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1,052 results on '"Essex, Max"'

201. Short Communication: Low False Recent Rate of Limiting Antigen-Avidity Assay Combined with HIV-1 RNA Data in Botswana

Author

Moyo, Sikhulile, primary, Kotokwe, Kenanao P., additional, Mohammed, Terence, additional, Boleo, Corretah, additional, Mupfumi, Lucy, additional, Chishala, Samuel, additional, Tsalaile, Lesedi, additional, Bussmann, Hermann, additional, Gaseitsiwe, Simani, additional, Musonda, Rosemary, additional, Makhema, Joseph, additional, Baum, Marianna, additional, Marlink, Richard, additional, Engelbrecht, Susan, additional, Essex, Max, additional, and Novitsky, Vladimir, additional

Published
2017
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202. Point-of-Care Cepheid Xpert HIV-1 Viral Load Test in Rural African Communities Is Feasible and Reliable

Author

Moyo, Sikhulile, primary, Mohammed, Terence, additional, Wirth, Kathleen E., additional, Prague, Melanie, additional, Bennett, Kara, additional, Holme, Molly Pretorius, additional, Mupfumi, Lucy, additional, Sebogodi, Philemon, additional, Moraka, Natasha O., additional, Boleo, Corretah, additional, Maphorisa, Comfort N., additional, Seraise, Boitumelo, additional, Gaseitsiwe, Simani, additional, Musonda, Rosemary M., additional, van Widenfelt, Erik, additional, Powis, Kathleen M., additional, Gaolathe, Tendani, additional, Tchetgen Tchetgen, Eric J., additional, Makhema, Joseph M., additional, Essex, Max, additional, Lockman, Shahin, additional, and Novitsky, Vladimir, additional

Published
2016
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203. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial

Author

Godbole, Sheela V, Havlir, Diane, Eron, Joseph, Wang, Lei, Celentano, David, Nielsen-Saines, Karin, Hosseinipour, Mina C, Kumwenda, Johnstone, Piwowar-Manning, Estelle, Kumarasamy, Nagalingeshwaran, Mayer, Kenneth H, Essex, Max, Ribaudo, Heather J, Swindells, Susan, Chen, Ying Q, Eshleman, Susan H, Mills, Lisa A, Taha, Taha E, Pilotto, Jose H S, Gallant, Joel, Sanne, Ian, Chariyalertsak, Suwat, de Melo, Marineide Gonçalves, Hakim, James G, Panchia, Ravindre, Ou, San-San, McCauley, Marybeth, Anderson, Maija, Makhema, Joseph, Gamble, Theresa, Hoffman, Irving, and Grinsztejn, Beatriz

Subjects
virus diseases
Abstract

Use of antiretroviral treatment for HIV-1 infection has decreased AIDS-related morbidity and mortality and prevents sexual transmission of HIV-1. However, the best time to initiate antiretroviral treatment to reduce progression of HIV-1 infection or non-AIDS clinical events is unknown. We reported previously that early antiretroviral treatment reduced HIV-1 transmission by 96%. We aimed to compare the effects of early and delayed initiation of antiretroviral treatment on clinical outcomes.

Published
2014
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204. Risk Factors for Mortality among HIV-exposed and HIV-unexposed Infants Admitted to a Neonatal Intensive Care Unit in Botswana

Author

Zash, Rebecca M., Ajose-Popoola, Olubunmi, Stordal, Ketil, Souda, Sajini, Ogwu, Anthony, Dryden-Peterson, Scott, Powis, Kathleen, Lockman, Shahin, Makhema, Joe, Essex, Max, and Shapiro, Roger L.

Subjects
Male, Botswana, Infant, Newborn, Infant, Article, Infectious Disease Transmission, Vertical, Risk Factors, Cause of Death, Intensive Care Units, Neonatal, HIV Seropositivity, Infant Mortality, Confidence Intervals, Humans, Female, Hospital Mortality, Prospective Studies, Proportional Hazards Models
Abstract

Newborns admitted to neonatal units (NNUs) in resource-limited settings face a high risk of mortality, but the epidemiology of these deaths is poorly understood. We describe risk factors for NNU mortality in an area with high prevalence of human immunodeficiency virus (HIV).We performed a prospective cohort study of infants admitted to the NNU at a public referral hospital in Gaborone, Botswana. The primary outcome was neonatal death, defined as death within 28 days of a live delivery. Cox proportional hazard models were used to evaluate risk factors for mortality.From October 2008 to April 2009, 449 neonates were admitted to the NNU. Cumulative mortality was 24.5% (110/449). Factors associated with increased risk of death included lack of enteral feeding (hazard ratio (HR) 18.8, 95% confidence interval (CI) 10.3, 34.2), gestational age28 weeks (HR 2.0, 95% CI 1.1, 3.8) and Apgar score7 at 10 min (HR 2.5, 95% CI 1.5, 4.2). Among 348 (78%) infants who were fed, there was no difference in mortality between infants who were breastfed compared with those who were formula fed or had mixed feeding (P = 0.76). There was no significant mortality difference by HIV exposure status; 35 (28%) of 128 HIV-exposed infants died compared with 55 (21%) of 272 HIV-unexposed infants (P = 0.19).This study identified low Apgar scores, extreme prematurity and lack of enteral feeding as the most important risk factors for mortality in this NNU setting. HIV exposure and formula feeding were not significantly associated with death in neonates who were very ill.

Published
2013

206. HIV-exposed children account for more than half of 24-month mortality in Botswana

Author

Zash, Rebecca, primary, Souda, Sajini, additional, Leidner, Jean, additional, Ribaudo, Heather, additional, Binda, Kelebogile, additional, Moyo, Sikhulile, additional, Powis, Kathleen M., additional, Petlo, Chipo, additional, Mmalane, Mompati, additional, Makhema, Joe, additional, Essex, Max, additional, Lockman, Shahin, additional, and Shapiro, Roger, additional

Published
2016
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207. The aetiology of diarrhoea, pneumonia and respiratory colonization of HIV-exposed infants randomized to breast- or formula-feeding

Author

Zash, Rebecca M., primary, Shapiro, Roger L., additional, Leidner, Jean, additional, Wester, Carolyn, additional, McAdam, Alexander J., additional, Hodinka, Richard L., additional, Thior, Ibou, additional, Moffat, Claire, additional, Makhema, Joseph, additional, McIntosh, Kenneth, additional, Essex, Max, additional, and Lockman, Shahin, additional

Published
2016
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209. Prognostic Value of HIV-1 RNA on CD4 Trajectories and Disease Progression Among Antiretroviral-Naive HIV-Infected Adults in Botswana: A Joint Modeling Analysis

Author

Farahani, Mansour, primary, Novitsky, Vladimir, additional, Wang, Rui, additional, Bussmann, Hermann, additional, Moyo, Sikhulile, additional, Musonda, Rosemary M., additional, Moeti, Themba, additional, Makhema, Joseph M., additional, Essex, Max, additional, and Marlink, Richard, additional

Published
2016
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210. Plasma Cytokine Levels in Chronic Asymptomatic HIV-1 Subtype C Infection as an Indicator of Disease Progression in Botswana: A Retrospective Case Control Study

Author

Iketleng, Thato, primary, Moyo, Sikhulile, additional, Gaseitsiwe, Simani, additional, Nyombi, Balthazar, additional, Mitchell, Rebecca M., additional, Makhema, Joseph, additional, Baum, Marianna K., additional, Marlink, Richard, additional, Essex, Max, additional, and Musonda, Rosemary, additional

Published
2016
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212. Slow CD4+ T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana

Author

Anderson, Motswedi, primary, Gaseitsiwe, Simani, additional, Moyo, Sikhulile, additional, Thami, Kerapetse P., additional, Mohammed, Terence, additional, Setlhare, Ditiro, additional, Sebunya, Theresa K., additional, Powell, Eleanor A., additional, Makhema, Joseph, additional, Blackard, Jason T., additional, Marlink, Richard, additional, Essex, Max, additional, and Musonda, Rosemary M., additional

Published
2016
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213. Plasma Viral Loads During Early HIV-1 Infection Are Similar in Subtype C– and Non-Subtype C–Infected African Seroconverters

Author

Campbell, Mary S., Kahle, Erin M., Celum, Connie, Lingappa, Jairam R., Kapiga, Saidi, Mujugira, Andrew, Mugo, Nelly R., Fife, Kenneth H., Mullins, James I., Baeten, Jared M., Wald, Anna, Lingappa, Jairam, Corey, Lawrence, Coombs, Robert W., Hughes, James P., Magaret, Amalia, McElrath, M. Juliana, Morrow, Rhoda, Coetzee, David, Fife, Kenneth, Were, Edwin, Essex, Max, Makhema, Joseph, Katabira, Elly, Ronald, Allan, Allen, Susan, Kayitenkore, Kayitesi, Karita, Etienne, Bukusi, Elizabeth, Cohen, Craig, Kanweka, William, Vwalika, Bellington, Manongi, Rachel, Farquhar, Carey, John-Stewart, Grace, Kiarie, James, Inambao, Mubiana, Farm, Orange, Delany-Moretlwe, Sinead, Rees, Helen, de Bruyn, Guy, Gray, Glenda, McIntyre, James, and Mugo, Nelly Rwamba

Subjects
Adult, Male, Time Factors, Human immunodeficiency virus (HIV), Black People, Viremia, HIV Infections, Biology, medicine.disease_cause, Sensitivity and Specificity, gag Gene Products, Human Immunodeficiency Virus, Plasma viral load, South Africa, Major Articles and Brief Reports, Viral Load result, HIV Seropositivity, medicine, Disease Transmission, Infectious, Immunology and Allergy, Humans, Prospective Studies, Extramural, env Gene Products, Human Immunodeficiency Virus, Africa, Eastern, Middle Aged, Viral Load, medicine.disease, Hiv seropositivity, Virology, Infectious Diseases, Immunology, HIV-1, RNA, Viral, Female, Viral load, Disease transmission
Abstract

Recent data suggest that infection with human immunodeficiency virus type 1 (HIV-1) subtype C results in prolonged high-level viremia (>5 log10 copies/mL) during early infection. We examined the relationship between HIV-1 subtype and plasma viremia among 153 African seroconverters. Mean setpoint viral loads were similar for C and non-C subtypes: 4.36 vs 4.42 log10 copies/mL (P = .61). The proportion of subtype C-infected participants with viral loads >5 log10 copies/mL was not greater than the proportion for those with non-C infection. Our data do not support the hypothesis that higher early viral load accounts for the rapid spread of HIV-1 subtype C in southern Africa.

Published
2013

216. AZT Trial in Thailand

Author

Lallemant, Marc, Le Coeur, Sophie, McIntosh, Kenneth, Brennan, Troyen, Gelber, Richard, Lee, Tun-Hou, Hammer, Scott, Essex, Max, Vithayasai, Vicharn, Sirivatanapa, Pannee, Vithayasai, Prakong, Rangsiyanond, Prapasri, Phoolcharen, Wiput, and Luckmann, Roger

Published
1995

217. Increased Risk of Severe Infant Anemia Following Exposure to Maternal HAART, Botswana

Author

Dryden-Peterson, Scott, Shapiro, Roger L., Hughes, Michael D., Powis, Kathleen, Ogwu, Anthony, Moffat, Claire, Moyo, Sikhulile, Makhema, Joseph, Essex, Max, and Lockman, Shahin

Subjects
Adult, Male, Botswana, Incidence, Infant, Newborn, Anemia, HIV Infections, Severity of Illness Index, Article, Infectious Disease Transmission, Vertical, Perinatal Care, Breast Feeding, Treatment Outcome, Pregnancy, Antiretroviral Therapy, Highly Active, Prenatal Exposure Delayed Effects, HIV-1, Humans, Reverse Transcriptase Inhibitors, Female, Pregnancy Complications, Infectious, Zidovudine
Abstract

Maternal highly-active antiretroviral therapy (HAART) reduces mother-to-child HIV transmission but may increase the risk for infant anemia.The incidence of first severe anemia (grade 3 or 4, Division of AIDS 2004 Toxicity Table) was assessed among HIV-uninfected infants in the Mashi and Mma Bana mother-to-child HIV transmission prevention trials in Botswana. Severe anemia rates were compared between 3 groups: infants exposed to maternal HAART in utero and during breastfeeding (BF) and 1 month of postnatal zidovudine (ZDV) (HAART-BF); infants exposed to maternal ZDV in utero, 6 months of postnatal ZDV, and BF (ZDV-BF); and infants exposed to maternal ZDV in utero, 1 month of postnatal ZDV, and formula-feeding (ZDV-FF).A total of 1719 infants were analyzed-691 HAART-BF, 503 ZDV-BF, and 525 ZDV-FF. Severe anemia was detected in 118 infants (7.4%). By 6 months, 12.5% of HAART-BF infants experienced severe anemia, compared with 5.3% of ZDV-BF (P0.001) and 2.5% of ZDV-FF infants (P0.001). In adjusted analysis, HAART-BF infants were at greater risk of severe anemia than ZDV-BF or ZDV-FF infants (adjusted odds ratios 2.6 and 5.8, respectively; P0.001). Most anemias were asymptomatic and improved with iron/multivitamin supplementation and cessation of ZDV exposure. However, 11 infants (0.6% of all infants) required transfusion for symptomatic anemia. Microcytosis and hypochromia were common among infants with severe anemia.Exposure to maternal HAART starting in utero was associated with severe infant anemia. Confirmation of this finding and possible strategies to mitigate hematologic toxicity warrant further study.

Published
2011

219. Molecular characterisation of hepatitis B virus in HIV-1 subtype C infected patients in Botswana

Author

Anderson, Motswedi, primary, Gaseitsiwe, Simani, additional, Moyo, Sikhulile, additional, Wessels, Matthijs J. C., additional, Mohammed, Terence, additional, Sebunya, Theresa K., additional, Powell, Eleanor A., additional, Makhema, Joseph, additional, Blackard, Jason T., additional, Marlink, Richard, additional, Essex, Max, additional, and Musonda, Rosemary M., additional

Published
2015
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220. Non-Nucleoside Reverse Transcriptase Inhibitor Outcomes Among cART-Treated Adults in Botswana

Author

Wester, C. William, Thomas, Ann Muir, Bussmann, Hermann, Moyo, Sikhulile, Makhema, Joseph M., Gaolathe, Tendani, Novitsky, Vladimir, Essex, Max, deGruttola, Victor, and Marlink, Richard G.

Subjects
Adult, Male, Botswana, Anti-HIV Agents, HIV Infections, Article, Treatment Outcome, Pregnancy, Antiretroviral Therapy, Highly Active, Family Planning Services, HIV-1, Humans, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female
Abstract

National initiatives offering non-nucleoside reverse transcriptase inhibitor (NNRTI)-based combination antiretroviral therapy (cART) have expanded in sub-Saharan Africa. The Tshepo study is the first clinical trial evaluating the long-term efficacy and tolerability of efavirenz versus nevirapine-based cART among adults in Botswana.A 3-year randomized study (n = 650) using a 3 x 2 x 2 factorial design comparing efficacy and tolerability among: (i) zidovudine/lamivudine versus zidovudine/didanosine versus stavudine/lamivudine; (ii) efavirenz versus nevirapine; and (iii) community-based supervision versus standard adherence strategies. This paper focuses on comparison (ii).There was no significant difference by assigned NNRTI in time to virological failure with resistance (log-rank P = 0.14), nevirapine versus efavirenz [risk ratio (RR) 1.54, 95% CI 0.86-2.70]. Rates of virological failure with resistance were 9.6% nevirapine-treated (95% CI 6.8-13.5) versus 6.6% efavirenz-treated (95% CI 4.2-10.0) at 3 years. Women receiving nevirapine-based cART trended towards higher virological failure rates when compared with efavirenz-treated women, Holm-corrected (log-rank P = 0.072), nevirapine versus efavirenz (RR 2.22, 95% CI 0.94-5.00). A total of 139 patients had 176 treatment-modifying toxicities, with a shorter time to event in nevirapine-treated versus efavirenz-treated patients (RR 1.85, 1.20-2.86; log-rank P = 0.0002).Tshepo-treated patients had excellent overall immunological and virological outcomes, and no significant differences were observed by randomized NNRTI comparison. Nevirapine-treated women trended towards higher virological failure with resistance compared with efavirenz-treated women. Nevirapine-treated adults had higher treatment modifying toxicity rates when compared with those receiving efavirenz. Nevirapine-based cART can continue to be offered to women in sub-Saharan Africa if patient education concerning toxicity is emphasized, routine safety monitoring chemistries are performed and the potential risk of efavirenz-related teratogenicity is considered.

Published
2010

222. The Biology of HIV-1 and HIV-2 in Africa

Author

Kanki, Phyllis, primary, M�Boup, Souleymane, additional, Barin, Francis, additional, Denis, Fran�ois, additional, Marlink, Richard, additional, Romet-Lemonne, Jean-Loup, additional, and Essex, Max, additional

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228. Vitamin D Insufficiency in HIV-infected Pregnant Women Receiving Antiretroviral Therapy is Not Associated With Morbidity, Mortality or Growth Impairment in Their Uninfected Infants in Botswana

Author

Powis, Kathleen, primary, Lockman, Shahin, additional, Smeaton, Laura, additional, Hughes, Michael D., additional, Fawzi, Wafaie, additional, Ogwu, Anthony, additional, Moyo, Sikhulile, additional, van Widenfelt, Erik, additional, von Oettingen, Julia, additional, Makhema, Joseph, additional, Essex, Max, additional, and Shapiro, Roger L., additional

Published
2014
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231. Unreported Antiretroviral Use by HIV-1–Infected Participants Enrolling in a Prospective Research Study

Author

Kahle, Erin M., primary, Kashuba, Angela, additional, Baeten, Jared M., additional, Fife, Kenneth H., additional, Celum, Connie, additional, Mujugira, Andrew, additional, Essex, Max, additional, De Bruyn, Guy, additional, Wald, Anna, additional, Donnell, Deborah, additional, John-Stewart, Grace, additional, Delany-Moretlwe, Sinead, additional, Mugo, Nelly R., additional, Farquhar, Carey, additional, and Lingappa, Jairam R., additional

Published
2014
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233. Risk factors for mortality among human immunodeficiency virus-exposed and unexposed infants admitted to a neonatal intensive care unit in Botswana

Author

Zash, Rebecca M, primary, Ajose-Popoola, Olubunmi, additional, Stordal, Ketil, additional, Souda, Sajini, additional, Ogwu, Anthony, additional, Dryden-Peterson, Scott, additional, Powis, Kathleen, additional, Lockman, Shahin, additional, Makhema, Joe, additional, Essex, Max, additional, and Shapiro, Roger L, additional

Published
2013
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234. Children who acquire HIV infection perinatally are at higher risk of early death than those acquiring infection through breastmilk: a meta-analysis.

Author

Becquet, Renaud, Marston, Milly, Dabis, François, Moulton, Lawrence H, Gray, Glenda, Coovadia, Hoosen M, Essex, Max, Ekouevi, Didier K, Jackson, Debra, Coutsoudis, Anna, Kilewo, Charles, Leroy, Valériane, Wiktor, Stefan Z, Nduati, Ruth, Msellati, Philippe, Zaba, Basia, Ghys, Peter D, Newell, Marie-Louise, Castetbon, Katia, Becquet, Renaud, Marston, Milly, Dabis, François, Moulton, Lawrence H, Gray, Glenda, Coovadia, Hoosen M, Essex, Max, Ekouevi, Didier K, Jackson, Debra, Coutsoudis, Anna, Kilewo, Charles, Leroy, Valériane, Wiktor, Stefan Z, Nduati, Ruth, Msellati, Philippe, Zaba, Basia, Ghys, Peter D, Newell, Marie-Louise, and Castetbon, Katia

Abstract

Assumptions about survival of HIV-infected children in Africa without antiretroviral therapy need to be updated to inform ongoing UNAIDS modelling of paediatric HIV epidemics among children. Improved estimates of infant survival by timing of HIV-infection (perinatally or postnatally) are thus needed., 0, UNAIDS Child Survival Group, info:eu-repo/semantics/published

Published
2012

235. Cotrimoxazole Prophylaxis and Risk of Severe Anemia or Severe Neutropenia in HAART-Exposed, HIV-Uninfected Infants

Author

Dryden-Peterson, Scott, primary, Jayeoba, Oluwemimo, additional, Hughes, Michael D., additional, Jibril, Haruna, additional, McIntosh, Kenneth, additional, Modise, Taolo A., additional, Asmelash, Aida, additional, Powis, Kathleen M., additional, Essex, Max, additional, Shapiro, Roger L., additional, and Lockman, Shahin, additional

Published
2013
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236. No Clinically Significant Drug-Resistance Mutations in HIV-1 Subtype C–Infected Women After Discontinuation of NRTI-Based or PI-Based HAART for PMTCT in Botswana

Author

Souda, Sajini, primary, Gaseitsiwe, Simani, additional, Georgette, Nathan, additional, Powis, Kathleen, additional, Moremedi, Daisy, additional, Iketleng, Thato, additional, Leidner, Jean, additional, Moffat, Claire, additional, Ogwu, Anthony, additional, Lockman, Shahin, additional, Moyo, Sikhulile, additional, Mmalane, Mompati, additional, Musonda, Rosemary, additional, Makhema, Joseph, additional, Essex, Max, additional, and Shapiro, Roger, additional

Published
2013
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237. Persistently Elevated Serum Interleukin-6 Predicts Mortality Among Adults Receiving Combination Antiretroviral Therapy in Botswana: Results from a Clinical Trial

Author

McDonald, Bethan, primary, Moyo, Sikhulile, additional, Gabaitiri, Lesego, additional, Gaseitsiwe, Simani, additional, Bussmann, Hermann, additional, Koethe, John R., additional, Musonda, Rosemary, additional, Makhema, Joseph, additional, Novitsky, Vladimir, additional, Marlink, Richard G., additional, Wester, C. William, additional, and Essex, Max, additional

Published
2013
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239. High Viral Load and Elevated Angiogenic Markers Associated With Increased Risk of Preeclampsia Among Women Initiating Highly Active Antiretroviral Therapy in Pregnancy in the Mma Bana Study, Botswana

Author

Powis, Kathleen M., primary, McElrath, Thomas F., additional, Hughes, Michael D., additional, Ogwu, Anthony, additional, Souda, Sajini, additional, Datwyler, Saul A., additional, von Widenfelt, Erik, additional, Moyo, Sikhulile, additional, Nádas, Marisa, additional, Makhema, Joseph, additional, Machakaire, Esther, additional, Lockman, Shahin, additional, Essex, Max, additional, and Shapiro, Roger L., additional

Published
2013
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241. Similar HIV protection from four weeks of zidovudine versus nevirapine prophylaxis among formula-fed infants in Botswana

Author

Powis, Kathleen M., Lockman, Shahin, Ajibola, Gbolahan, Hughes, Michael D., Bennett, Kara, Leidner, Jean, Batlang, Oganne, Botebele, Kerapetse, Moyo, Sikhulile, van Widenfelt, Erik, Makhema, Joseph, Petlo, Chipo, Jibril, Haruna B., McIntosh, Kenneth, Essex, Max, and Shapiro, Roger L.

Abstract

Background: The World Health Organization HIV guidelines recommend either infant zidovudine (ZDV) or nevirapine (NVP) prophylaxis for the prevention of intrapartum mother-to-child HIV transmission (MTCT) among formula-fed infants. No study has evaluated the comparative efficacy of infant prophylaxis with twice daily ZDV versus once daily NVP in exclusively formula-fed HIV-exposed infants. Methods: Using data from the Mpepu Study, a Botswana-based clinical trial investigating whether prophylactic co-trimoxazole could improve infant survival, retrospective analyses of MTCT events and Division of AIDS (DAIDS) Grade 3 or Grade 4 occurrences of anaemia or neutropenia were performed among infants born full-term (≥ 37 weeks gestation), with a birth weight ≥ 2500 g and who were formula-fed from birth. ZDV infant prophylaxis was used from Mpepu Study inception. A protocol modification mid-way through the study led to the subsequent use of NVP infant prophylaxis. Results: Among infants qualifying for this secondary retrospective analysis, a total of 695 (52%) infants received ZDV, while 646 (48%) received NVP from birth for at least 25 days but no more than 35 days. Confirmed intrapartum HIV infection occurred in two (0.29%) ZDV recipients and three (0.46%) NVP recipients (p = 0.68). Anaemia occurred in 19 (2.7%) ZDV versus 12 (1.9%) NVP (p = 0.36) recipients. Neutropenia occurred in 28 (4.0%) ZDV versus 21 (3.3%) NVP recipients (p = 0.47). Conclusions: Both ZDV and NVP resulted in low intrapartum transmission rates and no significant differences in severe infant haematologic toxicity (DAIDS Grade 3 or Grade 4) among formula-fed full-term infants with a birthweight ≥ 2500 g.

Published
2018
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242. Chronic and Occult Hepatitis B Virus Infection in Pregnant Women in Botswana

Author

Mbangiwa, Tshepiso, Kasvosve, Ishmael, Anderson, Motswedi, Thami, Prisca K., Choga, Wonderful T., Needleman, Austen, Phinius, Bonolo B., Moyo, Sikhulile, Leteane, Melvin, Leidner, Jean, Blackard, Jason T., Mayondi, Gloria, Kammerer, Betsy, Musonda, Rosemary M., Essex, Max, Lockman, Shahin, and Gaseitsiwe, Simani

Subjects
pregnant women, hepatitis B virus (HBV), human immunodeficiency virus (HIV), Botswana
Abstract

The hepatitis B virus (HBV) is a global problem; however, the burden of HBV infection in pregnant women in Botswana is unknown. We sought to determine the prevalence of chronic and occult HBV infection in human immunodeficiency virus (HIV)-infected and -uninfected pregnant women in Botswana. Samples from 752 pregnant women were tested for hepatitis B surface antigen (HBsAg), and HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) and HBV DNA load. Samples that were HBsAg negative were screened for occult HBV infection by determining the HBV DNA load. HBV genotypes were determined based on a 415-base-pair fragment of the surface gene. Among the 752 women tested during pregnancy or early postpartum, 16 (2.1%) (95% confidence interval (CI): 2.0–2.2) were HBsAg-positive. The prevalence of chronic HBV infection was higher (3.1%) among HIV-infected (95% CI: 3.0–3.2) compared with HIV-uninfected women (1.1%) (95% CI: 1.07–1.1, p = 0.057). Among the 622 HBsAg-negative women, the prevalence of occult HBV infection was 6.6% (95% CI: 6.5–6.7). Three of thirteen HBsAg-positive participants were HBeAg-positive, and all were HIV-negative. Of the 11 maternal samples successfully genotyped, five (45.5%) were genotype D3, five (45.5%) were genotype A1, and one was genotype E (9%). Low and similar proportions of HIV-infected and -uninfected pregnant women in Botswana had occult or chronic HBV infection. We identified a subset of HIV-negative pregnant women who had high HBV DNA levels and were HBeAg-positive, and thus likely to transmit HBV to their infants.

Published
2018
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243. Immunological non-response and low hemoglobin levels are predictors of incident tuberculosis among HIV-infected individuals on Truvada-based therapy in Botswana

Author

Mupfumi, Lucy, Moyo, Sikhulile, Molebatsi, Kesaobaka, Thami, Prisca K., Anderson, Motswedi, Mogashoa, Tuelo, Iketleng, Thato, Makhema, Joseph, Marlink, Ric, Kasvosve, Ishmael, Essex, Max, Musonda, Rosemary M., and Gaseitsiwe, Simani

Subjects
Medicine and Health Sciences, Infectious Diseases, Bacterial Diseases, Tuberculosis, Tropical Diseases, Diagnostic Medicine, Tuberculosis Diagnosis and Management, Medicine and health sciences, Infectious diseases, Viral diseases, HIV infections, Biology and Life Sciences, Biochemistry, Proteins, Hemoglobin, Immunology, Vaccination and Immunization, Antiviral Therapy, Antiretroviral Therapy, Public and Occupational Health, Preventive Medicine, Hematology, Anemia, Microbiology, Virology, Viral Transmission and Infection, Viral Load, Medical Microbiology, Microbial Pathogens, Viral Pathogens, Immunodeficiency Viruses, HIV, Pathology and Laboratory Medicine, Pathogens, Organisms, Viruses, Biology and life sciences, RNA viruses, Retroviruses, Lentivirus
Abstract

Background: There is a high burden of tuberculosis (TB) in HIV antiretroviral programmes in Africa. However, few studies have looked at predictors of incident TB while on Truvada-based combination antiretroviral therapy (cART) regimens. Methods: We estimated TB incidence among individuals enrolled into an observational cohort evaluating the efficacy and tolerability of Truvada-based cART in Gaborone, Botswana between 2008 and 2011. We used Cox proportional hazards regressions to determine predictors of incident TB. Results: Of 300 participants enrolled, 45 (15%) had a diagnosis of TB at baseline. During 428 person-years (py) of follow-up, the incidence rate of TB was 3.04/100py (95% CI, 1.69–5.06), with 60% of the cases occurring within 3 months of ART initiation. Incident cases had low baseline CD4+ T cell counts (153cells/mm3 [Q1, Q3: 82, 242]; p = 0.69) and hemoglobin levels (9.2g/dl [Q1, Q3: 8.5,10.1]; p<0.01). In univariate analysis, low BMI (HR = 0.73; 95% CI 0.58–0.91; p = 0.01) and hemoglobin levels <8 g/dl (HR = 10.84; 95%CI: 2.99–40.06; p<0.01) were risk factors for TB. Time to incident TB diagnosis was significantly reduced in patients with poor immunological recovery (p = 0.04). There was no association between baseline viral load and risk of TB (HR = 1.75; 95%CI: 0.70–4.37). Conclusion: Low hemoglobin levels prior to initiation of ART are significant predictors of incident tuberculosis. Therefore, there is potential utility of iron biomarkers to identify patients at risk of TB prior to initiation on ART. Furthermore, additional strategies are required for patients with poor immunological recovery to reduce excess risk of TB while on ART.

Published
2018
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244. Estimating the prevalence of transmitted HIV drug resistance using pooled samples.

Author

Finucane, Mariel M., Rowley, Christopher F., Paciorek, Christopher J., Essex, Max, and Pagano, Marcello

Subjects
DRUG resistance, ANTIRETROVIRAL agents, DISEASE prevalence, MEASUREMENT errors, BAYESIAN analysis, HIV infection transmission, ANTI-HIV agents, DRUG resistance in microorganisms, HIV, HIV infections, GENETIC mutation, PROBABILITY theory, RESEARCH funding, UNCERTAINTY
Abstract

In many resource-poor countries, hiv-infected patients receive a standardized antiretroviral cocktail. In these settings, population-level surveillance of drug resistance is needed to characterize the prevalence of resistance mutations and to enable antiretroviral therapy programs to select the optimal regimen for their local population. The surveillance strategy currently recommended by the World Health Organization is prohibitively expensive in some settings and may not provide a sufficiently precise rendering of the emergence of drug resistance. By using a novel assay on pooled sera samples, we decrease surveillance costs while simultaneously increasing the accuracy of drug resistance prevalence estimates for an important mutation that impacts first-line antiretroviral therapy. We present a Bayesian model for pooled-testing data that garners more information from each resistance assay conducted, compared with individual testing. We expand on previous pooling methods to account for uncertainty about the population distribution of within-subject resistance levels. In addition, our model accounts for measurement error of the resistance assay, and this added uncertainty naturally propagates through the Bayesian model to our inference on the prevalence parameter. We conduct a simulation study that informs our pool size recommendations and that shows that this model renders the prevalence parameter identifiable in instances when an existing non-model-based estimator fails. [ABSTRACT FROM AUTHOR]

Published
2016
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246. Specificity of Four Laboratory Approaches for Cross-Sectional HIV Incidence Determination: Analysis of Samples from Adults with Known Nonrecent HIV Infection from Five African Countries

Author

Laeyendecker, Oliver, primary, Brookmeyer, Ron, additional, Mullis, Caroline E., additional, Donnell, Deborah, additional, Lingappa, Jairam, additional, Celum, Connie, additional, Baeten, Jared M., additional, Campbell, Mary S., additional, Essex, Max, additional, de Bruyn, Guy, additional, Farquhar, Carey, additional, Quinn, Thomas C., additional, and Eshleman, for the Partners in Preve, Susan H., additional

Published
2012
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247. Risk Factors for Symptomatic Hyperlactatemia and Lactic Acidosis Among Combination Antiretroviral Therapy-Treated Adults in Botswana: Results from a Clinical Trial

Author

Wester, C. William, primary, Eden, Svetlana K., additional, Shepherd, Bryan E., additional, Bussmann, Hermann, additional, Novitsky, Vladimir, additional, Samuels, David C., additional, Hendrickson, Sher L., additional, Winkler, Cheryl A., additional, O'Brien, Stephen J., additional, Essex, Max, additional, D'Aquila, Richard T., additional, deGruttola, Victor, additional, and Marlink, Richard G., additional

Published
2012
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250. High Prevalence of Hypertension and Placental Insufficiency, but No In Utero HIV Transmission, among Women on HAART with Stillbirths in Botswana

Author

Shapiro, Roger L., primary, Souda, Sajini, additional, Parekh, Natasha, additional, Binda, Kelebogile, additional, Kayembe, Mukendi, additional, Lockman, Shahin, additional, Svab, Petr, additional, Babitseng, Orphinah, additional, Powis, Kathleen, additional, Jimbo, William, additional, Creek, Tracy, additional, Makhema, Joseph, additional, Essex, Max, additional, and Roberts, Drucilla J., additional

Published
2012
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