Research News

August 12, 2022

Dr. Shivakumar and his group discovered that a high proportion of patients classified as EPTB in India have concomitant PTB. Their results support the need for improved symptom and CXR screening, and recommends routine sputum TB microbiology screening of all Indian patients with EPTB.

Clinical Research

Leadership
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 consortia with many esteemed Indian research institutions, we have formal agreements with:
 
 

Management and control of multidrug-resistant tuberculosis (MDR-TB): addressing policy needs for India

Post Date: 
2016-05-06
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Journal of Public Health Policy
Multidrug-resistant tuberculosis (MDR-TB) challenges TB control efforts because of delays in diagnosis plus its long-term treatment which has toxic effects. Of TB high-incidence countries, India carries the highest burden of MDR-TB cases. We describe policy issues in India concerning MDR-TB...

Inflammation and change in body weight with antiretroviral therapy initiation in a multinational cohort of HIV-infected adults

Post Date: 
2016-04-01
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The Journal of Infectious Diseases
Background: Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown. Methods: Among a random virologically suppressed participants of the...

Persistently elevated C-reactive protein level in the first year of antiretroviral therapy, despite virologic suppression, is associated with HIV disease progression in resource-constrained settings

Post Date: 
2016-04-01
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Publication: 
The Journal of Infectious Diseases
A case-cohort analysis of human immunodeficiency virus (HIV)-infected individuals receiving antiretroviral therapy (ART) was performed within a multicountry randomized trial (PEARLS) to assess the prevalence of persistently elevated C-reactive protein (CRP) levels, based on serial...

Tuberculosis risk among medical trainees, Pune, India

Post Date: 
2016-03-22
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Emerging Infectious Diseases
During 2012–2013, at a public hospital in Pune, India, 26 (3.9%) cases of tuberculosis were reported among 662 medical trainees, representing an estimated incidence of 3,279 cases/100,000 person-years. Three of these infections were isoniazid-resistant, 1 was multidrug-resistant, and 1...

Empirical tuberculosis therapy versus isoniazid in adult outpatients with advanced HIV initiating antiretroviral therapy (REMEMBER): a multicountry open-label randomised controlled trial

Post Date: 
2016-03-19
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The Lancet
Background: Mortality within the first 6 months after initiating antiretroviral therapy is common in resource-limited settings and is often due to tuberculosis in patients with advanced HIV disease. Isoniazid preventive therapy is recommended in HIV-positive adults, but subclinical...

Cohort for Tuberculosis Research by the Indo-US Medical Partnership (C-TRIUMPH): protocol for a multicentric prospective observational study

Post Date: 
2016-02-25
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BMJ Open
Introduction: Tuberculosis disease (TB) remains an important global health threat. An evidence-based response, tailored to local disease epidemiology in high-burden countries, is key to controlling the global TB epidemic. Reliable surrogate biomarkers that predict key active disease and...

Assessment of the quality of clinical documentation in India's JSY cash transfer program for facility births in Madhya Pradesh

Post Date: 
2016-02-15
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International Journal of Gynaecology and Obstetrics
Abstract Objective: To gain insight into the quality of care in facilities implementing the Janani Suraksha Yojana (JSY) cash transfer program in Madhya Pradesh, India, by reviewing the level of documentation in the clinical records of women who delivered. ...

Low Vitamin-D levels combined with PKP3-SIGIRR-TMEM16J host variants is strongly associated with tuberculosis and death in HIV-infected and -exposed infants

Post Date: 
2016-02-12
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PLOS One
Background: This study examined the associations of 25-hydroxyvitamin D and specific host genetic variants that affect vitamin D levels or its effects on immune function, with the risk of TB or mortality in children. Methods: A case-cohort sample of 466 South African infants...

Prevalence and risk factors of micronutrient deficiencies pre- and post-antiretroviral therapy (ART) among a diverse multicountry cohort of HIV-infected adults

Post Date: 
2016-02-10
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Publication: 
Clinical Nutrition
Background & Aims: HIV-infected adults have increased risk of several individual micronutrient deficiencies. However, the prevalence and risk factors of concurrent and multiple micronutrient deficiencies and whether micronutrient concentrations change after antiretroviral therapy (ART)...

Toward earlier inclusion of pregnant and postpartum women in TB drug trials: consensus statements from an International Expert Panel

Post Date: 
2016-01-04
Publication: 
Clinical Infectious Diseases
Tuberculosis is a major cause of morbidity and mortality in women of childbearing age (15–44 years). Despite increased tuberculosis risk during pregnancy, optimal clinical treatment remains unclear: safety, tolerability, and pharmacokinetic data for many tuberculosis drugs are lacking, and...

Cost effectiveness of isoniazid preventive therapy for HIV-infected pregnant women in India

Post Date: 
2016-01-01
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Publication: 
International Journal of Tuberculosis and Lung Disease
Background: India has a high burden of active tuberculosis (TB) and human immunodeficiency virus (HIV) infection. Pregnancy increases the risks of developing TB in HIV-infected women. Isoniazid preventive therapy (IPT) reduces progression to TB, but may increase costs and hepatotoxicity. The...

Pediatric tuberculous meningitis: model-based approach to determining optimal doses of anti-tuberculosis drugs for children

Post Date: 
2015-10-22
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Clinical Pharmacology and Therapeutics
Pediatric tuberculous meningitis (TBM) is a highly morbid, often fatal disease. Standard treatment includes isoniazid, rifampin, pyrazinamide, and ethambutol. Current rifampin dosing achieves low cerebrospinal fluid (CSF) concentrations, and CSF penetration of ethambutol is poor. In adult...

RePORT International: advancing tuberculosis biomarker research through global collaboration

Post Date: 
2015-10-15
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Clinical Infectious Diseases
Progress in tuberculosis clinical research is hampered by a lack of reliable biomarkers that predict progression from latent to active tuberculosis, and subsequent cure, relapse, or failure. Regional Prospective Observational Research for Tuberculosis (RePORT) International represents a...

Soluble CD14: An independent biomarker for risk of HIV mother-to-child transmission in setting of pre- and post-exposure antiretroviral prophylaxis

Post Date: 
2015-10-06
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Publication: 
The Journal of Infectious Diseases
Elevated soluble CD14 (sCD14) concentrations, a marker of monocyte activation, predicts adverse outcomes in human immunodeficiency virus (HIV)-infected adults. To examine the association of sCD14 concentrations with the risk of mother-to-child transmission (MTCT) of HIV, we nested a case-...

Economic and epidemiological impact of early antiretroviral therapy initiation in India

Post Date: 
2015-10-01
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Journal of the International AIDS Society
Introduction: Recent WHO guidance advocates for early antiretroviral therapy (ART) initiation at higher CD4 counts to improve survival and reduce HIV transmission. We sought to quantify how the cost-effectiveness and epidemiological impact of early ART strategies in India are affected by...

Pre-cART elevation of CRP and CD4+ T-cell immune activation associated with HIV clinical progression in a multinational case-cohort study

Post Date: 
2015-10-01
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Publication: 
Journal of Acquired Immune Deficiency Syndromes
Background: Despite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore, some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical...

Contraceptive use and factors associated with postpartum surgical sterilization among HIV-infected women in Pune, India

Post Date: 
2015-08-21
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Journal of HIV/AIDS & Social Services
The authors desire to better understand contraceptive practices and factors associated with surgical tubal ligation (STL) among HIV-infected women. Secondary data were obtained from HIV-infected women enrolled in a National Institutes of Health–funded clinical trial assessing the efficacy of...

Failure to use and sustain male condom usage: lessons learned from a prospective study among men attending STI clinic in Pune, India

Post Date: 
2015-08-13
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PLOS One
Background: Sustained or consistent use of condoms by men remains a challenge. A study was carried out to identify factors associated with failure to use condoms consistently by men attending STD clinics in Pune, India. Method: Among 14137 STI clinic...

Concurrent anemia and elevated CRP predicts HIV clinical treatment failure, including TB, post-antiretroviral therapy initiation

Post Date: 
2015-07-01
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Clinical Infectious Diseases
Background: Anemia is a known risk factor for clinical failure following antiretroviral therapy (ART). Notably, anemia and inflammation are interrelated, and recent studies have associated elevated C-reactive protein (CRP), an inflammation marker, with adverse human immunodeficiency virus (...

Efavirenz pharmacokinetics in HIV-infected persons receiving rifapentine and isoniazid for tuberculosis prevention

Post Date: 
2015-06-16
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Publication: 
Clinical Infectious Diseases
Background: Concomitant use of rifamycins to treat or prevent tuberculosis can result in subtherapeutic concentrations of antiretroviral drugs. We studied the interaction of efavirenz with daily rifapentine and isoniazid in human immunodeficiency virus (HIV)-infected individuals receiving a 4...

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