273 results on '"Luetkemeyer, Anne F."'
Search Results
52. Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomised, double-blind, double placebo-controlled trial
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Wolfe, Cameron R, primary, Tomashek, Kay M, additional, Patterson, Thomas F, additional, Gomez, Carlos A, additional, Marconi, Vincent C, additional, Jain, Mamta K, additional, Yang, Otto O, additional, Paules, Catharine I, additional, Palacios, Guillermo M Ruiz, additional, Grossberg, Robert, additional, Harkins, Michelle S, additional, Mularski, Richard A, additional, Erdmann, Nathaniel, additional, Sandkovsky, Uriel, additional, Almasri, Eyad, additional, Pineda, Justino Regalado, additional, Dretler, Alexandra W, additional, de Castilla, Diego Lopez, additional, Branche, Angela R, additional, Park, Pauline K, additional, Mehta, Aneesh K, additional, Short, William R, additional, McLellan, Susan L F, additional, Kline, Susan, additional, Iovine, Nicole M, additional, El Sahly, Hana M, additional, Doernberg, Sarah B, additional, Oh, Myoung-don, additional, Huprikar, Nikhil, additional, Hohmann, Elizabeth, additional, Kelley, Colleen F, additional, Holodniy, Mark, additional, Kim, Eu Suk, additional, Sweeney, Daniel A, additional, Finberg, Robert W, additional, Grimes, Kevin A, additional, Maves, Ryan C, additional, Ko, Emily R, additional, Engemann, John J, additional, Taylor, Barbara S, additional, Ponce, Philip O, additional, Larson, LuAnn, additional, Melendez, Dante Paolo, additional, Seibert, Allan M, additional, Rouphael, Nadine G, additional, Strebe, Joslyn, additional, Clark, Jesse L, additional, Julian, Kathleen G, additional, de Leon, Alfredo Ponce, additional, Cardoso, Anabela, additional, de Bono, Stephanie, additional, Atmar, Robert L, additional, Ganesan, Anuradha, additional, Ferreira, Jennifer L, additional, Green, Michelle, additional, Makowski, Mat, additional, Bonnett, Tyler, additional, Beresnev, Tatiana, additional, Ghazaryan, Varduhi, additional, Dempsey, Walla, additional, Nayak, Seema U, additional, Dodd, Lori E, additional, Beigel, John H, additional, Kalil, Andre C, additional, Wahid, Lana, additional, Walter, Emmanuel B., additional, Belur, Akhila G., additional, Dreyer, Grace, additional, Patterson, Jan E., additional, Bowling, Jason E., additional, Dixon, Danielle O., additional, Hewlett, Angela, additional, Odrobina, Robert, additional, Pupaibool, Jakrapun, additional, Mocherla, Satish, additional, Lazarte, Suzana, additional, Cayabyab, Meilani, additional, Hussein, Rezhan H., additional, Golamari, Reshma R., additional, Krill, Kaleigh L., additional, Rajme, Sandra, additional, Riska, Paul F., additional, Zingman, Barry S., additional, Mertz, Gregory, additional, Sosa, Nestor, additional, Goepfert, Paul A., additional, Berhe, Mezgebe, additional, Dishner, Emma, additional, Fayed, Mohamed, additional, Hubel, Kinsley, additional, Martinez-Orozco, José Arturo, additional, Bautista Felix, Nora, additional, Elmor, Sammy T., additional, Bechnak, Amer Ryan, additional, Saklawi, Youssef, additional, Van Winkle, Jason W., additional, Zea, Diego F., additional, Laguio-Vila, Maryrose, additional, Walsh, Edward E., additional, Falsey, Ann R., additional, Carvajal, Karen, additional, Hyzy, Robert C., additional, Hanna, Sinan, additional, Olbrich, Norman, additional, Traenkner, Jessica J., additional, Kraft, Colleen S., additional, Tebas, Pablo, additional, Baron, Jillian T, additional, Levine, Corri, additional, Nock, Joy, additional, Billings, Joanne, additional, Kim, Hyun, additional, Elie-Turenne, Marie-Carmelle, additional, Whitaker, Jennifer A., additional, Luetkemeyer, Anne F., additional, Dwyer, Jay, additional, Bainbridge, Emma, additional, Gyun Choe, Pyoeng, additional, Kyung Kang, Chang, additional, Jilg, Nikolaus, additional, Cantos, Valeria D, additional, Bhamidipati, Divya R., additional, Nithin Gopalsamy, Srinivasa, additional, Chary, Aarthi, additional, Jung, Jongtak, additional, Song, Kyoung-Ho, additional, Kim, Hong Bin, additional, Benson, Constance A., additional, McConnell, Kimberly, additional, Wang, Jennifer P., additional, Wessolossky, Mireya, additional, Perez, Katherine, additional, Eubank, Taryn A, additional, Berjohn, Catherine, additional, Utz, Gregory C., additional, Jackson, Patrick E.H., additional, Bell, Taison D., additional, Haughey, Heather M., additional, Moanna, Abeer, additional, Cribbs, Sushma, additional, Harrison, Telisha, additional, Colombo, Christopher J., additional, Schofield, Christina, additional, Colombo, Rhonda E., additional, Tapson, Victor F., additional, Grein, Jonathan, additional, Sutterwala, Fayyaz, additional, Ince, Dilek, additional, Winokur, Patricia L., additional, Fung, Monica, additional, Jang, Hannah, additional, Wyles, David, additional, Frank, Maria G., additional, Sarcone, Ellen, additional, Neumann, Henry, additional, Viswanathan, Anand, additional, Hochman, Sarah, additional, Mulligan, Mark, additional, Eckhardt, Benjamin, additional, Carmody, Ellie, additional, Ahuja, Neera, additional, Nadeau, Kari, additional, Svec, David, additional, Macaraeg, Jeffrey C., additional, Morrow, Lee, additional, Quimby, Dave, additional, Bessesen, Mary, additional, Nicholson, Lindsay, additional, Adams, Jill, additional, Kumar, Princy, additional, Lambert, Allison A., additional, Arguinchona, Henry, additional, Alicic, Radica Z., additional, Saito, Sho, additional, Ohmagari, Norio, additional, Mikami, Ayako, additional, Chien Lye, David, additional, Hong Lee, Tau, additional, Ying Chia, Po, additional, Hsieh, Lanny, additional, Amin, Alpesh N., additional, Watanabe, Miki, additional, Candiotti, Keith A., additional, Castro, Jose G., additional, Antor, Maria A., additional, Lee, Tida, additional, Lalani, Tahaniyat, additional, Novak, Richard M., additional, Wendrow, Andrea, additional, Borgetti, Scott A., additional, George, Sarah L., additional, Hoft, Daniel F., additional, Brien, James D., additional, Cohen, Stuart H., additional, Thompson, George R., additional, Chakrabarty, Melony, additional, Guirgis, Faheem, additional, Davey, Richard T., additional, Voell, Jocelyn, additional, Strich, Jeffrey R., additional, Lindholm, David A., additional, Mende, Katrin, additional, Wellington, Trevor R., additional, Rapaka, Rekha R., additional, Husson, Jennifer S., additional, Levine, Andrea R., additional, Yen Tan, Seow, additional, Shafi, Humaira, additional, Chien, Jaime M F, additional, Hostler, David C., additional, Hostler, Jordanna M., additional, Shahan, Brian T., additional, Adams, David H., additional, Osinusi, Anu, additional, Cao, Huyen, additional, Burgess, Timothy H., additional, Rozman, Julia, additional, Chung, Kevin K., additional, Nieuwoudt, Christina, additional, El-Khorazaty, Jill A., additional, Hill, Heather, additional, Pettibone, Stephanie, additional, Gettinger, Nikki, additional, Engel, Theresa, additional, Lewis, Teri, additional, Wang, Jing, additional, Deye, Gregory A., additional, Nomicos, Effie, additional, Pikaart-Tautges, Rhonda, additional, Elsafy, Mohamed, additional, Jurao, Robert, additional, Koo, Hyung, additional, Proschan, Michael, additional, Yokum, Tammy, additional, Arega, Janice, additional, and Florese, Ruth, additional
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- 2022
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53. Health-related quality of life in people receiving opioid agonist treatment and treatment for hepatitis C virus infection
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Dalgard, Olav, primary, Litwin, Alain H., additional, Shibolet, Oren, additional, Grebely, Jason, additional, Nahass, Ronald, additional, Altice, Frederick L., additional, Conway, Brian, additional, Gane, Edward J., additional, Luetkemeyer, Anne F., additional, Peng, Cheng-Yuan, additional, Iser, David, additional, Gendrano, Isaias Noel, additional, Kelly, Michelle M., additional, Haber, Barbara A., additional, Platt, Heather, additional, and Puenpatom, Amy, additional
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- 2022
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54. Safety and Efficacy of Ombitasvir, Paritaprevir With Ritonavir ± Dasabuvir With or Without Ribavirin in Patients With Human Immunodeficiency Virus-1 and Hepatitis C Virus Genotype 1 or Genotype 4 Coinfection: TURQUOISE-I Part 2
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Rockstroh, Jürgen K, Orkin, Chloe, Viani, Rolando M, Wyles, David, Luetkemeyer, Anne F, Lazzarin, Adriano, Soto-Malave, Ruth, Nelson, Mark R, Bhagani, Sanjay R, Klinker, Hartwig H F, Rizzardini, Giuliano, Girard, Pierre-Marie, Tural, Cristina, Shulman, Nancy S, Mobashery, Niloufar, Hu, Yiran B, Fredrick, Linda M, Pilot-Matias, Tami, Trinh, Roger, and Gane, Edward
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- 2017
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55. Relationship Between Weight, Efavirenz Exposure, and Virologic Suppression in HIV-Infected Patients on Rifampin-Based Tuberculosis Treatment in the AIDS Clinical Trials Group A5221 STRIDE Study
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Adult AIDS Clinical Trials Group A5221 Study Team, Luetkemeyer, Anne F., Rosenkranz, Susan L., Lu, Darlene, Marzan, Florence, Ive, Prudence, Hogg, Evelyn, Swindells, Susan, Benson, Constance A., Grinsztejn, Beatriz, Sanne, Ian M., Havlir, Diane V., and Aweeka, Francesca
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- 2013
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56. Development and Validation of a Treatment Benefit Index to Identify Hospitalized Patients With COVID-19 Who May Benefit From Convalescent Plasma
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Park, Hyung, primary, Tarpey, Thaddeus, additional, Liu, Mengling, additional, Goldfeld, Keith, additional, Wu, Yinxiang, additional, Wu, Danni, additional, Li, Yi, additional, Zhang, Jinchun, additional, Ganguly, Dipyaman, additional, Ray, Yogiraj, additional, Paul, Shekhar Ranjan, additional, Bhattacharya, Prasun, additional, Belov, Artur, additional, Huang, Yin, additional, Villa, Carlos, additional, Forshee, Richard, additional, Verdun, Nicole C., additional, Yoon, Hyun ah, additional, Agarwal, Anup, additional, Simonovich, Ventura Alejandro, additional, Scibona, Paula, additional, Burgos Pratx, Leandro, additional, Belloso, Waldo, additional, Avendaño-Solá, Cristina, additional, Bar, Katharine J, additional, Duarte, Rafael F., additional, Hsue, Priscilla Y., additional, Luetkemeyer, Anne F., additional, Meyfroidt, Geert, additional, Nicola, André M., additional, Mukherjee, Aparna, additional, Ortigoza, Mila B., additional, Pirofski, Liise-anne, additional, Rijnders, Bart J. A., additional, Troxel, Andrea, additional, Antman, Elliott M., additional, and Petkova, Eva, additional
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- 2022
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57. CROI 2021: Viral Hepatitis and Other Forms of Liver Injury Impacting People with HIV
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Luetkemeyer, Anne F. and Wyles, David L.
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Male ,Selected Highlights of the 2021 virtual Conference on Retroviruses and Opportunistic Infections (Part 2) ,Biomedical Research ,Hepatitis, Viral, Human ,virus diseases ,HIV Infections ,Congresses as Topic ,Hepatitis A ,Hepatitis B ,Hepatitis C ,digestive system diseases ,Liver ,Humans ,Homosexuality, Male - Abstract
At the 2021 Conference on Retroviruses and Opportunistic Infections, there was a focus on progress toward hepatitis C virus (HCV) microelimination in geographic regions and targeted populations. HCV elimination is facilitated by well-tolerated, highly effective HCV treatment that requires essentially no on-treatment monitoring in most patients, as highlighted by the MINMON (Minimal Monitoring Study or A5360) study, and that should be increasingly available to children with new data supporting feasible treatment in younger patients. Challenges to HCV elimination include HCV reinfection via sexual exposure in men who have sex with men (MSM) and continued barriers to diagnosis and access to HCV treatment. Hepatitis B virus (HBV) suppression may take years in HIV/HBV-coinfected patients. This may have important consequences as the risk for hepatocellular carcinoma was associated in a dose-dependent manner with HBV viral load and was lowest in those with sustained undetectable HBV, highlighting the need for HBV DNA monitoring during therapy. Public health programs should prioritize improving hepatitis A and hepatitis B vaccination in at-risk populations, including people with HIV, as vaccinations rates for these preventable diseases continue to be suboptimal in many settings. Fatty liver disease, heavy alcohol use, antiretroviral therapy, and COVID-19 infection were also examined as drivers of hepatic disease in HIV infection.
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- 2021
58. IL-6 Receptor Antagonist Therapy for Patients Hospitalized for COVID-19
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Matthay, Michael A., primary and Luetkemeyer, Anne F., additional
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- 2021
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59. High Sustained Virologic Response Rates of Glecaprevir/Pibrentasvir in Patients With Dosing Interruption or Suboptimal Adherence
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Zamor, Philippe J. Brown, Ashley Dylla, Douglas E. Dillon, John F. Luetkemeyer, Anne F. Feld, Jordan J. Mutimer, David and Ghalib, Reem Crown, Eric Lovell, Sandra S. Hu, Yiran and Moreno, Christophe Nelson, David R. Colombo, Massimo and Papatheodoridis, Georgios Rockstroh, Juergen K. Skoien, Richard and Lawitz, Eric Jacobson, Ira M.
- Abstract
INTRODUCTION: Pangenotypic, all-oral direct-acting antivirals, such as glecaprevir/pibrentasvir (G/P), are recommended for treatment of hepatitis C virus (HCV) infection. Concerns exist about the impact on efficacy in patients with suboptimal adherence, particularly with shorter treatment durations. These post hoc analyses evaluated adherence (based on pill count) in patients prescribed 8- or 12-week G/P, the impact of nonadherence on sustained virologic response at post-treatment week 12 (SVR12), factors associated with nonadherence, and efficacy in patients interrupting G/P treatment. METHODS: Data were pooled from 10 phase 3 clinical trials of treatment-naive patients with HCV genotype 1-6 without cirrhosis/with compensated cirrhosis (treatment adherence analysis) and 13 phase 3 clinical trials of all patients with HCV (interruption analysis). RESULTS: Among 2,149 patients included, overall mean adherence was 99.4%. Over the treatment duration, adherence decreased (weeks 0-4: 100%; weeks 5-8: 98.3%; and weeks 9-12: 97.1%) and the percentage of patients with >= 80% or >= 90% adherence declined. SVR12 rate in the intention-to-treat (ITT) population was 97.7% (modified ITT SVR12 99.3%) and remained high in nonadherent patients in the modified ITT population (= 80% adherence. Among 2,902 patients in the interruption analysis, 33 (1.1%) had a G/P treatment interruption of >= 1 day, with an SVR12 rate of 93.9% (31/33). No virologic failures occurred. DISCUSSION: These findings support the impact of treatment duration on adherence rates and further reinforce the concept of “treatment forgiveness” with direct-acting antivirals.
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- 2021
60. High Sustained Virologic Response Rates of Glecaprevir/Pibrentasvir in Patients With Dosing Interruption or Suboptimal Adherence
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Zamor, Philippe J., primary, Brown, Ashley, additional, Dylla, Douglas E., additional, Dillon, John F., additional, Luetkemeyer, Anne F., additional, Feld, Jordan J., additional, Mutimer, David, additional, Ghalib, Reem, additional, Crown, Eric, additional, Lovell, Sandra S., additional, Hu, Yiran, additional, Moreno, Christophe, additional, Nelson, David R., additional, Colombo, Massimo, additional, Papatheodoridis, Georgios, additional, Rockstroh, Juergen K., additional, Skoien, Richard, additional, Lawitz, Eric, additional, and Jacobson, Ira M., additional
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- 2021
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61. Tuberculosis Drug Development: Ensuring People Living with HIV Are Not Left Behind
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Luetkemeyer, Anne F., Getahun, Haileyesus, Chamie, Gabriel, Lienhardt, Christian, and Havlir, Diane V.
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- 2011
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62. Timing of Antiretroviral Therapy for HIV-1 Infection and Tuberculosis
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Havlir, Diane V., Kendall, Michelle A., Ive, Prudence, Kumwenda, Johnstone, Swindells, Susan, Qasba, Sarojini S., Luetkemeyer, Anne F., Hogg, Evelyn, Rooney, James F., Wu, Xingye, Hosseinipour, Mina C., Lalloo, Umesh, Veloso, Valdilea G., Some, Fatuma F., Kumarasamy, N., Padayatchi, Nesri, Santos, Breno R., Reid, Stewart, Hakim, James, Mohapi, Lerato, Mugyenyi, Peter, Sanchez, Jorge, Lama, Javier R., Pape, Jean W., Sanchez, Alejandro, Asmelash, Aida, Moko, Evans, Sawe, Fred, Andersen, Janet, and Sanne, Ian
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- 2011
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63. CROI 2019: Highlights of Viral Hepatitis
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Luetkemeyer, Anne F. and Wyles, David L.
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Hepatitis B, Chronic ,virus diseases ,Humans ,Highlights of the 2018 Conference on Retroviruses and Opportunistic Infections ,HIV Infections ,Antiviral Agents ,digestive system diseases - Abstract
At the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), there was a major focus on hepatitis C virus (HCV) elimination and improving each component of the hepatitis C care cascade. Many interventions showed promising improvements in diagnosis and linkage to care. Settings with robust access to direct-acting antivirals (DAAs) continue to demonstrate the role of HCV treatment as prevention. However, substantial barriers to accessing curative therapy remain. Reinfection after treatment presents an important barrier to elimination, particularly in some populations of men who have sex with men (MSM). MSM without HIV infection are at an elevated risk for sexual acquisition of HCV, and several studies reported HCV rates that were as high as those seen in MSM living with HIV. There was also a focus on HCV and HBV in pregnant women. Rates of HCV infection in women of child-bearing potential have increased, making prenatal diagnosis a priority. In the first study of HCV treatment during pregnancy, sofosbuvir/ledipasvir started at 28 weeks of gestation led to cure in 8 pregnant women. Hepatitis B virus (HBV)-active antiretrovirals are generally effective in suppressing HBV but have low rates of surface antigen loss despite long term treatment. Initial results from novel laboratory assessments of intrahepatic HBV viral infection events were presented, hopefully paving the way for more effective HBV treatment strategies to control and potentially cure HBV.
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- 2019
64. Switching to Bictegravir, Emtricitabine, and Tenofovir Alafenamide in Virologically Suppressed Adults With Human Immunodeficiency Virus.
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Sax, Paul E, Rockstroh, Jürgen K, Luetkemeyer, Anne F, Yazdanpanah, Yazdan, Ward, Douglas, Trottier, Benoit, Rieger, Armin, Liu, Hui, Acosta, Rima, Collins, Sean E, Brainard, Diana M, Martin, Hal, and Investigators, GS-US-380–4030
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HIV infections ,DRUG efficacy ,RESEARCH ,ANTI-HIV agents ,COMBINATION drug therapy ,CONFIDENCE intervals ,VIRAL load ,DRUG resistance ,MEDICAL cooperation ,RNA ,TREATMENT effectiveness ,EMTRICITABINE-tenofovir ,DESCRIPTIVE statistics ,HIV ,NUCLEOSIDE reverse transcriptase inhibitors ,THERAPEUTICS - Abstract
Background Bictegravir (B)/emtricitabine (F)/tenofovir alafenamide (TAF) is guideline-recommended treatment for human immunodeficiency virus type 1 (HIV-1). We evaluated whether people receiving dolutegravir (DTG) plus F/TAF or F/TDF (tenofovir disoproxil fumarate) with viral suppression can switch to B/F/TAF without compromising safety or efficacy, regardless of preexisting nucleoside reverse transcriptase inhibitor (NRTI) resistance. Methods In this multicenter, randomized, double-blinded, active-controlled, noninferiority trial, we enrolled adults who were virologically suppressed for ≥6 months before screening (with documented/suspected NRTI resistance) or ≥3 months before screening (with no documented/suspected NRTI resistance) on DTG plus either F/TDF or F/TAF. We randomly assigned (1:1) participants to switch to B/F/TAF or DTG + F/TAF once daily for 48 weeks, each with matching placebo. The primary endpoint was proportion of participants with plasma HIV-1 RNA ≥50 copies/mL at week 48 (snapshot algorithm); the prespecified noninferiority margin was 4%. Results Five hundred sixty-seven adults were randomized; 565 were treated (284 B/F/TAF, 281 DTG + F/TAF). At week 48, B/F/TAF was noninferior to DTG + F/TAF, as 0.4% (1/284) vs 1.1% (3/281) had HIV-1 RNA ≥50 copies/mL (difference, −0.7% [95.001% confidence interval {CI}, −2.8% to 1.0%]). There were no significant differences in efficacy among participants with suspected or confirmed prior NRTI resistance (n = 138). No participant had treatment-emergent drug resistance. Median weight change from baseline at week 48 was +1.3 kg (B/F/TAF) vs +1.1 kg (DTG + F/TAF) (P =.46). Weight change differed by baseline NRTIs (+2.2 kg [F/TDF] and +0.6 kg [F/TAF], P <.001), with no differences between B/F/TAF and DTG + F/TAF. Conclusions The single-tablet regimen B/F/TAF is a safe, effective option for people virologically suppressed on DTG plus either F/TDF or F/TAF, including in individuals with preexisting resistance to NRTIs. Clinical Trials Registration NCT03110380. [ABSTRACT FROM AUTHOR]
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- 2021
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65. Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections
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Grant, Juliana S, primary, Stafylis, Chrysovalantis, primary, Celum, Connie, primary, Grennan, Troy, primary, Haire, Bridget, primary, Kaldor, John, primary, Luetkemeyer, Anne F, primary, Saunders, John M, primary, Molina, Jean-Michel, primary, and Klausner, Jeffrey D, primary
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- 2019
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66. THE AUTHORS AND A STUDY TEAM MEMBER REPLY.
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Luetkemeyer, Anne F., Cannon, Chase, and Celum, Connie
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UNSAFE sex , *HUMAN sexuality , *TEAMS - Abstract
The article addresses concerns about differences in sexual behavior measures between the intervention groups in their study on post exposure doxycycline for preventing sexually transmitted infections (STIs). They acknowledge the importance of follow-up data to better understand the findings and clarify that the baseline sexual behavior did not significantly differ between the doxycycline and standard-care groups.
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- 2023
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67. CROI 2014: Viral Hepatitis and Complications of HIV Disease and Antiretroviral Therapy
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Luetkemeyer, Anne F, Havlir, Diane V, and Currier, Judith S
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Chronic Liver Disease and Cirrhosis ,Antitubercular Agents ,HIV Infections ,Review ,Antiviral Agents ,Hepatitis ,Rare Diseases ,Hepatitis - C ,Clinical Research ,Humans ,Tuberculosis ,Drug Interactions ,Chronic ,Liver Disease ,Evaluation of treatments and therapeutic interventions ,virus diseases ,Hepatitis C, Chronic ,Hepatitis C ,digestive system diseases ,Emerging Infectious Diseases ,Infectious Diseases ,Orphan Drug ,Good Health and Well Being ,Treatment Outcome ,5.1 Pharmaceuticals ,6.1 Pharmaceuticals ,HIV/AIDS ,Development of treatments and therapeutic interventions ,Digestive Diseases ,Infection - Abstract
The remarkable advances in interferon-sparing, all-oral hepatitis C virus (HCV) treatment were a highlight of the 2014 Conference on Retroviruses and Opportunistic Infections (CROI). The backbone of the nucleotide inhibitor sofosbuvir and the nonstructural protein 5A (NS5A) inhibitor ledipasvir with an additional third agent (HCV protease inhibitor or HCV nonnucleoside reverse transcriptase inhibitor) led to a sustained virologic response (SVR) rate 12 weeks after cessation of treatment of 95% to 100% after only 6 weeks of treatment. These results demonstrate the potential of combination directacting antiviral (DAA) therapy for abbreviated, well-tolerated, and highly effective HCV treatment. Two triple-drug regimens that comprised 12 weeks of an NS5A inhibitor, an HCV protease inhibitor, and a nonnucleoside inhibitor also resulted in SVRs of more than 90% in patients with HCV genotype 1. HIV coinfection does not appear to negatively impact response to DAA-based HCV therapy, as evidenced by similar response rates in HIV/HCV-coinfected patients compared with HCV-monoinfected patients receiving interferon-sparing or -containing regimens. There was continued emphasis at CROI 2014 on non-AIDS complications of HIV infection, specifically cardiovascular disease, renal insufficiency, and bone and endocrine disorders that persist among patients with treated HIV disease and contribute to morbidity and mortality. Finally, new data on novel drugs and combinations for treatment of tuberculosis (TB), patient outcomes using new rapid TB diagnostics, and a short-course TB prevention strategy were presented.
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- 2016
68. CROI 2015: Highlights of Viral Hepatitis Therapy
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Luetkemeyer, Anne F. and Wyles, David L.
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virus diseases ,Review ,digestive system diseases - Abstract
High cure rates with all-oral regimens for patients with HIV/hepatitis C virus (HCV) coinfection were a highlight of the 2015 Conference on Retroviruses and Opportunistic Infections. Twelve weeks of sofosbuvir and daclatasvir led to sustained virologic response (SVR) rates of 96% in treatment-nave and 98% in treatment-experienced HCV genotype 1–infected patients. Twelve weeks of sofosbuvir plus ledipasvir had similar results, with SVR rates of 95% in treatment-naive and 96% in treatment-experienced patients. Patients with cirrhosis were included in both trials and attained SVR rates of 92% to 94%. Real-world performance of sofosbuvir and simeprevir resulted in SVR rates similar to those attained in clinical trials. Identifying HCV infection, linking patients to care, reducing barriers to drug access, and ensuring adherence will be key to realizing the enormous potential of high cure rates with interferon alfa–free therapies. Preventing reinfection after cure will be of particular importance in the HIV-infected population, which was highly impacted by reinfection rates of more than 20% during 5 years of follow-up in a meta-analysis.
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- 2016
69. CROI 2016: Viral Hepatitis and Liver Fibrosis
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Luetkemeyer, Anne F. and Wyles, David L.
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Liver Cirrhosis ,Invited Review ,virus diseases ,Humans ,HIV Infections ,Hepatitis C, Chronic ,Antiviral Agents - Abstract
At the 2016 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, Massachusetts, hepatitis C virus (HCV) infection remained a major theme in the context of HIV-associated liver disease, although other causes of liver disease garnered increased attention, including fatty liver disease, hepatitis B, and the impact of HIV disease itself on the liver. Although no data from phase III studies of HCV direct-acting antiviral (DAA) drugs for the treatment of HIV/HCV coinfection were presented at CROI 2016, a broad range of HCV DAA-related topics were presented, including accumulating experience with real-world performance of DAA-based regimens outside of clinical trials, drug interactions between DAA and antiretroviral drugs, treatment of acute HCV infection, and retreatment of individuals whose DAA-based regimens failed and those in whom resistance to DAA drugs emerged. A summary of select abstracts from CROI 2016 is presented, including discussion of clinical relevance where appropriate and areas for future research.
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- 2016
70. Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections.
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Grant, Juliana S, Stafylis, Chrysovalantis, Celum, Connie, Grennan, Troy, Haire, Bridget, Kaldor, John, Luetkemeyer, Anne F, Saunders, John M, Molina, Jean-Michel, and Klausner, Jeffrey D
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BACTERIAL disease prevention ,PREVENTION of sexually transmitted diseases ,SYPHILIS prevention ,COST effectiveness ,DRUG resistance in microorganisms ,PATIENT safety ,DOXYCYCLINE ,ANTIBIOTIC prophylaxis - Abstract
Bacterial sexually transmitted infections (STIs) have been increasing over the past 2 decades in gay, bisexual, and other men who have sex with men. With the widespread use of early human immunodeficiency virus (HIV) treatment, which virtually eliminates transmission risk, and the availability of HIV pre-exposure prophylaxis, there have been attitudinal changes regarding HIV infection with resultant increases in sexual contact and declines in condom use. Doxycycline is used for primary prophylaxis in a number of infectious diseases. We conducted a state-of-the-art review to examine the current state of research, knowledge gaps, and challenges around the use of doxycycline prophylaxis to prevent syphilis and other STIs. International academic and government experts met in March 2019 to frame the initial inquiry, which was supplemented by focused literature searches. Two small short-term randomized controlled trials examining doxycycline prophylaxis found high efficacy. Five additional clinical studies are underway or in development. Studies differed in design, population, outcomes, and safety measures. Doxycycline prophylaxis for bacterial STIs shows promise. Better and more robust data are needed on efficacy; target population; community acceptability; behavioral risk compensation; doxycycline dose, regimen, and formulation; long-term safety; antimicrobial resistance; cost-effectiveness; and risk–benefit. [ABSTRACT FROM AUTHOR]
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- 2020
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71. Tuberculosis immune reconstitution inflammatory syndrome in A5221 STRIDE: timing, severity, and implications for HIV-TB programs
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Luetkemeyer, Anne F, Kendall, Michelle A, Nyirenda, Mulinda, Wu, Xingye, Ive, Prudence, Benson, Constance A, Andersen, Janet W, Swindells, Susan, Sanne, Ian M, Havlir, Diane V, Kumwenda, Johnstone, and Adult AIDS Clinical Trials Group A5221 Study Team
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Adult ,Male ,Time Factors ,Clinical Sciences ,HIV Infections ,Severity of Illness Index ,Rare Diseases ,Immune Reconstitution Inflammatory Syndrome ,Clinical Research ,Virology ,Adult AIDS Clinical Trials Group A5221 Study Team ,Humans ,Tuberculosis ,Evaluation of treatments and therapeutic interventions ,HIV ,paradoxical reaction ,CD4 Lymphocyte Count ,AIDS ,Infectious Diseases ,Good Health and Well Being ,Anti-Retroviral Agents ,6.1 Pharmaceuticals ,Public Health and Health Services ,HIV/AIDS ,Female ,Infection - Abstract
Rationale and objectivesEarlier initiation of antiretroviral therapy (ART) in HIV-tuberculosis (TB) is associated with increased immune reconstitution inflammatory syndrome (IRIS). The severity, frequency, and complications of TB IRIS were evaluated in A5221, a randomized trial of earlier ART (within 2 weeks after TB treatment initiation) vs. later ART (8-12 weeks after TB treatment) in HIV-infected patients starting TB treatment.Methods and measurementsIn 806 participants, TB IRIS was defined using published clinical criteria. Cases were classified as severe (hospitalization/death), moderate (corticosteroid use/invasive procedure), or mild (no hospitalization/procedures/steroids). Fisher exact, Wilcoxon, and log-rank tests were used for comparisons.Main resultsTB IRIS occurred in 61 (7.6%) patients: 10.4% in earlier vs. 4.7% in later ART, 11.5% with CD4
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- 2014
72. The Safety and Immunogenicity of an Interleukin-12–Enhanced Multiantigen DNA Vaccine Delivered by Electroporation for the Treatment of HIV-1 Infection
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Jacobson, Jeffrey M., primary, Zheng, Lu, additional, Wilson, Cara C., additional, Tebas, Pablo, additional, Matining, Roy M., additional, Egan, Michael A., additional, Eldridge, John, additional, Landay, Alan L., additional, Clifford, David B., additional, Luetkemeyer, Anne F., additional, Tiu, Jennifer, additional, Martinez, Ana L., additional, Janik, Jennifer, additional, Spitz, Teresa A., additional, Hural, John, additional, McElrath, Juliana, additional, and Frahm, Nicole, additional
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- 2016
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73. Role of a clinical pharmacist as part of a multidisciplinary care team in the treatment of HCV in patients living with HIV/HCV coinfection.
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Jr, Antonio Olea, Grochowski, Janet, Luetkemeyer, Anne F, Robb, Valerie, and Saberi, Parya
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HEPATITIS C treatment ,HIV infections ,MIXED infections - Abstract
Background: The objective of the study was to evaluate the role of a clinical pharmacist in hepatitis C virus (HCV) treatment of patients living with HIV/HCV coinfection. Methods: We conducted a descriptive study to quantify the functions of a clinical pharmacist in HCV treatment of patients living with HIV/HCV coinfection who were initiating HCV treatment at a publicly funded clinic between March 18, 2015 and September 15, 2016. The clinical pharmacist's role was categorized into eight categories: 1) HCV prior authorization (PA) completion; 2) HCV medication adherence counseling; 3) HCV drug-drug interaction (DDI) counseling and screening; 4) HCV medication counseling regarding common adverse events (AEs); 5) HCV counseling regarding HCV treatment outcomes and risk of reinfection; 6) ordering laboratory tests and interpretation of HCV laboratory values; 7) HIV medication AE assessment; and 8) other (including refilling medications and management of other comorbidities). Results: One hundred and thirty-five patients initiated treatment during this timeframe: 77.0% were males, 56.3% non-cirrhotic, 77.0% HCV treatment-naïve, 45.9% HCV genotype 1a, and 83.0% initiated on ledipasvir/sofosbuvir. The clinical pharmacist completed 150 PAs, counseled on HCV medication adherence in 79.2% of patients, conducted HCV DDI counseling and screening in 54.2%, and monitored HCV medication AEs in 54.2%. The clinical pharmacist counseled patients on HCV treatment outcomes and risk of reinfection in 53.1%, ordered laboratory tests in 44.8%, and reported and interpreted laboratory values in 44.8%. The clinical pharmacist assessed HIV medication AEs in 54.2% of patients and participated in other activities in 42.7%. Conclusion: A clinical pharmacist's expertise as part of a multidisciplinary care team facilitates optimal treatment outcomes and provides critical support in the management of DAA therapy in individuals living with HIV/HCV coinfection. [ABSTRACT FROM AUTHOR]
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- 2018
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74. CROI 2018: Highlights of Viral Hepatitis.
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Luetkemeyer, Anne F. and Wyles, David L.
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- 2018
75. DOXYPEP & ANTIMICROBIAL RESISTANCE IN N. GONORRHOEAE, COMMENSAL NEISSERIA & S. AUREUS.
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Luetkemeyer, Anne F., Donnell, Deborah, Dombrowski, Julia C., Cohen, Stephanie, Grabow, Cole, Brown, Clare, Malinksi, Cheryl, Martens, Sharon K., Cohee, Alison, Viar, Veronica, Pham, Phong, Buchbinder, Susan P., Havlir, Diane V., Celum, Connie, and Soge, Olusegun O.
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- 2023
76. 901d Daclatasvir Plus Sofosbuvir for Treatment of HCV Genotypes 1-4 in HIV-HCV Coinfection: The ALLY-2 Study
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Wyles, David, primary, Ruane, Peter J, additional, Sulkowski, Mark, additional, Dieterich, Douglas Thomas, additional, Luetkemeyer, Anne F, additional, Morgan, Timothy R., additional, Sherman, Kenneth E., additional, Liu, Zhaohui, additional, Noviello, Stephanie, additional, and Ackerman, Peter, additional
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- 2015
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77. Complications of HIV Disease and Antiretroviral Therapy
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Luetkemeyer, Anne F., Havlir, Diane V., and Currier, Judith S.
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Anti-HIV Agents ,Chronic Liver Disease and Cirrhosis ,Antiretroviral Therapy ,HIV Infections ,Antiviral Agents ,Article ,Hepatitis ,Hepatitis - C ,Clinical Research ,Ribavirin ,Humans ,Highly Active ,Drug Interactions ,Chronic ,AIDS-Related Opportunistic Infections ,Prevention ,Liver Disease ,Evaluation of treatments and therapeutic interventions ,Highlights of the 18th Conference on Retroviruses and Opportunistic Infections ,Hepatitis C ,Infectious Diseases ,Emerging Infectious Diseases ,Good Health and Well Being ,Anti-Retroviral Agents ,5.1 Pharmaceuticals ,Cardiovascular Diseases ,6.1 Pharmaceuticals ,HIV/AIDS ,Kidney Diseases ,Interferons ,Development of treatments and therapeutic interventions ,Bone Diseases ,Digestive Diseases ,Infection - Abstract
Studies on the efficacy of and drug interactions with the hepatitis C virus (HCV) direct-acting antivirals (DAAs) in HCV/ HIV coinfection were a highlight of the 2012 Conference on Retroviruses and Opportunistic Infections. The addition of an HCV protease inhibitor (PI) to pegylated interferon alfa/ribavirin increased HCV cure rates by 30% to 35% in HCV genotype 1 treatment-naive HIV-coinfected patients, an increase similar to that observed in HIV-uninfected HCV-infected patients. Drug interactions with antiretrovirals can be complex, and DAAs are recommended for use only with antiretroviral drugs for which pharmacokinetic data are available. Further drug interaction and clinical data are needed to ensure the safe coadminstration of DAAs with antiretroviral therapy. The conference placed continued emphasis on pathogenesis, management, and prevention of the long-term complications of HIV disease and its therapies, including cardiovascular disease, lipodystrophy, renal disease, alterations in bone metabolism, and vitamin D deficiency, along with a growing focus on biomarkers to predict development of end-organ disease. HIV has increasingly been recognized as a disease of accelerated aging, manifested by increased progression of vascular disease, cellular markers of aging, and a heightened risk of certain non-AIDS-defining malignancies. This year's conference also highlighted data on diagnosis, prevention, and complications of tuberculosis coinfection as well as the treatment and prevention of coinfections that are common with HIV, including cryptococcal meningitis, influenza, and varicella zoster.
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- 2010
78. Impact of Larger Sputum Volume on Xpert® MTB/RIF Assay Detection of Mycobacterium tuberculosis in Smear-Negative Individuals with Suspected Tuberculosis.
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Badal-Faesen, Sharlaa, Firnhaber, Cynthia, Kendall, Michelle A., Xingye Wu, Grinsztejn, Beatriz, da Silva Escada, Rodrigo Otavio, Fernandez, Michel, Hogg, Evelyn, Sanne, Ian, Johnson, Pamela, Alland, David, Mazurek, Gerald H., Benator, Debra A., and Luetkemeyer, Anne F.
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MYCOBACTERIUM tuberculosis ,NUCLEIC acids ,SPUTUM ,LUNG diseases ,MEDICAL care - Abstract
As a strategy to improve the sensitivity of nucleic acid-based testing in acid-fast bacilli (AFB) negative samples, larger volumes of sputum (5-10 mL) were tested with Xpert® MTB/RIF from 176 individuals with smear-negative sputum undergoing tuberculosis evaluation. Despite larger volumes, this strategy had a suboptimal sensitivity of 50% (4/8). [ABSTRACT FROM AUTHOR]
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- 2017
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79. Understanding Hepatitis C Virus Drug Resistance: Clinical Implications for Current and Future Regimens.
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Wyles, David L. and Luetkemeyer, Anne F.
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- 2017
80. CROI 2017: Highlights of Advances in Viral Hepatitis and Liver Fibrosis.
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Luetkemeyer, Anne F. and Wyles, David L.
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- 2017
81. Combined Effect of CYP2B6 and NAT2 Genotype on Plasma Efavirenz Exposure During Rifampin-based Antituberculosis Therapy in the STRIDE Study.
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Luetkemeyer, Anne F., Rosenkranz, Susan L., Lu, Darlene, Grinsztejn, Beatriz, Sanchez, Jorge, Ssemmanda, Michael, Sanne, Ian, McIlleron, Helen, Havlir, Diane V., and Haas, David W.
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- *
EFAVIRENZ , *ANTI-HIV agents , *REVERSE transcriptase inhibitors , *TUBERCULOSIS treatment , *GENOTYPES - Abstract
In STRIDE, slow metabolizer CYP2B6 and NAT2 genotypes were each associated with increased plasma efavirenz concentrations during antituberculosis therapy. Concentrations were greater on therapy than off therapy in 58% with CYP2B6 and 93% with NAT2 slow metabolizer genotypes. Individuals with slow metabolizer genotypes in both genes had markedly elevated concentrations. [ABSTRACT FROM AUTHOR]
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- 2016
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82. A survey of tuberculosis infection control practices at the NIH/NIAID/DAIDS-supported clinical trial sites in low and middle income countries.
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Godfrey, Catherine, Tauscher, Gail, Hunsberger, Sally, Austin, Melissa, Scott, Lesley, Schouten, Jeffrey T., Luetkemeyer, Anne F., Benson, Constance, Coombs, Robert, Swindells, Susan, and HIV Network Coordinating (HANC) TB Diagnostic Laboratory Working Division of AIDS, National Institute of Allergy and Infectious Diseases
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TUBERCULOSIS diagnosis ,TUBERCULOSIS prevention ,PREVENTION of infectious disease transmission ,CLINICAL trials ,PREVENTION of communicable diseases ,DEVELOPING countries ,HAND washing ,HEALTH facility design & construction ,MEDICAL personnel ,PATIENT-professional relations ,MEDICAL protocols ,MEDICAL screening ,MYCOBACTERIUM tuberculosis ,RESEARCH funding ,VENTILATION - Abstract
Background: Health care associated transmission of Mycobacterium tuberculosis (TB) is well described. A previous survey of infection control (IC) practices at clinical research sites in low and middle income countries (LMIC) funded by the National Institute of Allergy and Infectious Diseases (NIAID) conducting HIV research identified issues with respiratory IC practices. A guideline for TB IC based on international recommendations was developed and promulgated. This paper reports on adherence to the guideline at sites conducting or planning to conduct TB studies with the intention of supporting improvement.Methods: A survey was developed that assessed IC activities in three domains: facility level measures, administrative control measures and environmental measures. An external site monitor visited each site in 2013-2014, to complete the audit. A central review committee evaluated the site-level survey and results were tabulated. Fisher's exact test was performed to determine whether there were significant differences in practices at sites that had IC officers versus sites that did not have IC officers. Significance was assessed at p=.05 RESULTS: Seven of thirty-three sites surveyed (22 %) had all the evaluated tuberculosis IC (TB IC) elements in place. Sixty-one percent of sites had an IC officer tasked with developing and maintaining TB IC standard operating procedures. Twenty-two (71 %) sites promptly identified and segregated individuals with TB symptoms. Thirty (93 %) sites had a separate waiting area for patients, and 26 (81 %) collected sputum within a specific well-ventilated area that was separate from the general waiting area. Sites with an IC officer were more likely to have standard operating procedures covering TB IC practices (p = 0.02) and monitor those policies (p = 0.02) and perform regular surveillance of healthcare workers (p = 0.02). The presence of an IC officer had a positive impact on performance in most of the TB IC domains surveyed including having adequate ventilation (p = 0.02) and a separate area for sputum collection (p = 0.02) CONCLUSIONS: Specific and targeted support of TB IC activities in the clinical research environment is needed and is likely to have a positive and sustained impact on preventing the transmission of TB to both health care workers and vulnerable HIV-infected research participants. [ABSTRACT FROM AUTHOR]- Published
- 2016
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83. Tuberculosis Drug Development
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Luetkemeyer, Anne F., primary, Getahun, Haileyesus, additional, Chamie, Gabriel, additional, Lienhardt, Christian, additional, and Havlir, Diane V., additional
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- 2011
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84. Resistance Patterns and Response to Entecavir Intensification Among HIV-HBV–Coinfected Adults With Persistent HBV Viremia
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Luetkemeyer, Anne F., primary, Charlebois, Edwin D., additional, Hare, C. Bradley, additional, Black, Douglas, additional, Smith, Anna, additional, Havlir, Diane V., additional, and Peters, Marion G., additional
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- 2011
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85. CROI 2015: Highlights of Viral Hepatitis Therapy.
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Luetkemeyer, Anne F. and Wyles, David L.
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- 2015
86. Bartonella quintanaAortitis in a Man with AIDS, Diagnosed by Needle Biopsy and 16S rRNA Gene Amplification
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Lee, Sulggi A., Plett, Sara K., Luetkemeyer, Anne F., Borgo, Gina M., Ohliger, Michael A., Conrad, Miles B., Cookson, Brad T., Sengupta, Dhruba J., and Koehler, Jane E.
- Abstract
ABSTRACTA man with newly diagnosed AIDS presented with months of back pain and fever. Computed tomography (CT) results demonstrated aortitis with periaortic tissue thickening. DNA amplification of biopsy tissue revealed Bartonella quintana, and Bartonellaserologies were subsequently noted to be positive. The patient improved with prolonged doxycycline and rifabutin treatment. This case illustrates how molecular techniques are increasingly important in diagnosing Bartonellainfections.
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- 2015
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87. Hepatitis C Virus Reinfection Among People Who Inject Drugs: Long-Term Follow-Up of the HERO Study.
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Litwin AH, Tsui JI, Heo M, Mehta SH, Taylor LE, Lum PJ, Feinberg J, Kim AY, Norton BL, Pericot-Valverde I, Arnsten J, Meissner P, Karasz A, McKee MD, Ward JW, Johnson N, Agyemang L, Stein ES, Thomas A, Borsuk C, Blalock KL, Wilkinson S, Wagner K, Carty J, Murray-Krezan C, Anderson J, Jacobsohn V, Luetkemeyer AF, Falade-Nwulia O, Groome M, Davies S, Costello K, and Page K
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- Humans, Male, Female, Adult, Middle Aged, Follow-Up Studies, Hepatitis C epidemiology, Hepatitis C drug therapy, Risk Factors, Incidence, Hepacivirus, Sustained Virologic Response, Cohort Studies, United States epidemiology, Antiviral Agents therapeutic use, Reinfection epidemiology, Substance Abuse, Intravenous epidemiology
- Abstract
Importance: Hepatitis C virus (HCV) reinfection after curative treatment remains a concern for people who inject drugs., Objective: To assess the incidence of HCV reinfection and associated risk factors., Design, Setting, and Participants: This cohort study is a secondary analysis of a randomized clinical trial that was conducted across opioid treatment programs and community health centers in the US between September 2016 and August 2018. The current analyses were performed in March 2022. People who inject drugs who achieved sustained virologic response (SVR) were followed for up to 42 months., Exposure: Patients were randomly assigned to receive modified directly observed therapy or patient navigation., Main Outcomes and Measures: The primary outcome was rate of HCV reinfection. Change in reinfection rates over time was assessed using a Poisson regression model., Results: A total of 415 participants (mean [SD] age, 44.7 [11.5] years; 302 male [72.8%]) achieved a SVR and had 1 or more post-SVR assessments for HCV RNA. Overall, 302 (72.8%) reported recent injection drug use, 192 (46.3%) were living in unstable housing, and 313 (75.4%) had received recent methadone or buprenorphine for opioid use disorder. The overall reinfection rate was 11.4 per 100 person-years at risk (95% CI, 8.7-14.7 per 100 person-years at risk) over 518 person-years of follow-up. Reinfection rates varied significantly across sites, ranging from 2.9 per 100 person-years at risk (95% CI, 0.1-16.3 per 100 person-years) to 25.2 per 100 person-years at risk (95% CI, 15.6-38.5 per 100 person-years at risk) (P = .006). There was a significant decrease in incident reinfection with increasing post-SVR follow-up (weeks 0-24, 15.5 per 100 person-years; 95% CI, 10.3-22.3 per 100 person-years; weeks 73-144, 4.3 per 100 person-years; 95% CI, 0.9-12.5 per 100 person-years; P = .008). Reinfection rates were lower for participants aged 40 years or older than for younger participants (adjusted incidence rate ratio, 0.32; 95% CI, 0.18-0.57) and for participants for whom methamphetamine was not detected in urinary drug screening compared with participants for whom methamphetamine was detected (adjusted incidence rate ratio, 0.41; 95% CI, 0.21-0.82). Participants who reported injection drug use within the preceding 3 months had higher risk of reinfection than those who did not have recent injection drug use (adjusted incidence rate ratio, 3.33; 95% CI, 1.86-5.97)., Conclusions and Relevance: In this cohort study of people who injected drugs and were treated for HCV infection in community settings, reinfection was high in the period immediately after SVR but decreased significantly over time. These findings highlight the importance of early intervention to prevent reinfection., Trial Registration: ClinicalTrials.gov Identifier: NCT02824640.
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- 2024
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88. Factors associated with tuberculosis treatment initiation among bacteriologically negative individuals evaluated for tuberculosis: an individual patient data meta-analysis.
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Kim S, Can MH, Agizew TB, Auld AF, Balcells ME, Bjerrum S, Dheda K, Dorman SE, Esmail A, Fielding K, Garcia-Basteiro AL, Hanrahan CF, Kebede W, Kohli M, Luetkemeyer AF, Mita C, Reeve BWP, Silva DR, Sweeney S, Theron G, Trajman A, Vassall A, Warren JL, Yotebieng M, Cohen T, and Menzies NA
- Abstract
Background: Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative diagnostic test result. Understanding factors associated with clinicians' decisions to initiate treatment for individuals with negative test results is critical for predicting the potential impact of new diagnostics., Methods: We performed a systematic review and individual patient data meta-analysis using studies conducted between January/2010 and December/2022 (PROSPERO: CRD42022287613). We included trials or cohort studies that enrolled individuals evaluated for TB in routine settings. In these studies participants were evaluated based on clinical examination and routinely-used diagnostics, and were followed for ≥1 week after the initial test result. We used hierarchical Bayesian logistic regression to identify factors associated with treatment initiation following a negative result on an initial bacteriological test (e.g., sputum smear microscopy, Xpert MTB/RIF)., Findings: Multiple factors were positively associated with treatment initiation: male sex [adjusted Odds Ratio (aOR) 1.61 (1.31-1.95)], history of prior TB [aOR 1.36 (1.06-1.73)], reported cough [aOR 4.62 (3.42-6.27)], reported night sweats [aOR 1.50 (1.21-1.90)], and having HIV infection but not on ART [aOR 1.68 (1.23-2.32)]. Treatment initiation was substantially less likely for individuals testing negative with Xpert [aOR 0.77 (0.62-0.96)] compared to smear microscopy and declined in more recent years., Interpretation: Multiple factors influenced decisions to initiate TB treatment despite negative test results. Clinicians were substantially less likely to treat in the absence of a positive test result when using more sensitive, PCR-based diagnostics.
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- 2024
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89. Twice-Daily Dolutegravir Based Antiretroviral Therapy with One Month of Daily Rifapentine and Isoniazid (1HP) for TB Prevention.
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Podany AT, Cramer Y, Imperial M, Rosenkranz SL, Avihingsanon A, Arduino R, Samaneka W, Gelmanova I, Savic R, Swindells S, Dawson R, and Luetkemeyer AF
- Abstract
Background: One month of daily rifapentine + isoniazid (1HP) is an effective, ultrashort option for TB prevention in people with HIV (PWH). However, rifapentine may decrease antiretroviral drug concentrations and increase the risk of virologic failure. ACTG A5372 evaluated the effect of 1HP on the pharmacokinetics of twice daily dolutegravir., Methods: A5372 was a multicenter, pharmacokinetic study in PWH (≥18 years) already on dolutegravir-containing antiretroviral therapy with HIV RNA < 50 copies/mL. Participants received daily rifapentine/isoniazid (600mg/300mg) for 28 days as part of 1HP. Dolutegravir was increased to 50mg twice daily during 1HP and intensive pharmacokinetic sampling was performed on day 0 (before 1HP) and on the final day of 1HP treatment., Results: Thirty-two participants (41% female; 66% Black/African; median (Q1, Q3) age 42 (34, 49) years) were included in the pharmacokinetic analysis. Thirty-one of 32 had HIV RNA levels <50 copies/mL at the end of 1HP dosing. One participant had an HIV RNA of 160 copies/mL at day 28, with HIV RNA <50 copies/mL upon repeat testing on day 42. The median (Q1, Q3) dolutegravir trough concentration was 1751 ng/mL (1195, 2542) on day 0 vs. 1987ng/mL (1331, 2278) on day 28 (day 28:day 0 GMR 1.05, [90% CI 0.93-1.2]; p = 0.43). No serious adverse events were reported., Conclusion: Dolutegravir trough concentrations with 50mg twice daily dosing during 1HP treatment were greater than those with standard dose dolutegravir once daily without 1HP. These pharmacokinetic, virologic, and safety data provide support for twice daily dolutegravir use in combination with 1HP for TB prevention., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2024
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90. Filling in the Gaps: Updates on Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections.
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Hazra A, McNulty MC, Pyra M, Pagkas-Bather J, Gutierrez JI, Pickett J, Stewart J, Bolan RK, Molina JM, Celum C, Luetkemeyer AF, and Klausner JD
- Abstract
Over the past two decades, cases of sexually transmitted infections (STIs) due to syphilis, gonorrhea, and chlamydia have been rising in the United States, disproportionately among gay, bisexual, and other men who have sex with men (MSM), as well as racial and ethnic minorities of all genders. In this review, we address updates about the evidence on doxycycline post-exposure prophylaxis (doxy-PEP) for prevention of bacterial STIs, including efficacy, safety, antimicrobial resistance (AMR), acceptability, modeling population impact, and evolving guidelines for use. Equitable implementation of doxy-PEP will require evaluation of who is offered and initiates it, understanding patterns of use and longer-term STI incidence and AMR, provider training, and tailored community education., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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91. Daily second-generation INSTIs and short-course TPT: What more do we need to know?
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Chamie G and Luetkemeyer AF
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- 2023
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92. Postexposure Doxycycline for Sexually Transmitted Infections. Reply.
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Luetkemeyer AF, Cannon C, and Celum C
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- Humans, Anti-Bacterial Agents therapeutic use, Doxycycline therapeutic use, Sexually Transmitted Diseases drug therapy, Sexually Transmitted Diseases prevention & control
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- 2023
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93. Immunogenicity of a Two Dose Regimen of Moderna mRNA Beta/Omicron BA.1 Bivalent Variant Vaccine Boost in a Randomized Clinical Trial.
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Rouphael NG, Branche AR, Diemert DJ, Falsey AR, Losada C, Baden LR, Frey SE, Whitaker JA, Little SJ, Kamidani S, Walter EB, Novak RM, Rupp R, Jackson LA, Babu TM, Kottkamp AC, Luetkemeyer AF, Immergluck LC, Presti RM, Bäcker M, Winokur PL, Mahgoub SM, Goepfert PA, Fusco DN, Atmar RL, Posavad CM, Netzl A, Smith DJ, Telu K, Mu J, Makowski M, Makhene MK, Crandon S, Montefiori DC, Roberts PC, and Beigel JH
- Abstract
In this brief report, we compare the magnitude and durability of the serologic response of one versus two doses (separated by 56 days) of a variant vaccine (Moderna mRNA-1273 Beta/Omicron BA.1 bivalent vaccine) in adults.
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- 2023
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94. Immunogenicity of the BA.1 and BA.4/BA.5 SARS-CoV-2 Bivalent Boosts: Preliminary Results from the COVAIL Randomized Clinical Trial.
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Branche AR, Rouphael NG, Losada C, Baden LR, Anderson EJ, Luetkemeyer AF, Diemert DJ, Winokur PL, Presti RM, Kottkamp AC, Falsey AR, Frey SE, Rupp R, Bäcker M, Novak RM, Walter EB, Jackson LA, Little SJ, Immergluck LC, Mahgoub SM, Whitaker JA, Babu TM, Goepfert PA, Fusco DN, Atmar RL, Posavad CM, Netzl A, Smith DJ, Telu K, Mu J, Makowski M, Makhene MK, Sonja C, Montefiori DC, Roberts PC, and Beigel JH
- Abstract
In a randomized clinical trial, we compare early neutralizing antibody responses after boosting with bivalent SARS-CoV-2 mRNA vaccines based on either BA.1 or BA.4/BA.5 Omicron spike protein combined with wildtype spike. Responses against SARS-CoV-2 variants exhibited the greatest reduction in titers against currently circulating Omicron subvariants for both bivalent vaccines., Competing Interests: EJA has received grants from Pfizer, Moderna, Janssen, GSK, Sanofi, Micron, and Regeneron through institution as well as consulting fees from Pfizer, Janssen, Moderna, and Sanofi. EJA serves on safety/advisory boards for Sanofi, ACI Clinical/WCG and Kentucky Bioscience, Inc.ARB has received research support from NIH-NIAID, grants from Pfizer, Cyanvac, and Merck as well as consulting fees from Janssen and GSK.LRB has received grants from Wellcome Trust, Gates Foundation, NIH/Harvard Medical School through institution. Serves as member of DSMB for NIH and AMDAC for FDA. Dr Baden is involved in HIV and SARS-CoV-2 vaccine clinical trials conducted in collaboration with the NIH, HIV Vaccine Trials Network (HVTN), Covid Vaccine Prevention Network (CoVPN), International AIDS Vaccine Initiative (IAVI), Crucell/Janssen, Moderna, Military HIV Research Program (MHRP), the Gates Foundation, and Harvard Medical School.DJD has received a contract from Leidos Biomedical research to conduct the clinical trial through institution.ARF has received grants from Janssen, Pfizer, Merck, BioFire Diagnostics, and CyanVac through institution, consultant fees from Arrowhead and Icosavax, and honoraria as a speaker from Moderna and GlaxoSmithKline. ARF also serves on safety/advisory boards for Novavax and received travel/meeting support from GlaxoSmithKline.SEF has received f unding from Leidos to Saint Louis University to conduct Protocol DMID22-0004.DNF has as a contract from CDC and is the site PI for clinical trials from Gilead, Regeneron and MetroBiotech LLC. She is the PI on one investigator-initiated award from Gilead and the co-PI on another investigator initiated award from Gilead. DNF served on an HBV Advisory board for Gilead in 2021 and received payment for expert testimony not related to COVID in 2022.PAG has received funding for COVAIL clinical trial. PAG has also received consulting fees from Janssen Vaccines.LCI has received support for the present manuscript from NIH-NIAID/DMID, Moderna, Pfizer, and Sanofi. LCI has also received grants from GSK, Merck, Sharpe & Dohme Corp, CDC, Novavax, AHRQ, and NIH/NLM/NIMHD as well as consulting fees from Moderna, CDC, and Pediatric Emergency Medicine Associates, LLC. LCI has received honoraria as a speaker from American Academy of Pediatrics, Rockefeller University, and American Academy of Pediatrics- Georgia Chapter. LCI Serves on Data Safety Monitoring for NIH-Phase 2 Vaccine Trial for Monkeypox, Moderna Scientific Advisory Board- North America, and CoVID-19 Task Force, Georgia. LCI has a leadership role in the Pediatric Infectious Disease Society and serves as board member on the Emory University- Pediatric and Reproductive Environmental Health Scholars-Southeastern, the Center for Spatial Analytics of the Georgia Institute of Technology, and the American Academy of Pediatrics (Executive Board for Section on Infectious Diseases). LCI has received travel/meeting support from the American Academy of Pediatrics and Moderna.LAJ has received funding from NIH for support for this study, funding from Pfizer to support a clinical trial and contract funding for research support from the CDC and the NIH, all through institution. LAJ also reports unpaid participation on Data Safety Monitoring Boards for NIH funded clinical trials.SJL has received NIH grants through institution.AFL has received grants from Merck, Gilead and, Viiv through institution as well as consulting fees from Vir Biotechnology. AFL has also received travel support from Merck to attend a required investigator meeting, testing kits and supplies to support research study from Hologic, and medication donated by Mayne Pharma to support research study.MM has received funding from Division of Microbiology and Infectious Diseases for contract # 75N93021C00012.DCM has received funding from NIH/75N93019C00050-21A: CIVICS A- Option 21A-DMID Trials of COVID-19 Vaccines.JM has received funding from Division of Microbiology and Infectious Diseases, contract # 75N93021C00012.AN has received support from NIH-NIAID, CEIRR (Centers of Excellence for Influenza Research and Response) and Gates Cambridge Trust as well as grants from NIH-NIAID R01.RMN has received grants from Moderna and Janssen and travel/meeting support from Moderna.CMP has received funding from NIAID UM1AI148684.RMP has received funding from NIH DMID COVAIL as well as grants from Janssen, Moderna and NIH through institution.NGR has received research grants from Pfizer, Merck, Sanofi, Quidel and Lilly through institution, consulting fees from Krog, honoraria as speaker for Virology education, and travel support from Sanofi. NGR serves on safety committees for ICON and EMMES and is a member of the Moderna Advisory board.DJS has received support from NIH-NIAID CEIRR , grants from NIH-NIAID R01, and travel support from NIH-NIAID CEIRR for NIH-related meetings.KT has received funding from Division of Microbiology and Infectious Diseases contract # 75N93021C00012.EBW has received funding from Leidos Biomedical Research AGREEMENT NO. 22CTA-DM0009 as well as grants from Pfizer, Moderna, Sequiris, Clinetic, and Najit Technologies, with payments made to institution. EBW has also received honoraria as a speaker from College of Diplomates of the American Board of Pediatric Dentistry, consulting fees from Iliad Biotechnologies, and travel/meeting support from the American Academy of Pediatrics. EBW serves as member of Vaxcyte Scientific Advisory board.PLW has received subcontract funding from NIH for this study as well as NIH grant funding and contract funding from Pfizer through University of Iowa. PLW has also received consulting fees from Pfizer and serves on safety/advisory board for Emmes Corporation.The following group has no conflicts to declare: RLA, TMB, SMM, MB, MKM, JHB , SC, ACK, CL, PCR, RR, JAW.
- Published
- 2023
- Full Text
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95. SARS-CoV-2 Variant Vaccine Boosters Trial: Preliminary Analyses.
- Author
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Branche AR, Rouphael NG, Diemert DJ, Falsey AR, Losada C, Baden LR, Frey SE, Whitaker JA, Little SJ, Anderson EJ, Walter EB, Novak RM, Rupp R, Jackson LA, Babu TM, Kottkamp AC, Luetkemeyer AF, Immergluck LC, Presti RM, Bäcker M, Winokur PL, Mahgoub SM, Goepfert PA, Fusco DN, Malkin E, Bethony JM, Walsh EE, Graciaa DS, Samaha H, Sherman AC, Walsh SR, Abate G, Oikonomopoulou Z, El Sahly HM, Martin TCS, Rostad CA, Smith MJ, Ladner BG, Porterfield L, Dunstan M, Wald A, Davis T, Atmar RL, Mulligan MJ, Lyke KE, Posavad CM, Meagher MA, Stephens DS, Neuzil KM, Abebe K, Hill H, Albert J, Lewis TC, Giebeig LA, Eaton A, Netzl A, Wilks SH, Türeli S, Makhene M, Crandon S, Lee M, Nayak SU, Montefiori DC, Makowski M, Smith DJ, Roberts PC, and Beigel JH
- Abstract
Background: Protection from SARS-CoV-2 vaccines wanes over time and is compounded by emerging variants including Omicron subvariants. This study evaluated safety and immunogenicity of SARS-CoV-2 variant vaccines., Methods: This phase 2 open-label, randomized trial enrolled healthy adults previously vaccinated with a SARS-CoV-2 primary series and a single boost. Eligible participants were randomized to one of six Moderna COVID19 mRNA vaccine arms (50µg dose): Prototype (mRNA-1273), Omicron BA.1+Beta (1 or 2 doses), Omicron BA.1+Delta, Omicron BA.1 monovalent, and Omicron BA.1+Prototype. Neutralization antibody titers (ID
50 ) were assessed for D614G, Delta, Beta and Omicron BA.1 variants and Omicron BA.2.12.1 and BA.4/BA.5 subvariants 15 days after vaccination., Results: From March 30 to May 6, 2022, 597 participants were randomized and vaccinated. Median age was 53 years, and 20% had a prior SARS-CoV-2 infection. All vaccines were safe and well-tolerated. Day 15 geometric mean titers (GMT) against D614G were similar across arms and ages, and higher with prior infection. For uninfected participants, Day 15 Omicron BA.1 GMTs were similar across Omicron-containing vaccine arms (3724-4561) and higher than Prototype (1,997 [95%CI:1,482-2,692]). The Omicron BA.1 monovalent and Omicron BA.1+Prototype vaccines induced a geometric mean ratio (GMR) to Prototype for Omicron BA.1 of 2.03 (97.5%CI:1.37-3.00) and 1.56 (97.5%CI:1.06-2.31), respectively. A subset of samples from uninfected participants in four arms were also tested in a different laboratory at Day 15 for neutralizing antibody titers to D614G and Omicron subvariants BA.1, BA.2.12.2 and BA.4/BA.5. Omicron BA.4/BA.5 GMTs were approximately one third BA.1 GMTs (Prototype 517 [95%CI:324-826] vs. 1503 [95%CI:949-2381]; Omicron BA.1+Beta 628 [95%CI:367-1,074] vs. 2125 [95%CI:1139-3965]; Omicron BA.1+Delta 765 [95%CI:443-1,322] vs. 2242 [95%CI:1218-4128] and Omicron BA.1+Prototype 635 [95%CI:447-903] vs. 1972 [95%CI:1337-2907)., Conclusions: Higher Omicron BA.1 titers were observed with Omicron-containing vaccines compared to Prototype vaccine and titers against Omicron BA.4/BA.5 were lower than against BA.1 for all candidate vaccines., Clinicaltrialsgov: NCT05289037.- Published
- 2022
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96. CROI 2021: Viral Hepatitis and Other Forms of Liver Injury Impacting People with HIV.
- Author
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Luetkemeyer AF and Wyles DL
- Subjects
- Hepatitis A complications, Hepatitis B complications, Hepatitis C complications, Humans, Male, Biomedical Research, Congresses as Topic, HIV Infections complications, Hepatitis, Viral, Human complications, Homosexuality, Male, Liver injuries
- Abstract
At the 2021 Conference on Retroviruses and Opportunistic Infections, there was a focus on progress toward hepatitis C virus (HCV) microelimination in geographic regions and targeted populations. HCV elimination is facilitated by well-tolerated, highly effective HCV treatment that requires essentially no on-treatment monitoring in most patients, as highlighted by the MINMON (Minimal Monitoring Study or A5360) study, and that should be increasingly available to children with new data supporting feasible treatment in younger patients. Challenges to HCV elimination include HCV reinfection via sexual exposure in men who have sex with men (MSM) and continued barriers to diagnosis and access to HCV treatment. Hepatitis B virus (HBV) suppression may take years in HIV/HBV-coinfected patients. This may have important consequences as the risk for hepatocellular carcinoma was associated in a dose-dependent manner with HBV viral load and was lowest in those with sustained undetectable HBV, highlighting the need for HBV DNA monitoring during therapy. Public health programs should prioritize improving hepatitis A and hepatitis B vaccination in at-risk populations, including people with HIV, as vaccinations rates for these preventable diseases continue to be suboptimal in many settings. Fatty liver disease, heavy alcohol use, antiretroviral therapy, and COVID-19 infection were also examined as drivers of hepatic disease in HIV infection.
- Published
- 2021
97. CROI 2019: highlights of viral hepatitis.
- Author
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Luetkemeyer AF and Wyles DL
- Subjects
- HIV Infections drug therapy, Humans, Antiviral Agents therapeutic use, HIV Infections complications, Hepatitis B, Chronic diagnosis, Hepatitis B, Chronic drug therapy
- Abstract
At the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), there was a major focus on hepatitis C virus (HCV) elimination and improving each component of the hepatitis C care cascade. Many interventions showed promising improvements in diagnosis and linkage to care. Settings with robust access to direct-acting antivirals (DAAs) continue to demonstrate the role of HCV treatment as prevention. However, substantial barriers to accessing curative therapy remain. Reinfection after treatment presents an important barrier to elimination, particularly in some populations of men who have sex with men (MSM). MSM without HIV infection are at an elevated risk for sexual acquisition of HCV, and several studies reported HCV rates that were as high as those seen in MSM living with HIV. There was also a focus on HCV and HBV in pregnant women. Rates of HCV infection in women of child-bearing potential have increased, making prenatal diagnosis a priority. In the first study of HCV treatment during pregnancy, sofosbuvir/ledipasvir started at 28 weeks of gestation led to cure in 8 pregnant women. Hepatitis B virus (HBV)-active antiretrovirals are generally effective in suppressing HBV but have low rates of surface antigen loss despite long term treatment. Initial results from novel laboratory assessments of intrahepatic HBV viral infection events were presented, hopefully paving the way for more effective HBV treatment strategies to control and potentially cure HBV.
- Published
- 2019
98. Role of a clinical pharmacist as part of a multidisciplinary care team in the treatment of HCV in patients living with HIV/HCV coinfection.
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Olea A Jr, Grochowski J, Luetkemeyer AF, Robb V, and Saberi P
- Abstract
Background: The objective of the study was to evaluate the role of a clinical pharmacist in hepatitis C virus (HCV) treatment of patients living with HIV/HCV coinfection., Methods: We conducted a descriptive study to quantify the functions of a clinical pharmacist in HCV treatment of patients living with HIV/HCV coinfection who were initiating HCV treatment at a publicly funded clinic between March 18, 2015 and September 15, 2016. The clinical pharmacist's role was categorized into eight categories: 1) HCV prior authorization (PA) completion; 2) HCV medication adherence counseling; 3) HCV drug-drug interaction (DDI) counseling and screening; 4) HCV medication counseling regarding common adverse events (AEs); 5) HCV counseling regarding HCV treatment outcomes and risk of reinfection; 6) ordering laboratory tests and interpretation of HCV laboratory values; 7) HIV medication AE assessment; and 8) other (including refilling medications and management of other comorbidities)., Results: One hundred and thirty-five patients initiated treatment during this timeframe: 77.0% were males, 56.3% non-cirrhotic, 77.0% HCV treatment-naïve, 45.9% HCV genotype 1a, and 83.0% initiated on ledipasvir/sofosbuvir. The clinical pharmacist completed 150 PAs, counseled on HCV medication adherence in 79.2% of patients, conducted HCV DDI counseling and screening in 54.2%, and monitored HCV medication AEs in 54.2%. The clinical pharmacist counseled patients on HCV treatment outcomes and risk of reinfection in 53.1%, ordered laboratory tests in 44.8%, and reported and interpreted laboratory values in 44.8%. The clinical pharmacist assessed HIV medication AEs in 54.2% of patients and participated in other activities in 42.7%., Conclusion: A clinical pharmacist's expertise as part of a multidisciplinary care team facilitates optimal treatment outcomes and provides critical support in the management of DAA therapy in individuals living with HIV/HCV coinfection., Competing Interests: Disclosure Parya Saberi has received a National Institute of Mental Health Grant (K23MH097649). Anne F Luetkemeyer has received research grant support to the University of California, San Francisco from AbbVie, Gilead, and Merck. The authors report no other conflicts of interest in this work.
- Published
- 2018
- Full Text
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99. CROI 2016: Viral Hepatitis and Liver Fibrosis.
- Author
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Luetkemeyer AF and Wyles DL
- Subjects
- Hepatitis C, Chronic epidemiology, Humans, Antiviral Agents therapeutic use, HIV Infections complications, Hepatitis C, Chronic complications, Hepatitis C, Chronic drug therapy, Liver Cirrhosis epidemiology
- Abstract
At the 2016 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, Massachusetts, hepatitis C virus (HCV) infection remained a major theme in the context of HIV-associated liver disease, although other causes of liver disease garnered increased attention, including fatty liver disease, hepatitis B, and the impact of HIV disease itself on the liver. Although no data from phase III studies of HCV direct-acting antiviral (DAA) drugs for the treatment of HIV/HCV coinfection were presented at CROI 2016, a broad range of HCV DAA-related topics were presented, including accumulating experience with real-world performance of DAA-based regimens outside of clinical trials, drug interactions between DAA and antiretroviral drugs, treatment of acute HCV infection, and retreatment of individuals whose DAA-based regimens failed and those in whom resistance to DAA drugs emerged. A summary of select abstracts from CROI 2016 is presented, including discussion of clinical relevance where appropriate and areas for future research.
- Published
- 2016
100. Complications of HIV disease and antiretroviral therapy.
- Author
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Luetkemeyer AF, Havlir DV, and Currier JS
- Subjects
- Hepatitis C complications, Hepatitis C drug therapy, Humans, Time Factors, Anti-HIV Agents administration & dosage, Anti-HIV Agents adverse effects, Antiretroviral Therapy, Highly Active adverse effects, Antiretroviral Therapy, Highly Active methods, HIV Infections complications, HIV Infections drug therapy
- Abstract
Studies on new direct-acting antivirals (DAAs) for hepatitis C virus infection were a focus of the 2011 Conference on Retroviruses and Opportunistic Infections. Although the majority of the data were from HIV-uninfected patients, much-needed work has begun to characterize DAA and antiretroviral drug interactions and to evaluate performance of DAAs for HIV/HCV-coinfected patients. There was continued emphasis on pathogenesis, management, and prevention of the long-term complications of HIV disease and its therapies, including cardiovascular disease, lipodystrophy, renal disease, and alterations in bone metabolism. Malignancies, particularly non-AIDS-defining cancers, have emerged as a leading complication and cause of death in HIV infection that may not be fully mitigated by immune reconstitution with antiretroviral therapy. This year's conference also highlighted important data on the optimal timing of antiretroviral therapy in tuberculosis coinfection, as well as the treatment and prevention of common coinfections including cryptococcal meningitis and influenza.
- Published
- 2011
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