9 results on '"Aarti Kinikar"'
Search Results
2. The changing characteristics of a cohort of children and adolescents living with HIV at antiretroviral therapy initiation in Asia.
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Johanna Beulah Sornillo, Rossana Ditangco, Aarti Kinikar, Dewi Kumara Wati, Quy Tuan Du, Dinh Qui Nguyen, Vohith Khol, Lam Van Nguyen, Thanyawee Puthanakit, Pradthana Ounchanum, Nia Kurniati, Kulkanya Chokephaibulkit, Thahira A Jamal Mohamed, Tavitiya Sudjaritruk, Siew Moy Fong, Nagalingeswaran Kumarasamy, Pope Kosalaraksa, Revathy A Nallusamy, Nik Khairulddin Nik Yusoff, Annette H Sohn, Azar Kariminia, and TREAT Asia Pediatric HIV Observational Database of IeDEA Asia-Pacific
- Subjects
Medicine ,Science - Abstract
Despite improvements in HIV testing and earlier antiretroviral therapy (ART) initiation in children living with HIV through the years, a considerable proportion start treatment with advanced disease. We studied characteristics of children and adolescents living with HIV and their level of immunodeficiency at ART initiation using data from a multi-country Asian cohort. We included children and adolescents who were ART-naïve and
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- 2023
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3. Tuberculosis preventive treatment should be considered for all household contacts of pulmonary tuberculosis patients in India.
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Mandar Paradkar, Chandrasekaran Padmapriyadarsini, Divyashri Jain, Shri Vijay Bala Yogendra Shivakumar, Kannan Thiruvengadam, Akshay N Gupte, Beena Thomas, Aarti Kinikar, Krithika Sekar, Renu Bharadwaj, Chandra Kumar Dolla, Sanjay Gaikwad, S Elilarasi, Rahul Lokhande, Devarajulu Reddy, Lakshmi Murali, Vandana Kulkarni, Neeta Pradhan, Luke Elizabeth Hanna, Sathyamurthi Pattabiraman, Rewa Kohli, Rani S, Nishi Suryavanshi, Shrinivasa B M, Samyra R Cox, Sriram Selvaraju, Nikhil Gupte, Vidya Mave, Amita Gupta, Robert C Bollinger, and CTRIUMPH-RePORT India Study Team
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Medicine ,Science - Abstract
The World Health Organization (WHO) recently changed its guidance for tuberculosis (TB) preventive treatment (TPT) recommending TPT for all pulmonary TB (PTB) exposed household contacts (HHC) to prevent incident TB disease (iTBD), regardless of TB infection (TBI) status. However, this recommendation was conditional as the strength of evidence was not strong. We assessed risk factors for iTBD in recently-exposed adult and pediatric Indian HHC, to determine which HHC subgroups might benefit most from TPT. We prospectively enrolled consenting HHC of adult PTB patients in Pune and Chennai, India. They underwent clinical, microbiologic and radiologic screening for TB disease (TBD) and TBI, at enrollment, 4-6, 12 and 24 months. TBI testing was performed by tuberculin skin test (TST) and Quantiferon®- Gold-in-Tube (QGIT) assay. HHC without baseline TBD were followed for development of iTBI and iTBD. Using mixed-effect Poisson regression, we assessed baseline characteristics including TBI status, and incident TBI (iTBI) using several TST and/or QGIT cut-offs, as potential risk factors for iTBD. Of 1051 HHC enrolled, 42 (4%) with baseline TBD and 12 (1%) with no baseline TBI test available, were excluded. Of the remaining 997 HHC, 707 (71%) had baseline TBI (TST #x2265; 5 mm or QGIT #x2265; 0.35 IU/ml). Overall, 20 HHC (2%) developed iTBD (12 cases/1000 person-years, 95%CI: 8-19). HIV infection (aIRR = 29.08, 95% CI: 2.38-355.77, p = 0.01) and undernutrition (aIRR = 6.16, 95% CI: 1.89-20.03, p = 0.003) were independently associated with iTBD. iTBD was not associated with age, diabetes mellitus, smoking, alcohol, and baseline TBI, or iTBI, regardless of TST (#x2265; 5 mm, #x2265; 10 mm, #x2265; 6 mm increase) or QGIT (#x2265; 0.35 IU/ml, #x2265; 0.7 IU/ml) cut-offs. Given the high overall risk of iTBD among recently exposed HHCs, and the lack of association between TBI status and iTBD, our findings support the new WHO recommendation to offer TPT to all HHC of PTB patients residing in a high TB burden country such as India, and do not suggest any benefit of TBI testing at baseline or during follow-up to risk stratify recently-exposed HHC for TPT.
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- 2020
- Full Text
- View/download PDF
4. Infection free 'resisters' among household contacts of adult pulmonary tuberculosis.
- Author
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Vidya Mave, Padmapriyadarshini Chandrasekaran, Amol Chavan, Shri Vijay Bala Yogendra Shivakumar, Kavitha Danasekaran, Mandar Paradkar, Kannan Thiruvengadam, Aarti Kinikar, Lakshmi Murali, Sanjay Gaikwad, Luke Elizabeth Hanna, Vandana Kulkarni, Sathyamoorthy Pattabiraman, Nishi Suryavanshi, Beena Thomas, Rewa Kohli, Gomathi Narayan Sivaramakrishnan, Neeta Pradhan, Brindha Bhanu, Anju Kagal, Jonathan Golub, Neel Gandhi, Akshay Gupte, Nikhil Gupte, Soumya Swaminathan, Amita Gupta, and CTRIUMPH RePORT India Study Team
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Medicine ,Science - Abstract
Despite substantial exposure to infectious pulmonary tuberculosis (TB) cases, some household contacts (HHC) never acquire latent TB infection (LTBI). Characterizing these "resisters" can inform who to study immunologically for the development of TB vaccines. We enrolled HHCs of culture-confirmed adult pulmonary TB in India who underwent LTBI testing using tuberculin skin test (TST) and QuantiFERON TB Gold Test-in-tube (QFT-GIT) at baseline and, if negative by both (
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- 2019
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5. High risk for latent tuberculosis infection among medical residents and nursing students in India.
- Author
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Aarti Kinikar, Ajay Chandanwale, Dileep Kadam, Samir Joshi, Anita Basavaraj, Geeta Pardeshi, Sunita Girish, Sangeeta Shelke, Andrea DeLuca, Gauri Dhumal, Jonathan Golub, Nilima Lokhande, Nikhil Gupte, Amita Gupta, Robert Bollinger, and Vidya Mave
- Subjects
Medicine ,Science - Abstract
Defining occupational latent tuberculosis infection (LTBI) risk among healthcare workers is needed to support implementation of prevention guidelines. Prospective cohort study of 200 medical residents and nursing students in India was conducted May 2016-December 2017. Tuberculin skin test (TST) and QuantiFERON TB Gold Test-in-tube (QFT-GIT) were performed at study entry and 12 months. Primary outcome was incident LTBI (≥10mm TST induration and/or ≥0.35IU/mL QFT-GIT) at 12 months; secondary outcomes included baseline LTBI prevalence and risk factors for incident and prevalent LTBI using Poisson regression. Among 200, [90 nursing students and 110 medical residents], LTBI prevalence was 30% (95% CI, 24-37); LTBI incidence was 26.8 (95% CI, 18.6-37.2) cases per 100 person-years and differed by testing method (28.7 [95% CI, 20.6-38.9] vs 17.4 [95% CI, 11.5-25.4] cases per 100 person-years using TST and QFT-GIT, respectively). Medical residents had two-fold greater risk of incident LTBI than nursing students (Relative Risk, 2.16; 95% CI, 1.05-4.42). During study period 6 (3%) HCWs were diagnosed with active TB disease. Overall, median number of self-reported TB exposures was 5 (Interquartile Range, 1-15). Of 60 participants with prevalent and incident LTBI who were offered free isoniazid preventive therapy (IPT), only 2 participants initiated and completed IPT. High risk for LTBI was noted among medical residents compared to nursing students. Self-reported TB exposure is underreported, and uptake of LTBI prevention therapy remains low. New approaches are needed to identify HCWs at highest risk for LTBI.
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- 2019
- Full Text
- View/download PDF
6. Isoniazid concentrations in hair and plasma area-under-the-curve exposure among children with tuberculosis.
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Vidya Mave, Aarti Kinikar, Anju Kagal, Smita Nimkar, Hari Koli, Sultanat Khwaja, Renu Bharadwaj, Roy Gerona, Anita Wen, Geetha Ramachandran, Hemanth Kumar, Peter Bacchetti, Kelly E Dooley, Nikhil Gupte, Amita Gupta, and Monica Gandhi
- Subjects
Medicine ,Science - Abstract
We measured hair and plasma concentrations of isoniazid among sixteen children with tuberculosis who underwent personal or video-assisted directly observed therapy and thus had 100% adherence. This study therefore defined typical isoniazid exposure parameters after two months of treatment among fully-adherent patients in both hair and plasma (plasma area under the concentration-time curve, AUC, estimated using pharmacokinetic data collected 0, 2, 4, and 6 hours after drug administration). We found that INH levels in hair among highly-adherent individuals did not correlate well with plasma AUC or trough concentrations, suggesting that each measure may provide incremental and complementary information regarding drug exposure in the context of TB treatment.
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- 2017
- Full Text
- View/download PDF
7. Efficacy of Six-Week Extended-Dose Nevirapine Varies by Infant Birth Weight with Greatest Relative Efficacy in Low Birth Weight Infants.
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Nikhil Gupte, Aarti Kinikar, Katherine N McIntire, Ramesh Bhosale, Sandesh Patil, Nishi Suryavanshi, Vidya Mave, Vandana Kulkarni, Robert C Bollinger, and Amita Gupta
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Medicine ,Science - Abstract
Latest World Health Organization guidelines recommend weight-based nevirapine prophylaxis for all HIV-exposed infants in resource-limited settings, yet low birth weight (LBW) infants (< 2500 g) have been understudied. Using data from the NIH-funded India six-week extended-dose nevirapine (SWEN) study, a randomized clinical trial of SWEN versus single-dose nevirapine (SD) for prevention of breast-milk HIV-1 transmission, we examined the relative impact of SWEN among 737 mother-infant pairs stratified by infant birth weight. Birth weight groups were defined as very LBW (VLBW) ≤ 2000 g, moderate LBW (MLBW) >2000 g and ≤ 2500 g, and normal birth weight (NBW) > 2500 g. Outcomes were HIV-1 infection, HIV-1 infection or death by 12 months, and severe adverse events (SAEs). The Kaplan-Meier method was used to estimate probability of efficacy outcomes in birth weight groups, and differential effects of SWEN by birth weight group were examined using Cox proportional hazards models adjusting for independent risk factors for HIV maternal-to-child transmission and significant covariates. Among 50 VLBW, 249 MLBW, and 433 NBW infants, 50% were randomized to SWEN; median gestational age was 36, 38 and 38 weeks, respectively; and there was no difference in breastfeeding duration (p = 0.99). Compared to SD: SWEN-treated VLBW had lower estimates of HIV-1 infection (13% vs. 38%, p = 0.004) and HIV-1 infection or death (13% vs. 41%, p = 0.002); SWEN-treated MLBW had lower estimated HIV-1 infection (13% vs. 17%, p = 0.042); and efficacy endpoints were similar by treatment arm in NBW. In multivariate analysis, SWEN was associated with reduced risk of HIV-1 infection or death by 83% (p = 0.03) in VLBW versus 45% (p = 0.05) in MLBW. SAE frequency was similar by treatment arm in VLBW (68% vs. 76%, p = 0.53) and MLBW (37% vs. 36%, p = 0.93). SWEN may safely increase HIV-free survival among HIV-exposed LBW infants with greatest protective advantage among infants ≤ 2000 g.
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- 2016
- Full Text
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8. High risk for latent tuberculosis infection among medical residents and nursing students in India
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Robert C. Bollinger, Jonathan E. Golub, Nilima Lokhande, Samir Joshi, Sunita Girish, Andrea DeLuca, Gauri Dhumal, Sangeeta Shelke, Dileep Kadam, Ajay Chandanwale, Anita Basavaraj, Geeta Pardeshi, Aarti Kinikar, Nikhil Gupte, Vidya Mave, and Amita Gupta
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Male ,Bacterial Diseases ,Epidemiology ,Physiology ,Health Care Providers ,Antitubercular Agents ,Cohort Studies ,Geographical Locations ,0302 clinical medicine ,Interquartile range ,Risk Factors ,Prevalence ,Medicine and Health Sciences ,Medicine ,030212 general & internal medicine ,Longitudinal Studies ,Prospective Studies ,Prospective cohort study ,Allied Health Care Professionals ,0303 health sciences ,Multidisciplinary ,Latent tuberculosis ,Incidence (epidemiology) ,Incidence ,3. Good health ,Body Fluids ,Occupational Diseases ,Professions ,Infectious Diseases ,Educational Status ,Tuberculosis Diagnosis and Management ,Female ,Anatomy ,Cohort study ,Research Article ,Adult ,Tuberculosis ,Asia ,Science ,Tuberculin ,India ,03 medical and health sciences ,Young Adult ,Nursing Science ,Nursing ,Latent Tuberculosis ,Diagnostic Medicine ,Occupational Exposure ,Isoniazid ,Humans ,030306 microbiology ,business.industry ,Tuberculin Test ,Sputum ,Internship and Residency ,Biology and Life Sciences ,medicine.disease ,Tropical Diseases ,bacterial infections and mycoses ,Trainees ,Health Care ,Mucus ,Relative risk ,Medical Risk Factors ,People and Places ,Students, Nursing ,Population Groupings ,business ,Interferon-gamma Release Tests - Abstract
Defining occupational latent tuberculosis infection (LTBI) risk among healthcare workers is needed to support implementation of prevention guidelines. Prospective cohort study of 200 medical residents and nursing students in India was conducted May 2016-December 2017. Tuberculin skin test (TST) and QuantiFERON TB Gold Test-in-tube (QFT-GIT) were performed at study entry and 12 months. Primary outcome was incident LTBI (≥10mm TST induration and/or ≥0.35IU/mL QFT-GIT) at 12 months; secondary outcomes included baseline LTBI prevalence and risk factors for incident and prevalent LTBI using Poisson regression. Among 200, [90 nursing students and 110 medical residents], LTBI prevalence was 30% (95% CI, 24-37); LTBI incidence was 26.8 (95% CI, 18.6-37.2) cases per 100 person-years and differed by testing method (28.7 [95% CI, 20.6-38.9] vs 17.4 [95% CI, 11.5-25.4] cases per 100 person-years using TST and QFT-GIT, respectively). Medical residents had two-fold greater risk of incident LTBI than nursing students (Relative Risk, 2.16; 95% CI, 1.05-4.42). During study period 6 (3%) HCWs were diagnosed with active TB disease. Overall, median number of self-reported TB exposures was 5 (Interquartile Range, 1-15). Of 60 participants with prevalent and incident LTBI who were offered free isoniazid preventive therapy (IPT), only 2 participants initiated and completed IPT. High risk for LTBI was noted among medical residents compared to nursing students. Self-reported TB exposure is underreported, and uptake of LTBI prevention therapy remains low. New approaches are needed to identify HCWs at highest risk for LTBI.
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- 2019
9. Isoniazid concentrations in hair and plasma area-under-the-curve exposure among children with tuberculosis
- Author
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Nikhil Gupte, Roy Gerona, Peter Bacchetti, Anita Wen, Vidya Mave, Sultanat Khwaja, Aarti Kinikar, Hari Koli, Geetha Ramachandran, Smita Nimkar, Amita Gupta, Renu Bharadwaj, Anju Kagal, Monica Gandhi, Kelly E. Dooley, Hemanth Kumar, and Wilkinson, Katalin Andrea
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0301 basic medicine ,Bacterial Diseases ,RNA viruses ,Physiology ,Antitubercular Agents ,lcsh:Medicine ,Pathology and Laboratory Medicine ,0302 clinical medicine ,Immunodeficiency Viruses ,Blood plasma ,Medicine and Health Sciences ,Medicine ,030212 general & internal medicine ,Prospective Studies ,Child ,lcsh:Science ,Multidisciplinary ,biology ,Pharmaceutics ,Isoniazid ,Area under the curve ,Drugs ,3. Good health ,Body Fluids ,Actinobacteria ,Infectious Diseases ,Blood ,Medical Microbiology ,6.1 Pharmaceuticals ,Viral Pathogens ,Area Under Curve ,Child, Preschool ,Viruses ,Patient Safety ,Anatomy ,Integumentary System ,Pathogens ,medicine.drug ,Research Article ,Tuberculosis ,Drug Administration ,General Science & Technology ,030106 microbiology ,Context (language use) ,Microbiology ,Blood Plasma ,Mycobacterium tuberculosis ,03 medical and health sciences ,Pharmacotherapy ,Rare Diseases ,Pharmacokinetics ,Drug Therapy ,Retroviruses ,Humans ,Preschool ,Microbial Pathogens ,Pharmacology ,Bacteria ,business.industry ,lcsh:R ,Lentivirus ,Organisms ,Evaluation of treatments and therapeutic interventions ,Biology and Life Sciences ,HIV ,biology.organism_classification ,medicine.disease ,Tropical Diseases ,Orphan Drug ,Good Health and Well Being ,lcsh:Q ,business ,Mycobacterium Tuberculosis ,Hair - Abstract
We measured hair and plasma concentrations of isoniazid among sixteen children with tuberculosis who underwent personal or video-assisted directly observed therapy and thus had 100% adherence. This study therefore defined typical isoniazid exposure parameters after two months of treatment among fully-adherent patients in both hair and plasma (plasma area under the concentration-time curve, AUC, estimated using pharmacokinetic data collected 0, 2, 4, and 6 hours after drug administration). We found that INH levels in hair among highly-adherent individuals did not correlate well with plasma AUC or trough concentrations, suggesting that each measure may provide incremental and complementary information regarding drug exposure in the context of TB treatment.
- Published
- 2017
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