David R. Boulware
A5027410574- Fungal Infections and Studies
- Antifungal resistance and susceptibility
- Nail Diseases and Treatments
- Infectious Diseases and Tuberculosis
- Pneumocystis jirovecii pneumonia detection and treatment
- Cytomegalovirus and herpesvirus research
- Tuberculosis Research and Epidemiology
- Bacterial Infections and Vaccines
- COVID-19 Clinical Research Studies
- Long-Term Effects of COVID-19
- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- Orthopedic Infections and Treatments
- Pharmacological Receptor Mechanisms and Effects
- SARS-CoV-2 and COVID-19 Research
- COVID-19 and Mental Health
- Streptococcal Infections and Treatments
- Phytoplasmas and Hemiptera pathogens
- Respiratory viral infections research
- Mycobacterium research and diagnosis
- Epilepsy research and treatment
- Infectious Encephalopathies and Encephalitis
- HIV-related health complications and treatments
- Travel-related health issues
- HIV/AIDS drug development and treatment
University of Minnesota Medical Center
2010-2025
University of Minnesota
2016-2025
Makerere University
2014-2025
Infectious Diseases Institute
2016-2025
University of Minnesota System
2016-2025
University of Atlanta
2025
London School of Hygiene & Tropical Medicine
2019-2024
University of Kansas
2017-2024
Twin Cities Orthopedics
2019-2024
Office of Infectious Diseases
2010-2023
BackgroundCoronavirus disease 2019 (Covid-19) occurs after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For persons who are exposed, the standard of care is observation and quarantine. Whether hydroxychloroquine can prevent symptomatic infection SARS-CoV-2 unknown.MethodsWe conducted a randomized, double-blind, placebo-controlled trial across United States parts Canada testing as postexposure prophylaxis. We enrolled adults had household or occupational someone...
No effective oral therapy exists for early coronavirus disease 2019 (COVID-19).
Cryptococcal meningitis accounts for 20 to 25% of acquired immunodeficiency syndrome-related deaths in Africa. Antiretroviral therapy (ART) is essential survival; however, the question when ART should be initiated after diagnosis cryptococcal remains unanswered.We assessed survival at 26 weeks among 177 human virus-infected adults Uganda and South Africa who had not previously received ART. We randomly assigned study participants undergo either earlier initiation (1 2 diagnosis) or deferred...
Cryptococcal meningitis (CM) is the proximate cause of death in 20%-30% persons with acquired immunodeficiency syndrome Africa.Two prospective, observational cohorts enrolled human virus (HIV)-infected, antiretroviral-naive CM Kampala, Uganda. The first cohort was 2001-2002 (n = 92), prior to availability highly active antiretroviral therapy (HAART), and second 2006-2007 44), when HAART available.Ugandans presented prolonged symptoms (median duration, 14 days; interquartile range, 7-21...
Substantial morbidity occurs during the first year of antiretroviral therapy (ART) in persons with advanced human immunodeficiency virus (HIV) disease despite HIV suppression. Biomarkers may identify high-risk groups.Pre-ART and 1-month samples from an initial ART trial were evaluated for biomarkers associated AIDS events or death within 1-12 months. Case patients (n = 63) control 126) 1:2 matched on baseline CD4 cell count, hepatitis status, randomization date. All had ≥ 1 log(10) RNA level...
Background. Cryptococcal meningitis (CM) remains a common AIDS-defining illness in Africa and Asia. Subclinical cryptococcal antigenemia is frequently unmasked with antiretroviral therapy (ART). We sought to define the cost-effectiveness of serum antigen (CRAG) screening identify persons subclinical cryptococcosis efficacy preemptive fluconazole therapy.
Abstract Cryptococcal meningitis is common in sub-Saharan Africa. Given the need for data a rapid, point-of-care cryptococcal antigen (CRAG) lateral flow immunochromatographic assay (LFA), we assessed diagnostic performance of cerebrospinal fluid (CSF) culture, CRAG latex agglutination, India ink microscopy, and LFA 832 HIV-infected persons with suspected during 2006–2009 (n = 299) Uganda 2010–2012 533) South had best (sensitivity 99.3%, specificity 99.1%). Culture sensitivity was dependent...
David Boulware and colleagues investigate clinical features in a prospective cohort with AIDS recent cryptococcal meningitis after initiation of antiretroviral therapy to identify biomarkers for prediction diagnosis CM-IRIS (cryptococcal meninigitis-related immune reconstitution inflammatory syndrome).
WHO recommends Xpert MTB/RIF as initial diagnostic testing for tuberculous meningitis. However, diagnosis remains difficult, with sensitivity of about 50-70% and culture 60%. We evaluated the performance new Ultra (Xpert Ultra)
Pulmonary mycoses are often associated with type-2 helper T (Th2) cell responses. However, mechanisms of Th2 accumulation multifactorial and incompletely known. To investigate responses to pulmonary fungal infection, we developed a peptide-MHCII tetramer track antigen-specific CD4+ cells produced in response infection the pathogen Cryptococcus neoformans. We noted massive accruement pathologic cryptococcal lungs following that was coordinated by lung-resident CD11b+ IRF4-dependent...
Early treatment to prevent severe coronavirus disease 2019 (Covid-19) is an important component of the comprehensive response acute respiratory syndrome 2 (SARS-CoV-2) pandemic.
The efficacy of ivermectin in preventing hospitalization or extended observation an emergency setting among outpatients with acutely symptomatic coronavirus disease 2019 (Covid-19), the caused by severe acute respiratory syndrome 2 (SARS-CoV-2), is unclear.We conducted a double-blind, randomized, placebo-controlled, adaptive platform trial involving SARS-CoV-2-positive adults recruited from 12 public health clinics Brazil. Patients who had symptoms Covid-19 for up to 7 days and at least one...
Cryptococcal meningitis is a leading cause of human immunodeficiency virus (HIV)-related death in sub-Saharan Africa. Whether treatment regimen that includes single high dose liposomal amphotericin B would be efficacious not known.
Rapid, simple, and cost-effective diagnostics are needed to improve healthcare at the point of care (POC). However, most widely used POC diagnostic, lateral flow immunoassay (LFA), is ∼1000-times less sensitive has a smaller analytical range than laboratory tests, requiring confirmatory test establish truly negative results. Here, rational systematic strategy design LFA contrast label (i.e., gold nanoparticles) sensitivity, detection range, antigen quantification LFAs. Specifically, we...
Abstract We report a real-world experience using fluvoxamine for coronavirus disease 19 (COVID-19) in prospective cohort the setting of mass outbreak. Overall, 65 persons opted to receive (50 mg twice daily) and 48 declined. Incidence hospitalization was 0% (0 65) with 12.5% (6 48) observation alone. At 14 days, residual symptoms persisted 60% (29 observation.
The effectiveness of ivermectin to shorten symptom duration or prevent hospitalization among outpatients in the US with mild moderate symptomatic COVID-19 is unknown.To evaluate efficacy ivermectin, 400 μg/kg, daily for 3 days compared placebo treatment early COVID-19.ACTIV-6, an ongoing, decentralized, double-blind, randomized, placebo-controlled platform trial, was designed repurposed therapies COVID-19. A total 1591 participants aged 30 years and older confirmed COVID-19, experiencing 2...
Importance The effectiveness of fluvoxamine to shorten symptom duration or prevent hospitalization among outpatients with mild moderate symptomatic COVID-19 is unclear. Objective To evaluate the efficacy low-dose (50 mg twice daily) for 10 days compared placebo treatment in US. Design, Setting, and Participants ongoing Accelerating Therapeutic Interventions Vaccines (ACTIV-6) platform randomized clinical trial was designed test repurposed medications COVID-19. A total 1288 participants aged...