A5068560299- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- HIV/AIDS drug development and treatment
- HIV, Drug Use, Sexual Risk
- HIV-related health complications and treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- Adolescent Sexual and Reproductive Health
- Viral-associated cancers and disorders
- Palliative Care and End-of-Life Issues
- Tuberculosis Research and Epidemiology
- Helicobacter pylori-related gastroenterology studies
- Lymphoma Diagnosis and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Data-Driven Disease Surveillance
- HIV/AIDS Impact and Responses
- Microbial Metabolites in Food Biotechnology
- Gastroesophageal reflux and treatments
- Global Maternal and Child Health
- Veterinary medicine and infectious diseases
- Antifungal resistance and susceptibility
- Histiocytic Disorders and Treatments
- Cervical Cancer and HPV Research
- Enhanced Recovery After Surgery
- Clinical Reasoning and Diagnostic Skills
- Patient Dignity and Privacy
Vanderbilt University Medical Center
2015-2024
Vanderbilt University
2014-2024
Royal Hospital for Children
2018-2023
St George’s University Hospitals NHS Foundation Trust
2011-2019
Fundacion Arriarán
2011-2019
University of Chile
2011-2019
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
2019
Instituto Evandro Chagas
2019
Fundação Oswaldo Cruz
2019
Gheskio Centers
2019
To describe the CD4 cell count at start of combination antiretroviral therapy (cART) in low-income (LIC), lower middle-income (LMIC), upper (UMIC), and high-income (HIC) countries.Patients aged 16 years or older starting cART a clinic participating multicohort collaboration spanning 6 continents (International epidemiological Databases to Evaluate AIDS ART Cohort Collaboration) were eligible. Multilevel linear regression models adjusted for age, gender, calendar year; missing counts...
Early initiation of combination antiretroviral therapy (cART), at higher CD4 cell counts, prevents disease progression and reduces sexual transmission human immunodeficiency virus (HIV). We describe the temporal trends in counts start cART adults from low-income, lower-middle-income, upper-middle-income, high-income countries (LICs, LMICs, UMICs, HICs, respectively).We included HIV-infected individuals aged ≥16 years who started between 2002 2015 a clinic participating International...
HIV stigma is a contributing factor to poor patient outcomes. Although has been documented, its impact on well-being in the southern US not well understood.Thirty-two adults participated cognitive interviews after completing Berger or Van Rie scale. Participant responses were probed ensure scales accurately measured and assess had behavior.Three main themes emerged regarding stigma: (1) negative attitudes, fear of contagion, misperceptions about transmission; (2) acts discrimination by...
Abstract Introduction We assessed mortality and losses to follow‐up ( LTFU ) during adolescence in routine care settings the International epidemiology Databases Evaluate AIDS (Ie DEA consortium. Methods Cohorts Asia‐Pacific, Caribbean, Central, South America, sub‐Saharan Africa (Central, East, Southern, West) contributed data, included adolescents living with HIV ALHIV enrolled from January 2003 aged 10 19 years (period of adolescence) while under up database closure (June 2016). Follow‐up...
Background: Although nearly 2 million people live with HIV in Latin America and the Caribbean, mortality rates after initiation of highly active antiretroviral therapy (HAART) have not been well described. Methods: Five thousand one hundred fifty-two HIV-infected, antiretroviral-naive adults from clinics Argentina, Brazil, Chile, Haiti, Honduras, Mexico, Peru starting HAART during 1996-2007 were included. First-year their association demographics, regimen, baseline CD4, clinical stage...
Starting HAART in a very advanced stage of disease is assumed to be the most prevalent form initiation HIV-infected subjects developing countries. Data from Latin America and Caribbean still lacking. Our main objective was determine frequency, risk factors trends time for being late initiator (LHI) this region.Cross-sectional analysis 9817 treatment-naïve patients initiating at 6 sites (Argentina, Chile, Haiti, Honduras, Peru Mexico) October 1999 July 2010. LHI had CD4(+) count ≤200...
The Department of Health end-of-life strategy contains a number quality markers which include taking into account patients' wishes for their final place care. There is wide variation in how this information recorded.An audit was conducted on discussion preferred care (PPC) all patients referred to the hospital palliative team who died during period. Barriers achieving PPC and efficacy fast track discharge service were also monitored. first done 2007 repeated 2009.There an increase recording...
Long-term survival of HIV patients after initiating highly active antiretroviral therapy (ART) has not been sufficiently described in Latin America and the Caribbean, as compared to other regions. The aim this study was describe incidence mortality, loss follow-up (LTFU) associated risk factors for enrolled Central South Network (CCASAnet). We assessed time from ART initiation (baseline) death or LTFU between 2000 2014 among ART-naïve adults (≥18 years) sites seven countries included...
To investigate urease‐independent mechanisms by which Helicobacter pylori resists acid stress, subtractive RNA hybridization was used to identify H. genes whose expression is induced after exposure pH. This approach led the isolation of a gene that encoded predicted 34.8 kDa protein (WbcJ), homologous known bacterial O‐antigen biosynthesis proteins involved in conversion GDP‐mannose GDP‐fucose. An isogenic wbcJ null mutant strain failed express and Lewis X or Y determinants more sensitive...
Background HAART rollout in Latin America and the Caribbean has increased from approximately 210,000 2003 to 390,000 patients 2007, covering 62% (51%–70%) of eligible patients, with considerable variation among countries. No multi-cohort study examined rates reasons for change initial this region. Methodology Antiretroviral-naïve > = 18 years who started between 1996 2007 had at least one follow-up visit sites Argentina, Brazil, Chile, Haiti, Honduras, Mexico Peru were included. Time...
Objective: To compare incidence and distribution of non-AIDS-defining events (NADEs) among HIV-1-infected adults receiving combination antiretroviral therapy (cART) in urban sub-Saharan African versus United States settings. Design: Retrospective cohort analysis clinical trial observational data. Methods: Compared crude standardized (to US by age sex) NADE rates from two adult HIV-infected cART-initiating populations: a Gaborone, Botswana (Botswana) an Nashville, Tennessee (USA). Results:...
Introduction HIV care and treatment programmes worldwide are transforming as they push to deliver universal access essential prevention, services persons living with their communities. The characteristics capacity of these affect patient outcomes quality care. Despite the importance ensuring optimal outcomes, few studies have addressed comprehensive We sought describe such in seven regions worldwide. Methods Staff from 128 sites 41 countries participating International epidemiologic...
Late presentation to care and antiretroviral therapy (ART) initiation with advanced human immunodeficiency virus (HIV) disease are common in Latin America. We estimated the impact of these conditions on mortality region. included adults enrolled during 2001-2014 at HIV clinics. adjusted attributable risk (AR) population fraction (PAF) for all-cause (advanced LP), ART disease, not initiating ART. Advanced was defined as CD4 <200 cells/μL or acquired immune deficiency syndrome. AR PAF were...
Objective Drug use and receipt of highly active antiretroviral therapy (HAART) were assessed in HIV-infected persons from the Comprehensive Care Center (CCC; Nashville, TN) Johns Hopkins University HIV Clinic (JHU; Baltimore, MD) between 1999 2005. Methods Participants with without injection drug (IDU) history CCC JHU cohorts evaluated. Additional analysis IDU, non-injection (NIDU), no performed. Activity IDU NIDU also was for cohort. HAART time on analyzed according to category site care....
Abstract Clarifying the relationship between illicit drug use and HIV-1 virologic suppression requires characterization of both activity adherence to antiretroviral therapy (ART). We developed a rapid clinical questionnaire assess prior 7-day ART in cross-sectional study among 1777 HIV-infected persons care. Of these, 76% were male, 35% African-American, 8% reported injection as their probable route infection. Questionnaire-reported frequencies cocaine marijuana within previous 7 days 3.3%...
Abstract Introduction People living with HIV (PLHIV) on antiretroviral therapy (ART) experience high rates of non‐communicable diseases (NCDs). These co‐morbidities often accumulate and older adults may suffer from multimorbidity. Multimorbidity has been associated loss quality life, polypharmacy, increased risk frailty mortality. Little is known the trends or predictors NCD multimorbidity in PLHIV low‐ middle‐income countries. Methods We examined adult initiating ART between 2003 2014 using...
Observational studies of health conditions and outcomes often combine clinical care data from many sites without explicitly assessing the accuracy completeness these data. In order to improve quality in an international multi-site observational cohort HIV-infected patients, authors conducted on-site, Good Clinical Practice-based audits datasets submitted by participating HIV clinics. Discrepancies between for research records were categorized using audit codes published European Organization...
Background Since 2009, earlier initiation of highly active antiretroviral therapy (HAART) after an opportunistic infection (OI) has been recommended based on lower risks death and AIDS-related progression found in clinical trials. Delay HAART OIs may be important barrier for successful outcomes patients with advanced disease. Timing OI "real life" settings Latin America not evaluated. Methods Patients the Caribbean, Central South network HIV Epidemiology (CCASAnet) ≥18 years age at...