2023
Dectin-1 stimulation promotes a distinct inflammatory signature in the setting of HIV-infection and aging
Kumar A, Wang J, Esterly A, Radcliffe C, Zhou H, Wyk B, Allore H, Tsang S, Barakat L, Mohanty S, Zhao H, Shaw A, Zapata H. Dectin-1 stimulation promotes a distinct inflammatory signature in the setting of HIV-infection and aging. Aging 2023, 15: 7866-7908. PMID: 37606991, PMCID: PMC10497004, DOI: 10.18632/aging.204927.Peer-Reviewed Original ResearchConceptsDectin-1 stimulationDendritic cellsHIV-positive older adultsOlder adultsDectin-1 functionDistinct immune signaturesDistinct inflammatory signatureMonocytes of HIVCohort of HIVIFN-α productionPro-inflammatory environmentIFN-γ responsesPro-inflammatory phenotypeInnate immune receptorsDistinct gene signaturesStimulation of monocytesInflammatory signatureImmune signaturesHIV infectionIL-12Macrophage signatureCytokine productionIL-6Cytokine increaseHIVExpanded or Risk Factor-Based Annual Screening for Hepatitis C Virus (HCV) Among Persons With HIV: Which Is the Best Approach?
Hao R, Brooks R, Zelenev A, Spinner G, Barakat L, Villanueva M. Expanded or Risk Factor-Based Annual Screening for Hepatitis C Virus (HCV) Among Persons With HIV: Which Is the Best Approach? Health Promotion Practice 2023, 24: 1009-1017. PMID: 37439817, DOI: 10.1177/15248399231169794.Peer-Reviewed Original ResearchConceptsHepatitis C virusRisk factor-based screeningElectronic medical recordsHIV clinicAnnual screeningC virusRisk factorsScreening siteAnnual screening ratesNew HCV diagnosesClinical decision support toolRisk factor assessmentPublic health expertsHCV testingHCV casesClinical decision supportHCV diagnosisHCV testScreening ratesProspective studyMedical recordsPositivity ratePositive casesUnprotected sexClinicBuilding an Infectious Disease Diversity, Equity, and Antiracism (ID2EA) Curriculum: A Single Center's Experience and Reflections
Gleeson S, Zapata H, Bathgate M, Emu B, Frederick J, Friedland G, Golden M, Meyer J, Radin J, Sideleau R, Shaw A, Shenoi S, Trubin P, Virata M, Barakat L, Desruisseaux M. Building an Infectious Disease Diversity, Equity, and Antiracism (ID2EA) Curriculum: A Single Center's Experience and Reflections. Clinical Infectious Diseases 2023, 77: 703-710. PMID: 37078888, DOI: 10.1093/cid/ciad236.Peer-Reviewed Original ResearchConceptsEducational activitiesHealthcare inequitiesInfectious Diseases SectionSingle-center experienceCoronavirus disease 2019 (COVID-19) pandemicDisease 2019 pandemicMixed-methods assessmentLearning objectivesPilot curriculumEducational trainingCurriculumCenter experienceLong-term behavioral changesProgram outcomesDisease sectionDisease diversityPhysician perspectivesResponse rateHealth disparitiesYale SchoolInequitiesAntiracismBehavioral changesRacismEquityHIV risk profile and prevention needs of individuals seeking monkeypox (mpox) vaccination in an urban clinic in the U.S.: a brief report
Ogbuagu O, Sharma M, Igiraneza G, Andrews L, Tuan J, Barakat L. HIV risk profile and prevention needs of individuals seeking monkeypox (mpox) vaccination in an urban clinic in the U.S.: a brief report. BMC Infectious Diseases 2023, 23: 146. PMID: 36890468, PMCID: PMC9993362, DOI: 10.1186/s12879-023-08075-5.Peer-Reviewed Original ResearchConceptsHIV risk profilesSTI riskPre-exposure prophylaxis useRisk profileMedian age 28 yearsHIV-negative respondentsHIV-negative participantsHIV-negative individualsReceptive anal intercourseModerate alcohol useAge 28 yearsCross-sectional surveySexual partner numberProphylaxis useResultsEighty-onePrEP knowledgeHIV positivityPrevention gapUrban clinicCenter clinicPrevention needsSTI historyInclusion criteriaAnal intercourseIllicit substances
2022
Long-term quantitative assessment of anti-SARS-CoV-2 spike protein immunogenicity (QUASI) after COVID-19 vaccination in older people living with HIV (PWH)
Tuan JJ, Zapata H, Barakat L, Andrews L, Behnegar A, Kim YW, Kayani J, Mutic S, Ryall L, Turcotte B, Critch-Gilfillan T, Zhao M, Salahuddin S, Gupta S, Sutton R, Friedland G, Emu B, Ogbuagu O. Long-term quantitative assessment of anti-SARS-CoV-2 spike protein immunogenicity (QUASI) after COVID-19 vaccination in older people living with HIV (PWH). BMC Infectious Diseases 2022, 22: 744. PMID: 36131232, PMCID: PMC9491266, DOI: 10.1186/s12879-022-07737-0.Peer-Reviewed Original ResearchConceptsT cell responsesAnti-spike IgGVisit 3SARS-CoV-2Older PWHVisit 2Immune responseSingle-center longitudinal observational studyVirus-specific T cell responsesVaccine-induced humoral immunityLong-term protective immunityT cell immune responsesOlder peopleMedian age 61RBD IgG levelsPrimary study outcomeCOVID-19 vaccinationImmune response evaluationLongitudinal observational studyCOVID-19 vaccineWilcoxon signed-rank testBNT162b2 boosterBNT162b2 vaccinationCD8 responsesDetectable CD4Tenofovir disoproxil fumarate and coronavirus disease 2019 outcomes in men with HIV
Li G, Park LS, Lodi S, Logan RW, Cartwright EJ, Aoun-Barakat L, Casas JP, Dickerman BA, Rentsch CT, Justice AC, Hernán MA. Tenofovir disoproxil fumarate and coronavirus disease 2019 outcomes in men with HIV. AIDS 2022, 36: 1689-1696. PMID: 35848570, PMCID: PMC9444875, DOI: 10.1097/qad.0000000000003314.Peer-Reviewed Original ResearchConceptsTDF/FTCTenofovir disoproxil fumarateCoronavirus disease 2019 (COVID-19) outcomesTAF/FTCAntiretroviral therapyTenofovir alafenamideDisoproxil fumarateRisk ratioAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionCOVID-19 ICU admissionsIntensive care unit admissionPrevious COVID-19 diagnosisSyndrome coronavirus 2 infectionCOVID-19-related hospitalizationVeterans Aging Cohort StudySARS-CoV-2 infectionCare unit admissionCoronavirus 2 infectionChronic kidney diseaseHIV viral loadGlomerular filtration rateAging Cohort StudyCorresponding risk ratioPooled logistic regressionExperiences with Telemedicine for HIV Care During the COVID-19 Pandemic: A Mixed-Methods Study
Harsono D, Deng Y, Chung S, Barakat LA, Friedland G, Meyer JP, Porter E, Villanueva M, Wolf MS, Yager JE, Edelman EJ. Experiences with Telemedicine for HIV Care During the COVID-19 Pandemic: A Mixed-Methods Study. AIDS And Behavior 2022, 26: 2099-2111. PMID: 35064390, PMCID: PMC8782707, DOI: 10.1007/s10461-021-03556-7.Peer-Reviewed Original ResearchConceptsHIV careRe-engage patientsMixed-methods studyCare team membersRoutine clinical experienceCOVID-19 pandemicBenefits of telemedicineHIV clinicTelemedicine visitsTelemedicine appointmentsReimbursement concernsClinical experienceClinical staffCareAppropriate billingPatientsPWHTelemedicinePatient remote monitoringReimbursement methodsPandemicHIVClinicVisits
2021
Cumulative burden of non-communicable diseases predicts COVID hospitalization among people with HIV: A one-year retrospective cohort study
Virata MD, Shenoi SV, Ladines-Lim J, Villanueva MS, Barakat LA. Cumulative burden of non-communicable diseases predicts COVID hospitalization among people with HIV: A one-year retrospective cohort study. PLOS ONE 2021, 16: e0260251. PMID: 34851963, PMCID: PMC8635326, DOI: 10.1371/journal.pone.0260251.Peer-Reviewed Original ResearchConceptsOne-year retrospective cohort studyCohort of PWHNon-communicable comorbiditiesPredictors of hospitalizationRetrospective cohort studyChronic lung diseaseLikelihood of hospitalizationSingle-site experienceCOVID-19 infectionNon-communicable diseasesOutcomes of peopleCohort studyHIV diseaseOverall mortalityClinical outcomesLung diseaseCardiovascular diseaseHospitalizationCumulative burdenHIVLater timeframeDiseaseEarly epidemicPWHOutcomesHigh HIV Detection in a Tertiary Facility in Liberia: Implications and Opportunities
Ogbuagu O, Wachekwa I, Yasin F, Nuta C, Donato S, Toomey J, Adeiza M, Barakat LA. High HIV Detection in a Tertiary Facility in Liberia: Implications and Opportunities. Annals Of Global Health 2021, 87: 117. PMID: 34900617, PMCID: PMC8622250, DOI: 10.5334/aogh.3243.Peer-Reviewed Original ResearchConceptsHIV testing dataNon-pregnant individualsHIV detection rateTertiary facilityPrevention interventionsJohn F. Kennedy Medical CenterHospital-based retrospective analysisSignificant public health challengeStudy periodAnnual diagnosis ratePre-exposure prophylaxisPositive HIV testLarge tertiary hospitalCase detection ratePublic health challengeYears of ageNational prevalence estimatesDetection rateHIV/AIDSAntenatal clinicHIV testHIV testingTertiary hospitalPregnant womenUNAIDS 95Qualitative assessment of anti‐SARS‐CoV‐2 spike protein immunogenicity (QUASI) after COVID‐19 vaccination in older people living with HIV
Tuan JJ, Zapata H, Critch‐Gilfillan T, Ryall L, Turcotte B, Mutic S, Andrews L, Roh ME, Friedland G, Barakat L, Ogbuagu O. Qualitative assessment of anti‐SARS‐CoV‐2 spike protein immunogenicity (QUASI) after COVID‐19 vaccination in older people living with HIV. HIV Medicine 2021, 23: 178-185. PMID: 34632695, PMCID: PMC8652674, DOI: 10.1111/hiv.13188.Peer-Reviewed Original ResearchConceptsCOVID-19 vaccineCOVID-19 vaccinationFirst doseSeroconversion ratesSecond doseAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionYale New Haven Health SystemPrior COVID-19 infectionSyndrome coronavirus 2 infectionSafe COVID-19 vaccineIntegrase strand transfer inhibitorsAnti-spike IgGPositive IgG responseTwo-dose seriesCoronavirus 2 infectionVaccine-induced immunityDurability of protectionCOVID-19 infectionStrand transfer inhibitorsAntiretroviral regimenBNT162b2 vaccineNew seroconversionsPositive IgGQualitative antibodyVZV myelitis with secondary HIV CSF escape
Weiss JJ, Spudich S, Barakat L. VZV myelitis with secondary HIV CSF escape. BMJ Case Reports 2021, 14: e241738. PMID: 34187795, PMCID: PMC8245447, DOI: 10.1136/bcr-2021-241738.Peer-Reviewed Case Reports and Technical NotesConceptsVaricella-zoster virusCSF escapeVZV myelitisSkin lesionsCerebrospinal fluidCSF HIV viral loadRight upper extremity weaknessCentral nervous system infectionSubsequent oral therapyUpper extremity weaknessHIV viral loadNervous system infectionVesicular skin lesionsCopies/mLDirect fluorescent antibody testingFluorescent antibody testingIntravenous acyclovirVZV PCRExtremity weaknessOral therapyRare complicationSystem infectionAtypical presentationImmunosuppressed patientsVZV infectionRace and ethnicity do not impact eligibility for remdesivir: A single-center experience
Pischel L, Walelo M, Benson J, Osborn R, Schrier R, Tuan J, Barakat L, Ogbuagu O. Race and ethnicity do not impact eligibility for remdesivir: A single-center experience. PLOS ONE 2021, 16: e0250735. PMID: 33956849, PMCID: PMC8101938, DOI: 10.1371/journal.pone.0250735.Peer-Reviewed Original ResearchConceptsClinical trialsExclusion criteriaSingle health care systemObservational cohort studySingle-center experienceClinical trial criteriaTime of presentationMedical record chartsNon-Hispanic whitesEthnic minority enrollmentSimilar ratesHealth care systemCohort studyTrial criteriaMultiple therapiesInclusion criteriaRecord chartsEthnic groupsRemdesivirCare systemTrialsSelf-identified WhiteEligibilityWhite participantsMultiple potential barriers
2020
Decreased Overall Survival in HIV-associated Non–small-cell Lung Cancer
Hysell K, Yusuf R, Barakat L, Virata M, Gan G, Deng Y, Perez-Irizarry J, Vega T, Goldberg SB, Emu B. Decreased Overall Survival in HIV-associated Non–small-cell Lung Cancer. Clinical Lung Cancer 2020, 22: e498-e505. PMID: 33468393, PMCID: PMC8169710, DOI: 10.1016/j.cllc.2020.11.006.Peer-Reviewed Original ResearchConceptsCell lung cancerGeneral patientsNSCLC populationLung cancerCox proportional hazards modelYale-New Haven HospitalGeneral NSCLC populationOutcomes of patientsOverall median survivalRetrospective cohort studyPredictors of survivalKaplan-Meier curvesHIV-1 RNACopies/mLLog-rank testProportional hazards modelNew Haven HospitalCancer treatment regimensMedian CD4Antiretroviral therapyCohort studyMedian survivalOverall survivalHIV infectionMedian ageSubstantial gap in primary care: older adults with HIV presenting late to care
Yasin F, Rizk C, Taylor B, Barakat LA. Substantial gap in primary care: older adults with HIV presenting late to care. BMC Geriatrics 2020, 20: 438. PMID: 33129258, PMCID: PMC7603686, DOI: 10.1186/s12877-020-01842-y.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusCombination antiretroviral therapyViral suppressionCART initiationHIV clinicOlder patientsRetrospective medical record reviewHIV viral suppressionMedical record reviewPatient demographic dataSerious public health concernPublic health concernAntiretroviral therapyCD4 countHIV testingRecord reviewImmunodeficiency virusPrimary careOlder adult groupTreatment strategiesNew diagnosisAdvanced stagePatientsDemographic dataAdult groupAcute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19
Farhadian S, Glick LR, Vogels CBF, Thomas J, Chiarella J, Casanovas-Massana A, Zhou J, Odio C, Vijayakumar P, Geng B, Fournier J, Bermejo S, Fauver JR, Alpert T, Wyllie AL, Turcotte C, Steinle M, Paczkowski P, Dela Cruz C, Wilen C, Ko AI, MacKay S, Grubaugh ND, Spudich S, Barakat LA. Acute encephalopathy with elevated CSF inflammatory markers as the initial presentation of COVID-19. BMC Neurology 2020, 20: 248. PMID: 32552792, PMCID: PMC7301053, DOI: 10.1186/s12883-020-01812-2.Peer-Reviewed Original ResearchConceptsInitial presentationCentral nervous system inflammationSARS-CoV-2 infectionCSF inflammatory markersNervous system inflammationCerebrospinal fluid (CSF) cytokinesSeizure-like activityCOVID-19 infectionVirus SARS-CoV-2COVID-19SARS-CoV-2BackgroundCOVID-19Inflammatory markersNeurologic complicationsSystem inflammationImmunocompromised womanNeurologic manifestationsNeurologic symptomsViral neuroinvasionCase presentationWeInfected patientsMental statusRespiratory pathogensConclusionOur findingsInflammationTocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019 Survival and Clinical Outcomes
Price CC, Altice FL, Shyr Y, Koff A, Pischel L, Goshua G, Azar MM, Mcmanus D, Chen SC, Gleeson SE, Britto CJ, Azmy V, Kaman K, Gaston DC, Davis M, Burrello T, Harris Z, Villanueva MS, Aoun-Barakat L, Kang I, Seropian S, Chupp G, Bucala R, Kaminski N, Lee AI, LoRusso PM, Topal JE, Dela Cruz C, Malinis M. Tocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019 Survival and Clinical Outcomes. CHEST Journal 2020, 158: 1397-1408. PMID: 32553536, PMCID: PMC7831876, DOI: 10.1016/j.chest.2020.06.006.Peer-Reviewed Original ResearchConceptsCytokine release syndromeTocilizumab-treated patientsSevere diseaseRelease syndromeTocilizumab treatmentInflammatory biomarkersNonsevere diseaseSoluble IL-2 receptor levelsHigh-sensitivity C-reactive proteinIL-2 receptor levelsConsecutive COVID-19 patientsIL-6 receptor antagonistMechanical ventilation outcomesC-reactive proteinCOVID-19 patientsHigher admission levelsRace/ethnicityMV daysVentilation outcomesAdverse eventsChart reviewClinical responseMedian ageWhite patientsClinical outcomesConfronting Another Pandemic: Lessons from HIV can Inform Our COVID-19 Response
Edelman EJ, Aoun-Barakat L, Villanueva M, Friedland G. Confronting Another Pandemic: Lessons from HIV can Inform Our COVID-19 Response. AIDS And Behavior 2020, 24: 1977-1979. PMID: 32399798, PMCID: PMC7215127, DOI: 10.1007/s10461-020-02908-z.Peer-Reviewed Original Research
2019
Dysregulation of sterol regulatory element-binding protein 2 gene in HIV treatment-experienced individuals
Sopeyin A, Zhou L, Li M, Barakat L, Paintsil E. Dysregulation of sterol regulatory element-binding protein 2 gene in HIV treatment-experienced individuals. PLOS ONE 2019, 14: e0226573. PMID: 31846498, PMCID: PMC6917281, DOI: 10.1371/journal.pone.0226573.Peer-Reviewed Original ResearchConceptsTreatment-experienced individualsAntiretroviral therapyCholesterol biosynthesis genesSide effectsEffect of ARTLow density lipoprotein receptor pathwayHIV viral suppressionCase-control studyLipoprotein receptor pathwaySterol regulatory element-binding protein 2Cassette transporter A1Protein expression levelsViral suppressionLipid abnormalitiesClinical manifestationsMetabolic derangementsCardiovascular diseaseRetrospective analysisTherapeutic benefitProtein 2 geneMRNA expressionReceptor pathwayMarked decreaseDysregulationExpression levelsDevelopment of a Novel Competency-Based Evaluation System for HIV Primary Care Training: the HIV Entrustable Professional Activities
Dunne D, Green M, Tetrault J, Barakat LA. Development of a Novel Competency-Based Evaluation System for HIV Primary Care Training: the HIV Entrustable Professional Activities. Journal Of General Internal Medicine 2019, 35: 331-335. PMID: 31667752, PMCID: PMC6957645, DOI: 10.1007/s11606-019-04956-1.Peer-Reviewed Original ResearchConceptsPrimary care providersEntrustable professional activitiesPrimary care internal medicine residency programPrimary care trainingInternal medicine residency programsHIV wardHIV clinicMedicine residency programsCare providersInternal medicine milestonesHIV educationCare trainingExpert panelTraining trackResident assessmentResidency programsUnsupervised practiceEvaluation toolResident participantsResident evaluationsHIVPatientsAimToNovel competenciesClinic
2018
The Changing Face of HIV Care
Barakat LA, Dunne DW, Tetrault JM, Soares S, Chia D, Ogbuagu OE, Moriarty JP, Huot SJ, Green ML. The Changing Face of HIV Care. Academic Medicine 2018, 93: 1673-1678. PMID: 29901657, DOI: 10.1097/acm.0000000000002317.Peer-Reviewed Original ResearchConceptsHIV carePrimary careRisk of comorbiditiesPrimary care residency programsEntrustable professional activitiesHigh-quality HIVHIV/AIDSResidency programsInternal medicine residency programsMedicine residency programsHIV trainingShortage of physiciansHIVClinical training opportunitiesResident schedulesCarePatientsNeeds assessmentSingle settingPhysician workforceWeb-based curriculumProgram evaluationTraining trackComorbiditiesTraining opportunities