People who inject drugs have high rates of patient directed discharge (PDD). In a cohort patients hospitalized for serious injection related infections (SIRI), we aimed to assess the factors leading PDD and influence on rehospitalization. Characteristics study participants Methods CHOICE+ is multisite retrospective adults at four healthcare systems with SIRI due opioid use between 1/1/2018 3/31/2022. Data were collected by abstraction electronic medical record analyzed...
Abstract Background Guidelines recommend anal cancer screening in transgender women (TGW) – particularly those living with HIV (LWH) - using cytology followed by high-resolution anoscopy (HRA) abnormal results. This study examines factors associated completion of HRA TGW cytology. Methods We recruited 80 convenience sampling from 4/2021 9/2023. collected survey data, serum samples, and swabs for HPV testing. were scheduled off-site HRA. Non-completion was defined as being but not completing...
Abstract Background Despite achieving sustained virologic response (SVR), people with HCV, opioid use disorder (OUD) and ongoing injection drug (IDU) remain at risk of reinfection. Identification retreatment reinfected individuals is critical to HCV elimination. We sought evaluate the rate reinfection, factors associated in a cohort who inject drugs (PWID).Table 1.Bivariate analysis baseline sociodemographic characteristics. Methods The ANCHOR study provided treatment for 198 chronic OUD,...
Abstract Background Oral (PO) antibiotics are a convenient alternative to parenteral and decrease the need for inpatient care. Increasing evidence shows PO effective even in severe infections. We aim assess antibiotic use among hospitalized people who inject drugs (PWID). Methods CHOICE+ is multisite retrospective cohort study of adults at four healthcare systems with infections resulting from injection opioid between 1/1/2018 3/31/2022. Data were collected by abstraction electronic medical...
Abstract Background Harm reduction for persons who inject drugs (PWID) has many components, including HIV testing and Pre-exposure Prophylaxis (PrEP). However, despite the increasing evidence of effectiveness, PrEP remains highly underutilized in these patients at high-risk infection subsequent transmission risk to others. Our aim is identify gaps prevention care among a hospitalized PWID population.Table 1:Demographics Clinical Characteristics Methods CHOICE+ multisite retrospective cohort...
Abstract Background and Objectives Few studies have longitudinally investigated suicide risk (SR) in opioid use disorder (OUD). This investigation administered three screening tools to individuals with OUD compare rates of variables associated SR over 12 months. Methods 121 meeting criteria for within the past 3 years were Item #9 Patient Health Questionnaire‐9 (PHQ‐Item‐9), twelfth item DSM‐5‐TR Self‐Rated Level 1 Cross‐Cutting Measure (CCSM‐Item‐12), Ask Suicide‐Screening Questions (ASQ)...
Abstract Background Direct Acting Antiviral (DAA) therapy for hepatitis C (HCV) has ushered in an era of short duration treatment with high effectiveness across varied patient populations. In the ASCEND investigation, DAA was efficacious when delivered by non-specialist and specialist providers. However, long term outcomes after initial are unknown. Objective To determine long-term independently provided nurse practitioners (NPs), primary care physicians (PCPs) or using therapy. Design...
Background. The optimal retreatment strategy for chronic hepatitis C virus (HCV) patients who fail directly-acting antiviral agent (DAA)-based treatment is unknown. In this study, we assessed the efficacy and safety of ledipasvir (LDV) sofosbuvir (SOF) 12 weeks in HCV genotype-1 (GT-1) failed LDV/SOF–containing therapy. Methods. single-center, open-label, phase 2a trial, 34 participants with early-stage liver fibrosis previously 4–6 LDV/SOF GS-9669 and/or GS-9451 received weeks. primary...
Hepatitis C clearance with directly acting antivirals (DAAs) may be associated acute decreases in hemoglobin A1c (HbA1c). We prospectively evaluated 251 chronic hepatitis virus (HCV)-infected subjects (31% human immunodeficiency [HIV] positive) pre- and post-DAA therapy (median follow-up 28 months). Changes HbA1c glucose were minimal did not differ by sustained virologic response (SVR), HIV, diabetes, or fibrosis. Following SVR, mean change was -0.022 ± 0.53%; however, total low-density...
Abstract Background Stigma surrounding opioid use disorder (OUD) is a barrier to treatment. The of stigmatizing language may be evidence negative views toward patients. Objective We aimed identify associations between and clinical outcomes in patients admitted for infectious complications OUD. Designs performed retrospective medical record review. Settings Participants Four U.S. academic health systems. were with OUD injection from January 1, 2018, December 31, identified through...
Objective: To evaluate the association between medication for opioid use disorder (MOUD) initiation and addiction consultation outcomes patients hospitalized with infectious complications of injecting opioids. Design: Retrospective cohort study Setting: Four academic medical centers in United States Participants: 322 opioids 2018. Exposures: Inpatient receipt MOUD, Measurements: The main interest were: 1) premature discharge; 2) MOUD on 3) linkage to outpatient MOUD; 4) one-year readmission;...
In people with opioid use disorder (OUD), buprenorphine is a vital treatment to decrease and overdose. The US Food Drug Administration's prescribing information for advises dosing up 24 mg/day; however, doses of 32 mg have been shown be safe effective. We compared outcomes associated increased from mg/day.
Background. Treatment of genotype 1 hepatitis C virus (HCV) infection with combination directly acting antivirals (DAA) for 8–24 weeks is associated high rates sustained virologic response (SVR). We previously demonstrated that adding a third DAA to ledipasvir and sofosbuvir (LDV/SOF) can result in SVR patients without cirrhosis. In this study, we investigated whether similar regimen would yield equivalent cure advanced liver fibrosis.