A5012931164- Tuberculosis Research and Epidemiology
- Mycobacterium research and diagnosis
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV/AIDS drug development and treatment
- Diagnosis and treatment of tuberculosis
- Pneumonia and Respiratory Infections
- Hepatitis C virus research
- Vector-Borne Animal Diseases
- Infectious Diseases and Tuberculosis
- Antibiotics Pharmacokinetics and Efficacy
- Antibiotic Use and Resistance
- CNS Lymphoma Diagnosis and Treatment
- Animal Disease Management and Epidemiology
- HIV-related health complications and treatments
- Pharmacological Effects and Toxicity Studies
- Syphilis Diagnosis and Treatment
- Reproductive tract infections research
- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- T-cell and Retrovirus Studies
- Protein Degradation and Inhibitors
- Hepatitis Viruses Studies and Epidemiology
- Caveolin-1 and cellular processes
- Liver Diseases and Immunity
- Urinary Tract Infections Management
Imperial College London
2015-2024
Wellcome Centre for Infectious Diseases Research in Africa
2015-2024
University of Colombo
2021-2024
University of Cape Town
2015-2023
The Francis Crick Institute
2019-2020
Chelsea and Westminster Hospital
2011-2019
Chelsea and Westminster Hospital NHS Foundation Trust
2015-2018
Imperial Valley College
2017
Imperial College Healthcare NHS Trust
2015
There have been no data presented on the relative rates of development renal stones in those receiving ritonavir-boosted atazanavir (ATZ/r) when compared with other commonly used antiretrovirals (ARVs). We rate a cohort HIV-infected individuals attending Chelsea and Westminster Hospital Foundation Trust exposed to ATZ/r efavirenz (EFV)/ritonavir-boosted lopinavir (LPV/r) darunavir (DRV/r) over 45-month study period. The group (n = 1206) EFV/LPV/r/DRV/r combined 4449) was 7.3 [95% confidence...
Standardized dosing of antitubercular drugs leads to variable plasma drug levels, which are associated with adverse reactions, delayed treatment response, and relapse. Mutations in genes affecting metabolism explain considerable interindividual pharmacokinetic variability; however, pharmacogenomic assays that predict have been lacking.
The antioxidant enzyme heme oxygenase-1 (HO-1) is implicated in the pathogenesis of tuberculosis (TB) and has been proposed as a biomarker active disease. Nevertheless, mechanisms by which Mycobacterium (Mtb) induces HO-1 well how its expression affected HIV-1 coinfection successful antitubercular therapy (ATT) are poorly understood. We found that markedly increased rabbits, mice, non-human primates during experimental Mtb infection gradually decreased ATT. In addition, we examined...
There is scant evidence to support target drug exposures for optimal tuberculosis outcomes. We therefore assessed whether pharmacokinetic/pharmacodynamic (PK/PD) parameters could predict 2-month culture conversion. One hundred patients with pulmonary (65% human immunodeficiency virus coinfected) were intensively sampled determine rifampicin, isoniazid, and pyrazinamide plasma concentrations after 7–8 weeks of therapy, PK determined using nonlinear mixed-effects models. Detailed clinical data...
ABSTRACT There are contrasting data in the literature about antituberculosis plasma drug concentrations HIV-1-coinfected patients. We report pharmacokinetics of rifampin, isoniazid, and pyrazinamide a cohort patients being treated for active tuberculosis, majority whom were coinfected with HIV-1 had commenced antiretroviral therapy within 2 months starting treatment. also examined association between reported side effects at 2-month clinical review. One hundred pulmonary tuberculosis (65%...
Background Biomarkers of unfavourable tuberculosis (TB) treatment outcomes are needed to accelerate new drug and regimen development. Whether plasma cytokine levels can predict TB is unclear. Methods We identified internally validated the association between 20 a priori selected inflammatory markers failure, recurrence all-cause mortality among adults with drug-sensitive pulmonary in India. externally these findings two independent cohorts predominantly diabetic HIV co-infected patients...
The crucial transmission phase of tuberculosis (TB) relies on infectious sputum and yet cannot easily be modeled. We applied one-step RNA sequencing (RNA-Seq) to from TB patients investigate the host microbial environments underlying Mycobacterium tuberculosis. In such sputa, compared non-TB controls, transcriptional upregulation inflammatory responses, including an interferon-driven proinflammatory response a metabolic shift toward glycolysis, was observed in host. Among all bacterial...
Abstract Introduction Rifabutin, a rifamycin of equivalent potency to rifampicin, has several advantages in its pharmacokinetic and toxicity profile, particularly HIV co‐infected patients on combined antiretroviral therapy (cART). In this commentary, we evaluate evidence supporting increased global use rifabutin highlight key recommendations for action. Discussion Although extrapolation data from uninfected would suggest non‐inferiority, there been no randomized controlled study comparing...
Background There are limited data about the epidemiology and treatment-related outcomes associated with capreomycin resistance in patients XDR-TB. Capreomycin achieves high serum concentrations relative to MIC but whether has therapeutic benefit despite microbiological remains unclear. Methods We reviewed susceptibility profiles usage diagnosed XDR-TB between August 2002 October 2012 two provinces of South Africa. Patients whose isolates were genotypically tested for included analysis....
Human immunodeficiency virus type-1 (HIV-1) and human T lymphotropic (HTLV-1) infections have complex effects on adaptive immunity, with specific tropism for, but contrasting on, CD4 lymphocytes: depletion HIV-1, proliferation HTLV-1. Impaired lymphocyte function occurs early in HIV-1 infection opportunistic (OIs) rarely occur the absence of lymphopenia. In unusual case where a infected individual high count presents recurrent OIs, clinician is faced possibility second underlying...
The aim of the study was to identify possible causes pancreatic insufficiency in patients with HIV infection.A retrospective analysis 233 HIV-positive for whom faecal elastase measurement available performed investigate potential associations core demographic data, infection characteristics, degree immunosuppresion, exposure antiretroviral therapy (ART), alcohol misuse, diabetes, hepatitis C virus (HCV) infection, triglyceride and cholesterol levels symptomatology. response enzyme...
We estimated the incidence of acquired isoniazid and rifampicin resistance in rifampicin-susceptible tuberculosis a setting high human immunodeficiency virus type 1 (HIV-1) infection coprevalence. GeneXpert MTB/RIF–confirmed patients with were recruited at antituberculosis treatment initiation Khayelitsha, South Africa. Liquid culture adherence assessment performed 2 5–6 months. MTBDRplus was on mycobacteria-positive cultures to ascertain drug (ADR). Spoligotyping whole-genome sequencing...
The number of cases syphilis continues to rise in the UK, USA and elsewhere may present a variety clinical specialties. We report complex case early acquired disseminated causing an ulceronodular rash (lues maligna), orchitis, osteitis lung nodules immunocompetent man who has sex with men presented genitourinary medicine clinic. Syphilis should be considered differential diagnoses multiple presentations optimal management involve multidisciplinary care.
Background CYP3A4 induction by efavirenz (EFV) persists after drug cessation; we assessed the pharmacokinetics (PK), efficacy and safety of maraviroc (MVC) administered to HIV-infected individuals switching from EFV-containing therapy. Methods Patients with R5-tropic virus suppressed viral load on two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) plus EFV switched MVC 600 mg twice daily for 14 days, then 300 daily. Following screening, three intensive PK visits were...
ABSTRACT The utility of a line probe assay (Genotype MTBDR plus ) performed directly on 2-month sputa to monitor tuberculosis treatment response is unknown. We assessed if direct testing with can predict culture conversion and long-term outcome. Xpert MTB/RIF-confirmed rifampin-susceptible cases were recruited at diagnosis followed up 2 5 6 months. was all positive cultured isolates also investigated the association months subsequent unsuccessful outcome (failure/death during or disease...
Abstract The crucial transmission phase of tuberculosis (TB) relies on infectious sputum yet cannot easily be modeled. We applied one-step RNA-Sequencing to from TB patients investigate the host and microbial environments underlying Mycobacterium ( Mtb ). In such sputa, compared non-TB controls, transcriptional upregulation inflammatory responses a metabolic shift towards glycolysis was observed in host. Amongst all bacterial sequences sputum, only less than 1.5% originated its abundance is...
Background: The effect of boosted protease inhibitors (PI) on renal function is unclear. Methods: We assessed and compared the risk developing impairment in individuals commencing 3 first line PI-based regimens vs a non-nucleoside reverse transcriptase inhibitor- based regimen. Patients efavirenz, darunavir, atazanavir or lopinavir with 2 nucleos(t)ide from June 2006 - February 2010, baseline eGFR>60ml/min per 1.73m2 were included. Univariate adjusted Cox’s proportional hazards regression...