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1. World Congress Integrative Medicine & Health 2017: part two

Author

Carolyn Ee, Sharmala Thuraisingam, Marie Pirotta, Simon French, Charlie Xue, Helena Teede, Agnete E. Kristoffersen, Fuschia Sirois, Trine Stub, Jennifer Engler, Stefanie Joos, Corina Güthlin, Jennifer Felenda, Christiane Beckmann, Florian Stintzing, Roni Evans, Gert Bronfort, Daniel Keefe, Anna Taberko, Linda Hanson, Alex Haley, Haiwei Ma, Joseph Jolton, Lana Yarosh, Francis Keefe, Jung Nam, Liwanag Ojala, Mary J. Kreitzer, Careen Fink, Karin Kraft, Andrew Flower, George Lewith, Kim Harman, Beth Stuart, Felicity L. Bishop, Jane Frawley, Lilla Füleki, Eva Kiss, Tamas Vancsik, Tibor Krenacs, Martha Funabashi, Katherine A. Pohlman, Silvano Mior, Haymo Thiel, Michael D. Hill, David J. Cassidy, Michael Westaway, Jerome Yager, Eric Hurwitz, Gregory N. Kawchuk, Maeve O’Beirne, Sunita Vohra, Isabelle Gaboury, Chantal Morin, Katharina Gaertner, Loredana Torchetti, Martin Frei-Erb, Michael Kundi, Michael Frass, Eugenia Gallo, Valentina Maggini, Mattia Comite, Francesco Sofi, Sonia Baccetti, Alfredo Vannacci, Mariella Di Stefano, Maria V. Monechi, Luigi Gori, Elio Rossi, Fabio Firenzuoli, Rocco D. Mediati, Giovanna Ballerini, Paula Gardiner, Anna S. Lestoquoy, Lily Negash, Sarah Stillman, Prachi Shah, Jane Liebschutz, Pamela Adelstein, Christine Farrell-Riley, Ivy Brackup, Brian Penti, Robert Saper, Isabel Giralt Sampedro, Gilda Carvajal, Andreas Gleiss, Marie M. Gross, Dorothea Brendlin, Jonas Röttger, Wiebke Stritter, Georg Seifert, Noelle Grzanna, Rainer Stange, Peter W. Guendling, Wen Gu, Yan Lu, Jie Wang, Chengcheng Zhang, Hua Bai, Yuxi He, Xiaoxu Zhang, Zhengju Zhang, Dali Wang, Fengxian Meng, Alexander Hagel, Heinz Albrecht, Claudia Vollbracht, Wolfgang Dauth, Wolfgang Hagel, Francesco Vitali, Ingo Ganzleben, Hans Schultis, Peter Konturek, Jürgen Stein, Markus Neurath, Martin Raithel, Bianka Krick, Heidemarie Haller, Petra Klose, Gustav Dobos, Sherko Kümmel, Holger Cramer, Felix J. Saha, Anna Kowoll, Barbara Ebner, Bettina Berger, Kyung-Eun Choi, Lisha He, Han Wang, X. He, C. Gu, Y. Zhang, Linhua Zhao, Xiaolin Tong, Xinhui He, Chengjuan Gu, Ying Zhang, Robin S. T. Ho, Vincent C. H. Chung, Xinyin Wu, Charlene H. L. Wong, Justin C. Y. Wu, Samuel Y. S. Wong, Alexander Y. L. Lau, Regina W. S. Sit, Wendy Wong, Michelle Holmes, Felicity Bishop, Lynn Calman, Dave Newell, Jonathan Field, Win L. Htut, Dongwoon Han, Da I. Choi, Soo J. Choi, Ha Y. Kim, Jung H. Hwang, Ching W. Huang, Bo H. Jang, Fang P. Chen, Seong G. Ko, Wenjing Huang, De Jin, Fengmei Lian, Soobin Jang, Kyeong H. Kim, Eun K. Lee, Seung H. Sun, Ho Y. Go, Youme Ko, Sunju Park, Yong C. Shin, Hubert Janik, Natalie Greiffenhagen, Jürgen Bolte, Mariusz Jaworski, Miroslawa Adamus, Aleksandra Dobrzynska, Michael Jeitler, Jessica Jaspers, Christel von Scheidt, Barbara Koch, Andreas Michalsen, Nico Steckhan, Christian Kessler, Wen-jing Huang, Bing Pang, Feng-Mei Lian, Miek Jong, Erik Baars, Anja Glockmann, Harald Hamre, Mosaburo Kainuma, Aya Murakami, Toshio Kubota, Daisuke Kobayashi, Yasuhiro Sumoto, Norihiro Furusyo, Shin-Ichi Ando, Takao Shimazoe, Olaf Kelber, S. Verjee, Eva Gorgus, Dieter Schrenk, Kathi Kemper, Ellie Hill, Nisha Rao, Gregg Gascon, John Mahan, Gunver Kienle, Jörg Dietrich, Claudia Schmoor, Roman Huber, Weon H. Kim, Mansoor Ahmed, Luzhu He, Jung Hye Hwang, Nora Meggyeshazi, Csaba Kovago, Anne K. Klaus, Roland Zerm, Danilo Pranga, Thomas Ostermann, Marcus Reif, Hans Broder von Laue, Benno Brinkhaus, Matthias Kröz, Daniela Rodrigues Recchia, Hans B. von Laue, Christien T. Klein-Laansma, Mats Jong, Cornelia von Hagens, Jean P. Jansen, Herman van Wietmarschen, Miek C. Jong, Seung-Ho Sun, Ho-Yeon Go, Chan-Yong Jeon, Yun-Kyung Song, Seong-Gyu Ko, Anna K. Koch, Sybille Rabsilber, Romy Lauche, Jost Langhorst, Milena Trifunovic-Koenig, Evi Koster, Diana Delnoij, Lena Kroll, Kathrin Weiss, Ai Kubo, Sarah Hendlish, Andrea Altschuler, Nancy Connolly, Andy Avins, Jon Wardle, David Lee, David Sibbritt, Jon Adams, Crystal Park, Gita Mishra, Johann Lechner, Inseon Lee, Younbyoung Chae, Jisu Lee, Seung H. Cho, Yujin Choi, Jee Y. Lee, Han S. Ryu, Sung S. Yoon, Hye K. Oh, Lyun K. Hyun, Jin O. Kim, Seong W. Yoon, Ju-Yeon Lee, Sang-Hoon Shin, Min Jang, Indra Müller, So-Hyun Janson Park, Lance Laird, Suzanne Mitchell, Xiaofei Li, Yunhui Wang, Jianhua Zhen, He Yu, Tiegang Liu, Xiaohong Gu, Hui Liu, Weiguo Ma, Xuezheng Shang, Yu Bai, Wei Liu, Collin Rooney, Amos Smith, Shirlene Lopes, Marcelo Demarzo, Maria do Patrocínio Nunes, Peter Lorenz, Carsten Gründemann, Miriam Heinrich, Manuel Garcia-Käufer, Franziska Grunewald, Silke Messerschmidt, Anja Herrick, Kim Gruber, Matthias Knödler, Carmen Steinborn, Taoying Lu, Lixin Wang, Darong Wu, Christina M Luberto, Daniel L. Hall, Emma Chad-Friedman, Suzanne Lechner, Elyse R. Park, Christina M. Luberto, Elyse Park, Janice Goodman, Sonja Luer, Matthias Heri, Klaus von Ammon, Ida Landini, Andrea Lapucci, Stefania Nobili, Enrico Mini, Clare McDermott, Selwyn Richards, Diane Cox, Sarah Frossell, Geraldine Leydon, Caroline Eyles, Hilly Raphael, Rachael Rogers, Michelle Selby, Charlotte Adler, Jo Allam, Xiangwei Bu, Honghong Zhang, Jianpeng Zhang, Michael Mikolasek, Jonas Berg, Claudia Witt, Jürgen Barth, Ivan Miskulin, Zdenka Lalic, Maja Miskulin, Albina Dumic, Damir Sebo, Aleksandar Vcev, Nasr A. A. Mohammed, Soo Jeung Choi, Hyea Bin Im, Anwesha Mukherjee, Amit Kandhare, Subhash Bodhankar, Prasad Thakurdesai, Niki Munk, Erica Evans, Amanda Froman, Matthew Kline, Matthew J. Bair, Frauke Musial, Terje Alræk, Harald J. Hamre, Lars Björkman, Vinjar M. Fønnebø, Feng-mei Lian, Qing Ni, Xiao-lin Tong, Xin-long Li, Wen-ke Liu, Shuo Feng, Xi-yan Zhao, Yu-jiao Zheng, Xue-min Zhao, Yi-qun Lin, Tian-yu Zhao, Xi-Yan Zhao, Hui Che Phd, Chen Zhang, Feng Liu, Lin-hua Zhao, Ru Ye, Cheng-juan Gu, Wenbo Peng, Diana De Carvalho, Mohamed El-Bayoumi, Bob Haig, Kimbalin Kelly, Darrell J. Wade, Emanuela Portalupi, Giampietro Gobo, Luigi Bellavita, Chiara Guglielmetti, Christa Raak, Myriam Teuber, Friedrich Molsberger, Ulrich von Rath, Ulrike Reichelt, Uta Schwanebeck, Sabine Zeil, Christian Vogelberg, Dolores Rodríguez Veintimilla, Guerrero Tapia Mery, Marisol Maldonado Villavicencio, Sandra Herrera Moran, Christian Sachse, Peter W Gündlin, Monirsadat Sahebkarkhorasani, Hoda Azizi, Dania Schumann, Tobias Sundberg, Matthew J. Leach, Susana Seca, Henry Greten, Sugir Selliah, Anu Shakya, Ha Yun Kim, Hyea B. Im, Anna Sherbakova, Gudrun Ulrich-Merzenich, Heba Abdel-Aziz, Erica Sibinga, Lindsey Webb, Jonathan Ellen, Kari Skrautvol, Dagfinn Nåden, Rhayun Song, Weronika Grabowska, Kamila Osypiuk, Gloria V. Diaz, Paolo Bonato, Moonkyoung Park, Jeffrey Hausdorff, Michael Fox, Lewis R. Sudarsky, Daniel Tarsy, James Novakowski, Eric A. Macklin, Peter M. Wayne, Inok Hwang, Sukhee Ahn, Myung-Ah Lee, Min K. Sohn, Oleg Sorokin, Dagmar Heydeck, Astrid Borchert, Christoph-Daniel Hohmann, Harmut Kühn, Clemens Kirschbaum, Tobias Stalder, Barbara Stöckigt, Michael Teut, Ralf Suhr, Daniela Sulmann, Chris Streeter, Patrica Gerbarg, Marisa Silveri, Richard Brown, John Jensen, Britta Rutert, Angelika Eggert, Alfred Längler, Christine Holmberg, Jin Sun, Xin Deng, Wen-Yuan Li, Bin Wen, Nicola Robinson, Jian-Ping Liu, Hyun K. Sung, Narae Yang, Seon M. Shin, Hee Jung, Young J. Kim, Woo S. Jung, Tae Y. Park, Kiyoshi Suzuki, Toshinori Ito, Seiya Uchida, Seika Kamohara, Naoya Ono, Mitsuyuki Takamura, Ayumu Yokochi, Kazuo Maruyama, Patricio Tapia, Katarzyna Thabaut, Anja Thronicke, Megan Steele, Harald Matthes, Cornelia Herbstreit, Friedemann Schad, Jiaxing Tian, Libo Yang, Tian Tian, Hewei Zhang, Xia Tian, CongCong Wang, Qian Yun Chai, Lijuan Zhang, Ruyu Xia, Na Huang, Yutong Fei, Jianpin Liu, Natalie Trent, Mindy Miraglia, Jeffrey Dusek, Edi Pasalis, Sat B. Khalsa, Milena Trifunovic-König, Anna Koch, Lisa Uebelacker, Geoffrey Tremont, Lee Gillette, Gary Epstein-Lubow, David Strong, Ana Abrantes, Audrey Tyrka, Tanya Tran, Brandon Gaudiano, Ivan Miller, Gerhild Ullmann, Yuhua Li, Sujata Vaidya, Vinod Marathe, Ana C. Vale, Jacquelyne Motta, Fabíola Donadão, Angela C. Valente, Luana C. Carvalho Valente, Ricardo Ghelman, Dusan Vesovic, Dragan Jevdic, Aleksandar Jevdic, Katarina Jevdic, Mihael Djacic, Dragica Letic, Drago Bozic, Marija Markovic, Slobodan Dunjic, Gordana Ruscuklic, Dezire Baksa, Kenan Vrca, Ann Vincent, Dietlind Wahner-Roedler, Mary Whipple, Maria M. Vogelius, Iris Friesecke, Peter W. Gündling, Saswati Mahapatra, Rebecca Hynes, Kimberly Van Rooy, Sherry Looker, Aditya Ghosh, Brent Bauer, Susanne Cutshall, Harald Walach, Ana Borges Flores, Michael Ofner, Andreas Kastner, Gerhard Schwarzl, Hermann Schwameder, Nathalie Alexander, Gerda Strutzenberger, Xianwei Bu, Jianping Zhang, Shang Wang, Jinfeng Shi, Yu Hao, Jun Wu, Zeji Qiu, Yuh-Hai Wang, Chi-Jung Lou, Sam Watts, Peter Wayne, Gloria Vergara-Diaz, Brian Gow, Jose Miranda, Lewis Sudarsky, Eric Macklin, Kathrin Wode, Jenny Bergqvist, Britt-Marie Bernhardsson, Johanna Hök Nordberg, Lena Sharp, Roger Henriksson, Yeonju Woo, Min K. Hyun, Hao Wu, Tian-Fang Wang, Yan Zhao, Yu Wei, Lei Tian, Lei He, Xue Wang, Ruohan Wu, Mei Han, Patrina H. Y. Caldwell, Shigang Liu, Jing Zhang, Jianping Liu, Qianyun Chai, Zhongning Guo, Congcong Wang, Zhijun Liu, Xun Li, I. J. Yang, V. Ruberio Lincha, S. H. Ahn, D. U. Lee, H. M. Shin, Lu Yang, N. Yang, H. Sung, S. M. Shin, H. Y. Go, H. Jung, Y. Kim, T. Y. Park, Angela Yap, Yu H. Kwan, Chuen S. Tan, Syed Ibrahim, Seng B. Ang, Alfred Yayi, Jeong E. Yoo, Ho R. Yoo, Sae B. Jang, Hye L. Lee, Ala’a Youssef, Shahira Ezzat, Amira Abdel Motaal, Hesham El-Askary, Xiaotong Yu, Yashan Cui, Younghee Yun, Jin-Hyang Ahn, Bo-Hyung Jang, Kyu-Seok Kim, Inhwa Choi, Augustina Glinz, Fadime ten Brink, Arnd Büssing, Christoph Gutenbrunner, Bert Helbrecht, Tiesheng Fang, Fengxion Meng, Zhiming Shen, Ruixin Zhang, Fan Wu, Ming Li, Xinyun Xuan, Xueyong Shen, Ke Ren, Brian Berman, Zian Zheng, Yuxiang Wan, Xueyan Ma, Fei Dong, Suzie Zick, Richard Harris, Go E. Bae, Jung N. Kwon, Hye Y. Lee, Jong K. Nam, Sang D. Lee, Dong H. Lee, Ji Y. Han, Young J. Yun, Ji H. Lee, Hye L. Park, Seong H. Park, Chiara Bocci, Giovanni B. Ivaldi, Ilaria Vietti, Ilaria Meaglia, Marta Guffi, Rubina Ruggiero, Marita Gualea, Emanuela Longa, Massimo Bonucci, Sarah Croke, Lourdes Diaz Rodriguez, Juan C. Caracuel-Martínez, Manuel F. Fajardo-Rodríguez, Angélica Ariza-García, Francisca García-De la Fuente, Manuel Arroyo-Morales, Maria S. Estrems, Vicente G. Gómez, Mónica Valero Sabater, Rosaria Ferreri, Simonetta Bernardini, Roberto Pulcri, Franco Cracolici, Massimo Rinaldi, Claudio Porciani, Peter Fisher, John Hughes, Ariadna Mendoza, Hugh MacPherson, Jacqueline Filshie, Antonia Di Francesco, Alberto Bernardini, Monica Messe, Vincenzo Primitivo, Piera A. Iasella, Monica Taminato, Jaqueline Do Carmo Alcantara, Katia R. De Oliveira, Debora C. De Azevedo Rodrigues, Juliana R. Campana Mumme, Olga K. Matsumoto Sunakozawa, Vicente Odone Filho, Joshua Goldenberg, Andrew Day, Masa Sasagawa, Lesley Ward, Kieran Cooley, Thora Gunnarsdottir, Ingibjorg Hjaltadottir, Mahdie Hajimonfarednejad, Nicole Hannan, Rut Hellsing, Susanne Andermo, Maria Arman, Iris von Hörsten, Patricia Vásquez Torrielo, Carmen L. Andrade Vilaró, Francisco Cerda Cabrera, Henny Hui, Eric Ziea, Dora Tsui, Joyce Hsieh, Christine Lam, Edith Chan, Mark P. Jensen, Samuel L. Battalio, Joy Chan, Karlyn A. Edwards, Kevin J. Gertz, Melissa A. Day, Leslie H. Sherlin, Dawn M. Ehde, Bo-Hyoung Jang, Anja Börner, Jihong Lee, Boram Lee, Gyu T. Chang, Alejandra Menassa, Yoshiharu Motoo, Jürgen Müller, Sabine Rabini, Bettina Vinson, Martin Storr, Martin Niemeijer, Joop Hoekman, Wied Ruijssenaaars, Faith C. Njoku, Arne J. Norheim, Filiz Okumus, and Halime Oncu-Celik

Subjects
Other systems of medicine, RZ201-999
Published
2017
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2. Pain-related beliefs, coping, and function: An observational study on the moderating influence of country of origin

Author

Alexandra Ferreira-Valente, Saurab Sharma, Joy Chan, Sónia Bernardes, José Pais-Ribeiro, Mark P. Jensen, and Veritati - Repositório Institucional da Universidade Católica Portuguesa

Subjects
Moderation, Anesthesiology and Pain Medicine, Pain coping, Pain-related beliefs, Neurology, Chronic pain, Cross-cultural, Neurology (clinical)
Abstract

Chronic pain is a multidimensional experience and pain treatments targeting psychosocial factors reduce pain and improve function. These treatments often overlook the sociocultural factors that influence pain and the psychological factors associated with function in people with chronic pain. Although preliminary findings suggest that cultural background may influence pain and function via their effects on beliefs and coping, no previous study has directly tested if the country of origin moderates the associations between these psychological factors and pain and function. This study sought to address this knowledge gap. Five hundred sixty-one adults with chronic pain, born and living in the USA (n = 273) or Portugal (n = 288), completed measures of pain, function, pain-related beliefs, and coping. Between-country similarities were found in the endorsement of beliefs related to disability, pain control, and emotion, and in asking for assistance, task persistence, and coping self-statement responses. Portuguese participants reported greater endorsement of harm, medication, solicitude, and medical cure beliefs, more frequent use of relaxation and support seeking, and less frequent use of guarding, resting, and exercising/stretching. In both countries, disability and harm beliefs and guarding responses were associated with worse outcomes; pain control and task persistence were associated with better outcomes. Six country-related small effect-size moderation effects emerged, such that task persistence and guarding are stronger predictors of pain and function in adults from the USA, but pain control, disability, emotion, and medication beliefs are more important in adults from Portugal. Some modifications may be needed when adapting multidisciplinary treatments from one country to another. Perspective: This article examines the similarities and differences in beliefs and coping endorsed by adults with chronic pain from 2 countries, and the potential moderation effects of country on the associations between these variables and pain and function. The findings suggest that some modifications may be needed when culturally customizing psychological pain treatments.

Published
2023

6. Relationship Between HIV Infection, Antiretroviral Therapy, Inflammatory Markers, and Cerebrovascular Endothelial Function Among Adults in Urban China

Author

Joy Chan, Richard W. Price, Yinghuan Hu, Taisheng Li, Yanling Li, Huanling Wang, Felicia C. Chow, Weihai Xu, and Farzaneh A. Sorond

Subjects
Male, Pathology, Urban Population, HIV Infections, cerebrovascular endothelial function, chemistry.chemical_compound, 0302 clinical medicine, HIV and stroke, Antiretroviral Therapy, Highly Active, Surveys and Questionnaires, 2.1 Biological and endogenous factors, cerebral vasoreactivity, Pharmacology (medical), 030212 general & internal medicine, Aetiology, Endothelial dysfunction, Ultrasonography, Doppler, virus diseases, Lopinavir, Middle Aged, Stroke, Infectious Diseases, Anti-Retroviral Agents, Public Health and Health Services, HIV/AIDS, Female, medicine.symptom, Infection, transcranial Doppler ultrasound, medicine.drug, Adult, China, medicine.medical_specialty, Efavirenz, Clinical Sciences, Antiretroviral Therapy, Inflammation, Article, 03 medical and health sciences, Clinical Research, Virology, Internal medicine, medicine, Humans, Highly Active, Cholesterol, business.industry, Prevention, Neurosciences, Endothelial Cells, Ultrasonography, Doppler, medicine.disease, Antiretroviral therapy, Brain Disorders, Transcranial Doppler, Cerebrovascular Disorders, chemistry, Ritonavir, business, 030217 neurology & neurosurgery
Abstract

BACKGROUND Cerebrovascular risk is increased in people living with HIV infection compared with age-matched uninfected individuals. Cerebrovascular endothelial dysfunction related to antiretroviral therapy (ART) and inflammation may contribute to higher stroke risk in HIV infection. METHODS We compared cerebral vasoreactivity-a measure of cerebrovascular endothelial function assessed by the breath-holding index (BHI) using transcranial Doppler ultrasound-between virologically suppressed Chinese HIV-infected individuals followed in an HIV clinic in Beijing, China, and uninfected controls. We constructed mixed-effects models to evaluate the association of HIV, ART, and inflammatory markers with cerebral vasoreactivity. RESULTS In an unadjusted model, HIV infection was associated with a trend toward lower cerebral vasoreactivity (BHI 1.08 versus 1.26, P = 0.079). In multivariable analyses, cholesterol modified the association between HIV infection and cerebral vasoreactivity (P = 0.015 for interaction). At a lower total cholesterol of 4.15 mmol/L, HIV was associated with lower cerebral vasoreactivity (BHI -0.28, P = 0.019), whereas at a cholesterol of 5.15 mmol/L, the reduction in cerebral vasoreactivity associated with HIV was no longer statistically significant (BHI -0.05, P = 0.64). Among HIV-infected individuals, use of lopinavir/ritonavir compared with efavirenz was associated with lower cerebral vasoreactivity (BHI -0.24, P = 0.040). We did not find a significant association between inflammatory markers and cerebral vasoreactivity. CONCLUSIONS Cerebrovascular endothelial dysfunction associated with HIV infection may be most relevant for individuals with less traditional vascular risk, such as those with lower cholesterol. Further study of the impact of ART on cerebrovascular endothelial function is warranted to aid with ART selection in individuals at high cerebrovascular risk.

Published
2017

8. Design expert software assisted development and evaluation of empagliflozin and sitagliptin combination tablet with improved in-vivo anti-diabetic activities

Author

Md Saddam Hossain, Sadia Jahan, Sad Al Rezwan Rahman, Mashiur Rahman, Diponkor Kumar, Susmita Paul, and Joy Chandra Rajbangshi

Subjects
Immediate, Design expert, Combination, Anti-diabetic, Streptozotocin, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

Background: The combination of empagliflozin and sitagliptin to treat type-2 diabetes might be more economical and patient compliance with an additive improvement in glycemic control due to complementary modes of action. Aim of the study: To design, formulate and optimize an immediate tablet dosage form containing empagliflozin and sitagliptin utilizing statistically reliable study design followed by in-vitro and in-vivo testing. Method: ology: To determine the effects of copovidone (X1) and croscarmellose sodium (X2) amounts on the dependent variables of disintegration time and percent drug release, the formulation was developed using Design Expert Software v.13's direct compression method-based central composite design optimization study. The formulations' assay, dissolution, friability, hardness, weight variation, disintegration, and anti-diabetic effects were evaluated in comparison to the standard drug. The analysis included the use of high performance liquid chromatography (HPLC) assay methods. Mice were employed to investigate the efficacy of an anti-diabetic drug after they were administered a high-fat diet and two injections of streptozotocin at a dosage of 30 mg/kg BW each. Results: Formulation of F3 out of nine had all in-vitro parameters at the most satisfactory condition. It was found that assay of the best formulation is 100.99% and 100.19% for empagliflozin and sitagliptin respectively. The disintegration time of F3 was found at 5.32 min. Percentage release of empagliflozin in 30 min was found 89.05% while sitagliptin was with 93.76%. The results showed that administration of F3 significantly reduced FBG (68.61%, p

Published
2023
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9. A Partially Multiplexed HIV Drug Resistance (HIVDR) Assay for Monitoring HIVDR Mutations of the Protease, Reverse-Transcriptase (PRRT), and Integrase (INT)

Author

Joshua DeVos, Kimberly McCarthy, Victor Sewe, Grace Akinyi, Muthoni Junghae, Valarie Opollo, Janin Nouhin, Robert Shafer, Clement Zeh, Artur Ramos, Heather Alexander, and Joy Chang

Subjects
drug resistance, human immunodeficiency virus, integrase, Microbiology, QR1-502
Abstract

ABSTRACT As dolutegravir (DTG)-containing HIV regimens are scaled up globally, monitoring for HIV drug resistance (HIVDR) will become increasingly important. We designed a partially multiplexed HIVDR assay using Sanger sequencing technology to monitor HIVDR mutations in the protease, reverse-transcriptase (PRRT), and integrase (INT). A total of 213 clinical and analytical plasma and dried blood spot (DBS) samples were used in the evaluation. The assay detected a wide range of known HIV-1 subtypes and circulating recombinant forms (CRFs) of group M from 139 samples. INT accuracy showed that the average nucleotide (nt) sequence concordance was 99.8% for 75 plasma samples and 99.5% for 11 DBS samples compared with the reference sequences. The PRRT accuracy also demonstrated the average nucleotide sequence concordance was 99.5% for 57 plasma samples and 99.2% for 33 DBS samples. The major PRRT and INT DR mutations of all samples tested were concordant with those of the reference sequences using the Stanford HIV database (db). Amplification sensitivity of samples with viral load (VL) >5000 copies/mL showed plasma exceeded 95% of positivity, and DBS exceeded 90% for PRRT and INT. Samples with VL (1000 to 5000 copies/mL) showed plasma exceeded 90%, and DBS reached 88% positivity for PRRT and INT. Assay precision and reproducibility showed >99% nucleotide sequence concordance in each set of replicates for PRRT and INT. In conclusion, this HIVDR assay met WHO HIVDR assay performance criteria for surveillance, worked for plasma and DBS, used minimal sample volume, was sensitive, and was a potentially cost-effective tool to monitor HIVDR mutations in PRRT and INT. IMPORTANCE This HIVDR genotyping assay works for both plasma and DBS samples, requires low sample input, and is sensitive. This assay has the potential to be a user-friendly and cost-effective HIVDR assay because of its partially multiplexed design. Application of this genotyping assay will help HIVDR monitoring in HIV high-burdened countries using a DGT-based HIV drug regimen recommended by the U.S. President's Emergency Plan for AIDS Relief and the WHO.

Published
2022
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10. Circumcision status at HIV infection is not associated with plasma viral load in men: analysis of specimens from a randomized controlled trial

Author

Stephanie M. Davis, Sherri Pals, Chunfu Yang, Elijah Odoyo-June, Joy Chang, Maroya Spalding Walters, Walter Jaoko, Naomi Bock, Larry Westerman, Carlos Toledo, and Robert C. Bailey

Subjects
Circumcision, HIV prevention, Viral load, Clinical trials, Intervention, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Male circumcision provides men with approximately 60% protection from acquiring HIV infection via heterosexual sex, and has become a key component of HIV prevention efforts in sub-Saharan Africa. Possible mechanisms for this protection include removal of the inflammatory anaerobic sub-preputial environment and the high concentration of Langerhans cells on the inside of the foreskin, both believed to promote local vulnerability to HIV infection. In people who do acquire HIV, viral load is partially determined by infecting partner viral load, potentially mediated by size of infecting inoculum. By removing a portal for virion entry, prior male circumcision could decrease infecting inoculum and thus viral load in men who become HIV-infected, conferring the known associated benefits of slower progression to disease and decreased infectiousness. Methods We performed an as-treated analysis of plasma samples collected under a randomized controlled trial of male circumcision for HIV prevention, comparing men based on their circumcision status at the time of HIV acquisition, to determine whether circumcision is associated with lower viral load. Eligible men were seroconverters who had at least one plasma sample available drawn at least 6 months after infection, reported no potential exposures other than vaginal sex and, for those who were circumcised, were infected more than 6 weeks after circumcision, to eliminate the open wound as a confounder. Initial viral load testing indicated that quality of pre-2007 samples might have been compromised during storage and they were excluded, as were those with undetectable or unquantifiable results. Log viral loads were compared between groups using univariable and multivariable linear regression, adjusting for sample age and sexually transmitted infection diagnosis with 3.5 months of seroconversion, with a random effect for intra-individual clustering for samples from the same man. A per-protocol analysis was also performed. Results There were no viral load differences between men who were circumcised and uncircumcised at the time of HIV infection (means 4.00 and 4.03 log10 copies/mL respectively, p = .88) in any analysis. Conclusion Circumcision status at the time of HIV infection does not affect viral load in men. Trial registration The original RCT which provided the samples was ClinicalTrials.gov trial NCT00059371.

Published
2018
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11. Performance characteristics of finger-stick dried blood spots (DBS) on the determination of human immunodeficiency virus (HIV) treatment failure in a pediatric population in Mozambique.

Author

Joy Chang, Amina de Sousa, Jennifer Sabatier, Mariamo Assane, Guoqing Zhang, Dulce Bila, Paula Vaz, Charity Alfredo, Loide Cossa, Nilesh Bhatt, Emilia H Koumans, Chunfu Yang, Emilia Rivadeneira, Ilesh Jani, and James C Houston

Subjects
Medicine, Science
Abstract

Quantitative plasma viral load (VL) at 1000 copies /mL was recommended as the threshold to confirm antiretroviral therapy (ART) failure by the World Health Organization (WHO). Because of ongoing challenges of using plasma for VL testing in resource-limited settings (RLS), especially for children, this study collected 717 DBS and paired plasma samples from children receiving ART ≥1 year in Mozambique and compared the performance of DBS using Abbott's VL test with a paired plasma sample using Roche's VL test. At a cut-off of 1000 copies/mL, sensitivity of DBS using Abbott DBS VL test was 79.9%, better than 71.0% and 63.9% at 3000 and 5000 copies/mL, respectively. Specificities were 97.6%, 98.8%, 99.3% at 1000, 3000, and 5000 copies/mL, respectively. The Kappa value at 1000 copies/mL, 0.80 (95% CI: 0.73, 0.87), was higher than 0.73 (95% CI: 0.66, 0.80) and 0.66 (95% CI: 0.59, 0.73) at 3000, 5000 copies/mL, respectively, also indicating better agreement. The mean difference between the DBS and plasma VL tests with 95% limits of agreement by Bland-Altman was 0.311 (-0.908, 1.530). Among 73 children with plasma VL between 1000 to 5000 copies/mL, the DBS results were undetectable in 53 at the 1000 copies/mL threshold. While one DBS sample in the Abbott DBS VL test may be an alternative method to confirm ART failure at 1000 copies/mL threshold when a plasma sample is not an option for treatment monitoring, because of sensitivity concerns between 1,000 and 5,000 copies/ml, two DBS samples may be preferred accompanied by careful patient monitoring and repeat testing.

Published
2017
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