Pharmacy and Pharmaceutical Sciences Commons^™

Understanding The Impact Of Pharmacist Prescriptive Authority On Hiv Pre-Exposure Prophylaxis At The State Level, Cameron G. King

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

HIV transmission, with relative risk reductions of up to 99%. However, real world data have revealed that even with large increases in PrEP use, new HIV diagnoses may only slightly decline. This disparity suggests that access to PrEP may be suboptimal, especially among high-risk subgroups, who are often hard to maintain on the continuum of HIV care. Pharmacists, because of their accessibility, trusted role in their communities, and growing scope of practice, could serve as an intervention point to improve access to PrEP.

A previously validated algorithm using National Drug Codes (NDCs) and the International Classification of Disease, 10^{th …}

At A Crossroads: The Crucial Role Of Pharmacists In Healthcare Teams To End The Hiv Epidemic, Jerika Lam, Jennifer M. Cocohoba

Pharmacy Faculty Articles and Research

"Therapeutic advances in treatment and prevention have slowed the human immunodeficiency virus (HIV) epidemic, yet the virus and complications related to it still claim an alarming 630,000 lives globally every year.^1,2 The United States’ goals for the Ending the HIV Epidemic (EHE) initiative include reducing new infections by 90% by the year 2030 and advancing health equity through key treatment and prevention initiatives.³ Multiple agencies, professions, and patient groups are working diligently to achieve the EHE goals. Pharmacists have long recognized that our profession is a key resource in ending the HIV epidemic. We demonstrate this in the …

Development Of Long-Acting Antiviral And Antimicrobial Prodrug Nanoformulations, Srijanee Das

Theses & Dissertations

Over the past decade, the global burden of infectious diseases has increased substantively, underscoring the need for more effective treatment strategies. However, the discovery and development of new drugs with desirable safety, pharmacokinetics, and efficacy is a time consuming and costly process with great uncertainty around success rate. As an alternative to new drug development, prodrugs and novel drug delivery systems have increasingly been explored. Both serve to overcome the drug development challenges. Such drug formulations that permit extended dosing intervals of potent native drugs serve multiple purposes by promoting patient adherence to in improving treatment outcomes. This is especially …

Prep And Intimate Partner Violence Among Gay, Bisexual, And Other Men Who Have Sex With Men: A Scoping Review Of The Literature, Swarnali Goswami Ph.D., Joanne Canedo Pharm.D., Cynthia Siddique B.S., Erin Holmes Pharm.D., Ph.D., Marie Barnard Ph.D.

Faculty and Student Publications

Intimate Partner Violence (IPV) continues to be a serious public health concern, impacting nearly affecting diverse communities worldwide. Approximately one in three men experience sexual violence, physical violence, or stalking by an intimate partner in their lifetime.1 Men who have sex with men (MSM) are a particularly vulnerable population, facing unique challenges in the context of both IPV and HIV prevention. MSM experience disproportionately high rates of IPV and remain at an elevated risk of HIV transmission, making them a critical target group for research and intervention efforts.2,3 In recent decades, significant strides have been made in advancing the understanding …

Drug Repurposing: New Mechanisms And Applications Of Existing Compounds, Biyun Celia Cui

Theses and Dissertations

HIV infection remains a significant global health challenge. Despite the widespread use of combination antiretroviral therapy, people living with HIV (PLWH) still face a disproportionate burden of major health problems. One of these problems is HIV-associated neurocognitive disorders (HAND), which includes a spectrum of cognitive, motor, and behavioral impairments. Although severe forms of HAND have decreased, milder forms are on the rise, posing a significant obstacle for PLWH.

The persistence of HIV in the central nervous system (CNS) is a challenge of HAND treatment and involves a combination of factors, including neurotoxic HIV proteins, chronic neuroinflammation, and comorbidity with substance …

Effects Of Cannabichromene On Pain And Neuroinflammation In Hiv-1 Tat Transgenic Mice, Sydney Wheeler

Honors Theses

HIV-1 TransActivator of Transcription (Tat) is a vital regulatory protein involved in HIV replication and implicated in development of HIV-associated pain and neurocognitive deficits. Tat is thought to contribute to these pathologies through proinflammatory pathways. Developing mechanisms to curb Tat-mediated inflammation is a key step in improving the quality of life of those living with HIV. Both recreational and medicinal cannabis use is prevalent among many people living with HIV; given this prevalence and the perceived anti-inflammatory benefits of cannabis use, it is important to investigate how chemical constituents of cannabis may impact HIV. In the present study, the effects …

Various Synthetic Pathways Towards Efavirenz And Its Analogs; The Replacement Of The Side Chain, Elizabeth S. Bautista

Selected Honors Theses

Cyclopropyl acetylene (CA) is a key intermediate in the synthesis of the human immunodeficiency virus (HIV) reverse transcriptase inhibitor, Efavirenz (EFV), an antiviral drug used to treat HIV. CA is an expensive raw material, difficult to obtain, and employed in the preparation of medications to combat acquired immunodeficiency syndrome (AIDS). It was found that the structure could be synthesized by the utilization of PCl5; however, this resulted in unwanted ring opening products. To address this issue, a one pot synthesis was developed using Ph3PCl2 as a mild chlorinating agent. In addition, a new analog has been proposed substituting the cyclopropyl …

The Impact Of Hiv-1 Tat And Morphine On Spatial Distribution Of Drugs In The Brain., Austin M. Jones

Theses and Dissertations

Despite combination antiretroviral therapy effectively suppressing HIV within the periphery, the central nervous system (CNS) remains affected by the virus. Approximately half of people living with HIV will experience HIV-associated neurocognitive disorders (HAND) or neuroHIV. Concurrent opioid use exacerbates neuroHIV by promoting neuroinflammation, viral replication, and potentially altering the antiretroviral concentrations within the brain.

Using a transgenic mouse that expresses the HIV-1 Tat protein, we examined the effects of Tat and morphine on antiretroviral accumulation and distribution and the effects of Tat on morphine accumulation within the brain using infrared matrix-assisted laser desorption electrospray ionization with mass spectrometry imaging (IR-MALDESI-MSI). …

Nanotherapeutics And Hiv: Four Decades Of Infection Canvass The Quest For Drug Development Using Nanomedical Technologies, Bhupender S. Chhikara, Nirpendra Singh, Poonam, Parveen Bazard, Rajender S. Varma, Keykavous Parang

Pharmacy Faculty Articles and Research

We have seen four decades of human struggle to cure or eradicate HIV infection since the first clinical detection of HIV infection. Various developed drugs such as nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors, integrase inhibitors, microbicides, and others have known restrictions, such as side effects and resistance development when used alone, and hidden reservoir of the virus, which have opened the gates for the involvement of nanomedicine associated systems, particularly for latent sites of HIV infection. The nanotechnological vehicles, such as liposomes, dendrimers, metal nanoparticles, polymeric nanocapsules/particles, surfactants, and targeted vehicles have become part …

Ameliorative Effects Of Minor Cannabinoids Over Hiv-1 Tat-Mediated Visceral Pain, Charlie Worth

Honors Theses

As the total number of people living with HIV continues to rise across the world, an effective HIV treatment is still sought after. While modern-day advanced therapies exist for mitigating much of the negative effects of HIV, the virus remains evasive and problematic in the central nervous system. Thus, even with treatment, many people living with HIV continue to suffer from a plethora of symptoms. However, a large proportion of HIV-positive patients claim to feel a reduction in those persevering symptoms after cannabis usage. This anecdotal evidence has sparked interest in the efficacy of cannabis constituents for HIV therapy. This …

Studying Patterns And Predictors Of Hiv Viral Suppression Using A Big Data Approach: A Research Protocol, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xueying Yang Ph.D., Zhenglong Li, Jianjun Hu, Xiaoming Li

Faculty Publications

Background: Given the importance of viral suppression in ending the HIV epidemic in the US and elsewhere, an optimal predictive model of viral status can help clinicians identify those at risk of poor viral control and inform clinical improvements in HIV treatment and care. With an increasing availability of electronic health record (EHR) data and social environmental information, there is a unique opportunity to improve our understanding of the dynamic pattern of viral suppression. Using a statewide cohort of people living with HIV (PLWH) in South Carolina (SC), the overall goal of the proposed research is to examine the dynamic …

A Qualitative Study On Pharmacy Policies Toward Over-The-Counter Syringe Sales In A Rural Epicenter Of Us Drug-Related Epidemics, Monica Fadanelli, Hannah L. F. Cooper, Patricia R. Freeman, April M. Ballard, Umed Ibragimov, April M. Young

Pharmacy Practice and Science Faculty Publications

BACKGROUND: Expanding access to sterile syringes in rural areas is vital, as injection-related epidemics expand beyond metropolitan areas globally. While pharmacies have potential to be an easily accessible source of sterile syringes, research in cities has identified moral, legal and ethical barriers that preclude over-the-counter (OTC) sales to people who inject drugs (PWID). The current study builds on prior urban-based research by elucidating (1) pharmacy OTC policies and (2) pharmacists' rationale for, and barriers and facilitators to, OTC syringe sales in a US rural area hard hit by drug-related epidemics.

METHODS: We conducted 14 semi-structured interviews with pharmacists recruited from …

Human Immunodeficiency Virus Type-1 (Hiv-1) Transcriptional Regulation, Latency And Therapy In The Central Nervous System, Joseph Hokello, Adhikarimayum Lakhikumar Sharma, Priya Tyagi, Alok Bhushan, Mudit Tyagi

College of Pharmacy Faculty Papers

The central nervous system (CNS) is highly compartmentalized and serves as a specific site of human immunodeficiency virus (HIV) infection. Therefore, an understanding of the cellular populations that are infected by HIV or that harbor latent HIV proviruses is imperative in the attempts to address cure strategies, taking into account that HIV infection and latency in the CNS may differ considerably from those in the periphery. HIV replication in the CNS is reported to persist despite prolonged combination antiretroviral therapy due to the inability of the current antiretroviral drugs to penetrate and cross the blood–brain barrier. Consequently, as a result …

Red Algal Sulfated Galactan Binds And Protects Neural Cells From Hiv-1 Gp120 And Tat, Vitor H. Pomin, Fakhri Mahdi, Weihua Jin, Fuming Zhang

Faculty and Student Publications

The potential neuroprotective capacity of four different sulfated glycans: Botryocladia occidentalis-derived sulfated galactan (BoSG) (MW > 100 kDa), Lytechinus variegatus-derived sulfated fucan (LvSF) (MW~90 kDa), high-molecular weight dextran sulfate (DxS) (MW 100 kDa), and unfractionated heparin (UFH) (MW~15 kDa), was assessed in response to the HIV-1 proteins, R5-tropic glycoprotein 120 (gp120) and/or trans-activator of transcription (Tat), using primary murine neurons co-cultured with mixed glia. Compared to control-treated cells in which HIV-1 proteins alone or combined were neurotoxic, BoSG was, among the four tested sulfated glycans, the only one capable of showing significant concentration-dependent neuroprotection against Tat and/or gp120, alone or combined. …

Hiv Research "Year In Review" In Haiti, Chris Delcher, June Bae, Shannan Rich, Jacob Peace

Institute for Pharmaceutical Outcomes and Policy Reports

Introduction

For this issue of the Epidemiologic Surveillance Bulletin, we summarize the prior year’s research on populations living with HIV (PLWH) in Haiti for World AIDS Day 2020.

Methods

We retrieved 50 articles from PubMed (pubmed.gov) for articles written in English using the search term [Haiti* AND (HIV OR "human immunodeficiency virus" OR AIDS)] from December 2019 to November 19, 2020 (approximately 1 year). We included studies that of cohorts of people living with HIV in Haiti, patients enrolled from Haiti in multi-country clinical studies and studies involving populations at substantial risk of HIV in Haiti. We excluded studies of …

Fanconi Syndrome Leading To Hypophosphatemic Osteomalacia Related To Tenofovir Use., Mana Rao, Liam Dadey, Thomas Glowa, Peter Veldkamp

Parkview Pharmacy Department

Tenofovir disoproxil fumarate (TDF) is used worldwide to treat and prevent Human Immunodeficiency Virus (HIV) infection. Fanconi syndrome is a complication of TDF use and is characterized by inadequate reabsorption of glucose, phosphate and protein in the proximal tubule of the kidney which may eventually lead to osteomalacia manifested by symptoms of pain, muscular weakness and difficulty ambulating. We present a patient with severe osteomalacia due to progressive and unrecognized Fanconi's syndrome, who responded rapidly to TDF withdrawal, oral phosphate repletion and calcitriol. With the widespread use of TDF-containing antiviral regimens, it is critically important that physicians adhere to screening …

Non-Prescription Sale Of Syringes In Monterey County, Ruby Ramos Godoy

Capstone Projects and Master's Theses

I have interned for the Monterey County Health Department in the Human Immunodeficiency Virus (HIV) Prevention Program. My capstone project focuses on a community problem targeting high HIV and Hepatitis C (HCV) transmission rates in Monterey County. There are high HIV and HCV rates among injection drug users (IDUs), and many of our community members may partake in these harmful activities. The cause of these high HIV and HCV rates is because there are limited amounts of pharmacies selling syringes without a prescription, which then causes the high HIV and HCV rates among injection drug users and low life expectancy …

Risk Factors For Delayed Viral Suppression On First-Line Antiretroviral Therapy Among Persons Living With Hiv In Haiti, 2013-2017, Shannan N. Rich, Robert L. Cook, Lusine Yaghjyan, Kesner Francois, Nancy Puttkammer, Ermane Robin, Jungjun Bae, Nadjy Joseph, Luisa Pessoa-Brandão, Chris Delcher

Institute for Pharmaceutical Outcomes and Policy Faculty Publications

Studies of viral suppression on first-line antiretroviral therapy (ART) in persons living with human immunodeficiency virus (PLHIV) in Haiti are limited, particularly among PLHIV outside of the Ouest department, where the capital Port-au-Prince is located. This study described the prevalence and risk factors for delayed viral suppression among PLHIV in all geographic departments of Haiti between 2013 and 2017. Individuals who received viral load testing 3 to 12 months after ART initiation were included. Data on demographics and clinical care were obtained from the Haitian Active Longitudinal Tracking of HIV database. Multivariable logistic regression was performed to predict delayed viral …

Feasibility And Acceptability Of A Proposed Pharmacy-Based Harm Reduction Intervention To Reduce Opioid Overdose, Hiv And Hepatitis C, Beth E. Meyerson, Jon D. Agley, Wasantha Parakrama Jayawardene, Lori Ann Eldridge, Prachi Arora, Carriann Smith, Nina Vadiei, Amy K. Kennedy, Taylor J. Moehling

Scholarship and Professional Work – COPHS

Background: Evidence-based harm reduction intervention components which might benefit pharmacy patients have not been integrated and studied.

Objective: To investigate the feasibility and acceptability of a proposed pharmacy-based harm reduction intervention to reduce opioid overdose, HIV and hepatitis C called PharmNet.

Methods: Indiana managing pharmacists were surveyed in 2018 to assess the feasibility and acceptability of an intervention for opioid misuse screening, brief intervention, syringe and naloxone dispensing, and referrals provision. The Consolidated Framework for Implementation Research informed the survey development and analysis.

Result: The sample included 303 (30.8%) pharmacists; 215 (70.9%) provided detailed written comments. Intervention Characteristics: 83.3% believed …

The Incidence And Severity Of Drug Interactions Before And After Switching Antiretroviral Therapy To Bictegravir/Emtricitabine/Tenofovir Alafenamide In Treatment Experienced Patients, Ciara Walshe, Pharmd Candidate, Jason J. Schafer, Pharmd, Mph, Bcps-Aq Id, Bcidp, Aahivp

College of Pharmacy Posters

Objective

• The primary outcome was to measure the proportion of patients experiencing DIs before and after the ART switch.
• The secondary outcome was to measure changes in DI scores before and after the ART switch.

Tuberculoma Presenting As Paradoxical Iris In A Hiv Positive Patient, Dr. Supritha Chintamaneni, Dr.Rajendra Prasad S, Dr.Bhanukumar M, Dr.Adarsh L S

Digital Journal of Clinical Medicine

No abstract provided.

A Real World Assessment Of The Efficacy And Safety Of Switching From Tdf To Taf In Treatment Experienced Patients With Hiv Infection, Jaclyn O'Connor, Pharmd Candidate, Kaitlin N. Sassa, Pharmd, Jason J. Schafer, Pharmd, Mph, Bcps Aq-Id, Bcidp, Aahivp

College of Pharmacy Posters

Objective

• The primary objective of this study was to determine if patients maintain viral suppression after switching from TDF to TAF
• The secondary objective was to assess changes in renal function and serum cholesterol levels

Changes In Body Mass Index And Atherosclerotic Disease Risk Score After Switching From Tenofovir Disoproxil Fumarate To Tenofovir Alafenamide., Jason J. Schafer, Kaitlin N. Sassa, Jaclyn R. O'Connor, Ayako Shimada, Scott W. Keith, Joseph A. Desimone

College of Pharmacy Faculty Papers

Background: Switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF)-containing antiretroviral therapy (ART) can improve renal function and bone mineral density in people with human immunodeficiency virus (PWH). The switch can also negatively influence cholesterol, but changes in body mass index (BMI) and atherosclerotic cardiovascular disease (ASCVD) risk are unknown.

Methods: This retrospective observational study evaluated BMI and ASCVD risk score changes in virologically suppressed PWH who switched from TDF to TAF without switching other ART regimen components. Adults on TDF for ≥1 year with 2 consecutive HIV ribonucleic acid values/mL before a TAF switch were included. Body weight, …

Patients Living With Hiv Infection Are Less Likely To Receive The Correct Statin Intensity For Cardiovascular Disease Risk Reduction, Jason J. Schafer, Pharmd, Mph, Roshni Emmons, Pharmd, Bcps, Nick V. Hastain, Pharmd, Todd Miano, Pharmd, Phd

College of Pharmacy Posters

• Patients living with HIV (PLWH) are at high risk for atherosclerotic cardiovascular disease (ASCVD)
• Eligible PLWH should receive statins for ASCVD risk reduction according to current guidelines
• Studies suggest that statins are underprescribed in PLWH, but comparisons to uninfected patients and assessments of statin intensity have not occurred

Objective

To determine the influence of HIV infection on appropriate statin prescribing for ASCVD risk reduction

Exploring The Prevalence And Characteristics Associated With Weight Gain And Metabolic Changes In Plwh Who Are Virologically Suppressed On Antiretroviral Therapy And Switch To Integrase Inhibitor Containing Regimens, Matty Zimmerman, Joseph Desimone Jr., Md, Jason J. Schafer, Pharmd, Mph, Bcps-Aq Id, Bcidp, Aahivp

College of Pharmacy Posters

Objectives

• To determine the prevalence, extent and characteristics of weight gain among virologically suppressed PLWH whose ART has been switched to an INSTI-containing regimen
• To examine the presence of metabolic changes in PLWH who have been switched to INSTI-containing ART

Effects Of Human Dopamine Transporter (Dat) Mutations And Novel Allosteric Modulatory Compounds In Disrupting Hiv-1 Tat-Dat Protein Interaction, Pamela Marie P. Quizon

Theses and Dissertations

More than 37 million people are living with HIV worldwide. Despite the widespread use of antiretroviral therapy (ART), up to 70% of HIV-positive individuals suffer from cognitive and behavioral deficits collectively known as HIV-associated neurocognitive disorders (HAND). HIV-mediated damage to the dopaminergic system is a mediating factor in HAND. Dopamine (DA) transporter (DAT)-mediated reuptake is essential for maintaining DA homeostasis. Because most ART cannot efficiently cross the blood-brain barrier (BBB), the brain serves as a viral reservoir that facilitates the spread of infection to microglia and astrocytes. Infected cells shed viral proteins such as Tat, which plays a critical role …

Optimizing An Order Set To Streamline Health Care Delivery In The Emergency Department For Patients Requiring Hiv Post-Exposure Care, Marlisha Smith

Doctor of Nursing Practice Final Manuscripts

Background: The Centers for Disease Control and Prevention (CDC) updated guidelines to support efforts to decrease the number of Human Immunodeficiency Virus (HIV) incidences. The principle method for risk reduction utilized in the guidelines is the 28-day non-occupational post-exposure prophylaxis (nPEP) antiretroviral course administered within 72 hours of exposure. Despite this recommendation, adherence to a full 28-day course nPEP is very low nationally. Root cause analysis completed at the study site indicated that the use of an outdated order set caused unwarranted variability in care which accounted for failure in the delivery of appropriate nPEP care and low medication adherence. …

Development Of A Lectin-Fc Fusion Protein With Antiviral And Anti-Cancer Activity., Matthew William Dent

Electronic Theses and Dissertations

This thesis describes the development of a novel lectin-Fc fusion protein and its antiviral and anti-cancer activity. The molecule, Avaren-Fc (AvFc), is a fusion of a variant of the actinomycete lectin actinohivin (Avaren) and the Fc region of human IgG1, and is selective for the terminal α1,2-mannose residues found at the ends of high-mannose-type glycans that can be found on the surface of certain heavily glycosylated viruses and cancer cells. Here, AvFc was found to be able to neutralize simian immunodeficiency virus as well as Hepatitis C virus with nanomolar IC₅₀ values. Furthermore, AvFc recognizes a number of cell …

Weight Gain In Patients With Hiv Infection Who Are Virologically Suppressed On Antiretroviral Therapy And Switch To Integrase Inhibitor Containing Regimens, Matty Zimmerman, Jason Schafer, Pharmd, Mph, Bcps, Bcidp, Aahivp

College of Pharmacy Posters

Objective

To determine the prevalence and extent of weight gain among virologically suppressed PLWH whose antiretroviral therapy (ART) has been switched to an integrase inhibitor (INSTI) containing regimen.

The Incidence And Severity Of Drug Interactions Before And After Antiretroviral Therapy Simplification In Treatment Experienced Patients With Hiv Infection, Aleena Santana, Pharmd Candidate, Nick Hastain, Pharmd Candidate, Jason J. Schafer, Pharmd, Mph, Bcps, Aahivp

College of Pharmacy Posters

Purpose

• The primary objective of this study was to assess changes in the incidence and severity of drug interactions before and after ART simplification in treatment experienced patients.
• Describe ART medication class changes and analyze predictors for achieving drug interaction score reductions.