A5080631846- HIV Research and Treatment
- HIV/AIDS Research and Interventions
- HIV/AIDS drug development and treatment
- HIV, Drug Use, Sexual Risk
- SARS-CoV-2 and COVID-19 Research
- SARS-CoV-2 detection and testing
- HIV-related health complications and treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- Antimicrobial Resistance in Staphylococcus
- Sex work and related issues
- Viral-associated cancers and disorders
- Cervical Cancer and HPV Research
- Adolescent Sexual and Reproductive Health
- Infective Endocarditis Diagnosis and Management
- Immune Cell Function and Interaction
- Genital Health and Disease
- Herpesvirus Infections and Treatments
- Cytomegalovirus and herpesvirus research
- Hepatitis C virus research
- Mycobacterium research and diagnosis
- Food Security and Health in Diverse Populations
- Bacterial Identification and Susceptibility Testing
- Streptococcal Infections and Treatments
- Poverty, Education, and Child Welfare
- HIV/AIDS oral health manifestations
University of Washington
2016-2025
Massachusetts General Hospital
2020
Seattle University
2009-2019
National Institute of Allergy and Infectious Diseases
2018
National Clinical Research
2016
Imperial College London
2016
Office of Infectious Diseases
2010
University of Washington Medical Center
2000-2001
Duke University
1997-2000
Duke Medical Center
1999-2000
To determine whether recommendations of infectious diseases specialists affect outcome for patients, we evaluated 244 hospitalized patients with Staphylococcus aureus bacteremia. We offered our management to each patient's physicians and then assessed the clinical both whom consultative advice was followed those not heeded. All were up 12 weeks after their first positive blood culture. Our 112 (45.9%) partially or completely ignored 132 (54.1%). Patients more likely be cured S. infection...
Fifty-nine consecutive patients with definite Staphylococcus aureus infective endocarditis (IE) by the Duke criteria were prospectively identified at our hospital over a 3-year period. Twenty-seven (45.8%) of 59 had hospital-acquired S. bacteremia. The presumed source infection was an intravascular device in 50.8% patients. Transthoracic echocardiography (TTE) revealed evidence IE 20 (33.9%), whereas transesophageal (TEE) 48 (81.4%). outcome for strongly associated echocardiographic...
Human immunodeficiency virus (HIV) type 2 infection is characterized by slower disease progression to acquired syndrome than results from HIV-1 infection. To better understand the biological factors underlying different natural histories of with these retroviruses, we examined relationship between HIV RNA and DNA levels rate CD4+ T cell decline among 472 HIV-1- 114 HIV-2-infected individuals Senegal. The annual in HIV-2 cohort was approximately one-fourth that seen cohort. However, when...
To identify risk factors for relapse among 309 prospectively identified cases of Staphylococcus aureus bacteremia, patients with recurrent S. bacteremia were identified, and pulsed-field gel electrophoresis (PFGE) was performed on isolates from both episodes. PFGE banding patterns identical in 23 patients, consistent relapsed infection. Patients PFGE-confirmed more likely by univariate multivariate analyses to have an indwelling foreign body (odds ratio [OR] = 18.2, 95% confidence interval...
Background: Previous studies give conflicting results regarding the effect of age on outcomes in Staphylococcus aureus bacteremia (SAB).These have been limited by retrospective design or small sample size. Methods:We conducted a prospective cohort study 385 patients with SAB aged 18 to 90 years.The setting was large academic medical center.We observed from diagnosis discharge death.Discharged were contacted 12 weeks after their first positive culture findings.Data collected demographics,...
Selecting human immunodeficiency virus (HIV) sequences for inclusion within vaccines has been a difficult problem, as circulating HIV strains evolve relentlessly and become increasingly divergent over time. We report an assessment of this divergence from three perspectives: (i) across different hosts function time infection, (ii) between donors recipients in known transmission pairs, (iii) individual relation to the initially replicating deduced ancestral sequence intrahost viral population....
The V3 loop of the HIV-1 Env protein is primary determinant viral coreceptor usage, whereas V1V2 region thought to influence binding and participate in shielding neutralization-sensitive regions glycoprotein gp120 from antibody responses. functional properties antigenicity are influenced by changes amino acid sequence, sequence length patterns N-linked glycosylation. However, how these polymorphisms relate HIV pathogenesis not fully understood. We examined 5185 nucleotide fragments clinical...
Background. The compilation of previous genomewide association studies AIDS shows a major polymorphism in the HCP5 gene associated with both control viral load and long-term nonprogression (LTNP) to AIDS. Methods. To look for genetic variants that affect LTNP without necessary load, we reanalyzed data unique Genomics Resistance Immunodeficiency Virus (GRIV) cohort by excluding "elite controller" patients, who were controlling at very low levels (<100 copies/mL). Results. rs2234358 CXCR6 was...
Malnutrition and food insecurity are associated with increased mortality poor clinical outcomes among people living HIV/AIDS; however, the prevalence of malnutrition HIV/AIDS in Senegal, West Africa is unknown. The objective this study was to determine severity HIV-infected adults identify associations between insecurity, malnutrition, HIV outcomes.We conducted a cross-sectional at outpatient clinics Dakar Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry,...
Oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (F/TDF) has high efficacy against HIV-1 acquisition. Seventy-two prospective studies of daily oral F/TDF PrEP were conducted to evaluate incidence, drug resistance, adherence, and bone renal safety in diverse settings. incidence was calculated from incident diagnoses after initiation within 60 days discontinuation. Tenofovir concentrations dried blood spots (DBS), bone/renal indicators evaluated a subset...
HIV-2 is endemic in West Africa, but, unlike HIV-1, has had limited spread to other locales [1]. HIV-1 emerged Africa more recently and because cocirculate this region, some individuals become dually infected with both viruses [2,3]. Compared infection, infection characterized by a much longer asymptomatic stage, lower plasma viral loads, slower decline CD4 cell count, decreased mortality rate due AIDS, rates of mother-to-child transmission, genital tract shedding, sexual transmission...
Background. The efficacy of various antiretroviral (ARV) therapy regimens for human immunodeficiency virus type 2 (HIV-2) infection remains unclear. HIV-2 is intrinsically resistant to the nonnucleoside reverse-transcriptase inhibitors and enfuvirtide may also be less susceptible than HIV-1 some protease (PIs). However, mutations in that confer ARV resistance are not well characterized. Methods. Twenty-three patients were studied as part an ongoing prospective longitudinal cohort study...
A mean of 9-10 years human immunodeficiency virus type 1 (HIV-1) infection elapse before clinical AIDS develops in untreated persons, but this rate disease progression varies substantially among individuals. To investigate host genetic determinants the to AIDS, we performed a multistage genomewide association study.
Abstract Background: There is evidence of an interaction between HIV and human papillomavirus (HPV) resulting in increased HPV-associated morbidity cancer mortality among HIV-positive women. This study aims to determine how the natural history cervical HPV infection differs by status. Methods: A total 1,320 women (47% were positive for HIV-1 and/or HIV-2) followed average two years Senegal, West Africa 1994 2010. Cytology (with a sub-sample histology) DNA testing performed at approximately...
The WHO guidelines for the management of advanced HIV disease recommend a package care consisting rapid initiation antiretroviral therapy (ART), enhanced screening and diagnosis tuberculosis (TB) cryptococcal meningitis, co-trimoxazole prophylaxis, isoniazid preventive (IPT), fluconazole pre-emptive therapy, adherence support. goals this study were to determine prevalence among individuals initiating ART in Senegal, identify predictors disease, evaluate guidelines.This was conducted...
Novel variants continue to emerge in the SARS-CoV-2 pandemic. University testing programs may provide timely epidemiologic and genomic surveillance data inform public health responses. We conducted from September 2021 February 2022 a university population under vaccination indoor mask mandates. A total of 3,048 24,393 individuals tested positive for by RT-PCR; whole genome sequencing identified 209 Delta 1,730 Omicron genomes 1,939 sequenced. Compared Delta, had shorter median serial...