Browsing by Author "Taha, Taha E."
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Item Bacterial vaginosis and the risk of trichomonas vaginalis acquisition among HIV-1 negative women.(American Sexually Transmitted Diseases Association., 2014) Balkus, Jennifer E.; Richardson, Barbra Ann.; Rabe, Lorna K.; Taha, Taha E.; Mgodi, Nyaradzo.; Kasaro, Margaret Phiri.; Ramjee, Gita.; Hoffman, Irving F.; Abdool Karim, Salim Safurdeen.Background: The vaginal microbiota may play a role in mediating susceptibility to sexually transmitted infections, including Trichomonas vaginalis (TV). Methods: Data were analyzed from HIV-1-seronegative women participating in HIV Prevention Trials Network Protocol 035. At quarterly visits for up to 30 months, participants completed structured interviews and specimens were collected for genital tract infection testing. T. vaginalis was detected by saline microscopy. Bacterial vaginosis (BV) was characterized by Gram stain using the Nugent score (BV = 7Y10; intermediate = 4Y6; normal = 0Y3 [reference group]). Cox proportional hazards models stratified by study site were used to assess the association between Nugent score category at the prior quarterly visit and TV acquisition. Results: In this secondary analysis, 2920 participants from Malawi, South Africa, United States, Zambia, and Zimbabwe contributed 16,259 follow-up visits. Bacterial vaginosis was detected at 5680 (35%) visits,and TV was detected at 400 (2.5%) visits. Adjusting for age, marital status, hormonal contraceptive use, unprotected sex in the last week and TV at baseline, intermediate Nugent score, and BVat the prior visit were associated with an increased risk of TV (intermediate score: adjusted hazard ratio [aHR], 1.73; 95% confidence interval [CI], 1.21Y2.19; BV: aHR, 2.40; 95% CI, 1.92Y3.00). Sensitivity analyses excluding 211 participants with TV at baseline were similar to those from the full study population (intermediate score: aHR, 1.54; 95% CI, 1.10Y2.14; BV: aHR, 2.23; 95% CI, 1.75Y2.84). Conclusions: Women with a Nugent score higher than 3 were at an increased risk for acquiring TV. If this relationship is causal, interventions that improve the vaginal microbiota could contribute to reductions in TV incidence.Item Benefits and risks of antiretroviral therapy for perinatal HIV prevention.(Massachusetts Medical Society., 2016) Fowler, Mary Glenn.; Qin, Min.; Fiscus, Susan A.; Currier, Judith S.; Flynn, Patricia M.; Chipato, Tsungai.; McIntyre, James.; Gnanashanmugam, Devasena.; Siberry, George K.; Coletti, Anne S.; Taha, Taha E.; Klingman, Karin L.; Martinson, Francis E.; Owor, Maxensia.; Violari, Avy.; Moodley, Dhayendre.; Theron, Gerhard.; Bhosale, Ramesh.; Bobat, Raziya Ahmed.; Chi, Benjamin H.; Strehlau, Renate.; Mlay, Pendo.; Loftis, Amy J.; Browning, Renee.; Fenton, Terence.; Purdue, Lynette.; Basar, Michael.; Shapiro, David E.; Mofenson, Lynne Meryl.Abstract available in pdf.Item Development of methods for cross-sectional HIV incidence estimation in a large, community randomized trial.(PLOS ONE., 2013) Laeyendecker, Oliver.; Kulich, Michal.; Donnell, Deborah.; Koma´rek, Arnosˇt.; Omelka, Marek.; Mullis, Caroline E.; Szekeres, Greg.; Piwowar-Manning, Estelle.; Fiamma, Agnes.; Gray, Ronald H.; Lutalo, Tom.; Morrison, Charles S.; Salata, Robert A.; Chipato, Tsungai.; Celum, Connie Locke.; Kahle, Erin M.; Taha, Taha E.; Kumwenda, Newton I.; Abdool Karim, Quarraisha.; Naranbhai, Vivek.; Lingappa, Jairam R.; Sweat, Michael D.; Coates, Thomas.; Eshleman, Susan H.Background: Accurate methods of HIV incidence determination are critically needed to monitor the epidemic and determine the population level impact of prevention trials. One such trial, Project Accept, a Phase III, community-randomized trial, evaluated the impact of enhanced, community-based voluntary counseling and testing on population-level HIV incidence. The primary endpoint of the trial was based on a single, cross-sectional, post-intervention HIV incidence assessment. Methods and Findings: Test performance of HIV incidence determination was evaluated for 403 multi-assay algorithms [MAAs] that included the BED capture immunoassay [BED-CEIA] alone, an avidity assay alone, and combinations of these assays at different cutoff values with and without CD4 and viral load testing on samples from seven African cohorts (5,325 samples from 3,436 individuals with known duration of HIV infection [1 month to >10 years]). The mean window period (average time individuals appear positive for a given algorithm) and performance in estimating an incidence estimate (in terms of bias and variance) of these MAAs were evaluated in three simulated epidemic scenarios (stable, emerging and waning). The power of different test methods to detect a 35% reduction in incidence in the matched communities of Project Accept was also assessed. A MAA was identified that included BED-CEIA, the avidity assay, CD4 cell count, and viral load that had a window period of 259 days, accurately estimated HIV incidence in all three epidemic settings and provided sufficient power to detect an intervention effect in Project Accept. Conclusions: In a Southern African setting, HIV incidence estimates and intervention effects can be accurately estimated from cross-sectional surveys using a MAA. The improved accuracy in cross-sectional incidence testing that a MAA provides is a powerful tool for HIV surveillance and program evaluation.Item Mucosal escherichia coli bactericidal activity and immune mediators are associated with HIV-1 seroconversion in women participating in the HPTN 035 trial.(Oxford University Press on behalf of the Infectious Diseases Society of America., 2012) Dezzutti, Charlene S.; Richardson, Barbra Ann.; Marrazzo, Jeanne M.; Tugetman, Jessica.; Ramjee, Gita.; Taha, Taha E.; Chirenje, Zvavahera Mike.; Abdool Karim, Salim Safurdeen.; Hillier, Sharon Louise.; Herold, Betsy C.The mucosal environment may impact the risk for human immunodeficiency virus type 1 (HIV-1) acquisition. Immune mediators were measured in vaginal fluid collected from HPTN 035 participants who acquired HIV-1 and from those who remained HIV-1 negative (controls). Mediator concentrations were similar in samples obtained before as compared to after HIV-1 acquisition in the 8 seroconverters. Compared with controls, seroconverters were more likely to have detectable levels of HβD-2 (odds ratio [OR], 2.39; P = .005) and greater Escherichia coli bactericidal activity (OR, 1.22; P = .01) prior to seroconversion. E. coli bactericidal activity remained significant in a multivariable analysis (P = .02) and may be a biomarker for HIV-1 acquisition.Item The multi-country PROMOTE HIV antiretroviral treatment observational cohort in Sub-Saharan Africa: objectives, design, and baseline findings.(Public Library of Science., 2018) Taha, Taha E.; Yende-Zuma, Fortunate Nonhlanhla.; Aizire, Jim.; Chipato, Tsungai.; Wambuzi Ogwang, Lillian.; Makanani, Bonus.; Chinula, Lameck.; Nyati, Mandisa M.; Hanley, Sherika.; Brummel, Sean S.; Fowler, Mary Glenn.Abstract available in pdf.Item Prevention of HIV-1 transmission through breastfeeding: efficacy and safety of maternal antiretroviral therapy versus infant nevirapine prophylaxis for duration of breastfeeding in HIV-1-infected women with high CD4 cell count (IMPAACT PROMISE): a randomized, open label, clinical trial.(Wolters Kluwer., 2018) Flynn, Patricia M.; Taha, Taha E.; Cababasay, Mae.; Fowler, Mary Glenn.; Mofenson, Lynne Meryl.; Owor, Maxensia.; Fiscus, Susan A.; Stranix-Chibanda, Lynda.; Coutsoudis, Anna.; Gnanashanmugam, Devasena.; Chakhtoura, Nahida.; McCarthy, Katie.; Mukuzunga, Cornelius.; Makanani, Bonus.; Moodley, Dhayendre.; Nematadzira, Teacler.; Kusakara, Bangini.; Patil, Sandesh.; Vhembo, Tichaona.; Bobat, Raziya Ahmed.; Mmbaga, Blandina T.; Masenya, Maysseb.; Nyati, Mandisa M.; Theron, Gerhard.; Mulenga, Helen.; Butler, Kevin.; Shapiro, David E.Abstract available in pdf.Item Safety and effectiveness of BufferGel and 0.5% PRO 2000 gel for the prevention of HIV infection in women.(Lippincott Williams & Wilkins., 2010) Abdool Karim, Salim Safurdeen.; Richardson, Barbra Ann.; Ramjee, Gita.; Hoffman, Irving F.; Chirenje, Zvavahera Mike.; Taha, Taha E.; Kapina, Muzala.; Maslankowski, Lisa.; Coletti, Anne S.; Profy, Albert.; Moench, Thomas R.; Piwowar-Manning, Estelle.; Masse, Benoit.; Hillier, Sharon Louise.; Soto-Torres, Lydia.Objective: To determine the safety and effectiveness of BufferGel and 0.5% PRO2000 microbicide gels for the prevention of male-to-female HIV transmission. Design: Phase II/IIb, randomized, placebo-controlled trial with three double-blinded gel arms and an open-label no gel arm. Methods: Study participants from Malawi, South Africa, Zambia, Zimbabwe, and the USA were instructed to apply study gel up to 1 h before each sex act and safety, sexual behavior, pregnancy, gel adherence, acceptability, and HIV serostatus were assessed during follow-up. Results: The 3101 enrolled women were followed for an average of 20.4 months with 93.6% retention and 81.1% self-reported gel adherence. Adverse event rates were similar in all study arms. HIV incidence rates in the 0.5% PRO2000 gel, BufferGel, placebo gel, and no gel arms were 2.70, 4.14, 3.91, and 4.02 per 100 women-years, respectively. HIV incidence in the 0.5% PRO2000 gel arm was lower than the placebo gel arm (hazard ratio = 0.7, P=0.10) and the no gel arm (hazard ratio = 0.67, P=0.06). HIV incidence rates were similar in the BufferGel and both placebo gel (hazard ratio =1.10, P=0.63) and no gel control arms (hazard ratio =1.05, P=0.78). HIV incidence was similar in the placebo gel and no gel arms (hazard ratio =0.97, P=0.89). Conclusion: The 0.5% PRO2000 gel demonstrated a modest 30% reduction in HIV acquisition in women. However, these results were not statistically significant and subsequent findings from the Microbicide Development Programme (MDP) 301 trial have confirmed that 0.5% PRO2000 gel has little or no protective effect. BufferGel did not alter the risk of HIV infection. Both products were well tolerated.