Clinical Research

Leadership

While we conduct research all over the world, the majority of our work is in India. Our Indo-JHU Clinical Research Partnership is located in Pune and is directed by Dr. Amita Gupta (Baltimore, MD), with onsite direction from Dr. Vidya Mave, Dr. Nishi Suryavanshi, and Dr. Nikhil Gupte (Pune). The Indo-JHU Partnership employs more than 200 people and in addition to our memberships in cosortia with many esteemed Indian research institutions, we have formal agreements with:

Byramjee Jeejeebhoy Government Medical College, and Sassoon General Hospital (BJGMC). Pune, India
DY Patil Medical College, Hospital and Research Center. Pune, India
National Institute for Research in Tuberculosis. Chennai, India
PD Hinduja Hospital and Medical Group. Mumbai, India
Medanta The Medicity. Gurgaon, India
KEM Hospital. Pune, India
Bharati Vidyapeeth Medical College. Pune, India

Publications
Presentations

Unique aspects of the care of HIV-positive Latino patients living in the United States

Post Date:

2010-08-15

Countries:

United States

Publication:

Current HIV/AIDS Reports

Latinos are disproportionately affected by HIV, with a higher risk of infection and a delayed presentation to care as compared to non-Hispanic whites. Over the last decade many Latinos, especially foreign-born migrants, have settled in regions of the country with historically low Latino...

Antiretroviral regimens for patients with HIV who fail first-line antiretroviral therapy

Post Date:

2010-06-16

Publication:

Cochrane Database of Systematic Reviews

Background: Highly active antiretroviral therapy has reduced the morbidity and mortality of patients with HIV/AIDS. A common first-line ART regimen in low-resource settings includes a non-nucleoside reverse transcriptase inhibitor (NNRTI) and two nucleoside reverse transcriptase inhibitors (NRTIs...

Effect of peer health workers on AIDS care in Rakai, Uganda: a cluster-randomized trial

Post Date:

2010-06-02

Countries:

Uganda

Publication:

PLOS

Background: Human resource limitations are a challenge to the delivery of antiretroviral therapy (ART) in low-resource settings. We conducted a cluster randomized trial to assess the effect of community-based peer health workers (PHW) on AIDS care of adults in Rakai, Uganda. ...

Developing WHO guidelines with pragmatic, structured, evidence-based processes: a case study

Post Date:

2010-05-15

Publication:

Global Public Health

Many guidelines, including those produced by the World Health Organisation (WHO), have failed to adhere to rigorous methodological standards. Operational examples of guideline development processes may provide important lessons learned to improve the rigour and quality of future guidelines. To this...

Optimal monitoring strategies for guiding when to switch first-line antiretroviral therapy regimens for treatment failure among adults and adolescents living with HIV in low-resource settings

Post Date:

2010-04-14

Publication:

Cochrane Database of Systematic Reviews

Background: One of the critical clinical decisions made in antiretroviral therapy (ART) is when to switch from an initial regimen to another due to treatment failure. This complex process requires consideration of multiple factors including: (1) what type of monitoring (e.g. clinical, immunologic,...

Physician estimate of antiretroviral adherence: poor correlation with patient self-report and viral load

Post Date:

2010-03-15

Countries:

India

Publication:

AIDS Patient Care and STDs

Adherence to antiretroviral therapy (ART) is critical in maintaining viral suppression and minimizing resistance in HIV-infected patients. We compared physician estimates of their patients' ART adherence with participant's self-reported adherence to determine patient-provider agreement and identify...

Sexually transmitted infection prevalence and behavioral risk factors among Latino and non-Latino patients attending the Baltimore City STD clinics

Post Date:

2010-03-15

Countries:

United States

Publication:

Sexually Transmitted Diseases

Background: Many studies have evaluated factors influencing STD/HIV disparities between African-American and white populations, but fewer have explicitly included Latinos for comparison. Methods: We analyzed demographic and behavioral data captured in electronic medical records of patients first...

One-, two-, and three-class resistance among HIV-infected patients on antiretroviral therapy in private care clinics: Mumbai, India

Post Date:

2010-01-26

Countries:

India

Publication:

AIDS Research and Human Retroviruses

HIV-infected patients receiving antiretroviral (ARV) therapy (ART) in India are not all adequately virally suppressed. We analyzed ARV drug resistance in adults receiving ART in three private clinics in Mumbai, India. HIV viral load was measured in 200 patients with the Roche AMPLICOR HIV-1 Monitor...

Diagnostic accuracy of a urine lipoarabinomannan test for tuberculosis in hospitalized patients in a high HIV prevalence setting

Post Date:

2009-10-01

Countries:

South Africa

Publication:

Journal of Acquired Immune Deficiency Syndromes

We evaluated the accuracy of a urine lipoarabinomannan (LAM) test for TB diagnosis in South Africa.

Extended-dose nevirapine to 6 weeks of age for infants to prevent HIV transmission via breastfeeding in Ethiopia, India, and Uganda: an analysis of three randomized controlled trials

Post Date:

2009-07-26

Countries:

Clinical Sites:

Publication:

The Lancet

Background: UNICEF/WHO recommends that infants born to HIV-infected mothers who do not have access to acceptable, feasible, affordable, sustainable, and safe replacement feeding should be exclusively breastfed for at least 6 months. The aim of three trials in Ethiopia, India, and Uganda was to...

Strategies for gender-equitable HIV services in rural India

Post Date:

2009-05-15

Countries:

India

Publication:

Health Policy and Planning

The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt...

Highly complex neutralization determinants on a monophyletic lineage of newly transmitted subtype C HIV-1 Env clones from India

Post Date:

2009-03-15

Publication:

Virology

Little is known about the neutralization properties of HIV-1 in India to optimally design and test vaccines. For this reason, a functional Env clone was obtained from each of ten newly acquired, heterosexually transmitted HIV-1 infections in Pune, Maharashtra. These clones formed a phylogenetically...

Two year virologic outcomes of an alternative AIDS care model: evaluation of a peer health worker and nurse-staffed community-based program in Uganda

Post Date:

2009-03-01

Countries:

Uganda

Publication:

Journal of Acquired Immune Deficiency Syndromes

Background: There is growing concern about the human resources needed to care for increasing numbers of patients receiving antiretroviral therapy in resource-limited settings. We evaluated an alternative model, community-based, comprehensive antiretroviral program staffed primarily by peer health...

Nevirapine resistance and breast-milk HIV transmission: effects of single and extended-dose nevirapine prophylaxis in subtype C HIV-infected infants

Post Date:

2009-01-01

Countries:

India

Clinical Sites:

BJGMC

Publication:

PLOS One

Background: Daily nevirapine (NVP) prophylaxis to HIV-exposed infants significantly reduces breast-milk HIV transmission. We assessed NVP-resistance in Indian infants enrolled in the “six-week extended-dose nevirapine” (SWEN) trial who received single-dose NVP (SD-NVP) or SWEN for prevention of...

Traditional Indian medicine and homeopathy for HIV/AIDS: a review of the literature

Post Date:

2008-12-22

Countries:

India

Publication:

AIDS Research and Therapy

Background: Allopathic practitioners in India are outnumbered by practitioners of traditional Indian medicine and homeopathy (TIMH), which is used by up to two-thirds of its population to help meet primary health care needs, particularly in rural areas. India has an estimated 2.5 million HIV...

Neutralizing antibody responses in recent seroconverters with HIV-1 subtype C infections in India

Post Date:

2008-10-25

Countries:

India

Publication:

AIDS Research and Human Retroviruses

The longitudinal heterologous neutralization response against two HIV-1 subtype C isolates was studied in 33 ART-naive individuals recently infected with HIV-1 subtype C from India. Seven of 33 (21%) seroconverters demonstrated a consistent response against both isolates (65-100% neutralization),...

High risk for occupational exposure to HIV and utilization of post-exposure prophylaxis in a teaching hospital in Pune, India

Post Date:

2008-10-21

Countries:

India

Clinical Sites:

BJGMC

Publication:

BMC Infectious Diseases

Background: The risk for occupational exposure to HIV has been well characterized in the developed world, but limited information is available about this transmission risk in resource-constrained settings facing the largest burden of HIV infection. In addition, the feasibility and utilization of...

Neisseria gonorrhea and Chlamydia trachomatis among Human Immunodeficiency Virus-infected women

Post Date:

2008-10-15

Countries:

United States

Publication:

Sexually Transmitted Diseases

In this study, we determine risk factors for CT and GC infection in women receiving HIV continuity care using data from the Johns Hopkins HIV Clinical Cohort. The Johns Hopkins HIV Clinical Cohort is a longitudinal observational study of adult patients (≥18 years old) in HIV care in the Johns...

Repeated pregnancy in HIV positive Indian women with known HIV status

Post Date:

2008-09-29

Countries:

India

Clinical Sites:

BJGMC

Publication:

AIDS Care

HIV-positive women of reproductive age face challenges in decision making related to pregnancy. Understanding factors influencing repeat pregnancies in women with known HIV status are necessary to guide interventions and counseling strategies to better inform and support them. We compared three...

The Indian pediatric HIV epidemic: a systematic review

Post Date:

2008-09-15

Countries:

India

Publication:

Current HIV Research

Despite an estimated 70,000 Indian children living with HIV infection, little is known about India's pediatric HIV epidemic. Generalizations about epidemiology, natural history, and treatment outcomes from other resource-limited settings (RLS) may be inaccurate for several biologic and social...

Early mortality in HIV treatment and TB empiric therapy: Weighing the risks and benefits of an empiric TB strategy

Post Date:

2008-12-05

Gupta, A. Early mortality in HIV treatment and TB empiric therapy: Weighing the risks and benefits of an empiric TB strategy. ACTG Meeting. Baltimore, MD.

Update on opportunistic infections and IRIS

Post Date:

2008-12-03

Gupta, A. Update on opportunistic infections and IRIS. Mid-Atlantic AIDS Education Training. Wilmington Hospital. Wilmington, DE.

World AIDS day for African students

Post Date:

2008-12-02

Gupta, A. World AIDS day for African students. US State Department Live Webcast. Washington, DC.

Global Perspective of HIV

Post Date:

2008-12-01

Bollinger, R. Global Perspective of HIV. Caring for the City of HIV, World AIDS Day Celebration. Pastoral Care at the Johns Hopkins Hospital. The Johns Hopkins Hospital. Baltimore, MD.

Global epidemiology and its impact on the Macroeconomics of Countries

Post Date:

2008-10-28

Bollinger, R. Global epidemiology and its impact on the Macroeconomics of Countries. University of Pennsylvania: Wharton School. Philadelphia, PA.

Perspectives on Health Care Delivery in Latin America

Post Date:

2008-09-30

Page, K. Perspectives on Health Care Delivery in Latin America. Latin American Student Society. Johns Hopkins Bloomberg School of Public Health. Baltimore, MD.

Telemedicine in Resource Limited Countries

Post Date:

2008-09-25

Bollinger, R. Telemedicine in Resource Limited Countries. Children’s National Medical Center. Washington, DC.

Community-based HIV Care

Post Date:

2008-09-09

Chang, L. Community-based HIV Care. HIV Online Provider Education (H.O.P.E.) Conference. Harvard University Center for AIDS Research. Cambridge, MA.

Ceftriaxone-resistant Salmonella

Post Date:

2008-06-21

Gupta, A. Ceftriaxone-resistant Salmonella. International Conference on Infectious Diseases. Kuala Lumpur, Malaysia.

Tuberculosis in Pregnancy

Post Date:

2008-06-06

Thomas, A. Tuberculosis in Pregnancy. Workshop on Research Priorities for Pediatric Tuberculosis. NIAID/NICHD. Rockville, MD.

An update in opportunistic infections

Post Date:

2008-05-16

Gupta, A. An update in opportunistic infections. Johns Hopkins HIV Clinical Care Conference. Baltimore, MD.

An Annual Checkup of South Asia’s Public Health

Post Date:

2008-05-13

Bollinger, R. An Annual Checkup of South Asia’s Public Health. Foreign Service Institute. U.S. Department of State. Washington, DC.

Antibiotic Management Program

Post Date:

2008-05-10

Bollinger, R. Antibiotic Management Program. Experience and Nococomial Pneumonia and Respiratory Tract Infections and C-difficile. Johns Hopkins Medicine International and Clinic of Condes. Santiago, Chile.

Update on opportunistic infections

Post Date:

2008-04-04

Gupta, A. Update on opportunistic infections. Brazil-Hopkins AIDS Conference. Rio de Janeiro, Brazil.

The Need to Build a Culture and Capacity for Clinical Research within HIV Prevention, Care and Treatment Programs

Post Date:

2008-04-04

Bollinger, R. The Need to Build a Culture and Capacity for Clinical Research within HIV Prevention, Care and Treatment Programs. VIII Brasil-Johns Hopkins University on HIV/AIDS. Hotel Sofitel. Rio de Janeiro, Brazil.

Priorities and Opportunities for Vaccine Development: A Global View

Post Date:

2008-03-27

Bollinger, R. Priorities and Opportunities for Vaccine Development: A Global View. Jefferson Vaccine Center Yearly Retreat. Thomas Jefferson University. Philadelphia, PA.

Challenges in the Management of HIV in India

Post Date:

2008-03-06

Countries:

India

Bollinger, R. Challenges in the Management of HIV in India. Center for Global Development, 1776 Massachusetts Avenue, NW, Third Floor. Washington, DC.

HIV-1 Genotype Testing: Clinical Applications and Novel Assays

Post Date:

2007-10-31

Page, K. HIV-1 Genotype Testing: Clinical Applications and Novel Assays. COMISCA (Consejos de Ministerios de Salud de Centroamerica- Counsel of Central American Ministries of Health) Gorgas Memorial Institute. Panamá, Panama.

Barriers to Health Care for Latino Immigrants in Baltimore

Post Date:

2007-09-30

Page, K. Barriers to Health Care for Latino Immigrants in Baltimore. Department of Hispanic Languages, Literature, and Culture. Goucher College. Baltimore, MD.

Global Health Education: What in the World Must We Do?

Post Date:

2007-09-14

Bollinger, R. Global Health Education: What in the World Must We Do? Medical Education Grand Rounds. University of Pittsburgh School of Medicine. Pittsburgh, PA.

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