India

With a population of more than one billion, India is the second largest country in the world, represents 16% of the global population, and the national average for life expectancy is only 65 years. India leads the world in the largest absolute burden of TB, ranks third for HIV (behind South Africa and Nigeria), and ranks second for diabetes. The country receives funding to support HIV/AIDS prevention, treatment and care programs under the US President's Emergency Plan for AIDS Relief (PEPFAR).

Our Indo-JHU Clinical Research Partnership is dedicated to reversing poor patient outcomes. With operations based in Pune, our extensive research portfolio is directed by Dr. Amita Gupta (Baltimore, MD), with onsite direction from Dr. Vidya MaveDr. Nishi Suryavanshi, and Dr. Nikhil Gupte (Pune). The Indo-JHU Partnership employs more than 200 people and, in addition to our memberships in consortia with many esteemed Indian research institutions, we have formal agreements with:

CCGHE WORK IN INDIA

Tuberculosis (TB) Aftermath

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2020-06-05
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Dr. Jonathan Golub is PI for this study. TB Aftermath seeks to provide evidence for an effective and scalable strategy targeting HHs of treated TB cases, a high priority of the NTEP. Purpose To compare the effectiveness, cost-effectiveness and feasibility of two Active Case Finding (ACF) strategies...

Mental Health Outcomes among Health Care Professionals Involved in the Treatment and Care of COVID 19 Patients in India

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2020-06-01
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Drs. Nikhil Gupta and Nishi Suryavanshi are leading this survey project. This study is investigating the immediate impact of the COVID-19 pandemic on mental health outcomes and overall quality of life and what are the factors associated with it among Indian Health care workers. Among health care...

Prevalence of Risk Factors for Lung Cancer and Facilitators and Barriers for Tobacco Cessation among People Living with HIV

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2020-04-01
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India has the world’s third largest HIV epidemic, with 2.1 million people currently living with HIV and an additional 90,000 new infections each year.[29] At the same time, expansion of the HIV response under India’s premier governmental agency - the National AIDS Control Organization (NACO), has...

Hybrid Trial for Alcohol Reduction among People with TB and HIV in India

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2020-02-12
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The highest incidence of tuberculosis disease (TB) in the world is in India, accounting for 27% of all new cases globally, with approximately 86,000 among persons with HIV (PWH). Unhealthy alcohol use triples the risk of TB in the general population, increasing susceptibility to primary infection...

Pregnancy Associated Immune Responses to Tuberculosis and HIV in India and South Africa (PARTHISA)

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2020-01-14
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Dr. Jyoti Mathad is Co-PI of this study. Purpose: Tuberculosis (TB) is a leading cause of maternal mortality, especially among HIV-infected women. Women are most likely to develop active TB during and immediately after pregnancy. The immunologic conditions responsible for this phenomenon are not...

Increasing Market and Public Health Outcomes Through Scaling Up Affordable Access Models of Short Course Preventive Therapy for TB (IMPAACT4TB)

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2019-12-17
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Primary Objective: This study is being conducted in Brazil, Cambodia, China, Ethiopia, Ghana, Haiti, India, Indonesia, Kenya, Malawi, Mozambique, South Africa, Tanzania, and Zimbabwe. The overall goal is to reduce TB incidence among (1) people living with HIV who are on antiretroviral therapy, and...

Markers of Lung Impairment in HIV-TB Coinfected Indian Adults

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2019-12-11
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Objectives/Aims We will compare the degree of lung impairment between HIV-TB co-infected adults (HIV-TB group) and TB cases without HIV co-infection (TB group) who successfully complete TB therapy. We hypothesize that the HIV-TB group will have a greater degree of lung impairment compared to the TB...

T Cell Biomarkers and T-regulatory Responses to Pediatric TB

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2019-11-21
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The goals of this study are to: Validate host T cell biomarkers for diagnosis of pediatric TB Investigate the phenotype and functions of T-regulatory cells in pediatric TB We will use cryopreserved PBMC samples from CTRIUMPH cohorts: Pediatric unconfirmed TB, confirmed TB, latest Tb, and no TB...

Inflammasome Genetics and Tuberculosis Treatment Outcomes

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2019-11-07
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Dr. Amita Gupta is a Co-PI on this study. STUDY DESIGN We will conduct a retrospective case-cohort study nested within the CTRIUMPH and EDOTS cohorts to address our study objectives. This will enable us to measure the association of polymorphisms with multiple clinical outcomes simultaneously and...

Evaluation of a Urinary Biomarker Assay for Diagnosis and Test of Cure for Tuberculosis

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2019-09-09
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Dr. Jeff Tornheim is PI of this study. METHODS This study will make use of biorepository samples from the Cohort for TB Research by the Indo-US Medical Partnership (CTRIUMPh). CTRIUMPh, funded by the US NIH and Indian Department of Biotechnology, is an academic collaboration between Johns Hopkins...

A5300B/I2003B: Protecting Households On Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Patients (PHOENIx)

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2019-08-19
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Dr. Amita Gupta is Protocol Co-chair for this multinational clinical trial. BACKGROUND The World Health Organization (WHO) estimates that there were 480,000 incident cases of MDR-TB globally in 2015. MDR-TB has been shown to be almost twice as common in TB patients living with HIV compared with TB...

A5300B/I2003B: Protecting Households On Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Patients (PHOENIx)

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2019-08-19
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Dr. Amita Gupta is Protocol Co-chair for this multinational clinical trial. BACKGROUND The World Health Organization (WHO) estimates that there were 480,000 incident cases of MDR-TB globally in 2015. MDR-TB has been shown to be almost twice as common in TB patients living with HIV compared with TB...

Visual Field Loss in HIV-Positive Patients of Non-Infectious HIV Retinopathy

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2019-06-02
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New study will assess HIV+ patients and determine the prevalence of visual field loss due to noninfectious HIV retinopathy

Immune Correlates of LTBI in HIV-exposed Infants

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2019-04-29
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About 2 billion people worldwide harbor asymptomatic latent TB infection (LTBI), activation of which results in progression to TB disease. In areas of high tuberculosis (TB) prevalence, infants and young children have a 3-fold higher risk of progression and death from TB at age < 5 years...

P2010: Phase III Study of the Virologic Efficacy and Safety of Dolutegravir-Containing versus Efavirenz-Containing Antiretroviral Therapy Regimens in HIV-1-Infected Pregnant Women and their Infants “VESTED”

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2019-02-06
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Full Title: P2010: Phase III Study of the Virologic Efficacy and Safety of Dolutegravir-Containing versus Efavirenz-Containing Antiretroviral Therapy Regimens in HIV-1-Infected Pregnant Women and their Infants “VESTED”: V irologic E fficacy and S afety of ART Combinations with T AF/TDF, E FV, and D...

Prevalence of Tuberculosis in Severely Malnourished Indian Children

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2018-12-18
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This study is funded and conducted under the U.S. National Institutes of Health, Fogarty International Center. PIs are Robert Bollinger, MD, MPH; Dr. Muralidhar Tambe, BJGMC Severely malnourished children are vulnerable population for communicable and non-communicable disease. Diagnosis of TB among...

Characterization of Genomics and Metabolomics among Individuals Highly-Exposed, but Resistant to MTB Infection

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2018-12-13
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New study launched in India & South Africa to identify functional relationships between genomics & metabolomics, & to characterize fundamental biological systems underlying resistance to Mtb infection.

Host RNA Expression for Diagnosis and Monitoring of Pediatric TB in Africa and India

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2018-12-13
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We are leveraging the RePORT platform by including a cohort of Indian children together with South African children in a large validation study to study on changes in gene expression profiles during treatment for TB

Immune Responses and Effect of Disulfiram on MTB Infected PBMCs as a Potential Host Directed Therapy

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2018-11-26
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Dr. Mandar Paradkar is lead investigator for this study that is assessing the immune responses of adult pulmonary TB patients enrolled in the CTRIUMPh study, using PBMC samples of those with harmful use of alcohol assessed by AUDIT scores ≥ 8 compared to non-alcoholics (AUDIT < 8). Aim 1: To...

Characterization of TB-specific T Cell Responses in Highly-exposed, but Uninfected Health Care Workers in India

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2018-10-25
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This study is funded and conducted under the U.S. National Institutes of Health, Fogarty International Center. PIs are Robert Bollinger, MD, MPH; Jyothi Rengarajan, MD, Emory University. Primary Research Question Do health care workers who remain TST negative, despite high-exposure to TB,...

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Acceptability and Feasibility of a Behavioral and Mobile Health Intervention (COMBIND) Shown to Increase Uptake of Prevention of Mother to Child Transmission (PMTCT) Care in India

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2020-05-24
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BMC Public Health
A cluster-randomized trial recently demonstrated that an integrated behavioral and mobile technology intervention improved uptake of key components of a Prevention of Mother to Child Transmission (PMTCT) Option B+ program, among HIV- infected pregnant/breastfeeding women in India.

High prevalence of late presentation of ART-naïve perinatally infected children for care in Pune, India

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2020-02-19
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AIDS Care
AIDS Care : There is an urgent need to identify strategies that improve linkage of perinatally infected ART-naïve children to care, and earlier than what is currently observed.

Evaluating the Concordance of Clinician Antiretroviral Prescribing Practices and HIV-ASSIST, an Online Clinical Decision Support Tool

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2019-12-02
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Journal of General Internal Medicine
Recent studies have shown that more than half of HIV care is provided by primary care practitioners.However, clinicians with experience and expertise in HIV medicine are declining.

MAL adaptor (TIRAP) S180L polymorphism and severity of disease among tuberculosis patients

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2019-10-31
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Infection, Genetics, and Evolution
Infection, Genetics, and Evolution : We investigated the association of TIRAP variants with severity of TB disease and IP-10 production in humans, which may be useful in predicting poor clinical outcome

Incidence of tuberculosis in HIV-infected adults on first- and second-line antiretroviral therapy in India

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2019-10-29
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BMC Infectious Diseases
In this study among people living with HIV, Akshay Gupte and colleagues found that the risk of acquiring tuberculosis was higher in those receiving first-line antiretrovial therapy versus those receiving second-line medications.

Isoniazid preventive therapy in HIV-infected pregnant and postpartum women

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2019-10-03
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New England Journal of Medicine
New England Journal of Medicine: Dr. Amita Gupta and colleagues found that the current standard of care given to HIV+ pregnant women to prevent TB should wait until 12 weeks after delivery. The study underscores the need to include pregnant women in clinical trials.

Challenges in conducting trials for pediatric tuberculosis meningitis: lessons learned in the field

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2019-10-01
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International Journal of Tuberculosis and Lung Disease
International Journal of Tuberculosis and Lung Disease: Researchers describe the challenges associated with conducting the first randomized clinical trial of antimicrobial agents in pediatric tuberculosis meningitis.

Re: A Shorter Regimen for Rifampin-Resistant Tuberculosis

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2019-09-12
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New England Journal of Medicine
Dr. Jeff Tornheim and colleagues respond to an NEJM article about shorter course TB treatment.

Use of smartphone-based video Directly Observed Therapy (vDOT) in tuberculosis care: Single-arm, prospective feasibility study

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2019-08-30
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Journal of Medical Internet Research
Video-based monitoring is increasingly used as an efficient and low cost alternative to in-person observation and monitoring of TB patients. It showed promise in the high TB setting of India, too.

Inclusion of key populations in clinical trials of new antituberculosis treatments: Current barriers and recommendations for pregnant and lactating women, children, and HIV-infected persons

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2019-08-15
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PLOS Medicine
PLOS Medicine: Dr. Amita Gupta and colleagues discuss the scientific and ethical basis for including pregnant and lactation women, children, and HIV+ patients in tuberculosis therapeutic clinical trials.

Smoking, alcohol use disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be ignored

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2019-07-31
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PLoS One
BACKGROUND: More than 20% of tuberculosis (TB) disease worldwide may be attributable to smoking and alcohol abuse. India is the second largest consumer of tobacco products, a major consumer of alcohol particularly among males, and has the highest burden of TB globally. The impact of...

Third-line antiretroviral therapy in low-income and middle-income countries (ACTG A5288): a prospective strategy study

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2019-07-29
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Lancet HIV
BACKGROUND: Antiretroviral therapy (ART) management is challenging for individuals in resource-limited settings presenting for third-line treatment because of complex resistance patterns, partly due to reduced access to viral load monitoring. We aimed to evaluate use of newer...

Infection free "resisters" among household contacts of adult pulmonary tuberculosis

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2019-07-18
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PLoS One
Despite substantial exposure to infectious pulmonary tuberculosis (TB) cases, some household contacts (HHC) never acquire latent TB infection (LTBI). Characterizing these "resisters" can inform who to study immunologically for the development of TB vaccines. We enrolled HHCs of culture-...

High risk for latent tuberculosis infection among medical residents and nursing students in India

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2019-07-08
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PLoS One
PLoS ONE: Self-reported TB exposure is underreported, and uptake of LTBI prevention therapy remains low

Advancing the development of new tuberculosis treatment regimens: The essential role of translational and clinical pharmacology and microbiology

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2019-07-05
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PLOS
Application of clinical pharmacology best practices is essential to the efficient and rational development of drugs. In general, knowledge gained about exposure–response relationships in preclinical models aids drug and dose selection in human studies, and biomarkers and pharmacokinetic (PK) data...

Mobile phone access and comfort: implications for HIV and tuberculosis care in India and South Africa.

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2019-07-01
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International Journal of Tuberculosis and Lung Disease
SETTING: India and South Africa shoulder the greatest burden of tuberculosis (TB) and human immunodeficiency virus (HIV) infection respectively, but care retention is suboptimal. OBJECTIVE: We conducted a study in Pune, India, and Matlosana, South Africa ...

Age-specific prevalence of TB infection among household contacts of pulmonary tuberculosis: Is it time for TB preventive therapy?

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2019-06-21
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Transactions of the Royal Society of Tropical Medicine and Hygiene
BACKGROUND: Household contacts (HHCs) of TB patients are at high risk of developing evidence of latent TB infection (LTBI) and active disease from the index patient. We estimated the age-specific prevalence of LTBI and the force of infection (FI), as a measure of recent...

Assessment of lung function in successfully treated tuberculosis reveals high burden of ventilatory defects and COPD

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2019-05-23
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PLoS One
New in PLoS One: We found a high burden of lung function defects and COPD in tuberculosis cases who successfully completed treatment, suggesting a need for lung function screening as part of patient management.

High prevalence of insulin resistance and occurrence prior to hyperinsulinemia threshold among people living with HIV in Pune, India

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2019-05-21
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Diabetes Metabolic Syndrome: Clinical Research & Reviews
BACKGROUND Diabetes prevalence in HIV is not well characterized for India, despite the high burden of both individual diseases. Epidemiology of insulin resistance (IR): a precursor to diabetes, and its associated risk factors are also poorly understood in Asian Indian people living with HIV (PLHIV...

Subtherapeutic rifampicin concentration is associated with unfavourable tuberculosis treatment outcomes

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2019-05-10
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Clinical Infectious Diseases
Rifampicin concentrations were sub-therapeutic in most Indian patients taking a thrice-weekly TB regimen

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Predictors of tuberculosis infection in MDR-TB household contacts ≥15 years old.

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2020-03-11
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Kim S , Gupta A, Wu X, Hughes M, Dawson R, Mave V, Kumarasamy, Smith B, Rustomgee R, Shah NS, Hesseling A, Swindells S, Churchyard G for the ACTG/IMPAACT A5300/I2003 PHOENIx Feasibility Study Team. Predictors of tuberculosis infection in MDR-TB household contacts ≥15 years old. Presented at: CROI...

Rifapentine pharmacokinetics and safety in pregnant women with and without HIV on 3HP

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2020-03-11
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Mathad JS , Savic RM, Britto P, Wiesner L, Townley E, Chakhtoura N, Bradford S, Patil S, Vhembo T, Lespinasse D, Langat D, Werarak P, Kamthunzi P, Gupta A, Dooley KE. Rifapentine pharmacokinetics and safety in pregnant women with and without HIV on 3HP. Presented at: CROI 2020. Boston, MA; March 8-...

Effect of rifamycins on pretomanid exposure in patients with pulmonary TB

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2020-03-10
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Abdelwahab MT , Ignatius E, Denti P, Dooley KE, Gupte N, Dawson R, Barnes G, Narunsky K, Hendricks B. Effect of rifamycins on pretomanid exposure in patients with pulmonary TB. (ID 3688). Presented at: CROI 2020. Boston, Massachusetts. March 8-11, 2020.

Early bactericidal activity of meropenem (+ Amox/Clav) with and without rifampin for TB

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2020-03-10
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De Jager V, Abufathi AA, Feyt H, Gupte N, Vanker N, Barnes G, van Brakel E, Nuermberger E, Dorman SE, Svensson EM, Diacon AH, Dooley KE. Early bactericidal activity of meropenem (+ Amox/Clav) with and without rifampin for TB. Presented at: CROI 2020. Boston, Massachusetts. March 8-11, 2020.

Factors associated with gestational diabetes in HIV+ and HIV- women in Pune, India

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2020-03-09
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Chebrolu P , Alexander M, Bhosale R, Naik S, Patil N, Gupta A, Mathad J. Factors associated with gestational diabetes in HIV+ and HIV- women in Pune, India. Presented at: CROI 2020. Boston, Massachusetts. March 8-11, 2020.

Geographic and Individual Risk Factors for TB or Death in the Brief-TB Trial (A5279)

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2020-03-09
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Riviere C , Juste MAJ, Ramchandani R, Gupta A, Benson CA, Masheto G, Supparatpinyo K, Mohapi L, da Silva Escada RO, Mngqibisa R, Kanyama C, Langat D, Swindells S, Chaisson RE, for the A5279/BRIEF TB Study Team. Geographic and Individual Risk Factors for TB or Death in the Brief-TB Trial (A5279)...

Tuberculosis preventive therapy should be considered for all household contacts of pulmonary TB patients in India

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2020-02-07
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Paradkar M, Chandrasekara P, Jain D, Shivakumar SVBY, Thiruvengadan K, Gupte AN, Thomas B, Kinikar A, Sekar K, Bharadwaj R, Dolla CK, Gaikwad S, Elilarasi S, Lokhande R, Reddy D, Murali L, Kulkarni V, Pradhan N, Hanna LE, Pattabiraman S, Kohli R, Nayagam R, Suryavanshi N, Shrinivasa BM, Cox SR,...

The crisis in maternal TB: a case-based discussion of research gaps

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2019-11-02
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Naik SN . The crisis in maternal TB: a case-based discussion of research gaps. Speaker. Confronting the crisis: emerging research in maternal-child TB Symposium. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

Is there a connection between gestational diabetes and TB?

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2019-11-02
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Alexander M . Is there a connection between gestational diabetes and TB? Speaker. Confronting the crisis: emerging research in maternal-child TB Symposium.50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

Increased moxifloxacin dosing among MDR-TB patients with low-level resistance to moxifloxacin did not improve treatment outcomes in a tertiary care centre in Mumbai, India

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2019-11-02
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Tornheim JA , Gajjar I, Shivakumar SVBY, Gupte AN, Kishore G, Karane M, Rodrigues C, Gupta A, Udwadia ZF. Increased moxifloxacin dosing among MDR-TB patients with low-level resistance to moxifloxacin did not improve treatment outcomes in a tertiary care centre in Mumbai, India. 50th Union World...

Performance of QuantiFERON-TB Gold in Tube (QFT-GIT) and QuantiFERON-TB Gold Plus (QFT-Plus) for detection of Mycobacterium tuberculosis infection in pregnant women in India

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2019-11-01
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Kulkarni V , Bhosale R, Jain D, Deshpande P, Naik N, Alexander M, Patil N, Gupte N, Gupta A, Mathad J. Performance of QuantiFERON-TB Gold in Tube (QFT-GIT) and QuantiFERON-TB Gold Plus (QFT-Plus) for detection of Mycobacterium tuberculosis infection in pregnant women in India. Poster presentation...

Six-week culture conversion predicts tuberculosis treatment outcomes

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2019-11-01
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Pradhan N , Kagal A, Gupte N, Gaikwad S, Barthwa M, Gupta A, Golub JE, Mave V. Six-week culture conversion predicts tuberculosis treatment outcomes. Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

Inappropriate postpartum weight loss may predict development of active TB: Findings from a cohort study in Pune, India

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2019-11-01
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Alexander M , Bhosale R, Naik S, Gupte N, Jain D, Patil N, Pradhan N, Mave V, Gupta A, Mathad J. Inappropriate postpartum weight loss may predict development of active TB: Findings from a cohort study in Pune, India. Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India...

Does treatment of infertile women with probable genital tuberculosis improve fertility outcome?

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2019-11-01
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Naik SN , Chandanwale A, Kadam D, Sambarey PW, Dhumal G, DeLuca A, Jain D, Gupta A, Bollinger R, Mave V. Does treatment of infertile women with probable genital tuberculosis improve fertility outcome? Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-...

Tuberculosis infection and inflammation among HIV-infected adults in India

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2019-10-31
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Kulkarni V . Tuberculosis infection and inflammation among HIV-infected adults in India. Oral Presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

Resistance to Mycobacterium tuberculosis infection among household contacts of MDR TB patients

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2019-10-31
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Baliashvili D , Gandhi NR, Kim S, Gupta A, Churchyard G, Swindells S, Hesseling A, Hughes M, Shah S for the ACTG 5300/IMPAACT I2003 PHOENIx Feasibility Study Team. Resistance to Mycobacterium tuberculosis infection among household contacts of MDR TB patients. Poster presentation. 50th Union World...

High prevalence of tuberculosis infection in children living in households of MDR-TB patients

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2019-10-31
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Kim S , Wu X, Hughes M, Mendoza-Ticona A, Churchyard G, Swindells S, Shah NS, Gupta A, Hesseling A for the A5300/I2003 PHOENIx Feasibility Study Team. High prevalence of tuberculosis infection in children living in households of MDR-TB patients. Short oral presentation. 50th Union World Conference...

Assessing TB-related knowledge and stigma and associated risk factors among pregnant women in low-resource settings of Pune, India

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2019-10-30
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Mehta S , Murrill M, Suryavanshi N, Bhosale R, Naik S, Patil N, Gupta A, Mathad J, Shivakoti R, Alexander M. Assessing TB-related knowledge and stigma and associated risk factors among pregnant women in low-resource settings of Pune, India. Poster presentation. 50th Union World Conference on Lung...

Association of latent TB infection in pregnancy with perinatal health outcomes in an Indian cohort

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2019-10-30
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Bhosale R , Graham H, Alexander M, Kinikar A, Khwaja S, Patil N, Gupta A, Mathad J, Shivakoti R. Association of latent TB infection in pregnancy with perinatal health outcomes in an Indian cohort. Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November...

Mobile health technologies to improve the HIV cascade in India: Opportunities & considerations

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2019-09-06
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Chang L. Mobile health technologies to improve the HIV cascade in India: Opportunities & considerations. Invited Speaker. National Consultation on Global & Local Evidence to Improve the HIV Cascade in India. Dehli, India; September 6, 2019.

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