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2. Discordant performance of mpox serological assays

Author

Hunt, Joanne H., Jones, Joyce L., Gebo, Kelly A., Hansoti, Bhakti, Traut, Caroline C., Hamill, Matthew M., Keller, Sara C., Gilliams, Elizabeth A., Manabe, Yukari C., Mostafa, Heba H., Fernandez, Reinaldo E., Sanders, Renata A., Cochran, Willa V., Blankson, Joel N., and Laeyendecker, Oliver

Published
2024
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3. The forecasted prevalence of comorbidities and multimorbidity in people with HIV in the United States through the year 2030: A modeling study

Author

Althoff, Keri N., Stewart, Cameron, Humes, Elizabeth, Gerace, Lucas, Boyd, Cynthia, Gebo, Kelly, Justice, Amy C., Hyle, Emily P., Coburn, Sally B., Lang, Raynell, Silverberg, Michael J., Horberg, Michael A., Lima, Viviane D., Gill, M. John, Karris, Maile, Rebeiro, Peter F., Thorne, Jennifer, Rich, Ashleigh J., Crane, Heidi, Kitahata, Mari, Rubtsova, Anna, Wong, Cherise, Leng, Sean, Marconi, Vincent C., D'Souza, Gypsyamber, Kim, Hyang Nina, Napravnik, Sonia, McGinnis, Kathleen, Kirk, Gregory D., Sterling, Timothy R., Moore, Richard D., and Kasaie, Parastu

Subjects
Comorbidity -- Diagnosis -- Care and treatment, Antiviral agents -- Dosage and administration, HIV patients -- Care and treatment, Biological sciences
Abstract

Background Estimating the medical complexity of people aging with HIV can inform clinical programs and policy to meet future healthcare needs. The objective of our study was to forecast the prevalence of comorbidities and multimorbidity among people with HIV (PWH) using antiretroviral therapy (ART) in the United States (US) through 2030. Methods and findings Using the PEARL model-an agent-based simulation of PWH who have initiated ART in the US-the prevalence of anxiety, depression, stage [greater than or equal to]3 chronic kidney disease (CKD), dyslipidemia, diabetes, hypertension, cancer, end-stage liver disease (ESLD), myocardial infarction (MI), and multimorbidity ([greater than or equal to]2 mental or physical comorbidities, other than HIV) were forecasted through 2030. Simulations were informed by the US CDC HIV surveillance data of new HIV diagnosis and the longitudinal North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) data on risk of comorbidities from 2009 to 2017. The simulated population represented 15 subgroups of PWH including Hispanic, non-Hispanic White (White), and non-Hispanic Black/African American (Black/AA) men who have sex with men (MSM), men and women with history of injection drug use and heterosexual men and women. Simulations were replicated for 200 runs and forecasted outcomes are presented as median values (95% uncertainty ranges are presented in the Supporting information). In 2020, PEARL forecasted a median population of 670,000 individuals receiving ART in the US, of whom 9% men and 4% women with history of injection drug use, 60% MSM, 8% heterosexual men, and 19% heterosexual women. Additionally, 44% were Black/AA, 32% White, and 23% Hispanic. Along with a gradual rise in population size of PWH receiving ART-reaching 908,000 individuals by 2030-PEARL forecasted a surge in prevalence of most comorbidities to 2030. Depression and/or anxiety was high and increased from 60% in 2020 to 64% in 2030. Hypertension decreased while dyslipidemia, diabetes, CKD, and MI increased. There was little change in prevalence of cancer and ESLD. The forecasted multimorbidity among PWH receiving ART increased from 63% in 2020 to 70% in 2030. There was heterogeneity in trends across subgroups. Among Black women with history of injection drug use in 2030 (oldest demographic subgroup with median age of 66 year), dyslipidemia, CKD, hypertension, diabetes, anxiety, and depression were most prevalent, with 92% experiencing multimorbidity. Among Black MSM in 2030 (youngest demographic subgroup with median age of 42 year), depression and CKD were highly prevalent, with 57% experiencing multimorbidity. These results are limited by the assumption that trends in new HIV diagnoses, mortality, and comorbidity risk observed in 2009 to 2017 will persist through 2030; influences occurring outside this period are not accounted for in the forecasts. Conclusions The PEARL forecasts suggest a continued rise in comorbidity and multimorbidity prevalence to 2030, marked by heterogeneities across race/ethnicity, gender, and HIV acquisition risk subgroups. HIV clinicians must stay current on the ever-changing comorbidities-specific guidelines to provide guideline-recommended care. HIV clinical directors should ensure linkages to subspecialty care within the clinic or by referral. HIV policy decision-makers must allocate resources and support extended clinical capacity to meet the healthcare needs of people aging with HIV., Author(s): Keri N. Althoff 1,*, Cameron Stewart 1, Elizabeth Humes 1, Lucas Gerace 1, Cynthia Boyd 1,2,3, Kelly Gebo 4, Amy C. Justice 5,6, Emily P. Hyle 7,8, Sally B. [...]

Published
2024
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5. Impact of subgroup-specific heterogeneities and dynamic changes in mortality rates on forecasted population size, deaths, and age distribution of persons receiving antiretroviral treatment in the United States: a computer simulation study

Author

Kasaie, Parastu, Stewart, Cameron, Humes, Elizabeth, Gerace, Lucas, Hyle, Emily P., Zalla, Lauren C., Rebeiro, Peter F., Silverberg, Michael J., Rubtsova, Anna A., Rich, Ashleigh J., Gebo, Kelly, Lesko, Catherine R., Fojo, Anthony T., Lang, Raynell, Edwards, Jessie K., and Althoff, Keri N.

Published
2023
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6. Dynamics of inflammatory responses after SARS-CoV-2 infection by vaccination status in the USA: a prospective cohort study

Author

Zhu, Xianming, Gebo, Kelly A, Abraham, Alison G, Habtehyimer, Feben, Patel, Eshan U, Laeyendecker, Oliver, Gniadek, Thomas J, Fernandez, Reinaldo E, Baker, Owen R, Ram, Malathi, Cachay, Edward R, Currier, Judith S, Fukuta, Yuriko, Gerber, Jonathan M, Heath, Sonya L, Meisenberg, Barry, Huaman, Moises A, Levine, Adam C, Shenoy, Aarthi, Anjan, Shweta, Blair, Janis E, Cruser, Daniel, Forthal, Donald N, Hammitt, Laura L, Kassaye, Seble, Mosnaim, Giselle S, Patel, Bela, Paxton, James H, Raval, Jay S, Sutcliffe, Catherine G, Abinante, Matthew, Broderick, Patrick, Cluzet, Valerie, Cordisco, Marie Elena, Greenblatt, Benjamin, Petrini, Joann, Rausch, William, Shade, David, Lane, Karen, Gawad, Amy L, Klein, Sabra L, Pekosz, Andrew, Shoham, Shmuel, Casadevall, Arturo, Bloch, Evan M, Hanley, Daniel, Sullivan, David J, and Tobian, Aaron A R

Published
2023
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7. Mpox in people with advanced HIV infection: a global case series

Author

Leiro, Viviana, Marchetta, Lucila, Fernandez Pardal, Patricia, Figueroa, María Inés, Cahn, Pedro, Grabmeier-Pfistershammer, Katharina, Libois, Agnes, Liesenborghs, Laurens, Grinsztejn, Beatriz, Schechter, Mauro, dos Santos de Lemos, Alberto, Furtado Costa, Alvaro, Queiroz Rocha, Simone, Valdez Madruga, José, S. Tan, Darrell H., Mishra, Sharmistha, Shah, Shreya, Jorquera, Camila, Castillo, Alberto, Carrión, Mauricio, Cevallos, Nelson, Palich, Romain, Pourcher, Valerie, Rubenstein, Emma, Migaud, Pascal, Boesecke, Christoph, Hoffmann, Christian, Protopapas, Konstantinos, Nozza, Silvia, Cattelan, Anna Maria, Mussini, Cristina, d'Arminio Monforte, Antonella, Cruz Flores, Raúl Adrian, Pérez Barragán, Edgar, Rodríguez Guzmán, Alma Leticia, Ogoina, Dimie, Chika-Igwenyi, Nneka Marian, Chizaram, Onyeaghala, Valverde López, Jenny, García Tello, Angelica, Ubals, Maria, Vall, Martí, Mendoza, Adrià, Suñer, Clara, Clotet, Bonaventura, Bechini, Jordi, Lepe, Jose A, Navarro-Amuedo, M. Dolores, Bernadino, Jose Ignacio, Català, Alba, Tarín Vicente, Eloy José, González Rodríguez, Borja, Rodriguez-Mercader, Sergi, Sánchez-Martinez, Francisca, Cañas-Ruano, Esperanza, Parra-Navarro, Laura, Filén, Finn, Tallón de Lara, Carmen, Braun, Dominique, Piezzi, Vanja, Burkhard, Michael, Kovari, Helen, Mönch, Anja, Dunning, Jake, Simoes, Pedro, Nori, Achyuta, Keegan, Sarah, Thornhill, John P, Apea, Vanessa, Noori, Teymur, Jones, Joyce L., Judson, Seth, Gilliams, Elizabeth A., Hamill, Matthew M., Keruly, Jeanne, Henao Martínez, Andrés F., Lin, Aung, So, Jessica, Davar, Kusha, Villareal, Diana, Tapia Paredes, Miguel, Mitjà, Oriol, Alemany, Andrea, Marks, Michael, Lezama Mora, Jezer I, Rodríguez-Aldama, Juan Carlos, Torres Silva, Mayara Secco, Corral Herrera, Ever Arturo, Crabtree-Ramirez, Brenda, Blanco, José Luis, Girometti, Nicolo, Mazzotta, Valentina, Hazra, Aniruddha, Silva, Macarena, Montenegro-Idrogo, Juan José, Gebo, Kelly, Ghosn, Jade, Peña Vázquez, María Fernanda, Matos Prado, Eduardo, Unigwe, Uche, Villar-García, Judit, Wald-Dickler, Noah, Zucker, Jason, Paredes, Roger, Calmy, Alexandra, Waters, Laura, Galvan-Casas, Cristina, Walmsley, Sharon, and Orkin, Chloe M

Published
2023
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9. The All of Us Research Program: Data quality, utility, and diversity

Author

Ahmedani, Brian, Cole Johnson, Christine D., Ahsan, Habib, Antoine-LaVigne, Donna, Singleton, Glendora, Anton-Culver, Hoda, Topol, Eric, Baca-Motes, Katie, Steinhubl, Steven, Wade, James, Begale, Mark, Jain, Praduman, Sutherland, Scott, Lewis, Beth, Korf, Bruce, Behringer, Melissa, Gharavi, Ali G., Goldstein, David B., Hripcsak, George, Bier, Louise, Boerwinkle, Eric, Brilliant, Murray H., Murali, Narayana, Hebbring, Scott Joseph, Farrar-Edwards, Dorothy, Burnside, Elizabeth, Drezner, Marc K., Taylor, Amy, Channamsetty, Veena, Montalvo, Wanda, Sharma, Yashoda, Chinea, Carmen, Jenks, Nancy, Cicek, Mine, Thibodeau, Steve, Holmes, Beverly Wilson, Schlueter, Eric, Collier, Ever, Winkler, Joyce, Corcoran, John, D’Addezio, Nick, Daviglus, Martha, Winn, Robert, Wilkins, Consuelo, Roden, Dan, Denny, Joshua, Doheny, Kim, Nickerson, Debbie, Eichler, Evan, Jarvik, Gail, Funk, Gretchen, Philippakis, Anthony, Rehm, Heidi, Lennon, Niall, Kathiresan, Sekar, Gabriel, Stacey, Gibbs, Richard, Gil Rico, Edgar M., Glazer, David, Grand, Joannie, Greenland, Philip, Harris, Paul, Shenkman, Elizabeth, Hogan, William R., Igho-Pemu, Priscilla, Pollan, Cliff, Jorge, Milena, Okun, Sally, Karlson, Elizabeth W., Smoller, Jordan, Murphy, Shawn N., Ross, Margaret Elizabeth, Kaushal, Rainu, Winford, Eboni, Wallace, Febe, Khatri, Parinda, Kheterpal, Vik, Ojo, Akinlolu, Moreno, Francisco A., Kron, Irving, Peterson, Rachele, Menon, Usha, Lattimore, Patricia Watkins, Leviner, Noga, Obedin-Maliver, Juno, Lunn, Mitchell, Malik-Gagnon, Lynda, Mangravite, Lara, Marallo, Adria, Marroquin, Oscar, Visweswaran, Shyam, Reis, Steven, Marshall, Gailen, Jr., McGovern, Patrick, Mignucci, Deb, Moore, John, Munoz, Fatima, Talavera, Gregory, O'Connor, George T., O'Donnell, Christopher, Ohno-Machado, Lucila, Orr, Greg, Randal, Fornessa, Theodorou, Andreas A., Reiman, Eric, Roxas-Murray, Mercedita, Stark, Louisa, Tepp, Ronnie, Zhou, Alicia, Topper, Scott, Trousdale, Rhonda, Tsao, Phil, Weidman, Lisa, Weiss, Scott T., Wellis, David, Whittle, Jeffrey, Wilson, Amanda, Zuchner, Stephan, Zwick, Michael E., Ramirez, Andrea H., Sulieman, Lina, Schlueter, David J., Halvorson, Alese, Qian, Jun, Ratsimbazafy, Francis, Loperena, Roxana, Mayo, Kelsey, Basford, Melissa, Deflaux, Nicole, Muthuraman, Karthik N., Natarajan, Karthik, Kho, Abel, Xu, Hua, Clark, Cheryl R., Cohn, Elizabeth, Schully, Sheri D., Ahmedani, Brian K., Argos, Maria, Cronin, Robert M., O’Donnell, Christopher, Fouad, Mona, Hebbring, Scott J., Smoller, Jordan W., Sodeke, Stephen, Wilbanks, John, Hentges, Justin, Mockrin, Stephen, Lunt, Christopher, Devaney, Stephanie A., Gebo, Kelly, Denny, Joshua C., Carroll, Robert J., Harris, Paul A., and Roden, Dan M.

Published
2022
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10. Convalescent plasma with a high level of virus-specific antibody effectively neutralizes SARS-CoV-2 variants of concern

Author

Li, Maggie, Beck, Evan J., Laeyendecker, Oliver, Eby, Yolanda, Tobian, Aaron A.R., Caturegli, Patrizio, Wouters, Camille, Chiklis, Gregory R., Block, William, McKie, Robert O., Joyner, Michael J., Wiltshire, Timothy D., Dietz, Allan B., Gniadek, Thomas J., Shapiro, Arell J., Yarava, Anusha, Lane, Karen, Hanley, Daniel F., Bloch, Evan M., Shoham, Shmuel, Cachay, Edward R., Meisenberg, Barry R., Huaman, Moises A., Fukuta, Yuriko, Patel, Bela, Heath, Sonya L., Levine, Adam C., Paxton, James H., Anjan, Shweta, Gerber, Jonathan M., Gebo, Kelly A., Casadevall, Arturo, Pekosz, Andrew, and Sullivan, David J.

Published
2022
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13. Comparative performance of multiplex salivary and commercially available serologic assays to detect SARS-CoV-2 IgG and neutralization titers

Author

Heaney, Christopher D., Pisanic, Nora, Randad, Pranay R., Kruczynski, Kate, Howard, Tyrone, Zhu, Xianming, Littlefield, Kirsten, Patel, Eshan U., Shrestha, Ruchee, Laeyendecker, Oliver, Shoham, Shmuel, Sullivan, David, Gebo, Kelly, Hanley, Daniel, Redd, Andrew D., Quinn, Thomas C., Casadevall, Arturo, Zenilman, Jonathan M., Pekosz, Andrew, Bloch, Evan M., and Tobian, Aaron A.R.

Published
2021
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15. Improving health equity and ending the HIV epidemic in the USA: a distributional cost-effectiveness analysis in six cities

Author

Del Rio, Carlos, Colijn, Caroline, Geng, Elvin, Meisel, Zachary F, Metsch, Lisa R, Shoptaw, Steven, Weiner, Janet, Quan, Amanda My Linh, Mah, Cassandra, Krebs, Emanuel, Zang, Xiao, Chen, Siyuan, Althoff, Keri, Armstrong, Wendy, Behrends, Czarina Navos, Dombrowski, Julia C, Enns, Eva, Feaster, Daniel J, Gebo, Kelly A, Goedel, William C, Golden, Matthew, Marshall, Brandon D L, Mehta, Shruti H, Pandya, Ankur, Schackman, Bruce R, Strathdee, Steffanie A, Sullivan, Patrick, Tookes, Hansel, and Nosyk, Bohdan

Published
2021
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16. Combined estimation of disease progression and retention on antiretroviral therapy among treated individuals with HIV in the USA: a modelling study

Author

Edelstein, Howard, Rutstein, Richard, Baranoski, Amy, Allen, Sara, Boswell, Stephen, Mayer, Kenneth, Gebo, Kelly A., Moore, Richard D., Agwu, Allison, Beil, Robert, Felsen, Uriel, Aberg, Judith A., Urbina, Antonio, Korthuis, P. Todd, Nijhawan, Ank, Akbar, Muhammad, Gaur, Aditya, Somboonwit, Charurut, Valenti, William, Mathews, W. Christopher, Hellinger, Fred, Fleishman, John, Mills, Robert, Keruly, Jeanne, Voss, Cindy, Collins, Charles, Diaz-Reyes, Rebeca, Wang, Linwei, Krebs, Emanuel, Min, Jeong E, Mathews, W Christopher, Aberg, Judith A, Moore, Richard D, Gebo, Kelly A, and Nosyk, Bohdan

Published
2019
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17. Accuracy of Provider Predictions of Viral Suppression Among Adolescents and Young Adults With HIV in an HIV Clinical Program.

Author

Thrul, Johannes, Yusuf, Hasiya, Devkota, Janardan, Owczarzak, Jill, Ohene-Kyei, Elise Tirza, Gebo, Kelly, and Agwu, Allison

Abstract

Background: Providers caring for adolescents and young adults with HIV (AYA-HIV) mostly base their adherence counseling during clinical encounters on clinical judgment and expectations of patients' medication adherence. There is currently no data on provider predictions of viral suppression for AYA-HIV. We aimed to assess the accuracy of provider predictions of patients' viral suppression status compared to viral load results. Methods: Providers caring for AYA-HIV were asked to predict the likelihood of viral suppression of patients before a clinical encounter and give reasons for their predictions. Provider predictions were compared to actual viral load measurements of patients. Patient data were abstracted from electronic health records. The final analysis included 9 providers, 28 patients, and 34 observations of paired provider predictions and viral load results. Results: Provider prediction accuracy of viral suppression was low (59%, Cohen's Kappa = 0.16). Provider predictions of lack of viral suppression were based on nonadherence to medications, new patient status, or structural vulnerabilities (e.g., unstable housing). Anticipated viral suppression was based on medication adherence, history of viral suppression, and the presence of family or other social forms of support. Conclusions: Providers have difficulty accurately predicting viral suppression among AYA-HIV and may base their counseling on incorrect assumptions. Rapid point-of-care viral load testing may provide opportunities to improve counseling provided during the clinical encounter. Plain Language Summary: Accuracy of Provider Predictions of Viral Suppression among Adolescents and Young Adults with HIV in an HIV Clinical Program Providers caring for adolescents and young adults with HIV (AYA-HIV) mostly base their adherence counseling during clinical encounters on clinical judgment and expectations of patients' medication adherence. Currently, no data exist on provider predictions of viral suppression for AYA-HIV. We aimed to assess the accuracy of provider predictions of patients' viral suppression compared to viral load results. Providers caring for AYA-HIV were asked to predict the likelihood of viral suppression of patients before a clinical encounter with reasons for their predictions. Provider predictions were compared to actual viral load measurements of patients. Patient data were abstracted from electronic health records. The final analysis included nine providers, 28 patients, and 34 observations of paired provider predictions and viral load results. Provider prediction accuracy of viral suppression was low (59%, Cohen's Kappa=0.16). Provider predictions of lack of viral suppression were based on non-adherence to medications, new patient status, or structural vulnerabilities (e.g., unstable housing). Anticipated viral suppression was based on medication adherence, history of viral suppression, and presence of family or other social forms of support. Providers have difficulty predicting viral suppression among AYA-HIV and may base counseling on incorrect assumptions. Rapid point-of-care viral load testing may provide opportunities to improve counseling. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Ending the HIV epidemic in the USA: an economic modelling study in six cities

Author

Behrends, Czarina N, del Rio, Carlos, Dombrowski, Julia C, Feaster, Daniel J, Gebo, Kelly A, Golden, Matthew, Kirk, Gregory, Marshall, Brandon D L, Mehta, Shruti H, Metsch, Lisa R, Montaner, Julio, Nosyk, Bohdan, Pandya, Ankur, Schackman, Bruce R, Shoptaw, Steven, Strathdee, Steffanie A, Zang, Xiao, Krebs, Emanuel, Enns, Benjamin, and Min, Jeong E

Published
2020
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20. Association of immunosuppression and HIV viraemia with non-Hodgkin lymphoma risk overall and by subtype in people living with HIV in Canada and the USA: a multicentre cohort study

Author

Betts, Adrian, Brooks, John T., Freeman, Aimee M., Van Rompaey, Stephen E., Burchell, Ann, Yip, Benita, You, Bin, Hogan, Brenna, Grasso, Chris, Hogg, Robert S., Benson, Constance A., Drozd, Daniel R., Sterling, Timothy R., Haas, David, Humes, Elizabeth, Crane, Heidi M., Willig, James, Eron, Joseph J., Martin, Jeffrey N., Saag, Michael S., Jing, Jerry, Zhang, Jinbing, Lindsay, Joanne, Hunter-Mellado, Robert F., Deeks, Steven G., Zhu, Julia, Montaner, Julio S.G., McReynolds, Justin, Gabler, Karyn, Buchacz, Kate, Rodriguez, Benigno, Thorne, Jennifer E., Margolick, Joseph B., Anastos, Kathryn, Jacobson, Lisa P., Klein, Marina B., Kroch, Abigail, Morton, Liz, Turner, Megan, Fiellin, David, Gange, Stephen J., Mugavero, Michael J., Harrigan, P. Richard, Rebeiro, Peter, Bosch, Ronald J., Kirk, Gregory D., Mayer, Kenneth H., McKaig, Rosemary G., Coburn, Sally, Napravnik, Sonia, Kitahata, Mari M., Lober, William B., Lee, Jennifer S., Hernández-Ramírez, Raúl U, Qin, Li, Lin, Haiqun, Leyden, Wendy, Neugebauer, Romain S, Althoff, Keri N, Achenbach, Chad J, Hessol, Nancy A, D'Souza, Gypsyamber, Gebo, Kelly A, Gill, M John, Grover, Surbhi, Horberg, Michael A, Li, Jun, Mathews, W Christopher, Mayor, Angel M, Park, Lesley S, Rabkin, Charles S, Salters, Kate, Justice, Amy C, Moore, Richard D, Engels, Eric A, Silverberg, Michael J, and Dubrow, Robert

Published
2019
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21. Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies

Author

Althoff, Keri N, Gebo, Kelly A, Moore, Richard D, Boyd, Cynthia M, Justice, Amy C, Wong, Cherise, Lucas, Gregory M, Klein, Marina B, Kitahata, Mari M, Crane, Heidi, Silverberg, Michael J, Gill, M John, Mathews, William Christopher, Dubrow, Robert, Horberg, Michael A, Rabkin, Charles S, Klein, Daniel B, Lo Re, Vincent, Sterling, Timothy R, Desir, Fidel A, Lichtenstein, Kenneth, Willig, James, Rachlis, Anita R, Kirk, Gregory D, Anastos, Kathryn, Palella, Frank J, Jr, Thorne, Jennifer E, Eron, Joseph, Jacobson, Lisa P, Napravnik, Sonia, Achenbach, Chad, Mayor, Angel M, Patel, Pragna, Buchacz, Kate, Jing, Yuezhou, and Gange, Stephen J

Published
2019
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22. Orthopoxvirus-Specific T-Cell Responses in Convalescent Mpox Patients.

Author

Traut, Caroline C, Jones, Joyce L, Sanders, Renata A, Clark, Laura R, Hamill, Matthew M, Stavrakis, Georgia, Sop, Joel, Beckey, Tyler P, Keller, Sara C, Gilliams, Elizabeth A, Cochran, Willa V, Laeyendecker, Oliver, Manabe, Yukari C, Mostafa, Heba H, Thomas, David L, Hansoti, Bhakti, Gebo, Kelly A, and Blankson, Joel N

Subjects
MONKEYPOX, T cells, VACCINIA, HIV, IMMUNOSUPPRESSIVE agents
Abstract

Orthopoxvirus-specific T-cell responses were analyzed in 10 patients who had recovered from Mpox including 7 people with human immunodeficiency virus (PWH). Eight participants had detectable virus-specific T-cell responses, including a PWH who was not on antiretroviral therapy and a PWH on immunosuppressive therapy. These 2 participants had robust polyfunctional CD4+ T-cell responses to peptides from the 121L vaccinia virus (VACV) protein. T-cells from 4 of 5 HLA-A2–positive participants targeted at least 1 previously described HLA-A2–restricted VACV epitope, including an epitope targeted in 2 participants. These results advance our understanding of immunity in convalescent Mpox patients. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Hospital Readmissions Among Persons With Human Immunodeficiency Virus in the United States and Canada, 2005–2018: A Collaboration of Cohort Studies.

Author

Davy-Mendez, Thibaut, Napravnik, Sonia, Hogan, Brenna C, Eron, Joseph J, Gebo, Kelly A, Althoff, Keri N, Moore, Richard D, Silverberg, Michael J, Horberg, Michael A, Gill, M John, Rebeiro, Peter F, Karris, Maile Y, Klein, Marina B, Kitahata, Mari M, Crane, Heidi M, Nijhawan, Ank, McGinnis, Kathleen A, Thorne, Jennifer E, Lima, Viviane D, and Bosch, Ronald J

Subjects
HIV, PATIENT readmissions, PSYCHIATRIC hospital care, CD4 lymphocyte count, COHORT analysis
Abstract

Background Hospital readmission trends for persons with human immunodeficiency virus (PWH) in North America in the context of policy changes, improved antiretroviral therapy (ART), and aging are not well-known. We examined readmissions during 2005–2018 among adult PWH in NA-ACCORD. Methods Linear risk regression estimated calendar trends in 30-day readmissions, adjusted for demographics, CD4 count, AIDS history, virologic suppression (<400 copies/mL), and cohort. Results We examined 20 189 hospitalizations among 8823 PWH (73% cisgender men, 38% White, 38% Black). PWH hospitalized in 2018 versus 2005 had higher median age (54 vs 44 years), CD4 count (469 vs 274 cells/μL), and virologic suppression (83% vs 49%). Unadjusted 30-day readmissions decreased from 20.1% (95% confidence interval [CI], 17.9%–22.3%) in 2005 to 16.3% (95% CI, 14.1%–18.5%) in 2018. Absolute annual trends were −0.34% (95% CI, −.48% to −.19%) in unadjusted and −0.19% (95% CI, −.35% to −.02%) in adjusted analyses. By index hospitalization reason, there were significant adjusted decreases only for cardiovascular and psychiatric hospitalizations. Readmission reason was most frequently in the same diagnostic category as the index hospitalization. Conclusions Readmissions decreased over 2005–2018 but remained higher than the general population's. Significant decreases after adjusting for CD4 count and virologic suppression suggest that factors alongside improved ART contributed to lower readmissions. Efforts are needed to further prevent readmissions in PWH. [ABSTRACT FROM AUTHOR]

Published
2023
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24. The association of a scholarly concentrations program with medical students' matched residencies.

Author

Alkhatib, Hosam H., Beach, Mary Catherine, Gebo, Kelly A., Bass, Eric B., Park, Jenny R., Atkinson, Meredith A., Kudchadkar, Sapna R., and Sozio, Stephen M.

Subjects
MEDICAL students, MEDICAL school curriculum, RESIDENTS (Medicine), STUDENT publications, STUDENT interests
Abstract

Purpose: Many medical school curricula include Scholarly Concentrations (SC) programs. While studies have examined how these programs affect students' future research involvement, the association of SC programs with students' specialty choices is uncertain. This study examines the SC program factors associated with congruence between the specialty focus of students' SC projects and the clinical specialty they matched into for residency. Methods: The authors conducted a retrospective cohort study of all students participating in the SC program at Johns Hopkins University School of Medicine for graduating classes 2013-2020. They used data from program questionnaires to categorize students' specialty interests (baseline) and SC program experiences (post-program). The authors categorized each student's project into specialties according to their faculty mentors' primary appointments, abstracted student publications from SCOPUS, and abstracted residency program rankings from Doximity Residency Navigator. The authors used multivariable logistic regression to calculate adjusted odds ratios (aOR) for specialty-congruent matching (same specialty as SC project) and for matching into a Doximity-ranked top 20 or top 10 program. Results: Overall, 35.3% of the 771 students matched into the same specialty as their SC projects. Increased odds of specialty-congruent matching occurred with 'definite' interest in the specialty at baseline [aOR (95% CI): 1.76 (0.98-3.15)] (P = 0.06) and with increasing publications with SC mentors [aOR (95% CI): 1.16 (1.03-1.30)] (P = 0.01). Congruence between SC specialty focus and matched specialty conferred no significant difference in odds of matching to a Doximity-ranked top 20 or top 10 program. Conclusions: Baseline certainty of specialty interest and research productivity were associated with specialty congruence. However, as completing an SC project in a given specialty was not associated with increased odds of matching into that specialty nor into a higher Doximity-ranked program, SC program directors should advise students to pursue SC projects in any topic of personal interest. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Risk Factors for Hospitalization and Effect of Immunosuppression on Clinical Outcomes Among an Urban Cohort of Patients With Mpox.

Author

Garneau, William M, Jones, Joyce L, Dashler, Gabriella M, Mostafa, Heba H, Judson, Seth D, Kwon, Nathan, Hamill, Matthew M, Gilliams, Elizabeth A, Rudolph, David S, Keruly, Jeanne C, Fall, Amary, Klein, Eili Y, Hansoti, Bhakti, and Gebo, Kelly A

Subjects
MONKEYPOX, HIV, TREATMENT effectiveness, HIV infections, IMMUNOSUPPRESSION
Abstract

Background During the 2022 mpox outbreak most patients were managed as outpatients, but some required hospitalization. Uncontrolled human immunodeficiency virus (HIV) has been identified as a risk factor for severe mpox. Methods Patients with mpox diagnosed or treated within the Johns Hopkins Health System between 1 June and 15 December 2022 were included. The primary outcome of interest was risk of hospitalization. Demographic features, comorbid conditions, treatment, and clinical outcomes were determined. Results A total of 353 patients were tested or treated for mpox; 100 had mpox diagnosed or treated (median age, 35.3 years; 97.0% male; 57.0% black and 10.0% Hispanic; 46.0% people with HIV [PWH]). Seventeen patients (17.0%) required hospitalization, 10 of whom were PWH. Age >40 years, race, ethnicity, HIV status, insurance status, and body mass index >30 (calculated as weight in kilograms divided by height in meters squared) were not associated with hospitalization. Eight of 9 patients (88.9%) with immunosuppression were hospitalized. Immunosuppression was associated with hospitalization in univariate (odds ratio, 69.3 [95% confidence interval, 7.8–619.7]) and adjusted analysis (adjusted odds ratio, 94.8 [8.5–1060.1]). Two patients (11.8%) who were hospitalized required intensive care unit admission and died; both had uncontrolled HIV infection and CD4 T-cell counts <50/µL. Median cycle threshold values for the first positive mpox virus sample did not differ between those who were hospitalized and those who were not. Conclusions Immunosuppression was a significant risk factor for hospitalization with mpox. PWH with CD4 T-cell counts <50/µL are at high risk of death due to mpox infection. Patients who are immunosuppressed should be considered for early and aggressive treatment of mpox, given the increased risk of hospitalization. [ABSTRACT FROM AUTHOR]

Published
2023
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27. Multimorbidity Among Persons Living with Human Immunodeficiency Virus in the United States

Author

North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), Wong, Cherise, Gange, Stephen J., Moore, Richard D., Justice, Amy C., Buchacz, Kate, Abraham, Alison G., Rebeiro, Peter F., Koethe, John R., Martin, Jeffrey N., Horberg, Michael A., Boyd, Cynthia M., Kitahata, Mari M., Crane, Heidi M., Gebo, Kelly A., Gill, M. John, Silverberg, Michael J., Palella, Frank J., Patel, Pragna, Samji, Hasina, Thorne, Jennifer, Rabkin, Charles S., Mayor, Angel, and Althoff, Keri N.

Published
2018

28. CD4 count at presentation for HIV care in the United States and Canada: Are those over 50 years more likely to have a delayed presentation?

Author

Althoff, Keri N, Gebo, Kelly A, Gange, Stephen J, Klein, Marina B, Brooks, John T, Hogg, Robert S, Bosch, Ronald J, Horberg, Michael A, Saag, Michael S, Kitahata, Mari M, Eron, Joseph J, Napravnik, Sonia, Rourke, Sean B, Gill, M John, Rodriguez, Benigno, Sterling, Timothy R, Deeks, Steven G, Martin, Jeffrey N, Jacobson, Lisa P, Kirk, Gregory D, Collier, Ann C, Benson, Constance A, Silverberg, Michael J, Goedert, James J, McKaig, Rosemary G, Thorne, Jennifer, Rachlis, Anita, Moore, Richard D, and Justice, Amy C

Abstract

Abstract We assessed CD4 count at initial presentation for HIV care among ≥50-year-olds from 1997-2007 in 13 US and Canadian clinical cohorts and compared to

Published
2010

29. HIV Infection, Immunosuppression, and Age at Diagnosis of Non-AIDS-Defining Cancers

Author

North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA), Shiels, Meredith S., Althoff, Keri N., Pfeiffer, Ruth M., Achenbach, Chad J., Abraham, Alison G., Castilho, Jessica, Cescon, Angela, D'Souza, Gypsyamber, Dubrow, Robert, Eron, Joseph J., Gebo, Kelly, Gill, M. John, Goedert, James J., Grover, Surbhi, Hessol, Nancy A., Justice, Amy, Kitahata, Mari, Mayor, Angel, Moore, Richard D., Napravnik, Sonia, Novak, Richard M., Thorne, Jennifer E., Silverberg, Michael J., and Engels, Eric A.

Published
2017

30. Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010

Author

Buchacz, Kate, Lau, Bryan, Jing, Yuezhou, Bosch, Ronald, Abraham, Alison G., Gill, M. John, Silverberg, Michael J., Goedert, James J., Sterling, Timothy R., Althoff, Keri N., Martin, Jeffrey N., Burkholder, Greer, Gandhi, Neel, Samji, Hasina, Patel, Pragna, Rachlis, Anita, Thorne, Jennifer E., Napravnik, Sonia, Henry, Keith, Mayor, Angel, Gebo, Kelly, Gange, Stephen J., Moore, Richard D., and Brooks, John T.

Published
2016

37. Examining sociodemographic correlates of opioid use, misuse, and use disorders in the All of Us Research Program.

Author

Yeh, Hsueh-Han, Peltz-Rauchman, Cathryn, Johnson, Christine C., Pawloski, Pamala A., Chesla, David, Waring, Stephen C., Stevens, Alan B., Epstein, Mara, Joseph, Christine, Miller-Matero, Lisa R., Gui, Hongsheng, Tang, Amy, Boerwinkle, Eric, Cicek, Mine, Clark, Cheryl R., Cohn, Elizabeth, Gebo, Kelly, Loperena, Roxana, Mayo, Kelsey, and Mockrin, Stephen

Subjects
OPIOID analgesics, OPIOID abuse, NALTREXONE, OPIOIDS, ELECTRONIC health records, ETHNIC groups, LOGISTIC regression analysis
Abstract

Background: The All of Us Research Program enrolls diverse US participants which provide a unique opportunity to better understand the problem of opioid use. This study aims to estimate the prevalence of opioid use and its association with sociodemographic characteristics from survey data and electronic health record (EHR). Methods: A total of 214,206 participants were included in this study who competed survey modules and shared EHR data. Adjusted logistic regressions were used to explore the associations between sociodemographic characteristics and opioid use. Results: The lifetime prevalence of street opioids was 4%, and the nonmedical use of prescription opioids was 9%. Men had higher odds of lifetime opioid use (aOR: 1.4 to 3.1) but reduced odds of current nonmedical use of prescription opioids (aOR: 0.6). Participants from other racial and ethnic groups were at reduced odds of lifetime use (aOR: 0.2 to 0.9) but increased odds of current use (aOR: 1.9 to 9.9) compared with non-Hispanic White participants. Foreign-born participants were at reduced risks of opioid use and diagnosed with opioid use disorders (OUD) compared with US-born participants (aOR: 0.36 to 0.67). Men, Younger, White, and US-born participants are more likely to have OUD. Conclusions: All of Us research data can be used as an indicator of national trends for monitoring the prevalence of receiving prescription opioids, diagnosis of OUD, and non-medical use of opioids in the US. The program employs a longitudinal design for routinely collecting health-related data including EHR data, that will contribute to the literature by providing important clinical information related to opioids over time. Additionally, this data will enhance the estimates of the prevalence of OUD among diverse populations, including groups that are underrepresented in the national survey data. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Optimizing Treatment for Human Immunodeficiency Virus to Improve Clinical Outcomes Using Precision Medicine.

Author

Jetsupphasuk, Michael, Hudgens, Michael G, Lu, Haidong, Cole, Stephen R, Edwards, Jessie K, Adimora, Adaora A, Althoff, Keri N, Silverberg, Michael J, Rebeiro, Peter F, Lima, Viviane D, Marconi, Vincent C, Sterling, Timothy R, Horberg, Michael A, Gill, M John, Kitahata, Mari M, Moore, Richard D, Lang, Raynell, Gebo, Kelly, Rabkin, Charles, and Eron, Joseph J

Subjects
HIV infection complications, AIDS prevention, STROKE prevention, HIV infection prognosis, HIV infections, CAUSES of death, EFAVIRENZ, DRUG efficacy, CHRONIC kidney failure, HIV-positive persons, HIV integrase inhibitors, CONFIDENCE intervals, INDIVIDUALIZED medicine, MYOCARDIAL infarction, RISK assessment, COMPARATIVE studies, DESCRIPTIVE statistics, RESEARCH funding, SOCIODEMOGRAPHIC factors, LIVER failure
Abstract

In first-line antiretroviral therapy (ART) for human immunodeficiency virus (HIV) treatment, some subgroups of patients may respond better to an efavirenz-based regimen than an integrase strand transfer inhibitor (InSTI)-based regimen, or vice versa, due to patient characteristics modifying treatment effects. Using data based on nearly 16,000 patients from the North American AIDS Cohort Collaboration on Research and Design from 2009–2016, statistical methods for precision medicine were employed to estimate an optimal treatment rule that minimizes the 5-year risk of the composite outcome of acquired immune deficiency syndrome (AIDS)-defining illnesses, serious non-AIDS events, and all-cause mortality. The treatment rules considered were functions that recommend either an efavirenz- or InSTI-based regimen conditional on baseline patient characteristics such as demographic information, laboratory results, and health history. The estimated 5-year risk under the estimated optimal treatment rule was 10.0% (95% confidence interval (CI): 8.6, 11.3), corresponding to an absolute risk reduction of 2.3% (95% CI: 0.9, 3.8) when compared with recommending an efavirenz-based regimen for all patients and 2.6% (95% CI: 1.0, 4.2) when compared with recommending an InSTI-based regimen for all. Tailoring ART to individual patient characteristics may reduce 5-year risk of the composite outcome compared with assigning all patients the same drug regimen. [ABSTRACT FROM AUTHOR]

Published
2023
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39. Coronavirus Disease 2019 Convalescent Plasma Utilization in the United States: Data From the National Inpatient Sample.

Author

Bloch, Evan M, Goel, Ruchika, Zhu, Xianming, Patel, Eshan U, Shoham, Shmuel, Sullivan, David J, Gebo, Kelly A, Casadevall, Arturo, and Tobian, Aaron A R

Subjects
COVID-19, COVID-19 treatment, AGE distribution, RACE, POPULATION geography, SEVERITY of illness index, HOSPITAL care, HEALTH insurance, DESCRIPTIVE statistics, RESEARCH funding, SEROTHERAPY, HEALTH equity, SECONDARY analysis
Abstract

Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) use between October and December 2020 was characterized using the National Inpatient Sample database. CCP was administered in 18.0% of COVID-19-associated hospitalizations and was strongly associated with older age and increased disease severity. There were disparities in the receipt of CCP by race and ethnicity, geography, and insurance. [ABSTRACT FROM AUTHOR]

Published
2023
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43. Comparison of Risk and Age at Diagnosis of Myocardial Infarction, End-Stage Renal Disease, and Non-AIDS-Defining Cancer in HIV-Infected Versus Uninfected Adults

Author

Veterans Aging Cohort Study (VACS), Althoff, Keri N., McGinnis, Kathleen A., Wyatt, Christina M., Freiberg, Matthew S., Gilbert, Cynthia, Oursler, Krisann K., Rimland, David, Rodriguez-Barradas, Maria C., Dubrow, Robert, Park, Lesley S., Skanderson, Melissa, Shiels, Meredith S., Gange, Stephen J., Gebo, Kelly A., and Justice, Amy C.

Published
2015

44. Disparities in the Quality of HIV Care When Using US Department of Health and Human Services Indicators

Author

North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), Althoff, Keri N., Rebeiro, Peter, Brooks, John T., Buchacz, Kate, Gebo, Kelly, Martin, Jeffrey, Hogg, Robert, Thorne, Jennifer E., Klein, Marina, Gill, M. John, Sterling, Timothy R., Yehia, Baligh, Silverberg, Michael J., Crane, Heidi, Justice, Amy C., Gange, Stephen J., Moore, Richard, Kitahata, Mari M., and Horberg, Michael A.

Published
2014
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50. Human Immunodeficiency Virus Status, Tenofovir Exposure, and the Risk of Poor Coronavirus Disease 19 Outcomes: Real-World Analysis From 6 United States Cohorts Before Vaccine Rollout.

Author

Lea, Alexandra N, Leyden, Wendy A, Sofrygin, Oleg, Marafino, Ben J, Skarbinski, Jacek, Napravnik, Sonia, Agil, Deana, Augenbraun, Michael, Benning, Lorie, Horberg, Michael A, Jefferson, Celeena, Marconi, Vincent C, Park, Lesley S, Gordon, Kirsha S, Bastarache, Lisa, Gangireddy, Srushti, Althoff, Keri N, Coburn, Sally B, Gebo, Kelly A, and Lang, Raynell

Subjects
HIV prevention, HIV infections, COVID-19, CONFIDENCE intervals, TENOFOVIR, RNA, SEVERITY of illness index, PRE-exposure prophylaxis, RISK assessment, ARTIFICIAL respiration, TREATMENT effectiveness, HOSPITAL care, DESCRIPTIVE statistics, RESEARCH funding, ODDS ratio, HIV, PSYCHOLOGY of HIV-positive persons
Abstract

Background People with human immunodeficiency virus (HIV) (PWH) may be at increased risk for severe coronavirus disease 2019 (COVID-19) outcomes. We examined HIV status and COVID-19 severity, and whether tenofovir, used by PWH for HIV treatment and people without HIV (PWoH) for HIV prevention, was associated with protection. Methods Within 6 cohorts of PWH and PWoH in the United States, we compared the 90-day risk of any hospitalization, COVID-19 hospitalization, and mechanical ventilation or death by HIV status and by prior exposure to tenofovir, among those with severe acute respiratory syndrome coronavirus 2 infection between 1 March and 30 November 2020. Adjusted risk ratios (aRRs) were estimated by targeted maximum likelihood estimation, with adjustment for demographics, cohort, smoking, body mass index, Charlson comorbidity index, calendar period of first infection, and CD4 cell counts and HIV RNA levels (in PWH only). Results Among PWH (n = 1785), 15% were hospitalized for COVID-19 and 5% received mechanical ventilation or died, compared with 6% and 2%, respectively, for PWoH (n = 189 351). Outcome prevalence was lower for PWH and PWoH with prior tenofovir use. In adjusted analyses, PWH were at increased risk compared with PWoH for any hospitalization (aRR, 1.31 [95% confidence interval, 1.20–1.44]), COVID-19 hospitalizations (1.29 [1.15–1.45]), and mechanical ventilation or death (1.51 [1.19–1.92]). Prior tenofovir use was associated with reduced hospitalizations among PWH (aRR, 0.85 [95% confidence interval,.73–.99]) and PWoH (0.71 [.62–.81]). Conclusions Before COVID-19 vaccine availability, PWH were at greater risk for severe outcomes than PWoH. Tenofovir was associated with a significant reduction in clinical events for both PWH and PWoH. [ABSTRACT FROM AUTHOR]

Published
2023
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