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Fehr J, Gunda R, Siedner MJ, Hanekom W, Ndung’u T, Grant A, Lippert C, Wong EB. CAD4TB software updates: different triaging thresholds require caution by users and regulation by authorities. Int J Tuberc Lung Dis 2023; 27:157-160. [PMID: 36853104 PMCID: PMC9904401 DOI: 10.5588/ijtld.22.0437] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- J. Fehr
- Africa Health Research Institute, KwaZulu-Natal, South Africa
,Digital Health & Machine Learning, Hasso Plattner Institute for Digital Engineering, Potsdam, Germany
,Digital Engineering Faculty, University of Potsdam, Potsdam, Germany
| | - R. Gunda
- Africa Health Research Institute, KwaZulu-Natal, South Africa
,School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
,Division of Infection and Immunity, University College London, London, UK
| | - M. J. Siedner
- Africa Health Research Institute, KwaZulu-Natal, South Africa
,School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
,Harvard Medical School, Boston, MA, USA
,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - W. Hanekom
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - T. Ndung’u
- Africa Health Research Institute, KwaZulu-Natal, South Africa
,Division of Infection and Immunity, University College London, London, UK
,HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
,Ragon Institute of MGH, MIT and Harvard University, Cambridge, MA, USA
| | - A. Grant
- Africa Health Research Institute, KwaZulu-Natal, South Africa
,School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
,London School of Hygiene & Tropical Medicine, London, UK
,School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - C. Lippert
- Digital Health & Machine Learning, Hasso Plattner Institute for Digital Engineering, Potsdam, Germany
,Digital Engineering Faculty, University of Potsdam, Potsdam, Germany
,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E. B. Wong
- Africa Health Research Institute, KwaZulu-Natal, South Africa
,Division of Infectious Diseases, University of Alabama at Birmingham, AL, USA
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Gounder K, Naidoo V, Padayachi N, Mthethwa Q, Dilernia D, Hunter E, Walker B, Ndung’u T. A20 Deep sequencing reveals viral evolution in GAG within protective HLA Alleles B*57: 02, B*58: 01, and B*7 supertype individuals acutely infected with HIV-1 subtype C in Durban, South Africa. Virus Evol 2018. [PMCID: PMC5905507 DOI: 10.1093/ve/vey010.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Gounder
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa
- KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH)
| | - V Naidoo
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa
- KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH)
| | - N Padayachi
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa
- KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH)
| | - Q Mthethwa
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa
- KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH)
| | - D Dilernia
- Emory Vaccine Center at Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - E Hunter
- Emory Vaccine Center at Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - B Walker
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa
- Ragon Institute of Massachusetts General Hospital, MIT and Harvard, Boston, Cambridge, MA, USA
| | - T Ndung’u
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban 4013, South Africa
- KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH)
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Roider J, Mbatha B, Hlope D, Muenchhoff M, Sprenger K, Graza Y, Lobenstein J, Bhoola R, Krishna M, Spicer K, Ndung’u T, Goulder P. 18 Initiation of ART within 24–48 hours of birth following in utero HIV infection: the Ucwaningo Lwabantwana Study. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)30963-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Makadzange AT, Higgins-Biddle M, Chimukangara B, Birri R, Gordon M, Mahlanza T, McHugh G, van Dijk JH, Bwakura-Dangarembizi M, Ndung’u T, Masimirembwa C, Phelps B, Amzel A, Ojikutu BO, Walker BD, Ndhlovu CE. Clinical, Virologic, Immunologic Outcomes and Emerging HIV Drug Resistance Patterns in Children and Adolescents in Public ART Care in Zimbabwe. PLoS One 2015; 10:e0144057. [PMID: 26658814 PMCID: PMC4678607 DOI: 10.1371/journal.pone.0144057] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/12/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine immunologic, virologic outcomes and drug resistance among children and adolescents receiving care during routine programmatic implementation in a low-income country. METHODS A cross-sectional evaluation with collection of clinical and laboratory data for children (0-<10 years) and adolescents (10-19 years) attending a public ART program in Harare providing care for pediatric patients since 2004, was conducted. Longitudinal data for each participant was obtained from the clinic based medical record. RESULTS Data from 599 children and adolescents was evaluated. The participants presented to care with low CD4 cell count and CD4%, median baseline CD4% was lower in adolescents compared with children (11.0% vs. 15.0%, p<0.0001). The median age at ART initiation was 8.0 years (IQR 3.0, 12.0); median time on ART was 2.9 years (IQR 1.7, 4.5). On ART, median CD4% improved for all age groups but remained below 25%. Older age (≥ 5 years) at ART initiation was associated with severe stunting (HAZ <-2: 53.3% vs. 28.4%, p<0.0001). Virologic failure rate was 30.6% and associated with age at ART initiation. In children, nevirapine based ART regimen was associated with a 3-fold increased risk of failure (AOR: 3.5; 95% CI: 1.3, 9.1, p = 0.0180). Children (<10 y) on ART for ≥4 years had higher failure rates than those on ART for <4 years (39.6% vs. 23.9%, p = 0.0239). In those initiating ART as adolescents, each additional year in age above 10 years at the time of ART initiation (AOR 0.4 95%CI: 0.1, 0.9, p = 0.0324), and each additional year on ART (AOR 0.4, 95%CI 0.2, 0.9, p = 0.0379) were associated with decreased risk of virologic failure. Drug resistance was evident in 67.6% of sequenced virus isolates. CONCLUSIONS During routine programmatic implementation of HIV care for children and adolescents, delayed age at ART initiation has long-term implications on immunologic recovery, growth and virologic outcomes.
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Affiliation(s)
- A. T. Makadzange
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, United States of America
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | | | - B. Chimukangara
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
- African Institute of Biomedical Sciences, Harare, Zimbabwe
| | - R. Birri
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - M. Gordon
- HIV Pathogenesis Program, University of Kwa-Zulu Natal, Durban, South Africa
| | - T. Mahlanza
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - G. McHugh
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - J. H. van Dijk
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - M. Bwakura-Dangarembizi
- Department of Pediatrics, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - T. Ndung’u
- HIV Pathogenesis Program, University of Kwa-Zulu Natal, Durban, South Africa
| | | | - B. Phelps
- United States Agency for International Development (USAID), Washington, DC, United States of America
| | - A. Amzel
- United States Agency for International Development (USAID), Washington, DC, United States of America
| | - B. O. Ojikutu
- John Snow Inc, Boston, Massachusetts, United States of America
| | - B. D. Walker
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - C. E. Ndhlovu
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
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Ogunshola F, Mewala N, Wright JK, Ismail N, Brockman MA, Walker BD, Ndung’u T, Ndhlovu ZM. P15.03 Development of a new cem reporter t-cells (gxr-cells) viral inhibition assay (via) for elucidating the role of class-i-hla alleles on the inhibitory capacity of hiv-1-specific cd8 +t-cells. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kleppa E, Ramsuran V, Zulu S, Karlsen G, Ndhlovu P, Lillebø K, Holmen S, Onsrud M, Gundersen S, Taylor M, Kjetland E, Ndung’u T. Expression of the CCR5 HIV co-receptor in women with genital schistosomiasis. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Chetty S, Porichis F, Govender P, Zupkosky J, Pillay M, Walker B, Ndung’u T, Kaufmann D, Kasprowicz V. Co-infection with Mycobacterium tuberculosis impairs HIV-specific CD8+ and CD4+ T cell functionality. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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