Virus Diseases Commons^™

Art Adherence And Viral Suppression Are High Among Most Non-Pregnant Individuals With Early-Stage, Asymptomatic Hiv Infection: An Observational Study From Uganda And South Africa, Jessica E. Haberer, Bosco M. Bwana, Catherine Orrell, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Mark J. Siedner, Lynn T. Matthews, Alexander Tsai, Ingrid T. Katz, Kathleen Bell, Annet Kembabazi, Stephen Mugisha, Victoria Kibirige, Anna Cross, Nicola Kelly, Bethany Hedt-Gauthie, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction

The success of universal antiretroviral therapy (ART) access and aspirations for an AIDS‐free generation depend on high adherence in individuals initiating ART during early‐stage HIV infection; however, adherence may be difficult in the absence of illness and associated support.

Methods

From March 2015 to October 2017, we prospectively observed three groups initiating ART in routine care in Uganda and South Africa: men and non‐pregnant women with early‐stage HIV infection (CD4 > 350 cells/μL), pregnant women with early‐stage HIV infection and men and non‐pregnant women with late‐stage HIV infection (CD4 < 200 cells/μL). Socio‐behavioural questionnaires were administered and viral loads were performed at 0, 6 and 12 months. Adherence was monitored electronically.

Results

Adherence data were available for 869 participants: 322 (37%) early/non‐pregnant, …

Timing Of Antiretroviral Therapy And Systemic Inflammation In Sub-Saharan Africa: Results From The Meta Longitudinal Cohort Study, Mark J. Siedner, Bosco M. Bwana, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Jose R. Castillo-Mancilla, Russell P. Tracy, Ingrid T. Katz, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/ μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P < .05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P > .05), owing to loss from observation and greater declines in biomarkers in latestage initiators (P < .001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.

Cellular Mechanisms By Which Alcohol Promotes Hiv Protease Inhibitor-Induced Hepatotoxicity, Michael Hinton

Theses and Dissertations

CELLULAR MECHANISMS BY WHICH ALCOHOL PROMOTES HIV PROTEASE INHIBITOR-INDUCED HEPATOTOXICITY

Michael Hinton, B.S.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2019

Major Director: Huiping Zhou

Professor, Department of Microbiology and Immunology

The development of highly-active-antiretroviral therapy(HAART) has allowed management of HIV and extended the lives of those infected. Alcohol abuse, which is very common in HIV-1 infected patients, is one of the most important co-morbid risk factors for liver injury and has been associated with the occurrence of serious metabolic syndrome and subsequent discontinuation …

Regulation Of The Long Non-Coding Rna Fam83h-As1 By Human Papillomavirus In Cervical Cancer, Jamie Ann Barr Ph.D.

Graduate Theses, Dissertations, and Problem Reports (ETD)

Non-coding RNAs (NcRNAs), such as long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), have been found to be involved in a variety of critical biological processes, and dysregulation of ncRNAs have been involved with several human diseases including cancer.

High-risk human papillomavirus (HPV) infection is one of the first events in the process of carcinogenesis in cervical and a subset of head and neck cancers. The expression of the viral oncoproteins E6 and E7 is essential in this process by inactivating the tumor suppressor proteins p53 and Rb, respectively, in addition to their interactions with other host proteins and regulation of …

Epidemiology, Clinical Features And Outcomes Of Patients With Sickle Cell Disease Hospitalized With Influenza, Kyle P. Openo

College of Graduate Studies: Theses & Dissertations

Influenza is a respiratory viral infection responsible for annual epidemics, periodic pandemics and regularly causes substantial morbidity, mortality and economic burden worldwide. In the United States alone, influenza causes between 9.2 – 35.6 million cases, 140,000 to 710,000 hospitalizations and 12,000 – 56,000 deaths annually. Individuals with comorbid health conditions are at increased risk of hospitalization and severe outcomes from influenza infection and were recommended for vaccination prior to universal vaccine recommendations. Individuals with sickle cell disease (SCD) have been included in this group for decades though limited data existed to describe influenza among those with SCD. Recent studies showed …

Seroepidemiology Of Parechovirus A3 Neutralizing Antibodies, Australia, The Netherlands, And United States, Eveliina Karelehto, Lieke Brouwer, Kimberley Benschop, Jen Kok, Kerri Basile, Brendan Mcmullan, William Rawlinson, Julian Druce, Suellen Nicholson, Rangaraj Selvarangan, Christopher J. Harrison, Kamani Lankachandra, Hetty Van Eijk, Gerrit Koen, Menno De Jong, Dasja Pajkrt, Katja C. Wolthers

Manuscripts, Articles, Book Chapters and Other Papers

© 2018, Centers for Disease Control and Prevention (CDC). All rights reserved. Recent parechovirus A3 (PeV-A3) outbreaks in Australia suggest lower population immunity compared with regions that have endemic PeV-A3 circulation. A serosurvey among populations in the Netherlands, the United States, and Australia before and after the 2013 Australia outbreak showed high PeV-A3 neutralizing antibody prevalence across all regions and time periods, indicating widespread circulation.

Surviving A Death Sentence, Amy K. Mackinnon

Capstones

Diagnosed with HIV at the peak of the AIDS epidemic, Sean McKenna had planned to die. Now, decades after life-saving drugs were first released, he and other long-term survivors are still figuring out how to live.
https://amykmackinnon.wordpress.com/capstone/

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Examining The Impact Of Hiv Medical And Social Case Management Program On Viral Load For Clients Living With Hiv/Aids In Nebraska, Abdulla Munir

Capstone Experience: Master of Public Health

Abstract

Case management (CM) is one of the standard practices that has been implemented since 1990 to help people living with HIV/AIDS (PLWHA) in the United States. The program is designed for low-income populations and it aims to address the barriers related to access to health care and improve the HIV outcomes. Previous studies identified a positive association with the provision of CM and improvement in viral outcomes. Increasing the viral suppression rates among HIV diagnosed individuals proved to reduce the risk of transmitting the infection, and disease incidence. Although CM program is provided to Nebraskans diagnosed with HIV, but …

Engineering Yeast To Evaluate Human Proteins Involved In Selective Rna Packaging During Hiv Particle Production, Ryan M. Bitter

Master's Theses

Despite recent advances in antiretroviral therapy, nearly 37 million people continue to live with human immunodeficiency virus (HIV). Basic and applied research on the assembly of HIV could be enhanced by using a genetically tractable organism, such as yeast, rather than mammalian cells. While previous studies showed that expression of the HIV Gag polyprotein in Saccharomyces cerevisiae spheroplasts resulted in the production of virus-like particles (VLPs), many questions regarding the utility of yeast in HIV assembly remain uninvestigated. Here, we report use of S. cerevisiae for both the production of VLPs with selectively packaged RNA and to evaluate the human …

Vertical Transmission Of Zika Virus In Aedes Aegypti And Aedes Albopictus, Stephanie Cantu

Honors Theses

Arboviruses such as Zika (ZIKV), dengue, chikungunya are responsible causing over 4 million people to live with debilitating conditions and may produce long-term health consequences. Zika virus, a newly emerging arbovirus, has potentially severe neurological complications and a potential to cause severe birth defects. There are no current vaccines for Zika virus, and the primary method for control the spread of this disease is through early detection and vector control. Assessing and quantifying viral transmission patterns is critical for successful control efforts. Zika virus shows some unique (among arboviruses) transmission patterns, notably the ability to be sexually transmitted. One aspect …

Risky Business: Millennials’ Protection Motivation Factors For Norovirus Outbreaks On College Campuses, Dylan Conrad Martinez

Graduate Theses and Dissertations

The risk and severity of hNoV transmission is obscurely recognized to foodservice millennial customers. Most commonly associated with cruise ships, consumers are not aware of its full potential to strike at other locations, especially college campuses. For the foodservice industry and the university community, it is imperative that a proactive method for increasing millennials’ motivation to practice mitigation methods emerges to reduce future hNoV outbreaks on college campuses. Research has shown that students can play a major role in the spread of hNoV on college campuses. Therefore, the purpose of these studies is to examine motivations for health protective behaviors …

A Comparison Of Agent-Based Models And Equation Based Models For Infectious Disease Epidemiology, Elizabeth Hunter, Brian Mac Namee, John D. Kelleher

Articles

There are two main methods that are used to model the spread of an infectious disease: agent-based modelling and equation based modelling. In this paper, we compare the results from an example implementation of each method, and show that although the agent-based model takes longer to setup and run, it provides additional information that is not available when using an equation based model. Specifically, the ability of the agent-based model to capture heterogeneous mixing and agent interactions enables it to give a better overall view of an outbreak. We compare the performance of both models by simulating a measles outbreak …

A Program To Treat Hepatitis B In North Korea: A Model Of Antiviral Therapy In A Resource-Poor Setting, Marcia Ann Kilsby, Alice Unah Lee, Heidi Linton, David C. Hilmers

Faculty Publications

Despite the well-proven, safe and effective therapies for hepatitis B infection, delivery of treatment remains a significant challenge in resource-poor settings. Geopolitical and economic restrictions present additional difficulties in providing care in North Korea. However, treatment of patients with chronic hepatitis B remains a top priority for both the North Korean Ministry of Public Health and international agencies working in North Korean hepatitis healthcare facilities. Working in partnership, a path was created to institute this much-needed program. A consortium of United States and Australian humanitarian non-governmental organizations along with generous individual and corporate donors working in concert with local and …

Internalized Hiv Stigma, Art Initiation And Hiv-1 Rna Suppression In South Africa: Exploring Avoidant Coping As A Longitudinal Mediator, Valerie A. Earnshaw, Laura M. Bogart, Jean-Philippe Laurenceau, Brian T. Chan, Brendan G. Maughan-Brown, Janan Dietrich, Ingrid Courtney, Gugu Tshabalala, Catherine Orrell, Glenda E. Gray, David Bangsberg, Ingrid T. Katz

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Cross‐sectional evidence suggests that internalized HIV stigma is associated with lower likelihoods of antiretroviral therapy (ART) initiation and HIV‐1 RNA suppression among people living with HIV (PLWH). This study examined these associations with longitudinal data spanning the first nine months following HIV diagnosis and explored whether avoidant coping mediates these associations.

Methods: Longitudinal data were collected from 398 South African PLWH recruited from testing centres in 2014 to 2015. Self‐report data, including internalized stigma and avoidant coping (denying and distracting oneself from stressors), were collected one week and three months following HIV diagnosis. ART initiation at six months and …

Routine, Opt-Out Hiv Testing In A Rural Emergency Department, Ciarra Jm Dortche

9th Annual Rural HIV Research & Training Conference (2014-2019) (Archived)

There are approximately 1,800 people living with HIV in eastern North Carolina and are unaware of their infection. A decade ago, the Centers for Disease Control and Prevention (CDC) issued revised recommendations to routinely test for HIV in various settings, including emergency departments. We used those guidelines to test adults, treat those unaware of their infection, and re-link others to care.

Hla-C Downregulation By Hiv-1 Adapts To Host Hla Genotype, Nathaniel D. Batchel, Gisele Umviligihozo, Suzanne Pickering, Talia Mota, Hua Liang, Gregory Q. Del Prete, Pramita Chatterjee, Guinevere Q. Lee, Rasmi Thomas, Mark A. Brockman, Stuart Neil, Mary Carrington, Bosco M. Bwana, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV-1 can downregulate HLA-C on infected cells, using the viral protein Vpu, and the magnitude of this downregulation varies widely between primary HIV-1 variants. The selection pressures that result in viral downregulation of HLA-C in some individuals, but preservation of surface HLA-C in others are not clear. To better understand viral immune evasion targeting HLA-C, we have characterized HLA-C downregulation by a range of primary HIV-1 viruses. 128 replication competent viral isolates from 19 individuals with effective anti-retroviral therapy, show that a substantial minority of individuals harbor latent reservoir virus which strongly downregulates HLA-C. Untreated infections display no change in …

Mechanisms Adopted By Dengue-2 Viruses To Induce Autophagy In Mammalian Cells, Sounak Ghosh Roy

Dissertations, Theses, and Capstone Projects

Dengue, the most rapidly spreading flavivirus, threatens to affect almost half of the human global population. We previously showed that dengue-2 protects canine kidney cells (MDCK) from cytotoxic chemicals. We showed, independently, that cell protection, as well as viral replication and maturation, are positively regulated by PI3K-dependent autophagy. However, we had not identified the specific pathway that induces autophagy in infected cells. The current study explores the role of a specific branch of the endoplasmic reticulum (ER) stress-mediated Unfolded Protein Response (UPR), the PERK/eIF2α/ATF4 pathway in the induction of autophagy by …

Congenital Zika Virus Infection In Immunocompetent Mice Causes Postnatal Growth Impediment And Neurobehavioral Deficits, Amber M. Paul, Dhiraj Acharya, Biswas Neupane, E. Ashley Thompson, Gabriel Gonzalez-Fernandez, Katherine M. Copeland

Publications

A small percentage of babies born to Zika virus (ZIKV)-infected mothers' manifest severe defects at birth, including microcephaly. Among those who appeared healthy at birth, there are increasing reports of postnatal growth or developmental defects. However, the impact of congenital ZIKV infection in postnatal development is poorly understood. Here, we report that a mild congenital ZIKV-infection in pups born to immunocompetent pregnant mice did not display apparent defects at birth, but manifested postnatal growth impediments and neurobehavioral deficits, which include reduced locomotor and cognitive deficits that persisted into adulthood. We found that the brains of these pups were smaller, had …

Implementing A Pre-Exposure Prophylaxis Intervention For Safer Conception Among Hiv Serodiscordant Couples: Recommendations For Health Care Providers, Mari-Lynn Drainoni, Dea L. Biancarelli, Ashley A. Leech, Meg Sullivan, Angela R. Bazzi

Journal of Health Disparities Research and Practice

Couples in HIV serodiscordant relationships frequently desire children. Although partners who are virally suppressed pose almost no risk of transmitting HIV to their partners, partners who are inconsistently on therapy may transmit HIV to their partners when attempting to conceive. Pre-exposure prophylaxis (PrEP) is an available safer conception strategy for these couples but is not consistently offered. We sought to better understand barriers to PrEP implementation for couples seeking conception and patient perceptions on what providers could do to encourage use. We conducted in-depth, qualitative interviews with 11 participants representing six couples taking PrEP for safer conception in a safety-net …