GUPTA-KLINSKY INDIA INSTITUTE, May 19, 2023
Mycobacterium tuberculosis (Mtb) is the most common infection among people with HIV (PWH). Mtb disease-associated inflammation could affect HIV-directed immune responses in PWH. We show that HIV antibodies are broader and more potent in PWH in the presence as compared to the absence of Mtb disease. With co-existing Mtb disease, the virus in PWH also encounters unique antibody selection pressure. The Mtb-linked HIV antibody enhancement associates with specific mediators important for B cell and antibody development. This Mtb humoral augmentation does not occur due to cross-reactivity, a generalized increase in all antibodies, or differences in duration or amount of antigen exposure. We speculate that the co-localization of Mtb and HIV in lymphatic tissues leads to the emergence of potent HIV antibodies. PWH’s Mtb disease status has implications for the future use of HIV broadly neutralizing antibodies as prophylaxis or treatment and the induction of better humoral immunity.
GUPTA-KLINSKY INDIA INSTITUTE, April 17, 2023
People living with HIV (PLHIV) are at higher risk for human papillomavirus (HPV)-related oropharyngeal cancers compared to the general population. Xpert HPV test is a polymerase chain reaction (PCR) assay capable of rapid HPV detection. Performing the assay requires minimal intervention by laboratory personnel. Its use could improve oropharyngeal cancer screening among PLHIV living in low-and middle-income countries (LMICs) with limited diagnostic capacities. However, Xpert HPV performance for oral samples has not been evaluated. Here, we describe our experience with Xpert HPV and compare its results with traditional PCR, for oral samples.
GUPTA-KLINSKY INDIA INSTITUTE, April 14, 2023
Respondent-driven sampling (RDS), a network recruitment approach, is effective at reaching people who inject drugs (PWID), but other strategies may be needed to reach PWID at risk or living with HIV and/or Hepatitis C (HCV). We examined the impact of integrating geospatially targeted community-based HIV/HCV testing with an RDS survey.
GUPTA-KLINSKY INDIA INSTITUTE, February 28, 2023
Senior investigators and PREVAIL researchers–including laboratory personnel, clinical research officers, and data analysts–met in Greater Noida, UP, on 11-12 February 2023 to discuss the preliminary results of the study.
Lancet: Southeast Asia, March 01, 2023
The worldwide control rate for hypertension is dismal. An inadequate number of physicians to treat patients with hypertension is one key obstacle. Innovative health system approaches such as delegation of basic tasks to non-physician health workers (task-sharing) might alleviate this problem. Massive scale up of population-wide hypertension management is especially important for low- and middle-income countries such as India.
Frontiers in Pharmacology, January 04, 2023
Linezolid is an oxazolidinone used to treat multidrug-resistant tuberculosis (MDR-TB), including in the recently-endorsed shorter 6-month treatment regimens. Due to its narrow therapeutic index, linezolid is often either dose-adjusted or discontinued due to intolerance or toxicity during treatment, and the optimal balance between linezolid efficacy and toxicity remains unclear. India carries a significant burden of MDR-TB cases in the world, but limited information on the pharmacokinetics of linezolid and minimum inhibitory concentration (MIC) distribution is available from Indian MDR-TB patients. We enrolled participants from a tertiary care centre in Mumbai, India, treated for MDR-TB and receiving linezolid daily doses of 600 or 300 mg.
The International Journal of Tuberculosis and Lung Disease, January 01, 2023
Annually, 1.5 million people die of TB.1 India has the highest burden of TB, and in 2020, the case fatality ratio (CFR) among people with drug-susceptible TB was 4.3%. Even after treatment, mortality is more than two-fold higher among people with prior TB compared to the general population. However, information about cause of death, particularly in India, is limited. Thus, we sought to characterise cause of death among individuals who accessed TB care.
From 2013 to 2018, we enrolled individuals within 1 week of being diagnosed with drug-susceptible TB at public clinics in Pune and Chennai, India, into two pooled prospective cohorts. Participants received care according to India’s standard guidelines andwere followed up to 18 months post-treatment. Sociodemographic and clinical data were collected at enrolment and microbiological results were tracked. Considering low paediatric mortality, participants, <18 years were excluded.
JACC: Advances, January 11, 2023
South Asian individuals (ancestry from Bhutan, Bangladesh, India, the Maldives, Nepal, Pakistan, and Sri Lanka) carry a disproportionately higher burden of atherosclerotic cardiovascular disease (ASCVD) and proportional mortality from ischemic heart disease when compared with other racial and ethnic groups.
Health Policy and Planning, October 31, 2022
Vaccination decision making in low-and-middle-income countries (LMICs) has become increasingly complex, particularly in the context of numerous competing health challenges. LMICs have to make difficult choices on which vaccines to prioritize for introduction while considering a wide range of factors such as disease burden, vaccine impact, vaccine characteristics, financing, health care infrastructures, whilst being adapted to each country's specific contexts. Our scoping review reviewed the factors that influence decision-making among policymakers for the introduction of new vaccines in LMICs. We identified the specific data points that are factored into the decision-making process for new vaccine introduction, while also documenting whether there have been any changes in decision-making criteria in new vaccine introduction over the last two decades.
Lancet: Southeast Asia, October 13, 2022
The course of the COVID-19 pandemic has been driven by several dynamic behavioral, immunological, and viral factors. We used mathematical modeling to explore how the concurrent reopening of schools, increasing levels of hybrid immunity, and the emergence of the Omicron variant affected the trajectory of the pandemic in India, using Andhra Pradesh (pop: 53 million) as an exemplar Indian state.
The Lancet, October 11, 2022
New tuberculosis vaccine candidates that are in the development pipeline need to be studied in people with HIV, who are at high risk of acquiring Mycobacterium tuberculosis infection and tuberculosis disease and tend to develop less robust vaccine-induced immune responses. To address the gaps in developing tuberculosis vaccines for people with HIV, a series of symposia was held that posed six framing questions to a panel of international experts: What is the use case or rationale for developing tuberculosis vaccines? What is the landscape of tuberculosis vaccines? Which vaccine candidates should be prioritised? What are the tuberculosis vaccine trial design considerations? What is the role of immunological correlates of protection? What are the gaps in preclinical models for studying tuberculosis vaccines? The international expert panel formulated consensus statements to each of the framing questions, with the intention of informing tuberculosis vaccine development and the prioritisation of clinical trials for inclusion of people with HIV.
Open Forum Infectious Diseases, September 17, 2022
Drug resistance testing is limited in public-sector human immunodeficiency virus (HIV) care in India, and there are few systematic samplings for prevalent drug resistance mutations (DRMs), particularly among men who have sex with men (MSM) and people who inject drugs (PWID).
We conducted genotypic resistance testing on 915 HIV sequences sampled from viremic self-reported antiretroviral therapy (ART) experienced and naive PWID and MSM recruited from 21 cities across India in 2016-2017. We analyzed factors associated with resistance using logistic regression and evaluated evidence for transmitted resistance using phylogenetic analyses.
Bloomberg School of Public Health, August 09, 2022
Ligia Paina, PhD ’14, MHS ‘08, an assistant professor in the Department of International Health’s Health Systems Program at the Johns Hopkins Bloomberg School of Public Health, and her co-PI Meng Zhu, PhD, MS, a professor at the Johns Hopkins Carey Business School, were awarded an Impact Grant from the Johns Hopkins Alliance for a Healthier World for their work aimed at narrowing the health equity gap in urban slums in Chandigarh, India.
Fogarty International Center, June 15, 2022
India, home to one in every six people on the planet, has one of the highest rates of antimicrobial resistance (AMR) in the world. As a Fogarty Global Health Fellow, Dr. Matt Robinson worked in Pune, India, to characterize the burden of antimicrobial resistance among hospitalized patients with fever illnesses. “Fever is the most common reason why people in India seek medical care and we found that almost every patient hospitalized with fever received antibiotics—despite mosquito-borne diseases, which are not treated by antibiotics, being the cause of most of these illnesses,” said Robinson.
BMJ Global Health, May 24, 2022
This study aimed to determine the effectiveness of Covishield vaccine among residents of congregate residential facilities.
The Indian Express, March 26, 2022
US-based National Institutes of Health has funded a hybrid trial for alcohol reduction among people with TB and HIV in India (HATHI) that is set to begin in April in Pune. Johns Hopkins University in collaboration with Pune’s B J Government Medical College and Dr. D.Y. Patil Medical College, Hospital, and Research Center have developed a behavioral intervention to reduce alcohol use among TB/HIV patients.
New England Journal of Medicine, March 10, 2022
Two thirds of children with tuberculosis have nonsevere disease, which may be treatable with a shorter regimen than the current 6-month regimen.
The Times of India, December 26, 2021
Days after the World Health Organization (WHO) recommended against the use of plasma therapy for Covid-19, a multi-centre clinical trial led by Johns Hopkins Medicine and the Johns Hopkins Bloomberg School of Public Health has reiterated the treatment is beneficial indeed.
Johns Hopkins India Institute, December 13, 2021
Drs. Matthew Robinson and Trish Simner of Johns Hopkins School of Medicine are collaborating with five Indian medical institutions with which JHU has longstanding research ties
US Centers for Disease Control and Prevention, December 07, 2021
These two new networks, paired with additional short-term research projects, will span more than 50 countries worldwide and build programs that focus on preventing infections in health care through proven infection control; build laboratory capacity to detect antimicrobial-resistant organisms in healthcare, the community, and environment; and develop new and innovative ways to more rapidly detect and respond to threats like AR and COVID-19.