A5018878850- HIV/AIDS drug development and treatment
- HIV Research and Treatment
- HIV/AIDS Research and Interventions
- Pharmacological Effects and Toxicity Studies
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV-related health complications and treatments
- Epilepsy research and treatment
- Child Nutrition and Water Access
- Machine Learning in Healthcare
- Birth, Development, and Health
- HIV, Drug Use, Sexual Risk
- Biochemical and Molecular Research
- COVID-19 epidemiological studies
- Global Maternal and Child Health
- Health Systems, Economic Evaluations, Quality of Life
- Cytomegalovirus and herpesvirus research
- Disaster Response and Management
- Gestational Diabetes Research and Management
- Mosquito-borne diseases and control
- Obesity, Physical Activity, Diet
- Diet and metabolism studies
- Iron Metabolism and Disorders
- Hepatitis C virus research
- Pharmaceutical studies and practices
- Ethics in Clinical Research
University of Liverpool
2010-2024
Leeds General Infirmary
2024
Liverpool School of Tropical Medicine
2018-2023
Virginia Commonwealth University
2023
Southern Illinois University School of Medicine
2021
Royal Liverpool University Hospital
2010-2013
Royal Liverpool and Broadgreen University Hospital NHS Trust
2009-2011
Children who have been hospitalized with severe anemia in areas of Africa which malaria is endemic a high risk readmission and death within 6 months after discharge. No prevention strategy specifically addresses this period.We conducted multicenter, two-group, randomized, placebo-controlled trial nine hospitals Kenya Uganda to determine whether 3 chemoprevention could reduce morbidity mortality hospital discharge children younger than 5 years age had admitted anemia. All received standard...
Background: Antiretroviral treatment (ART) significantly reduces cerebrospinal fluid (CSF) HIV-1 RNA levels and residual viremia is less frequently found in CSF than blood. However, persistent intrathecal immunoactivation common, even after several years of ART. To investigate whether low-level within the central nervous system (CNS) derive from ongoing local viral replication, we conducted a study intensification patients on effective Methods: Ten ART with plasma HIV <50 copies per...
The central nervous system has been proposed as a sanctuary site where HIV can escape antiretroviral control and develop drug resistance. HIV-1 RNA be at higher levels in CSF than plasma, termed CSF/plasma discordance. We aimed to examine whether discordance is associated with low level viraemia (LLV) blood. In this MRC-funded multicentre study, we prospectively recruited patients LLV, defined one or more episode of unexplained plasma within 12 months, undertook examination. Separately,...
The aim of this study was to assess the effect low maternal weight at pre-pregnancy and average gestational gain on undernourished children their intellectual development. From October 2012 September 2013, we followed 1744 offspring women who participated in a trial conducted from 2002 2006. Pregnant recruited original could receive three prenatal health checks for free, which height were measured. WISC-IV used estimate development children. Weight both pregnant measured by trained...
In order to assess the penetration of maraviroc central nervous system, we measured concentrations in cerebrospinal fluid (CSF) and plasma. Concentrations were determined by liquid chromatography tandem mass spectrometry (lower limit quantitation 1.25 ng/ml) seven paired CSF plasma samples. The median concentration was 94.9 ng/ml (range 21.4–478.0) 3.63 1.83–12.2). samples exceeded EC90 for (0.57 at least three-fold. levels found this study likely contribute viral suppression CSF.
In vivo data on tenofovir (TFV), emtricitabine (FTC), and efavirenz (EFV) concentration decay after intake cessation are limited; determinations of "true" elimination half-lives (t½) have often been based suboptimal sampling windows. Understanding these parameters is important in managing missed doses planning HIV pre-exposure prophylaxis (PrEP). This study investigated the pharmacokinetics (PK) plasma TFV/FTC, their intracellular (IC) anabolites, TFV-diphosphate (DP) FTC-triphosphate (TP),...
Pharmacokinetic parameters following modifications to antiretroviral therapy and sanctuary site exposure are often unknown for recently licensed antiretrovirals. We assessed plasma, CSF seminal plasma (SP) of rilpivirine after switching from nevirapine. HIV-infected male subjects receiving tenofovir/emtricitabine/nevirapine (245/200/400 mg) once daily switched tenofovir/emtricitabine/rilpivirine (245/200/25 60 days when semen samples were collected. Mean individual concentrations nevirapine...
There is interest in evaluating the efficacy of lower doses certain antiretrovirals for clinical care. We determined here bioequivalence plasma lamivudine (3TC) and intracellular 3TC-triphosphate (3TC-TP) concentrations after administration two different doses. ENCORE 2 was a randomized crossover study. Subjects received 3TC at 300 150 mg once daily 10 days (arm 1; n = 13) or vice versa 2; 11), separated by 10-day washout. Pharmacokinetic (PK) profiles (0 to 24 h) were assessed on 30. Plasma...
Onchocerciasis is a priority neglected tropical disease targeted for elimination by 2025. The standard strategy to combat onchocerciasis annual Community-Directed Treatment with ivermectin (CDTi). Yet, high prevalence rates and transmission persist following > 12 rounds in South-West Cameroon. Challenges include programme coverage, adherence to, acceptability of an area Loa loa co-endemicity. Loiasis patients harbouring heavy infections are at risk potentially fatal serious adverse events...
Abstract Background Hepatitis C virus self-testing (HCVST) is an additional approach that may expand access to HCV testing. We conducted a mixed-methods cross-sectional observational study assess the usability and acceptability of HCVST among people who inject drugs (PWID), men have sex with (MSM) transgender (TG) in Tbilisi, Georgia. Methods The was from December 2019 June 2020 PWID at one harm reduction site MSM/TG community-based organization. used convergent parallel design. Usability...
Abstract Background Many chronic conditions, such as epilepsy and asthma, are typified by recurrent events—repeated acute deterioration events of a similar type. Statistical models for these conditions often focus on evaluating the time to first event. They therefore do not make use data available all events. exist, but it is clear how best evaluate their performance. We compare relative performance statistical analysing asthma. Methods studied two clinical exemplars common infrequent...
Objective: To assess the pharmacokinetics of etravirine once and twice daily without with a preceding efavirenz intake period in healthy volunteers. Methods: Volunteers were randomized to receive 400 mg (arm 1) or 200 2) for 14 days. All subjects underwent washout days then took 600 Arm 1 2 restarted Etravirine was assessed each phase (before after 14-day intake) on 14. Efavirenz concentrations measured withholding. Pharmacokinetic parameters compared by determining geometric mean ratios 90%...
To investigate the pharmacokinetics of darunavir/ritonavir and raltegravir, in HIV-infected subjects, both plasma at intracellular (IC) site action.
We conducted a pharmacokinetic and in vivo cerebral (1)H magnetic resonance spectroscopy ((1)H-MRS) study to assess CSF exposure metabolite ratios (CMRs) following maraviroc intensification.HIV-infected neurologically asymptomatic adults receiving tenofovir, emtricitabine lopinavir/ritonavir with plasma HIV RNA <50 copies/mL were eligible received intensified therapy 150 mg of twice daily. (1)H-MRS was performed several locations, including the right basal ganglia (RBG), CMRs, N-acetyl...
Background Data on suppression of HIV replication in the CNS and subsequent risk neurocognitive impairment using monotherapy with boosted protease inhibitors are limited. Methods Ours was an exploratory cross-sectional study patients lopinavir/ritonavir-based (LPV/r-MT) or standard triple therapy (LPV/r-ART) for at least 96 weeks who maintained a plasma viral load <50 copies/mL. HIV-1 RNA CSF determined by SuperLow assay (lower limit detection, 1 copy/mL). Neurocognitive functioning assessed...
We determined the pharmacokinetics of efavirenz in plasma and cerebrospinal fluid (CSF) over a 24-h dosing interval patient who had undergone lumbar drain because cryptococcal meningitis. Drug concentrations were by high-performance liquid chromatography-tandem mass spectrometry paired CSF (n = 24) 25) samples. The median concentration was 3,718 ng/ml (range, 2,439 to 4,952), 16.3 7.3 22.3). CSF/plasma area-under-the-curve ratio 0.0044 corresponding penetration 0.44% plasma.
ABSTRACT The aim of this study was to evaluate the plasma and intracellular pharmacokinetics raltegravir in HIV-infected patients receiving once-daily raltegravir. Five on stable therapy with lopinavir-ritonavir monotherapy whose HIV-1 RNA load <50 copies/ml were included open-label, pilot study. Raltegravir added antiretroviral regimen at a dose 800 mg once daily from days 0 10. On day 10, full pharmacokinetic profile obtained for each participant. concentrations peripheral blood...
Data from retrospective studies have suggested that there may be an interaction between fluconazole and nevirapine, increasing nevirapine concentrations potentially leading to hepatotoxicity. This study was nested within a large double-blind placebo-controlled designed determine if primary prophylaxis with (200 mg three times per week) could reduce cryptococcal disease [CRYPTOPRO (ISRCTN 76481529)] in HIV-infected adults rural south-western Uganda. Detailed pharmacokinetic were performed on...
Abstract Background Patients who suffer from chronic conditions or diseases are susceptible to experiencing repeated events of the same type (e.g. seizures), termed ‘recurrent events’. Prediction models can be used predict risk recurrence so that intervention management tailored accordingly, but statistical methodology vary. The objective this systematic review was identify and describe approaches have been applied for development validation multivariable prediction with recurrent event...
The aim of the present study is to identify average effect across different time points and specify effects maternal pre-pregnancy BMI weekly gestational weight gain on mental development physical growth infants. cohort used a repeated measures design that began in 2004 with follow up at 3, 6, 12, 18, 24 months age. participants were subset from controlled, cluster-randomized, double-blind trial. Bayley Scales Infant Development (BSID) estimate A generalized estimating equation linear model...
Abstract Introduction Scale‐up of HIV self‐testing ( HIVST ) will play a key role in meeting the United Nation's 90‐90‐90 targets. Delayed re‐reading used devices has been by early implementation studies to validate performance self‐test kits and estimate positivity among self‐testers. We investigated stability results on under controlled conditions assess its potential as quality assurance approach for scale‐up. Methods 444 OraQuick ® ‐1/2 rapid antibody tests were conducted using...
Background This paper reports on the baseline prevalence and associated risk factor findings of a pilot, longitudinal study exploring community-wide treatment schistosomiasis soil-transmitted helminthiasis, using albendazole plus praziquantel in Greater Accra region Ghana. Method From three communities, at least, 658 individuals were enrolled into via random household selection. Prevalence intensity STH infection determined from stool urine samples with questionnaire being administered order...
Abstract The associations between growth during early life and subsequent cognitive development physical outcomes are not widely known in low-resource settings. We examined postnatal weight height gain through related these measurements to the nutritional status intellectual of same children when they were 7 9 years old. Mothers had enrolled an randomised controlled trial evaluate effect prenatal micronutrient supplementation on birth weight. Their born 2004, their measured at 6, 12, 18 24...