2024
Long-term impact of immediate versus deferred antiretroviral therapy on kidney health in people with HIV
Pelchen-Matthews A, Mocroft A, Ryom L, Ross M, Sharma S, Coca S, Achhra A, Cornell E, Tracy R, Phillips A, Alonso M, Toulomi G, Agan B, Medland N, Wyatt C, Group I. Long-term impact of immediate versus deferred antiretroviral therapy on kidney health in people with HIV. Kidney International 2024, 106: 136-144. PMID: 38697479, PMCID: PMC11193627, DOI: 10.1016/j.kint.2024.04.010.Peer-Reviewed Original ResearchHuman immunodeficiency virusUrine albumin/creatinine ratioDeferred antiretroviral therapyChronic kidney diseaseStrategic Timing of AntiRetroviral TreatmentAntiretroviral therapyNo significant differenceTreatment armsFollow-upAnnual rate of eGFR declineRate of eGFR declineTiming of AntiRetroviral TreatmentEarly ARTART-naive adultsCD4 cell countImmediate antiretroviral therapySignificant differenceKidney-related deathLong-term safetyKidney healthStandard of careComprehensive follow-upImmunodeficiency virusAlbumin/creatinine ratioEGFR declineAcute Hepatitis due to Primary Human Immunodeficiency Virus Infection
Elliott E, Smith D, Lipscomb J, Banini B, Meurer L, Vanderford T, Johnson J, Jain D, Achhra A. Acute Hepatitis due to Primary Human Immunodeficiency Virus Infection. Open Forum Infectious Diseases 2024, 11: ofae170. PMID: 38585186, PMCID: PMC10996125, DOI: 10.1093/ofid/ofae170.Peer-Reviewed Original ResearchHuman immunodeficiency virusHuman immunodeficiency virus infectionAcute hepatitisPrimary human immunodeficiency virus infectionConsistent with acute hepatitisPrimary human immunodeficiency virusHuman immunodeficiency virus p24 antigenAcute retroviral syndromeImmunodeficiency virus infectionSevere acute hepatitisHIV proviral DNAAcute liver diseaseP24 antigenImmunodeficiency virusLaboratory abnormalitiesSystemic manifestationsRare caseLiver diseaseProviral DNAVirus infectionLiver histopathologyHepatitisCell compartmentParenchymal cellsLiver tissueAcute Hepatitis Due to Primary Human Immunodeficiency Virus Infection
Open Forum Infectious Diseases, ofae170, https://doi.org/10.1093/ofid/ofae170 Published: 22 March 2024Peer-Reviewed Case Reports and Technical Notes
2023
1478. Evaluation Of Anal Cancer Screening Program in men who have sex with men (MSM) persons with HIV (PWH) At Two academic center HIV Clinics 2018-2022
Achhra A, Chan E, Applebaum S, Guerrero M, Hao R, Pantel H, Virata M, Barakat L. 1478. Evaluation Of Anal Cancer Screening Program in men who have sex with men (MSM) persons with HIV (PWH) At Two academic center HIV Clinics 2018-2022. Open Forum Infectious Diseases 2023, 10: ofad500.1314. PMCID: PMC10677807, DOI: 10.1093/ofid/ofad500.1314.Peer-Reviewed Original ResearchAnal dysplasiaAbnormal PapHIV clinicAnal cancer screening programsAmbulatory HIV clinicRetrospective chart reviewHistory of smokingCancer screening programsSquamous cell carcinomaAnal cytologyAntiretroviral therapyHIV careChart reviewClinic visitsMedian ageMultivariable analysisCell carcinomaScreening programPrior historyAge 35High riskType of insuranceBackground treatmentCharacteristics of peoplePWH1538. Is there value in performing yearly screening for latent tuberculosis infection by interferon-gamma release assay among patients living with HIV in non-endemic settings?
Palacios C, Achhra A, Barakat L, Virata M, Hao R, Baxter J, Malinis M. 1538. Is there value in performing yearly screening for latent tuberculosis infection by interferon-gamma release assay among patients living with HIV in non-endemic settings? Open Forum Infectious Diseases 2023, 10: ofad500.1373. PMCID: PMC10678242, DOI: 10.1093/ofid/ofad500.1373.Peer-Reviewed Original ResearchInterferon-gamma release assaysLatent tuberculosis infectionNew latent tuberculosis infectionsTuberculin skin testingNon-endemic settingRisk factorsCD4 countTuberculosis infectionCurrent guidelinesGroup APositive interferon-gamma release assaysHigher HIV viral loadUrban academic medical centerChest imaging resultsLow CD4 countTB exposure riskTB risk factorsCells/mm3HIV viral loadRetrospective chart reviewFeatures of patientsRisk of reactivationInterferon-gamma releaseCommon risk factorsAcademic medical center
2022
Contrasting Cases of HIV Vasculopathy Associated Fusiform Aneurysms
Kyle K, Maher M, Achhra A, Venna N. Contrasting Cases of HIV Vasculopathy Associated Fusiform Aneurysms. The Neurohospitalist 2022, 13: 69-73. PMID: 36531848, PMCID: PMC9755620, DOI: 10.1177/19418744221122863.Peer-Reviewed Original ResearchHuman immunodeficiency virusProgressive multifocal leukoencephalopathyFusiform aneurysmsAntiretroviral therapy adherenceAcquired Immunodeficiency SyndromeSpectrum of severityDevelopment of aneurysmsCerebral toxoplasmosisMultifocal leukoencephalopathyClinical courseImmunodeficiency syndromeImmunodeficiency virusTherapy adherenceVessel occlusionAneurysm formationAneurysm thrombosisIntracranial fusiform aneurysmsAneurysmsCerebral aneurysmsNine monthsFirst caseCase twoVasculopathyMoyamoyaLeukoencephalopathy
2015
O21.3 Pre-therapy inflammation/coagulation activation and long-term cd4 response to antiretroviral therapy
Achhra A, Phillips A, Emery S, MacArthur R, Furrer H, De Wit S, Losso M, Law M. O21.3 Pre-therapy inflammation/coagulation activation and long-term cd4 response to antiretroviral therapy. Sexually Transmitted Infections 2015, 91: a73.1-a73. DOI: 10.1136/sextrans-2015-052270.195.Peer-Reviewed Original ResearchShort‐term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study
Achhra A, Mocroft A, Reiss P, Sabin C, Ryom L, de Wit S, Smith C, Monforte A, Phillips A, Weber R, Lundgren J, Law, Group T. Short‐term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study. HIV Medicine 2015, 17: 255-268. PMID: 26216031, DOI: 10.1111/hiv.12294.Peer-Reviewed Original ResearchConceptsBody mass indexIncidence rate ratiosCardiovascular diseaseART initiationBMI categoriesHistory of CVDAntiretroviral therapy initiationRisk of diabetesTreatment-naïve individualsMain exposure variableLong-term riskPoisson regression modelsDiabetes eventsCD4 countCVD eventsTherapy initiationAdverse eventsCardiometabolic outcomesCohort studyMass indexRisk factorsSubsequent riskNormal rangeDiabetesExposure variablesPre‐therapy inflammation and coagulation activation and long‐term CD4 count responses to the initiation of antiretroviral therapy
Achhra A, Phillips A, Emery S, MacArthur R, Furrer H, De Wit S, Losso M, Law, groups I. Pre‐therapy inflammation and coagulation activation and long‐term CD4 count responses to the initiation of antiretroviral therapy. HIV Medicine 2015, 16: 449-454. PMID: 25959989, PMCID: PMC5676307, DOI: 10.1111/hiv.12258.Peer-Reviewed Original ResearchConceptsCD4 count responseBaseline CD4 countC-reactive proteinCD4 countART initiationClinical outcomesCoagulation activationBiomarker levelsInterleukin-6Therapy trialsMedian baseline CD4 countAntiretroviral Therapy (SMART) trialFirst-line ARTInflammatory marker levelsHIV-positive individualsLong-term CD4CD4 count measurementCD4 responseART-naïveCent of individualsStudy armsD-dimerCount responseMean ageMarker levelsKidney disease in antiretroviral‐naïve HIV‐positive adults with high CD4 counts: prevalence and predictors of kidney disease at enrolment in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial
Achhra A, Mocroft A, Ross M, Ryom L, Lucas G, Furrer H, Neuhaus J, Somboonwit C, Kelly M, Gatell J, Wyatt C, Group I. Kidney disease in antiretroviral‐naïve HIV‐positive adults with high CD4 counts: prevalence and predictors of kidney disease at enrolment in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial. HIV Medicine 2015, 16: 55-63. PMID: 25711324, PMCID: PMC4341947, DOI: 10.1111/hiv.12234.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseCD4 cell countPrevalence of CKDART-naïve adultsGlomerular filtration rateUrine proteinCell countAntiretroviral therapyBaseline characteristicsKidney diseaseFiltration rateHigher CD4 cell countsTraditional CKD risk factorsCKD risk factorsHigher CD4 countsCells/μLCells/μL.AntiRetroviral Treatment (START) studyClinical trial participantsRace/ethnicityCD4 countHIV infectionRisk factorsLow prevalenceTrial participants
2012
Race and CD4+ T-cell count in HIV prognosis and treatment
Achhra A, Amin J. Race and CD4+ T-cell count in HIV prognosis and treatment. Future Virology 2012, 7: 193-203. DOI: 10.2217/fvl.11.143.Peer-Reviewed Original ResearchT-cell countsFuture long-term trialsHIV-negative individualsHIV clinical studiesHIV/AIDSLong-term trialsTherapy initiationProspective cohortClinical outcomesHIV prognosisClinical significanceClinical studiesCD4Current evidenceRacial differencesCountRecent studiesDiverse populationsHIVPrognosisTherapyCohortRaceAIDSDifferences