646 results on '"Hopewell, Philip C"'
Search Results
202. The Epidemiology of Tuberculosis in San Francisco -- A Population-Based Study Using Conventional and Molecular Methods
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Small, Peter M., primary, Hopewell, Philip C., additional, Singh, Samir P., additional, Paz, Antonio, additional, Parsonnet, Julie, additional, Ruston, Delaney C., additional, Schecter, Gisela F., additional, Daley, Charles L., additional, and Schoolnik, Gary K., additional
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- 1994
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203. Evolution of Chest Radiographs in Treated Patients with Pulmonary Tuberculosis and HIV Infection
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Small, Peter M., primary, Hopewell, Philip C., additional, Schecter, Gisela F., additional, Chaisson, Richard E., additional, and Goodman, Philip C., additional
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- 1994
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204. Molecular epidemiology of tuberculosis in foreign-born persons living in San Francisco.
- Author
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Suwanpimolkul, Gompol, Jarlsberg, Leah G, Grinsdale, Jennifer A, Osmond, Dennis, Kawamura, L Masae, Hopewell, Philip C, and Kato-Maeda, Midori
- Abstract
Rationale: In San Francisco, 70% of the tuberculosis cases occur among foreign-born persons, mainly from China, the Philippines, and Mexico. We postulate that there are differences in the characteristics and risk factors for tuberculosis among these populations.Objectives: To determine the clinical, epidemiological and microbiological characteristics of tuberculosis caused by recent infection and rapid evolution in the major groups of foreign-born and the U.S.-born populations.Methods: We analyzed data from a 20-year prospective community-based study of the molecular epidemiology of tuberculosis in San Francisco. We included all culture-positive tuberculosis cases in the City during the study period.Measurements and Main Results: We calculated and compared incidence rates, clinical and microbiological characteristics, and risk factors for being a secondary case between the various foreign-born and U.S.-born tuberculosis populations. Between 1991 and 2010, there were 4,058 new cases of tuberculosis, of which 1,226 (30%) were U.S.-born and 2,832 (70%) were foreign-born. A total of 3,278 (81%) were culture positive, of which 2,419 (74%) had complete data for analysis. The incidence rate, including the incidence rate of tuberculosis due to recent infection and rapid evolution, decreased significantly in the U.S.-born and the major foreign-born populations. The clinical and microbiological characteristics and the risk factors for tuberculosis due to recent infection differed among the groups.Conclusions: There are differences in the characteristics and the risk factors for tuberculosis due to recent transmission among the major foreign-born and U.S.-born populations in San Francisco. These differences should be considered for the design of targeted tuberculosis control interventions. [ABSTRACT FROM AUTHOR]- Published
- 2013
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205. Use of Whole Genome Sequencing to Determine the Microevolution of Mycobacterium tuberculosis during an Outbreak.
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Kato-Maeda, Midori, Ho, Christine, Passarelli, Ben, Banaei, Niaz, Grinsdale, Jennifer, Flores, Laura, Anderson, Jillian, Murray, Megan, Rose, Graham, Kawamura, L. Masae, Pourmand, Nader, Tariq, Muhammad A., Gagneux, Sebastien, and Hopewell, Philip C.
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TUBERCULOSIS transmission ,NUCLEOTIDE sequence ,TUBERCULOSIS diagnosis ,BACTERIAL evolution ,MYCOBACTERIUM tuberculosis ,BACTERIAL genomes ,MOLECULAR epidemiology ,BACTERIOLOGY - Abstract
Rationale: Current tools available to study the molecular epidemiology of tuberculosis do not provide information about the directionality and sequence of transmission for tuberculosis cases occurring over a short period of time, such as during an outbreak. Recently, whole genome sequencing has been used to study molecular epidemiology of Mycobacterium tuberculosis over short time periods. Objective: To describe the microevolution of M. tuberculosis during an outbreak caused by one drug-susceptible strain. Method and Measurements: We included 9 patients with tuberculosis diagnosed during a period of 22 months, from a population-based study of the molecular epidemiology in San Francisco. Whole genome sequencing was performed using Illumina’s sequencing by synthesis technology. A custom program written in Python was used to determine single nucleotide polymorphisms which were confirmed by PCR product Sanger sequencing. Main results: We obtained an average of 95.7% (94.1–96.9%) coverage for each isolate and an average fold read depth of 73 (1 to 250). We found 7 single nucleotide polymorphisms among the 9 isolates. The single nucleotide polymorphisms data confirmed all except one known epidemiological link. The outbreak strain resulted in 5 bacterial variants originating from the index case A1 with 0–2 mutations per transmission event that resulted in a secondary case. Conclusions: Whole genome sequencing analysis from a recent outbreak of tuberculosis enabled us to identify microevolutionary events observable during transmission, to determine 0–2 single nucleotide polymorphisms per transmission event that resulted in a secondary case, and to identify new epidemiologic links in the chain of transmission. [ABSTRACT FROM AUTHOR]
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- 2013
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206. Tuberculosis and HIV co-infection, California, USA, 1993–2008.
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Metcalfe, John Z, Porco, Travis C, Westenhouse, Janice, Damesyn, Mark, Facer, Matt, Hill, Julia, Xia, Qiang, Watt, James P, Hopewell, Philip C, and Flood, Jennifer
- Abstract
To understand the epidemiology of tuberculosis (TB) and HIV co-infection in California, we cross-matched incident TB cases reported to state surveillance systems during 1993–2008 with cases in the state HIV/AIDS registry. Of 57,527 TB case-patients, 3,904 (7%) had known HIV infection. TB rates for persons with HIV declined from 437 to 126 cases/100,000 persons during 1993–2008; rates were highest for Hispanics (225/100,000) and Blacks (148/100,000). Patients co-infected with TB–HIV during 2001–2008 were significantly more likely than those infected before highly active antiretroviral therapy became available to be foreign born, Hispanic, or Asian/Pacific Islander and to have pyrazinamide-monoresistant TB. Death rates decreased after highly active antiretroviral therapy became available but remained twice that for TB patients without HIV infection and higher for women. In California, HIV-associated TB has concentrated among persons from low- and middle-income countries who often acquire HIV infection in the peri-immigration period. [ABSTRACT FROM AUTHOR]
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- 2013
207. Exogenous Reinfection with Multidrug-Resistant Mycobacterium tuberculosis in Patients with Advanced HIV Infection
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Small, Peter M., primary, Shafer, Robert W., additional, Hopewell, Philip C., additional, Singh, Samir P., additional, Murphy, Mary J., additional, Desmond, Ed, additional, Sierra, Marcelino F., additional, and Schoolnik, Gary K., additional
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- 1993
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208. Two-Year Incidence of Tuberculosis in Cohorts of HIV-infected and Uninfected Urban Rwandan Women
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Allen, Susan, primary, Batungwanayo, Jean, additional, Kerlikowske, Karla, additional, Lifson, Alan R., additional, Wolf, William, additional, Granich, Reuben, additional, Taelman, Henri, additional, van de Perre, Philippe, additional, Serufilira, Antoine, additional, Bogaerts, Joseph, additional, Slutkin, Gary, additional, and Hopewell, Philip C., additional
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- 1992
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209. Effect of Aerosolized Pentamidine Prophylaxis on the Clinical Severity and Diagnosis ofPneumocystis cariniiPneumonia
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Fahy, John V., primary, Chin, Daniel P., additional, Schnapp, Lynn M., additional, Steiger, David J., additional, Schaumberg, Thomas H., additional, Geaghan, Sharon M., additional, Klein, Jeffrey S., additional, and Hopewell, Philip C., additional
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- 1992
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210. Stability of Tuberculin Tests: Reply
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Gordin, Fred M., primary and Hopewell, Philip C., additional
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- 1992
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211. An Outbreak of Tuberculosis with Accelerated Progression among Persons Infected with the Human Immunodeficiency Virus
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Daley, Charles L., primary, Small, Peter M., additional, Schecter, Gisela F., additional, Schoolnik, Gary K., additional, McAdam, Ruth A., additional, Jacobs, William R., additional, and Hopewell, Philip C., additional
- Published
- 1992
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212. Interferon-&ggr; Release Assays for Active Pulmonary Tuberculosis Diagnosis in Adults in Low- and Middle-Income Countries: Systematic Review and Meta-analysis.
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Metcalfe, John Z., Everett, Charles K., Steingart, Karen R., Cattamanchi, Adithya, Huang, Laurence, Hopewell, Philip C., and Pai, Madhukar
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TUBERCULOSIS diagnosis ,INTERFERONS ,LOW-income countries ,MIDDLE-income countries ,SYSTEMATIC reviews ,META-analysis - Abstract
Background. The diagnostic value of interferon-&ggr; release assays (IGRAs) for active tuberculosis in low- and middle-income countries is unclear. Methods. We searched multiple databases for studies published through May 2010 that evaluated the diagnostic performance of QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB (T-SPOT) among adults with suspected active pulmonary tuberculosis or patients with confirmed cases in low- and middle-income countries. We summarized test performance characteristics with use of forest plots, hierarchical summary receiver operating characteristic (HSROC) curves, and bivariate random effects models. Results. Our search identified 789 citations, of which 27 observational studies (17 QFT-GIT and 10 T-SPOT) evaluating 590 human immunodeficiency virus (HIV)-uninfected and 844 HIV-infected individuals met inclusion criteria. Among HIV-infected patients, HSROC/bivariate pooled sensitivity estimates (highest quality data) were 76% (95% confidence interval [CI], 45%-92%) for T-SPOT and 60% (95% CI, 34%-82%) for QFT-GIT. HSROC/ bivariate pooled specificity estimates were low for both IGRA platforms among all participants (T-SPOT, 61% [95% CI, 40%-79%]; QFT-GIT, 52% [95% CI, 41%-62%]) and among HIV-infected persons (T-SPOT, 52% [95% CI, 40%-63%]; QFT-GIT, 50% [95% CI, 35%-65%]). There was no consistent evidence that either IGRA was more sensitive than the tuberculin skin test for active tuberculosis diagnosis. Conclusions. In low- and middle-income countries, neither the tuberculin skin test nor IGRAs have value for active tuberculosis diagnosis in adults, especially in the context of HIV coinfection. [ABSTRACT FROM AUTHOR]
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- 2011
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213. Evaluating Tuberculosis Case Detection via Real-Time Monitoring of Tuberculosis Diagnostic Services.
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Davis, J. Lucian, Katamba, Achilles, Vasquez, Josh, Crawford, Erin, Sserwanga, Asadu, Kakeeto, Stella, Kizito, Fred, Dorsey, Grant, Den Boon, Saskia, Vittinghoff, Eric, Huang, Laurence, Adatu, Francis, Kamya, Moses R., Hopewell, Philip C., and Cattamanchi, Adithya
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- 2011
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214. Racial Differences in Tuberculosis Infection in United States Communities: The Coronary Artery Risk Development in Young Adults Study.
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Nahid, Payam, Horne, David J., Jarlsberg, Leah G., Reiner, Alexander P., Osmond, Dennis, Hopewell, Philip C., and Bibbins-Domingo, Kirsten
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RACIAL differences ,TUBERCULOSIS ,CORONARY heart disease risk factors ,DISEASES in young adults ,BLACK youth ,WHITE youth ,EPIDEMIOLOGY - Abstract
Previously reported associations between race/ethnicity and tuberculosis infection have lacked sufficient adjustment for socioeconomic factors. We analyzed race/ethnicity and selfreported tuberculosis infection data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a well-characterized cohort of 5115 black and white participants, and found that after adjusting for sociodemographic and clinical factors, black participants were more likely to report tuberculosis infection and/or disease (odds ratio, 2.0; 95% confidence interval, 1.5-2.9). [ABSTRACT FROM AUTHOR]
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- 2011
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215. Factors associated with mortality in patients with drug-susceptible pulmonary tuberculosis.
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Nahid, Payam, Jarlsberg, Leah G., Rudoy, Irina, de Jong, Bouke C., Unger, Alon, Kawamura, L. Masae, Osmond, Dennis H., Hopewell, Philip C., and Daley, Charles L.
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MORTALITY ,TUBERCULOSIS patients ,TUBERCULOSIS diagnosis ,SPUTUM ,HIV infections - Abstract
Background: Tuberculosis is a leading cause of death worldwide, yet the determinants of death are not well understood. We sought to determine risk factors for mortality during treatment of drug-susceptible pulmonary tuberculosis under program settings. Methods: Retrospective chart review of patients with drug-susceptible tuberculosis reported to the San Francisco Tuberculosis Control Program from 1990-2001. Results: Of 565 patients meeting eligibility criteria, 37 (6.6%) died during the study period. Of 37 deaths, 12 (32.4%) had tuberculosis listed as a contributing factor. In multivariate analysis controlling for follow-up time, four characteristics were independently associated with mortality: HIV co-infection (HR = 2.57, p = 0.02), older age at tuberculosis diagnosis (HR = 1.52 per 10 years, p = 0.001); initial sputum smear positive for acid fast bacilli (HR = 3.07, p = 0.004); and experiencing an interruption in tuberculosis therapy (HR = 3.15, p = 0.002). The association between treatment interruption and risk of death was due to non-adherence during the intensive phase of treatment (HR = 3.20, p = 0.001). The median duration of treatment interruption did not differ significantly in either intensive or continuation phases between those who died and survived (23 versus 18 days, and 37 versus 29 days, respectively). No deaths were directly attributed to adverse drug reactions. Conclusions: In addition to advanced age, HIV and characteristics of advanced tuberculosis, experiencing an interruption in anti-tuberculosis therapy, primarily due to non-adherence, was also independently associated with increased risk of death. Improving adherence early during treatment for tuberculosis may both improve tuberculosis outcomes as well as decrease mortality. [ABSTRACT FROM AUTHOR]
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- 2011
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216. Chapter 3: Overview of Clinical Tuberculosis.
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Hopewell, Philip C.
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- 1994
217. Determinants of Multidrug-Resistant Tuberculosis Clusters, California, USA, 2004-2007.
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Metcalfe, John Z., Kim, Elizabeth Y., Lin, S.-Y. Grace, Cattamanchi, Adithya, Oh, Peter, Flood, Jennifer, Hopewell, Philip C., and Kato-Maeda, Midori
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TUBERCULOSIS ,EPIDEMIOLOGY ,PATHOGENIC microorganisms ,GENETIC mutation ,MULTIVARIATE analysis - Abstract
Laboratory and epidemiologic evidence suggests that pathogen-specific factors may affect multidrug-resistant (MDR) tuberculosis (TB) transmission and pathogenesis. To identify demographic and clinical characteristics of MDR TB case clustering and to estimate the effect of specific isoniazid resistance-conferring mutations and strain lineage on genotypic clustering, we conducted a population-based cohort study of all MDR TB cases reported in California from January 1, 2004, through December 31, 2007. Of 8,899 incident culture-positive cases for which drug susceptibility information was available, 141 (2%) were MDR. Of 123 (87%) strains with genotype data, 25 (20%) were aggregated in 8 clusters; 113 (92%) of all MDR TB cases and 21 (84%) of clustered MDR TB cases occurred among foreign-born patients. In multivariate analysis, the katG $315T mutati (odds ratio 11.2, 95% confidence interval 2.2-∞ p = 0.004), but not strain lineage, was independently associated with case clustering. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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218. Influence of M. tuberculosis Lineage Variability within a Clinical Trial for Pulmonary Tuberculosis.
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Nahid, Payam, Bliven, Erin E., Kim, Elizabeth Y., MacKenzie, William R., Stout, Jason E., Diem, Lois, Johnson, John L., Gagneux, Sebastien, Hopewell, Philip C., and Kato-Maeda, Midori
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MYCOBACTERIUM tuberculosis ,TUBERCULOSIS transmission ,PHYLOGENY ,GENETIC polymorphisms ,GENOMES ,PATHOGENIC bacteria ,GENETICS - Abstract
Recent studies suggest that M. tuberculosis lineage and host genetics interact to impact how active tuberculosis presents clinically. We determined the phylogenetic lineages of M. tuberculosis isolates from participants enrolled in the Tuberculosis Trials Consortium Study 28, conducted in Brazil, Canada, South Africa, Spain, Uganda and the United States, and secondarily explored the relationship between lineage, clinical presentation and response to treatment. Large sequence polymorphisms and single nucleotide polymorphisms were analyzed to determine lineage and sublineage of isolates. Of 306 isolates genotyped, 246 (80.4%) belonged to the Euro-American lineage, with sublineage 724 predominating at African sites (99/192, 51.5%), and the Euro- American strains other than 724 predominating at non-African sites (89/114, 78.1%). Uneven distribution of lineages across regions limited our ability to discern significant associations, nonetheless, in univariate analyses, Euro-American sublineage 724 was associated with more severe disease at baseline, and along with the East Asian lineage was associated with lower bacteriologic conversion after 8 weeks of treatment. Disease presentation and response to drug treatment varied by lineage, but these associations were no longer statistically significant after adjustment for other variables associated with week-8 culture status. [ABSTRACT FROM AUTHOR]
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- 2010
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219. Evaluation of quantitative IFN-gamma response for risk stratification of active tuberculosis suspects.
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Metcalfe JZ, Cattamanchi A, Vittinghoff E, Ho C, Grinsdale J, Hopewell PC, Kawamura LM, Nahid P, Metcalfe, John Z, Cattamanchi, Adithya, Vittinghoff, Eric, Ho, Christine, Grinsdale, Jennifer, Hopewell, Philip C, Kawamura, L Masae, and Nahid, Payam
- Abstract
Rationale: The contribution of interferon-gamma release assays (IGRAs) to appropriate risk stratification of active tuberculosis suspects has not been studied.Objectives: To determine whether the addition of quantitative IGRA results to a prediction model incorporating clinical criteria improves risk stratification of smear-negative-tuberculosis suspects.Methods: Clinical data from tuberculosis suspects evaluated by the San Francisco Department of Public Health Tuberculosis Control Clinic from March 2005 to February 2008 were reviewed. We excluded tuberculosis suspects who were acid fast-bacilli smear-positive, HIV-infected, or under 10 years of age. We developed a clinical prediction model for culture-positive disease and examined the benefit of adding quantitative interferon (IFN)-gamma results measured by QuantiFERON-TB Gold (Cellestis, Carnegie, Australia).Measurements and Main Results: Of 660 patients meeting eligibility criteria, 65 (10%) had culture-proven tuberculosis. The odds of active tuberculosis increased by 7% (95% confidence interval [CI], 3-11%) for each doubling of IFN-gamma level. The addition of quantitative IFN-gamma results to objective clinical data significantly improved model performance (c-statistic 0.71 vs. 0.78; P < 0.001) and correctly reclassified 32% of tuberculosis suspects (95% CI,11-52%; P < 0.001) into higher-risk or lower-risk categories. However, quantitative IFN-gamma results did not significantly improve appropriate risk reclassification beyond that provided by clinician assessment of risk (4%; 95% CI, -7 to +22%; P = 0.14).Conclusions: Higher quantitative IFN-gamma results were associated with active tuberculosis, and added clinical value to a prediction model incorporating conventional risk factors. Although this benefit may be attenuated within highly experienced centers, the predictive accuracy of quantitative IFN-gamma levels should be evaluated in other settings. [ABSTRACT FROM AUTHOR]- Published
- 2010
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220. Role of interferon-gamma release assays in the diagnosis of pulmonary tuberculosis in patients with advanced HIV infection.
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Cattamanchi, Adithya, Ssewenyana, Isaac, Davis, J. Lucian, Huang, Laurence, Worodria, William, den Boon, Saskia, Yoo, Samuel, Andama, Alfred, Hopewell, Philip C., and Huyen Cao
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INTERFERONS ,T cells ,TUBERCULOSIS diagnosis ,HIV infections ,IMMUNE response - Abstract
Background: T-cell interferon-gamma release assays (IGRAs) may have a role in the diagnosis of active tuberculosis when evaluating patients for whom standard microbiology has limited sensitivity. Our objective was to examine the accuracy of a commercial IGRA for diagnosis of active tuberculosis in HIV-infected persons. Methods: We enrolled HIV-infected patients admitted to Mulago Hospital in Kampala, Uganda with cough ⩾ 2 weeks. All patients underwent standard medical evaluation. We collected peripheral blood specimens at enrollment and performed a commercial, ELISPOT-based IGRA according to the manufacturer's recommendations. IGRA sensitivity and specificity were determined using mycobacterial culture results as the reference standard. Results: Overall, 236 patients were enrolled. The median CD4+ T-lymphocyte count was 49 cells/μl and 126 (53%) patients were diagnosed with active pulmonary tuberculosis. IGRAs were not performed in 24 (10%) patients due to insufficient mononuclear cell counts. In the remaining 212 patients, results were indeterminate in 54 (25%). IGRAs were positive in 95 of 158 (60%) patients with interpretable results. The proportion of positive test results was similar across CD4+ count strata. IGRA sensitivity was 73% and specificity 54%. IGRA results did not meaningfully alter the probability of active tuberculosis in patients with negative sputum smears. Conclusions: An ELISPOT-based IGRA detected a high prevalence of latent tuberculosis infection in a hospitalized population of tuberculosis suspects with advanced HIV/AIDS but had limited utility for diagnosis of active tuberculosis in a high prevalence setting. Further research is needed to identify stronger and more specific immune responses in patients with active tuberculosis. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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221. Stability of Positive Tuberculin Tests: Are Boosted Reactions Valid?
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Gordin, Fred M., primary, Perez-Stable, Eliseo J., additional, Reid, Marsha, additional, Schecter, Gisela, additional, Cosgriff, Lauren, additional, Flaherty, Denise, additional, and Hopewell, Philip C., additional
- Published
- 1991
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222. Morbidity and Mortality of Patients with AIDS and First-EpisodePneumocystis cariniiPneumonia Unaffected by Concomitant Pulmonary Cytomegalovirus Infection
- Author
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Jacobson, Mark A., primary, Mills, John, additional, Rush, Joanne, additional, Peiperl, Laurence, additional, Seru, Vinita, additional, Mohanty, Prasanna K., additional, Hopewell, Philip C., additional, Hadley, W. Keith, additional, Broaddus, V. Courtney, additional, Leoung, Gifford, additional, and Feigal, David W., additional
- Published
- 1991
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223. Isoniazid, Rifampin, Ethambutol, and Pyrazinamide Pharmacokinetics and Treatment Outcomes among a Predominantly HIV-Infected Cohort of Adults with Tuberculosis from Botswana.
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Chideya, Sekai, Winston, Carla A., Peloquin, Charles A., Bradford, William Z., Hopewell, Philip C., Wells, Charles D., Reingold, Arthur L., Kenyon, Thomas A., Moeti, Themba L., and Tappero, Jordan W.
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TUBERCULOSIS treatment ,ISONIAZID ,RIFAMPIN ,PYRAZINAMIDE ,HIV-positive persons ,TUBERCULOSIS patients ,PHARMACOKINETICS ,MEDICAL research - Abstract
Background. We explored the association between antituberculosis drug pharmacokinetics and treatment outcomes among patients with pulmonary tuberculosis in Botswana. Methods. Consenting outpatients with tuberculosis had blood samples collected 1, 2, and 6 h after simultaneous isoniazid, rifampin, ethambutol, and pyrazinamide ingestion. Maximum serum concentrations (C
max ) and areas under the serum concentration time curve were determined. Clinical status was monitored throughout treatment. Results. Of the 225 participants, 36 (16%) experienced poor treatment outcome (treatment failure or death); 155 (69%) were infected with human immunodeficiency virus (HIV). Compared with published standards, low isoniazidCmax occurred in 84 patients (37%), low rifampin Cmax in 188 (84%), low ethambutol Cmax in 87 (39%), and low pyrazinamide Cmax in 11 (5%). Median rifampin and pyrazinamide levels differed significantly by HIV status and CD4 cell count category. Only pyrazinamide pharmacokinetics were significantly associated with treatment outcome; low pyrazinamide Cmax was associated with a higher risk of documented poor treatment outcome, compared with normal Cmax (50% vs. 16%; P ! .01). HIV-infected patients with a CD4 cell count <200 cells/μL had a higher risk of poor treatment outcome (27%) than did HIV-uninfected patients (11%) or HIV-infected patients with a CD4 cell count ⩾200 cells/μL (12%; P = .01). After adjustment for HIV infection and CD4 cell count, patients with low pyrazinamide Cmax were 3 times more likely than patients with normal pyrazinamide Cmax to have poor outcomes (adjusted risk ratio, 3.38; 95% confidence interval, 1.84-6.22). Conclusions. Lower than expected antituberculosis drug Cmax occurred frequently, and low pyrazinamide Cmax was associated with poor treatment outcome. Exploring the global prevalence and significance of these findings may suggest modifications in treatment regimens that could improve tuberculosis cure rates. [ABSTRACT FROM AUTHOR]- Published
- 2009
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224. Clinical Characteristics and Treatment Outcomes of Patients with Isoniazid-Monoresistant Tuberculosis.
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Cattamanchi, Adithya, Dantes, Raymund B., Metcalfe, John Z., Jarlsberg, Leah G., Grinsdale, Jennifer, Kawamura, L. Masae, Osmond, Dennis, Hopewell, Philip C., and Nahid, Payam
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ISONIAZID ,ANTITUBERCULAR agents ,TUBERCULOSIS ,PYRAZINAMIDE ,MATHEMATICAL statistics ,CONFIDENCE intervals - Abstract
Background. Risk factors and treatment outcomes under program conditions for isoniazid (INH)-monoresistant tuberculosis have not been well described. Methods. Medical charts were retrospectively reviewed for all cases of culture-confirmed, INH-monoresistant tuberculosis ( ) reported n=137 to the San Francisco Department of Public Health Tuberculosis Control Section from October 1992 through October 2005, and those cases were compared with a time-matched sample of drugsusceptible tuberculosis cases (n=274). Results. In multivariate analysis, only a history of treatment for latent tuberculosis (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.5-6.4; P=.003) or for active tuberculosis (OR, 2.7; 95% CI, 1.4-5.0; P=.002) were significantly associated with INH-monoresistant tuberculosis. Of the 119 patients who completed treatment, 49 (41%) completed a 6-month treatment regimen. Treatment was extended to 7-12 months for 53 (45%) of the patients and to 112 months for 17 (14%). Treatment was most commonly extended because pyrazinamide was not given for the recommended 6-month duration (35 patients [29%]). Despite variation in treatment regimens, the combined end point of treatment failure or relapse was uncommon among patients with INH-monoresistant tuberculosis and was not significantly different for patients with drug-susceptible tuberculosis (1.7% vs. 2.2%; P=.73). Conclusions. A history of treatment for latent or active tuberculosis was associated with subsequent INH monoresistance. Treatment outcomes for patients with INH-monoresistant tuberculosis were excellent and were no different from those for patients with drug-susceptible tuberculosis. However, new, short-course regimens are needed because a small proportion of patients completed the 6-month treatment regimen recommended by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society ofAmerica, primarily because of pyrazinamide intolerance. [ABSTRACT FROM AUTHOR]
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- 2009
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225. Pneumocystis cariniiPneumonia and Respiratory Failure in AIDS: Improved Outcomes and Increased Use of Intensive Care Units
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Wachter, Robert M., primary, Russi, Mark B., additional, Bloch, Daniel A., additional, Hopewell, Philip C., additional, and Luce, John M., additional
- Published
- 1991
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226. Treatment of Tuberculosis in Patients with Advanced Human Immunodeficiency Virus Infection
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Small, Peter M., primary, Schecter, Gisela F., additional, Goodman, Philip C., additional, Sande, Merle A., additional, Chaisson, Richard E., additional, and Hopewell, Philip C., additional
- Published
- 1991
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227. Giants in Chest Medicine: John F. Murray, MD.
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Hopewell, Philip C. and Murray, John F
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PULMONOLOGY , *LUNG diseases , *HIV infections , *INTERNAL medicine , *MEDICAL societies , *CHEST diseases , *HISTORY - Abstract
The article discusses the contributions of Doctor John F. Murray to modern pulmonary medicine. Topics discussed include Murray's publications that center on the principles of chest medicine and his role in the creation of the Division of Lung Disease in the National Heart, Lung and Blood Institute. His leadership in the American Thoracic Society and his efforts in studying pulmonary disease in people with HIV infection are also mentioned. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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228. Reaching the Limits of Tuberculosis Prevention among Foreign-Born Individuals: A Tuberculosis-Control Program Perspective.
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Walter, Nicholas D., Jasmer, Robert M., Grinsdale, Jennifer, Kawamura, L. Masae, Hopewell, Philip C., and Nahid, Payam
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TUBERCULOSIS prevention ,IMMIGRANTS ,TUBERCULOSIS ,CHEST diseases ,COMMUNICABLE diseases - Abstract
Analysis of whether assiduous implementation of American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America guidelines for targeted testing and treatment of latent tuberculosis infection could have prevented any of 223 cases of active tuberculosis in foreign-born persons in San Francisco during the period 2002-2003. We report that 62% of these cases were not preventable and conclude that a further reduction in the incidence of tuberculosis among foreign-born persons will be modest without modification of current guidelines. [ABSTRACT FROM AUTHOR]
- Published
- 2008
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229. A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis.
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Steingart, Karen R., Henry, Megan, Laal, Suman, Hopewell, Philip C., Ramsay, Andrew, Menzies, Dick, Cunningham, Jane, Weldingh, Karin, and Pai, Madhukar
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MYCOBACTERIAL diseases ,SYSTEMATIC reviews ,HIV-positive persons ,IMMUNOGLOBULINS ,LYMPH nodes - Abstract
Conventional diagnostic tests for tuberculosis have several limitations and are often unhelpful in establishing the diagnosis of extrapulmonary tuberculosis. Although commercial serological antibody based tests are available, their usefulness in the diagnosis of extrapulmonary tuberculosis is unknown. A systematic review was conducted to assess the accuracy of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis. In a comprehensive search, 21 studies that reported data on sensitivity and specificity for extrapulmonary tuberculosis were identified. These studies evaluated seven different commercial tests, with Anda-TB IgG accounting for 48% of the studies. The results showed that (1) all commercial tests provided highly variable estimates of sensitivity (range 0.00-1.00) and specificity (range 0.59-1.00) for all extrapulmonary sites combined; (2) the Anda-TB IgG kit showed highly variable sensitivity (range 0.26- 1.00) and specificity (range 0.59-1.00) for all extrapulmonary sites combined; (3) for all tests combined, sensitivity estimates for both lymph node tuberculosis (range 0.23-1.00) and pleural tuberculosis (range 0.26-0.59) were poor and inconsistent; and (4) there were no data to determine the accuracy of the tests in children or in patients with HIV infection, the two groups for which the test would be most useful. At present, commercial antibody detection tests for extrapulmonary tuberculosis have no role in clinical care or case detection. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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230. Commercial Serological Antibody Detection Tests for the Diagnosis of Pulmonary Tuberculosis: A Systematic Review.
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Steingart, Karen R., Henry, Megan, Laal, Suman, Hopewell, Philip C., Ramsay, Andrew, Menzies, Dick, Cunningham, Jane, Weldingh, Karin, and Pai, Madhukar
- Subjects
TUBERCULOSIS diagnosis ,IMMUNOGLOBULINS ,SPUTUM examination ,PROVOCATION tests (Medicine) ,DIAGNOSIS - Abstract
Based on a systematic review, Madhukar Pai and colleagues conclude that none of the commercial immune-based tests for pulmonary tuberculosis so far evaluated perform well enough to replace sputum smear microscopy. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
231. International Standards for Tuberculosis Care: revisiting the cornerstones of tuberculosis care and control.
- Author
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Fair, Elizabeth, Hopewell, Philip C., and Pai, Madhukar
- Subjects
MEDICAL care ,TUBERCULOSIS treatment ,MULTIDRUG-resistant tuberculosis ,DIAGNOSIS ,CLINICAL trials ,PUBLIC health - Abstract
Tuberculosis (TB) remains an enormous global health problem. There are 8–9 million new cases and 2 million deaths from TB annually. Despite the overwhelming burden of disease, the basic principles of care for persons with, or suspected of having, TB are the same worldwide: a diagnosis should be established promptly and accurately, standardized treatment regimens of proven efficacy should be used together with appropriate treatment support and supervision, the response to treatment should be monitored, and the essential public health responsibilities must be carried out. As an approach to improving the care of patients with TB, an evidence-based document, the International Standards for Tuberculosis Care (ISTC) was developed and has been endorsed by more than 30 international and national agencies. This special report introduces the ISTC and discusses the fact that accurate diagnosis and effective treatment are not only essential for good patient care, they are the key elements in the public health response to TB and are the cornerstone of TB control. With the recent emergence of extensively drug-resistant TB, there is an urgent need to ensure globally that standards of TB care are based on rigorous scientific findings, are clear and well understood, and are accessible to and applied by all types of healthcare providers in all corners of the world. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
232. International Standards for Tuberculosis Care
- Author
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Hopewell, Philip C, Pai, Madhukar, Maher, Dermot, Uplekar, Mukund, and Raviglione, Mario C
- Subjects
- *
TUBERCULOSIS , *CHEST diseases , *LUNG diseases , *MYCOBACTERIAL diseases , *PUBLIC health - Abstract
Summary: Part of the reason for failing to bring about a more rapid reduction in tuberculosis incidence worldwide is the lack of effective involvement of all practitioners—public and private—in the provision of high quality tuberculosis care. While health-care providers who are part of national tuberculosis programmes have been trained and are expected to have adopted proper diagnosis, treatment, and public-health practices, the same is not likely to be true for non-programme providers. Studies of the performance of the private sector conducted in several different parts of the world suggest that poor quality care is common. The basic principles of care for people with, or suspected of having, tuberculosis are the same worldwide: a diagnosis should be established promptly; standardised treatment regimens should be used with appropriate treatment support and supervision; response to treatment should be monitored; and essential public-health responsibilities must be carried out. Prompt and accurate diagnosis, and effective treatment are essential for good patient care and tuberculosis control. All providers who undertake evaluation and treatment of patients with tuberculosis must recognise that not only are they delivering care to an individual, but they are also assuming an important public-health function. The International Standards for Tuberculosis Care (ISTC) describe a widely endorsed level of care that all practitioners should seek to achieve in managing individuals who have, or are suspected of having, tuberculosis. The document is intended to engage all care providers in delivering high quality care for patients of all ages, including those with smear-positive, smear-negative, and extra-pulmonary tuberculosis, tuberculosis caused by drug-resistant Mycobacterium tuberculosis complex, and tuberculosis combined with HIV infection. [Copyright &y& Elsevier]
- Published
- 2006
- Full Text
- View/download PDF
233. Variable host—pathogen compatibility in Mycobacterium tuberculosis.
- Author
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Gagneux, Sebastien, DeRiemer, Kathryn, Van, Tran, Kato-Maeda, Midori, de Jong, Bouke C., Narayanan, Sujatha, Nicol, Mark, Niemann, Stefan, Kremer, Kristin, Gutierrez, M. Cristina, Hilty, Markus, Hopewell, Philip C., and Small, Peter M.
- Subjects
MYCOBACTERIUM tuberculosis ,CARCINOGENESIS ,LUNG diseases ,MORTALITY ,PATHOGENIC microorganisms ,CARCINOGENICITY ,TUBERCULOSIS - Abstract
Mycobacterium tuberculosis remains a major cause of morbidity and mortality worldwide. Studies have reported human pathogens to have geographically structured population genetics, some of which have been linked to ancient human migrations. However, no study has addressed the potential evolutionary consequences of such longstanding human-pathogen associations. Here, we demonstrate that the global population structure of M. tuberculosis is defined by six phylogeographical lineages, each associated with specific, sympatric human populations. In an urban cosmopolitan environment, mycobacterial lineages were much more likely to spread in sympatric than in allopatric patient populations. Tuberculosis cases that did occur in allopatric hosts disproportionately involved high-risk individuals with impaired host resistance. These observations suggest that mycobacterial lineages are adapted to particular human populations. If confirmed, our findings have important implications for tuberculosis control and vaccine development. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
234. Oral Therapy forPneumocystis cariniiPneumonia in the Acquired Immunodeficiency Syndrome
- Author
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Medina, Ileana, primary, Mills, John, additional, Leoung, Gifford, additional, Hopewell, Philip C., additional, Lee, Belle, additional, Modin, Gunnard, additional, Benowitz, Neal, additional, and Wofsy, Constance B., additional
- Published
- 1990
- Full Text
- View/download PDF
235. Survival after Active Tuberculosis in Patients with HIV Infection: Reply
- Author
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Chaisson, Richard E., primary and Hopewell, Philip C., additional
- Published
- 1990
- Full Text
- View/download PDF
236. Why Tuberculosis Is Not Prevented
- Author
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Glassroth, Jeffrey, primary, Bailey, William C., additional, Hopewell, Philip C., additional, Schecter, Giesella, additional, and Harden, James W., additional
- Published
- 1990
- Full Text
- View/download PDF
237. Presumptive Diagnosis and Treatment of Pulmonary Tuberculosis Based on Radiographic Findings: Reply
- Author
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Gordin, Fred M., primary, Slutkin, Gary, additional, Schecter, Gisela, additional, Goodman, Philip C., additional, and Hopewell, Philip C., additional
- Published
- 1990
- Full Text
- View/download PDF
238. Tuberculosis, Vulnerability, and Access to Quality Care.
- Author
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Hopewell, Philip C. and Pai, Madhukar
- Subjects
- *
TUBERCULOSIS , *MYCOBACTERIAL diseases , *LUNG diseases , *MYCOBACTERIUM tuberculosis , *IMMUNE response - Abstract
Focuses on tuberculosis and the vulnerability to the disease. Factors that contribute to vulnerability; Categorization of these factors into those that influence the likelihood of acquisition of infection with Mycobacterium tuberculosis and those that influence the host-immune response to the infection; Need for the development of international standards for tuberculosis care.
- Published
- 2005
- Full Text
- View/download PDF
239. Treatment of Multidrug-Resistant Tuberculosis in San Francisco: An Outpatient-Based Approach.
- Author
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Burqos, Marcos, Gonzalez, Leah C., Paz, E. Antonio, Gournis, Effie, Kawamura, L. Masae, Schecter, Gisela, Hopewell, Philip C., and Daley, Charles L.
- Subjects
HIV infections ,HIV ,STANDARD deviations ,THERAPEUTICS ,MYCOBACTERIUM tuberculosis ,TUBERCULIN - Abstract
Treatment of patients with multidrug-resistant tuberculosis requires prolonged therapy, often involving long hospital stays. Despite intensive and costly therapy, cure rates are relatively low. We reviewed the outcomes for all patients with multidrug-resistant tuberculosis treated in San Francisco, California, during 1982-2000 and identified billing charges for patients treated during 1995-2000. Mycobacterium tuberculosis isolates were genotyped by 1S6110-based restriction fragment-length polymorphism analysis. Forty-eight cases were identified with resistance to a median of 3 drugs (range, 2-9 drugs). The median age of the patients was 49.5 years (range, 22-78 years); 36 (75%) of 48 patients were foreign born, 11 (23%) were human immunodeficiency virus (HIV) seropositive, and 45 (94%) had pulmonary tuberculosis. Thirty- two (97%) of the 33 HIV-seronegative patients were cured, with only 1 relapse occurring 5 years after treatment. All 11 HIV-seropositive patients died during observation. Twenty-one patients (44%) required hospitalization, with a median duration of stay of 14 days (range, 3-74 days). The estimated inpatient and outpatient aggregate cost for the 11 patients treated after 1994 was $519,928, with a median cost of $27,752 per patient. No secondary cases of multidrug-resistant tuberculosis were identified through population-based genotyping. Treatment of multidrug-resistant tuberculosis in HIV-seronegative patients largely on an outpatient basis was feasible and was associated with high cure rates and lower cost than in other published studies. Patients with underlying HIV infection had very poor outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
240. Short-Course Rifampin and Pyrazinamide Compared with Isoniazid for Latent Tuberculosis Infection: A Cost-Effectiveness Analysis Based on a Multicenter Clinical Trial.
- Author
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Jasmer, Robert M., Snyder, David C., Saukkonen, Jussi J., Hopewell, Philip C., Bernardo, John, King, Mark D., Kawamura, L. Masae, and Daley, Charles L.
- Subjects
RIFAMPIN ,ISONIAZID ,ANTITUBERCULAR agents ,TUBERCULOSIS treatment ,MEDICAL care costs ,COST effectiveness ,COST analysis - Abstract
Two months of treatment with rifampinpyrazinamide (RZ) and 9 months of treatment with isoniazid are both recommended for treatment of latent tuberculosis infection in adults without human immunodeficiency virus infection, but the relative cost-effectiveness of these 2 treatments is unknown. We used a Markov model to conduct a cost-effectiveness analysis to assess the impact on life expectancy and costs based on the results of a recent clinical trial that compared the rates of adverse events and completion of the 2 treatment regimens. Compared with no treatment, both regimens increased life expectancy by 1.2 years, but RZ cost $273 more per patient. Sensitivity analyses showed that, assuming equal efficacy between the 2 regimens, there was no threshold completion rate for RZ at which the 2 treatments would be of equal net cost. Under most circumstances, treatment of latent tuberculosis infection with isoniazid is cost-saving than treatment with RZ. [ABSTRACT FROM AUTHOR]
- Published
- 2004
241. A Molecular Epidemiological Assessment of Extrapulmonary Tuberculosis in San Francisco.
- Author
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Ong, Adrian, Creasman, Jennifer, Hopewell, Philip C., Gonzalez, Leah C., Wong, Maida, Jasmer, Robert M., and Daley, Charles L.
- Subjects
EPIDEMIOLOGY ,TUBERCULOSIS ,HEALTH risk assessment ,GENETIC polymorphisms ,MULTIVARIATE analysis ,HIV-positive persons - Abstract
The epidemiology of extrapulmonary tuberculosis (TB) is not well understood. We studied all cases of extrapulmonary TB reported in San Francisco during 1991-2000 to determine risk factors for extrapulmonary TB and the proportion caused by recent infection. Isolates were analyzed by IS6110-based restriction fragment- length polymorphisms analysis. There were 480 cases of extrapulmonary TB, of which 363 (76%) were culture positive; isolates were genotyped for 301 cases (83%). Multivariate analysis identified young age, female sex, and HIV infection as independent risk factors for nonrespiratory TB (excluding pulmonary, pleural, and disseminated TB). Pleural TB was less common in HIV-seropositive persons and women than were nonrespiratory forms of extrapulmonary TB. Pleural TB is different from other forms of extrapulmonary TB and is associated with the highest clustering rate (35% of cases) of all forms of TB. This high rate of clustering occurs because pleural TB is often an early manifestation of recent infection. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
242. Effect of drug resistance on the generation of secondary cases of tuberculosis.
- Author
-
Burgos, Marcos, DeRiemer, Kathryn, Small, Peter M., Hopewell, Philip C., and Daley, Charles L.
- Subjects
ISONIAZID ,DRUG resistance ,TUBERCULOSIS ,MYCOBACTERIA ,LUNG diseases ,COMMUNICABLE diseases - Abstract
Background: The results of animal studies suggest that isoniazid-resistant strains of Mycobacterium tuberculosis are less pathogenic than isoniazid-susceptible strains. Here, we assess the relative pathogenicity of drug-resistant and drug-susceptible strains, in a human population.Methods: We linked IS6110 genotype patterns of M. tuberculosis strains with drug-susceptibility test results and epidemiologic information for 85% of culture-positive incident cases of tuberculosis (TB) in San Francisco during 1991-1999. We assumed that drug-susceptible and drug-resistant strains were transmitted to secondary case patients if the drug-resistance and genotype patterns were identical. We calculated the number of secondary cases for each drug-resistance pattern and determined the relative secondary-case rate ratio (SR) of drug-resistant TB to drug-susceptible TB.Results: There were 1800 patients with culture-positive TB, drug-susceptibility test results, and genotyping results. The overall SR of drug-resistant to drug-susceptible TB cases was 0.51 (95% confidence interval [CI], 0.37-0.69). The SR was 0.29 (95% CI, 0.15-0.57) for isoniazid-resistant strains, 0.10 (95% CI, 0.02-0.42) for strains resistant to both isoniazid and streptomycin, and 0.88 (95% CI, 0.53-1.47) for streptomycin-resistant strains. There were no secondary cases caused by multidrug-resistant (MDR) TB. The SR for rifampin-resistant cases was 2.33 (95% CI, 1.04-5.25). Seventy-eight percent (7/9) of the patients with rifampin-resistant secondary cases of TB were seropositive for human immunodeficiency virus.Conclusion: In the context of an effective TB program in San Francisco, strains that were resistant to isoniazid either alone or in combination with other drugs were less likely to result in secondary cases than were drug-susceptible strains. In this setting, isoniazid-resistant and MDR TB cases were not likely to produce new, incident drug-resistant TB cases. [ABSTRACT FROM AUTHOR]- Published
- 2003
- Full Text
- View/download PDF
243. Short-course rifampin and pyrazinamide compared with isoniazid for latent tuberculosis infection: a multicenter clinical trial.
- Author
-
Jasmer, Robert M., Saukkonen, Jussi J., Blumberg, Henry M., Daley, Charles L., Bernardo, John, Vittinghoff, Eric, King, Mark D., Kawamura, L. Masae, Hopewell, Philip C., and Short-Course Rifampin and Pyrazinamide for Tuberculosis Infection (SCRIPT) Study Investigators
- Subjects
TUBERCULOSIS treatment ,RIFAMPIN ,ISONIAZID - Abstract
Background: Rifampin and pyrazinamide are recommended for treatment of latent tuberculosis infection in adults without HIV infection, but reports of severe hepatotoxicity have raised concerns about its safety. Clinical trials have not compared this treatment with isoniazid in adults without HIV infection.Objective: To compare the safety and tolerance of a 2-month regimen of rifampin and pyrazinamide with that of a 6-month regimen of isoniazid for treatment of latent tuberculosis infection.Design: Multicenter, prospective, open-label trial.Setting: Three urban public health tuberculosis clinics in the United States.Patients: 589 adults with latent tuberculosis infection who met U.S. criteria for treatment.Intervention: Patients were assigned in alternate weeks to receive rifampin and pyrazinamide daily for 2 months (n = 307) or isoniazid daily for 6 months (n = 282).Measurements: Primary end points were hepatotoxicity, other adverse events, and percentage of patients who completed treatment.Results: Sixteen of 207 (7.7%) patients assigned to rifampin and pyrazinamide developed grade 3 or 4 hepatotoxicity compared with 2 of 204 (1%) patients assigned to isoniazid (odds ratio, 8.46 [95% CI, 1.9 to 76.5]; P = 0.001). The rifampin plus pyrazinamide regimen was more likely than the isoniazid regimen to be discontinued because of hepatotoxicity (odds ratio, 5.19; P = 0.033). The overall percentage of nonhepatotoxic adverse events was 20% in the rifampin-pyrazinamide group and 16% in the isoniazid group. The proportion of patients who completed the study treatment was 61% and 57%, respectively.Conclusions: A 2-month regimen of rifampin and pyrazinamide was associated with an increased risk for grade 3 or 4 hepatotoxicity compared with a 6-month regimen of isoniazid. Liver enzymes should be measured routinely during treatment to screen for liver injury and prevent progression to severe toxicity. [ABSTRACT FROM AUTHOR]- Published
- 2002
244. Rifampin monoresistant tuberculosis and HIV comorbidity in California, 1993–2008
- Author
-
Prach, Lisa M., Pascopella, Lisa, Barry, Pennan M., Flood, Jennifer, Porco, Travis C., Hopewell, Philip C., and Metcalfe, John Z.
- Abstract
Rifampin monoresistant tuberculosis (RMR-TB) is increasingly identified because of scale-up of rapid molecular tests. The longitudinal association of RMR-TB, multidrug-resistant TB (MDR-TB), and HIVAIDS is incompletely described.
- Published
- 2013
- Full Text
- View/download PDF
245. Impact of Bacterial Pneumonia and Pneumocystis carinii Pneumonia on Human Immunodeficiency Virus Disease Progression.
- Author
-
Osmond, Dennis H., Chin, Daniel P., Glassroth, Jeffrey, Kvale, Paul A., Wallace, Jeane M., Rosen, Mark J., Reichman, Lee B., Poole, W. Kenneth, and Hopewell, Philip C.
- Subjects
PNEUMONIA ,OPPORTUNISTIC infections ,PNEUMOCYSTIS carinii ,HIV-positive persons - Abstract
Studies the effects of two species of pneumonia-causing bacteria on the progression of HIV among infected individuals. Comparison of median survival rates and CD4 lymphocyte counts among HIV infected and non-infected groups; Implications of the similarities of the effects of bacterial pneumonia and AIDS-defining opportunistic infection; Advice on the use of preventive measures for bacterial pneumonia.
- Published
- 1999
246. Beijing Sublineages of Mycobacterium tuberculosisDiffer in Pathogenicity in the Guinea Pig
- Author
-
Kato-Maeda, Midori, Shanley, Crystal A., Ackart, David, Jarlsberg, Leah G., Shang, Shaobin, Obregon-Henao, Andres, Harton, Marisabel, Basaraba, Randall J., Henao-Tamayo, Marcela, Barrozo, Joyce C., Rose, Jordan, Kawamura, L. Masae, Coscolla, Mireia, Fofanov, Viacheslav Y., Koshinsky, Heather, Gagneux, Sebastien, Hopewell, Philip C., Ordway, Diane J., and Orme, Ian M.
- Abstract
ABSTRACTThe Beijing family of Mycobacterium tuberculosisstrains is part of lineage 2 (also known as the East Asian lineage). In clinical studies, we have observed that isolates from the sublineage RD207 of lineage 2 were more readily transmitted among humans. To investigate the basis for this difference, we tested representative strains with the characteristic Beijing spoligotype from four of the five sublineages of lineage 2 in the guinea pig model and subjected these strains to comparative whole-genome sequencing. The results of these studies showed that all of the clinical strains were capable of growing and causing lung pathology in guinea pigs after low-dose aerosol exposure. Differences between the abilities of the four sublineages to grow in the lungs of these animals were not overt, but members of RD207 were significantly more pathogenic, resulting in severe lung damage. The RD207 strains also induced much higher levels of markers associated with regulatory T cells and showed a significant loss of activated T cells in the lungs over the course of the infections. Whole-genome sequencing of the strains revealed mutations specific for RD207 which may explain this difference. Based on these data, we hypothesize that the sublineages of M. tuberculosisare associated with distinct pathological and clinical phenotypes and that these differences influence the transmissibility of particular M. tuberculosisstrains in human populations.
- Published
- 2012
- Full Text
- View/download PDF
247. Tuberculin Reactivity in United States and Foreign-Born Latinos: Results of a Community-Based Screening Program.
- Author
-
Perez-Stable, Eliseo J., Slutkin, Gary, Paz, E. Antonio, and Hopewell, Philip C.
- Subjects
HISPANIC Americans ,TUBERCULOSIS vaccines ,TUBERCULOSIS diagnosis ,MEDICAL examinations of immigrants ,BCG vaccines ,TUBERCULIN test - Abstract
Because of the concern that we were underestimating the prevalence of tuberculosis within the Latino community in San Francisco, we undertook a community-based screening program directed largely towards recent immigrants. Of 1,871 intermediate-strength (5 TU) tuberculin tests applied and read, 37 per cent of the reactions were ≥ 10 mm. Significant reactions were found in 53 per cent of foreign-born persons compared to 7 per cent of those born in the United States. Persons older than 20 years of age were more likely to have significant reactions compared to younger Latinos. Among the foreign-born, the frequency of significant reactions was not influenced by the length of stay in the US or a history of BCG (bacille CalmetteGuérain) vaccination. Two foreign-born children were found to have current tuberculosis. The prevalence of tuberculin reactors among US-born Latino children was 3 per cent, which suggests that undetected transmission of tuberculosis may be occurring. We conclude that Latino immigrants should be systematically screened for tuberculosis [ABSTRACT FROM AUTHOR]
- Published
- 1986
- Full Text
- View/download PDF
248. Tuberculosis in Persons with Human Immunodeficiency Virus Infection: Clinical and Public Health Aspects.
- Author
-
Hopewell, Philip C.
- Published
- 1997
- Full Text
- View/download PDF
249. Effects of continuous positive-pressure ventilation in experimental pulmonary edema.
- Author
-
HOPEWELL, PHILIP C. and MURRAY, JOHN F.
- Published
- 1976
- Full Text
- View/download PDF
250. Predicting Mycobacterium avium Complex Bacteremia in Patients Infected with Human Immunodeficiency Virus: A Prospectively Validated Model.
- Author
-
Chin, Daniel P., Reingold, Arthur L., Horsburgh, C. Robert, Yajko, David M., Hadley, W. Keith, Elkin, Eric P., Stone, Elizabeth N., Simon, Ellen M., Gonzalez, Patricia C., Ostroff, Stephen M., Jacobson, Mark A., and Hopewell, Philip C.
- Abstract
In cases of advanced infection with human immunodeficiency virus, mycobacterial blood cultures are frequently used to diagnose disseminated infection with the Mycobacterium avium complex (MAC). However, no prospectively validated guidelines exist for the use of such cultures. In this study, a two-part model for predicting MAC bacteremia was developed and then validated prospectively. First, a CD4+ cell count of ⩽50/µL was used to predict bacteremia. then, among patients with ⩽50 CD4+ cellS/µL, the documentation of fever on more than 30 days during the preceding 3 months, a hematocrit of <30%, or a serum albumin concentration of <3.0 g/dL was used to predict bacteremia. This model had a sensitivity of 89% and positive and negative predictive values of 30% and 98%, respectively, for the identification of patients with bacteremia. Had the model been applied to patients in this study, the number of blood cultures performed would have decreased by 61%, but 11% of the positive cultures would have been missed. In short, this model can predict MAC bacteremia and can potentially guide the use of mycobacterial blood cultures. [ABSTRACT FROM PUBLISHER]
- Published
- 1994
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