2023
Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini
Molemans M, Reis R, Shabalala F, Dlamini N, Masilela N, Simelane N, Pell C, Chao A, Spiegelman D, Vernooij E, van Leth F. Reasons for using traditional and complementary care by people living with HIV on antiretroviral therapy and association with interrupted care: a mixed methods study in Eswatini. BMC Complementary Medicine And Therapies 2023, 23: 350. PMID: 37794359, PMCID: PMC10548651, DOI: 10.1186/s12906-023-04184-5.Peer-Reviewed Original ResearchConceptsInterrupted careAntiretroviral therapyType of illnessCurrent usersTCAM providersTCAM usersHIV diagnosisHIV continuumClinic recordsMultivariable analysisComplementary careVisit dateHealth facilitiesAlternative medicineTCAM useBiomedical careCareAdditional careMixed-methods studyHIVTherapyQualitative content analysisOpen-ended questionsMethods studyContextual factors
2022
Is the Product Method More Efficient Than the Difference Method for Assessing Mediation?
Cheng C, Spiegelman D, Li F. Is the Product Method More Efficient Than the Difference Method for Assessing Mediation? American Journal Of Epidemiology 2022, 192: 84-92. PMID: 35921210, PMCID: PMC10144745, DOI: 10.1093/aje/kwac144.Peer-Reviewed Original ResearchIron supplementation and paediatric HIV disease progression: a cohort study among children receiving routine HIV care in Dar es Salaam, Tanzania
Andersen CT, Duggan CP, Manji K, Seage GR, Spiegelman D, Perumal N, Ulenga N, Fawzi WW. Iron supplementation and paediatric HIV disease progression: a cohort study among children receiving routine HIV care in Dar es Salaam, Tanzania. International Journal Of Epidemiology 2022, 51: 1533-1543. PMID: 35167662, PMCID: PMC9557856, DOI: 10.1093/ije/dyac017.Peer-Reviewed Original ResearchConceptsDisease stage progressionIron supplementationStage progressionCohort studyDisease progressionRoutine HIV careHIV disease progressionProspective cohort studyManagement of anemiaRisk of anemiaHigher hazard rateProportional hazards modelIron supplement useDar es SalaamHaematological outcomesAntiretroviral therapyHIV careClinic visitsSupportive careAntiretroviral treatmentClinical outcomesClinical visitsAnemia statusSupplement useVital status
2021
Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial
Boeke CE, Khan S, Walsh FJ, Lejeune C, Hettema A, Spiegelman D, Okello V, Bärnighausen T. Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial. HIV Medicine 2021, 22: 854-859. PMID: 34293243, DOI: 10.1111/hiv.13144.Peer-Reviewed Original ResearchConceptsImpact of UTTStepped-wedge trialAntiretroviral therapyAppointment adherencePublic sector health systemJoint United Nations ProgrammeMultivariable-adjusted modelsHIV/AIDSUniversal testClient adherenceUTT strategyVisit adherenceHIV clientsUnited Nations ProgrammeStudy enrollmentClinical benefitTreat strategyHealth facilitiesART statusHealth systemAdherenceMarital statusNations ProgrammeMeasures analysisLongitudinal analysis
2020
Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial
Khan S, Spiegelman D, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Chao A, Bärnighausen T, Okello V. Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial. Journal Of The International AIDS Society 2020, 23: e25610. PMID: 32949103, PMCID: PMC7507004, DOI: 10.1002/jia2.25610.Peer-Reviewed Original ResearchConceptsViral suppressionStandard of careAntiretroviral treatmentCox proportional hazards modelHealth systemART-naïve participantsHIV-positive patientsHIV-positive adultsViral load monitoringHIV-positive participantsAppropriate care managementProportional hazards modelEarly accessPublic sector health facilitiesHealth system effectsPublic health systemHealth system's abilityClinic transitionAntiretroviral therapyCD4 countCare retentionVL monitoringPublic health sectorDisease stageEndpoint rateImpaired Hematological Status Increases the Risk of Mortality among HIV-Infected Adults Initiating Antiretroviral Therapy in Tanzania
Noor RA, Abioye AI, Hertzmark E, Darling AM, Aboud S, Mugusi FM, Sudfeld CR, Spiegelman D, Fawzi WW. Impaired Hematological Status Increases the Risk of Mortality among HIV-Infected Adults Initiating Antiretroviral Therapy in Tanzania. Journal Of Nutrition 2020, 150: 2375-2382. PMID: 32621487, PMCID: PMC7540061, DOI: 10.1093/jn/nxaa172.Peer-Reviewed Original ResearchConceptsRisk of mortalityPrevalence of anemiaHAART initiationHematological statusIron deficiencyAntiretroviral therapySerum ferritinSevere anemiaIncident clinical outcomesRelation of anemiaTrial of multivitaminsActive antiretroviral therapyHIV disease progressionCase-cohort studyIron deficiency anemiaProportional hazards modelElevated ironNonanemic participantsHIV patientsMultivariate adjustmentClinical outcomesMorbidity outcomesAnemia etiologyDeficiency anemiaIron supplementationMortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial
Chao A, Spiegelman D, Khan S, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Bärnighausen T, Okello V. Mortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial. HIV Medicine 2020, 21: 429-440. PMID: 32458567, DOI: 10.1111/hiv.12876.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMortality rateDisease-related mortality rateCox proportional hazards modelCause mortality ratesStepped-wedge trialProportional hazards modelStepped-wedge designQuality of lifeEvidence of harmClinic transitionSecondary outcomesSOC participantsHealth clinicsLong-term consequencesImplementation trialHazards modelHIVStudy participantsMortalityHealth systemDecrease infectionEarly accessClinicTherapy
2017
A public health approach to addressing and preventing misdiagnosis in the scale‐up of HIV rapid testing programmes
Johnson C, Dalal S, Baggaley R, Taegtmeyer M, Johnson C, Dalal S, Baggaley R, Taegtmeyer M, Johnson C, Fonner V, Sands A, Ford N, Obermeyer C, Tsui S, Wong V, Baggaley R, Bock P, Phiri C, Piwowar‐Manning E, Kosloff B, Mandla N, Young A, James A, Schaap, Scheepers M, Donnell D, Griffith S, El‐Sadr W, Shanaube K, Beyers N, Hayes R, Fidler S, Ayles H, Team O, Khan S, Mafara E, Pasipamire M, Spiegelman D, Mazibuko S, Ntshalintshali N, Hettema A, Lejeune C, Walsh F, Okello V, Kufa T, Kharsany A, Cawood C, Khanyile D, Lewis L, Grobler A, Chipeta Z, Bere A, Glenshaw M, Puren A, Olaru I, McHugh G, Dakshina S, Majonga E, Dauya E, Bandason T, Kranzer K, Mujuru H, Ferrand R, Technau K, Mazanderani A, Kuhn L, Hans L, Strehlau R, Abrams E, Conradie M, Coovadia A, Mbete N, Murnane P, Patel F, Shiau S, Tiemessen C, Sherman G, Hsiao N, Zerbe A, Phillips T, Myer L, Abrams E, Sacks E, Cohn J, Penazzato M, Nguyen V, Best S, Pham H, Troung T, Hoang T, Wilson K, Ngo T, Chien X, Lai K, Bui D, Kato M. A public health approach to addressing and preventing misdiagnosis in the scale‐up of HIV rapid testing programmes. Journal Of The International AIDS Society 2017, 20: 22190. DOI: 10.7448/ias.20.7.22290.Peer-Reviewed Original ResearchFalse-negative diagnosesHIV testing servicesRapid diagnostic testsNegative diagnosisDiagnostic testsMagnitude of misdiagnosisHIV-negative individualsLife-long treatmentHIV testing practicesDiscrepant test resultsTesting servicesFalse-positive diagnosesHIV misdiagnosisAntiretroviral therapyUndiagnosed HIVHIV diagnosisHIV testingPositive diagnosisHIVTreatment targetsSystematic reviewPotential misdiagnosisDiagnosisMisdiagnosisSubstantial proportion
2012
Elevated alanine aminotransferase in antiretroviral‐naïve HIV‐infected African patients: magnitude and risk factors
Nagu T, Kanyangarara M, Hawkins C, Hertmark E, Chalamila G, Spiegelman D, Mugusi F, Fawzi W. Elevated alanine aminotransferase in antiretroviral‐naïve HIV‐infected African patients: magnitude and risk factors. HIV Medicine 2012, 13: 541-548. PMID: 22416813, PMCID: PMC3391335, DOI: 10.1111/j.1468-1293.2012.01006.x.Peer-Reviewed Original ResearchConceptsElevated alanine aminotransferaseIU/LAlanine aminotransferaseAntiretroviral therapyHigh riskWorld Health Organization clinical stageCD4 T-lymphocyte countFirst-line antiretroviral therapyHepatitis B virus coinfectionALT measurementsLow-density lipoprotein cholesterolLog-binomial regression modelsB virus coinfectionT-lymphocyte countsART-naïve HIVCells/μLHepatotoxic side effectsCurrent tuberculosis (TB) treatmentResource-limited settingsCross-sectional analysisAdvanced immunosuppressionHBV coinfectionART-naïveHIV careLipoprotein cholesterol
2005
Increasing Risk of 5% or Greater Unintentional Weight Loss in a Cohort of HIV-Infected Patients, 1995 to 2003
Tang AM, Jacobson DL, Spiegelman D, Knox TA, Wanke C. Increasing Risk of 5% or Greater Unintentional Weight Loss in a Cohort of HIV-Infected Patients, 1995 to 2003. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 40: 70-76. PMID: 16123685, DOI: 10.1097/01.qai.0000159627.54149.2e.Peer-Reviewed Original ResearchConceptsCohort of HIVUnintentional weight lossWeight lossAntiretroviral therapyBody compositionLow CD4 cell countsHigher HIV viral loadHigher body mass indexCare of HIVHealthy Living cohortActive antiretroviral therapyCD4 cell countCombination antiretroviral therapyHIV viral loadBody mass indexRisk of deathPresence of diarrheaFederal poverty levelLiving cohortHIV infectionMass indexMost AIDSOpportunistic infectionsViral loadPatient populationPrevalence of, Evolution of, and Risk Factors for Fat Atrophy and Fat Deposition in a Cohort of HIV-Infected Men and Women
Jacobson DL, Knox T, Spiegelman D, Skinner S, Gorbach S, Wanke C. Prevalence of, Evolution of, and Risk Factors for Fat Atrophy and Fat Deposition in a Cohort of HIV-Infected Men and Women. Clinical Infectious Diseases 2005, 40: 1837-1845. PMID: 15909274, DOI: 10.1086/430379.Peer-Reviewed Original ResearchConceptsFat atrophyRisk factorsFat depositionBaseline prevalenceCentral fat depositionHIV-Infected MenActive antiretroviral therapyHigh triglyceride levelsHuman immunodeficiency virusNutrition Examination SurveyPercent of subjectsSkin-fold measurementsBody fat levelsAbacavir useHIV loadStavudine useAntiretroviral therapyHip ratioImmunodeficiency virusExamination SurveyTriglyceride levelsNational HealthHigh school educationSmaller hipIndependent syndromePregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2
Fawzi W, Msamanga G, Spiegelman D, Hunter DJ. Pregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2. Journal Of Nutrition 2005, 135: 938-944. PMID: 15795466, DOI: 10.1093/jn/135.4.938.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMultivitamin supplementsPregnant womenHIV-negative pregnant womenDaily multivitamin supplementEarly childhood infectionsAdverse pregnancy outcomesHIV disease progressionHIV-1 infectionAdequate dietary intakeEfficacy of vitaminAdverse health outcomesFurther studiesLow-cost interventionMo of ageUninfected childrenHIV diseasePregnancy outcomesPregnant HIVHIV infectionChildhood infectionsRandomized trialsNutritional interventionDietary intakeDisease progression
2004
Understanding the Role of HIV Load in Determining Weight Change in the Era of Highly Active Antiretroviral Therapy
Mwamburi DM, Wilson IB, Jacobson DL, Spiegelman D, Gorbach SL, Knox TA, Wanke CA. Understanding the Role of HIV Load in Determining Weight Change in the Era of Highly Active Antiretroviral Therapy. Clinical Infectious Diseases 2004, 40: 167-173. PMID: 15614708, DOI: 10.1086/426591.Peer-Reviewed Original ResearchConceptsActive antiretroviral therapyVirus loadBody weightAntiretroviral therapyHIV infectionWeight changeStudy visitHuman immunodeficiency virus RNA loadHighly Active Antiretroviral TherapyAbsence of HAARTProspective cohort studyCell count decreaseVirus RNA loadTime of enrollmentStudy intervalRepeated-measures analysisHIV loadHAART useCohort studyRNA loadHAARTPatientsEligible sampleCell countCount decreaseA Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality
Fawzi WW, Msamanga GI, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, Mugusi F, Hertzmark E, Essex M, Hunter DJ. A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality. New England Journal Of Medicine 2004, 351: 23-32. PMID: 15229304, DOI: 10.1056/nejmoa040541.Peer-Reviewed Original ResearchConceptsVitamin AHIV diseaseMultivitamin supplementsHuman immunodeficiency virus (HIV) diseasePlacebo-controlled trialHIV disease progressionStage 4 diseaseLow viral loadHigher CD4Antiretroviral therapyPrimary outcomeImmunodeficiency syndromeRandomized trialsViral loadPregnant womenDisease progressionRelative riskObservational studyDaily supplementCell countEnd pointMicronutrient statusMultivitaminsDiseaseProgression
2003
Difficulty Swallowing and Lack of Receipt of Highly Active Antiretroviral Therapy Predict Acute Weight Loss in Human Immunodeficiency Virus Disease
Jacobson DL, Bica I, Knox TA, Wanke C, Tchetgen E, Spiegelman D, Silva M, Gorbach S, Wilson IB. Difficulty Swallowing and Lack of Receipt of Highly Active Antiretroviral Therapy Predict Acute Weight Loss in Human Immunodeficiency Virus Disease. Clinical Infectious Diseases 2003, 37: 1349-1356. PMID: 14583869, DOI: 10.1086/379072.Peer-Reviewed Original ResearchConceptsAcute weight lossHuman immunodeficiency virus (HIV) diseaseOral symptomsWeight lossLack of receiptActive antiretroviral therapyUpper respiratory symptomsVirus diseaseTrouble swallowingAbdominal painAntiretroviral therapyRespiratory symptomsDifficulty swallowingNutrient malabsorptionSkin symptomsCommon symptomsRecent symptomsCaloric intakeSymptom complexSymptomsWeight changeDiarrheaMetabolic needsSwallowingDiseaseUse of Complementary and Alternative Therapies by Patients With Human Immunodeficiency Virus Disease in the Era of Highly Active Antiretroviral Therapy
Bica I, Tang AM, Skinner S, Spiegelman D, Knox T, Gorbach S, Wilson IB. Use of Complementary and Alternative Therapies by Patients With Human Immunodeficiency Virus Disease in the Era of Highly Active Antiretroviral Therapy. Journal Of Alternative And Complementary Medicine 2003, 9: 65-76. PMID: 12676036, DOI: 10.1089/107555303321222955.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusActive antiretroviral therapyCAM useAntiretroviral therapyHighly Active Antiretroviral TherapyHuman immunodeficiency virus (HIV) diseaseCAM therapy useHealthy Living StudyPotential drug interactionsUse of ComplementaryLow-risk groupAlternative medical therapiesEffective drug treatmentCross-sectional analysisLeast high schoolHAART useCohort studyMale patientsMedical therapyTherapy useImmunodeficiency virusComplementary therapiesAlternative therapiesStudy visitRisk groups
2002
Weight Loss and Survival in HIV-Positive Patients in the Era of Highly Active Antiretroviral Therapy
Tang AM, Forrester J, Spiegelman D, Knox TA, Tchetgen E, Gorbach SL. Weight Loss and Survival in HIV-Positive Patients in the Era of Highly Active Antiretroviral Therapy. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2002, 31: 230-236. PMID: 12394802, DOI: 10.1097/01.qai.0000026514.98625.8f.Peer-Reviewed Original ResearchConceptsActive antiretroviral therapyWeight lossAntiretroviral therapyHAART useIndependent predictorsPrevious visitHighly Active Antiretroviral TherapyHealthy Living StudyCD4 cell countHIV-positive patientsHIV-positive participantsBody mass indexStrong independent predictorFurther prognostic valueProportional hazards modelBioelectrical impedance analysisFour- to sixfold increaseImportant comorbidityMass indexPrognostic valuePotential confoundersRelative riskStudy populationLiving StudyHazards modelRole of cytokines and testosterone in regulating lean body mass and resting energy expenditure in HIV-infected men
Roubenoff R, Grinspoon S, Skolnik PR, Tchetgen E, Abad L, Spiegelman D, Knox T, Gorbach S. Role of cytokines and testosterone in regulating lean body mass and resting energy expenditure in HIV-infected men. AJP Endocrinology And Metabolism 2002, 283: e138-e145. PMID: 12067854, DOI: 10.1152/ajpendo.00426.2001.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntiretroviral Therapy, Highly ActiveBody CompositionBody WeightCD4 Lymphocyte CountCytokinesEnergy MetabolismFollow-Up StudiesHIV InfectionsHIV Wasting SyndromeHumansInterleukin-1Linear ModelsLongitudinal StudiesMaleMiddle AgedNutritional StatusRestTestosteroneThinnessTumor Necrosis Factor-alphaViral LoadConceptsLBM lossPeripheral blood mononuclear cellsIL-1 beta productionWeight lossActive antiretroviral therapyCohort of patientsSerum free testosteroneBlood mononuclear cellsInadequate dietary intakeOngoing cohort studyCytokine tumor necrosisRole of cytokinesIL-1 betaTNF-alpha productionInterleukin-1 betaMo of observationLean body massKcal/dayAntiretroviral therapyCohort studyFree testosteroneHIV infectionIndependent predictorsCytokine productionMononuclear cells
1999
Elevated resting energy expenditure among HIV-seropositive persons receiving highly active antiretroviral therapy
Shevitz A, Knox T, Spiegelman D, Roubenoff R, Gorbach S, Skolnik P. Elevated resting energy expenditure among HIV-seropositive persons receiving highly active antiretroviral therapy. AIDS 1999, 13: 1351-1357. PMID: 10449288, DOI: 10.1097/00002030-199907300-00012.Peer-Reviewed Original ResearchConceptsFat-free massActive antiretroviral therapyHAART useHIV RNAAntiretroviral therapyCohort studyViral burdenKJ/dayHIV-seropositive menCD4 cell countHIV-seropositive personsLog10 copies/Energy expenditureLarge cohort studyIndependent effectsCross-sectional analysisHIV diseaseMedication regimensViral loadCopies/Adjusted REECell countElevated REEViral replicationHAART
1998
The effect of protease inhibitors on weight and body composition in HIV-infected patients
Silva M, Skolnik P, Gorbach S, Spiegelman D, Wilson I, Fernández-DiFranco M, Knox T. The effect of protease inhibitors on weight and body composition in HIV-infected patients. AIDS 1998, 12: 1645-1651. PMID: 9764784, DOI: 10.1097/00002030-199813000-00012.Peer-Reviewed Original ResearchConceptsLean body massPI therapyHIV infectionWeight gainViral loadPhysical functioningHealth perceptionBody compositionCurrent health perceptionsActive antiretroviral therapyPI treatmentProtease inhibitor therapyBody mass indexGreater weight gainHuman growth hormoneAntiretroviral therapyHIV cohortBody massInhibitor therapyMass indexOptimal therapyFat massAnabolic stimuliPatientsGrowth hormone