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 rateUniversal test and treat in relation to HIV disease progression: results from a stepped‐wedge trial in Eswatini
Boeke C, Khan S, Walsh F, Hettema A, Lejeune C, Spiegelman D, Okello V, Harwell J, Mazibuko S, Bärnighausen T. Universal test and treat in relation to HIV disease progression: results from a stepped‐wedge trial in Eswatini. HIV Medicine 2020, 22: 54-59. PMID: 32876360, DOI: 10.1111/hiv.12941.Peer-Reviewed Original ResearchConceptsBody mass indexStepped-wedge trialDisease progressionCD4 countSevere diseaseMultivariate Cox proportional hazards modelWorld Health Organization stageCox proportional hazards modelHIV disease progressionMorbidity/mortalityCells/Proportional hazards modelLower ratesIncident tuberculosisCD4 declineMass indexUniversal testHealth facilitiesBaseline valuesHazards modelHealth outcomesCrowded hospitalsWeight lossProgressionHIV
2013
Determinants of anemia in postpartum HIV-negative women in Dar es Salaam, Tanzania
Petraro P, Duggan C, Urassa W, Msamanga G, Makubi A, Spiegelman D, Fawzi WW. Determinants of anemia in postpartum HIV-negative women in Dar es Salaam, Tanzania. European Journal Of Clinical Nutrition 2013, 67: 708-717. PMID: 23612515, PMCID: PMC3775569, DOI: 10.1038/ejcn.2013.71.Peer-Reviewed Original ResearchMeSH KeywordsAnemia, Iron-DeficiencyCD4 Lymphocyte CountDietDietary SupplementsErythrocyte IndicesFemaleFolic AcidHemoglobinsHIV InfectionsHumansIron, DietaryMaternal Nutritional Physiological PhenomenaMultivariate AnalysisPostpartum PeriodPregnancyProportional Hazards ModelsProspective StudiesRisk FactorsSocioeconomic FactorsTanzaniaConceptsIron/folate supplementationIron deficiency anemiaDeterminants of anemiaDeficiency anemiaFolate supplementationDelivery complicationsPregnant womenRisk factorsMultivariate Cox proportional hazards modelNon-anemic pregnant womenCox proportional hazards modelCD4 cell countHIV-negative womenModifiable risk factorsProspective cohort studyMaternal nutritional statusWeeks of gestationManagement of infectionsProportional hazards modelDar es SalaamSub-Saharan African womenBaseline anemiaIncident anemiaAnemic womenPostpartum anemia
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
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 ResearchMeSH KeywordsAdultAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveBody WeightCD4 Lymphocyte CountFemaleHIVHIV InfectionsHumansRNA, ViralViral LoadConceptsActive 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 decreaseSelenium Status Is Associated with Accelerated HIV Disease Progression among HIV-1–Infected Pregnant Women in Tanzania
Kupka R, Msamanga GI, Spiegelman D, Morris S, Mugusi F, Hunter DJ, Fawzi WW. Selenium Status Is Associated with Accelerated HIV Disease Progression among HIV-1–Infected Pregnant Women in Tanzania. Journal Of Nutrition 2004, 134: 2556-2560. PMID: 15465747, DOI: 10.1093/jn/134.10.2556.Peer-Reviewed Original ResearchConceptsPlasma selenium levelsCD4 cell countRisk of mortalityDisease progressionHIV-1-infected pregnant womenCell countSelenium levelsLow plasma selenium levelsHIV disease progressionAccelerated disease progressionCox multivariate modelSelenium statusMedian followHIV diseaseClinical outcomesPregnant womenPoor survivalTanzanian womenMultivariate modelL increaseCells/ProgressionWomenMortalityFirst yearA 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 statusMultivitaminsDiseaseProgressionBreastfeeding and maternal HIV-1 disease progression and mortality
Sedgh G, Spiegelman D, Larsen U, Msamanga G, Fawzi WW. Breastfeeding and maternal HIV-1 disease progression and mortality. AIDS 2004, 18: 1043-1049. PMID: 15096808, DOI: 10.1097/00002030-200404300-00013.Peer-Reviewed Original ResearchConceptsHIV-1 disease progressionCD4 cell countDisease progressionCell countHigher CD4 cell countsLow CD4 cell countsCox proportional hazards modelHealth of HIVCohort study designExcessive weight lossProportional hazards modelPartial breastfeedingRelative riskHazards modelInsufficient evidenceBreastfeedingMultivariate analysisStudy designWeight lossWomenProgressionDar es SalaamHIVDeathAssociation
2003
Role of Acquired Immune Deficiency Syndrome—Defining Conditions in Human Immunodeficiency Virus—Associated Wasting
Wanke CA, Silva M, Ganda A, Fauntleroy J, Spiegelman D, Knox TA, Gorbach SL. Role of Acquired Immune Deficiency Syndrome—Defining Conditions in Human Immunodeficiency Virus—Associated Wasting. Clinical Infectious Diseases 2003, 37: s81-s84. PMID: 12942378, DOI: 10.1086/375894.Peer-Reviewed Original ResearchConceptsRelative riskStudy visitImmune deficiency syndrome-defining conditionsAcquired Immune Deficiency SyndromeMonthly study visitsCD4 cell countHIV Cohort StudyHuman immunodeficiency virusImmune deficiency syndromeBaseline BMICohort studyImmunodeficiency virusDeficiency syndromeCell countEnergy intakeSocioeconomic statusWastingBMIRiskVisitsLongitudinal dataSyndromeIntakeBaselineMonthsEffect of Providing Vitamin Supplements to Human Immunodeficiency Virus-Infected, Lactating Mothers on the Child's Morbidity and CD4+ Cell Counts
Fawzi WW, Msamanga GI, Wei R, Spiegelman D, Antelman G, Villamor E, Manji K, Hunter D. Effect of Providing Vitamin Supplements to Human Immunodeficiency Virus-Infected, Lactating Mothers on the Child's Morbidity and CD4+ Cell Counts. Clinical Infectious Diseases 2003, 36: 1053-1062. PMID: 12684919, DOI: 10.1086/374223.Peer-Reviewed Original ResearchConceptsMultivitamin armCell countVitamin AHuman immunodeficiency virus type 1Immunodeficiency virus type 1Placebo-controlled trialCells/microLHIV-negative childrenHIV-positive childrenHuman immunodeficiency virusChildren of womenRapid respiratory rateVirus type 1Low-cost interventionEffect of supplementationMaternal receiptMean CD4Immunodeficiency virusMultivitamin supplementsChild morbidityChild healthVitamin supplementsLower riskRespiratory rateType 1
2002
Correlates of Plasma HIV-1 RNA Viral Load Among HIV-1 Seropositive Women in Dar es Salaam, Tanzania
Kapiga SH, Bang H, Spiegelman D, Msamanga GI, Coley J, Hunter DJ, Fawzi WW. Correlates of Plasma HIV-1 RNA Viral Load Among HIV-1 Seropositive Women in Dar es Salaam, Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2002, 30: 316-323. PMID: 12131569, DOI: 10.1097/01.qai.0000014767.47046.c8.Peer-Reviewed Original ResearchMeSH KeywordsAdultCD4 Lymphocyte CountFemaleHIV SeropositivityHIV-1HumansPregnancyPregnancy Complications, InfectiousRNA, ViralViral LoadConceptsHIV-1 RNA viral loadRNA viral loadPlasma HIV-1 RNA viral loadViral loadCopies/mLLymphocyte countHIV-1 positive pregnant womenHIV-1-seropositive womenMedian viral loadHigh viral loadPrevention of malariaTime of deliverySeropositive womenAbsolute CD4Pregnant womenClinical trialsHIV-1Long-term effectsDaily food expenditureMalaria parasitesBaselineMonthsDar es SalaamCD4Food expenditureChanges in lean body mass and total body weight are weakly associated with physical functioning in patients with HIV infection
Wilson I, Jacobson D, Roubenoff R, Spiegelman D, Knox T, Gorbach S. Changes in lean body mass and total body weight are weakly associated with physical functioning in patients with HIV infection. HIV Medicine 2002, 3: 263-270. PMID: 12444944, DOI: 10.1046/j.1468-1293.2002.00122.x.Peer-Reviewed Original ResearchConceptsTotal body weightSelf-reported physical functioningPhysical functioningHIV infectionBody weightRelationship of changesCells/ micro l.Mean CD4 countHIV-positive personsMain outcome measuresLean body massLongitudinal analysisCD4 countCohort studyPositive personsOutcome measuresHealthy personsBody compositionPatientsStudy designWeight lossMicro l.InfectionWomenHealthy livingRole 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 cellsNutrient intake and body weight in a large HIV cohort that includes women and minorities
WOODS MN, SPIEGELMAN D, Knox TA, FORRESTER JE, CONNORS JL, SKINNER SC, Silva M, KIM JH, GORBACH SL. Nutrient intake and body weight in a large HIV cohort that includes women and minorities. Journal Of The Academy Of Nutrition And Dietetics 2002, 102: 203-211. PMID: 11846114, DOI: 10.1016/s0002-8223(02)90049-0.Peer-Reviewed Original ResearchConceptsVitamin/mineral supplementsNutrient intakeMicronutrient intakeBaseline nutrient intakeLarge HIV cohortCD4 cell countCD4 lymphocyte countHIV-positive populationBody mass indexInadequate nutrient intakeStudy sampleNHANES III dataWilcoxon rank sum testCubic spline modelsMineral supplementsRank sum testHIV cohortLymphocyte countSpearman correlation coefficientMass indexProspective studyFood recordsMedian intakeDietary intakeNutritional intake
2001
Do HIV Type 1 RNA Levels Provide Additional Prognostic Value to CD4+ T Lymphocyte Counts in Patients with Advanced HIV Type 1 Infection?
Arduino J, Fischl M, Stanley K, Collier A, Spiegelman D. Do HIV Type 1 RNA Levels Provide Additional Prognostic Value to CD4+ T Lymphocyte Counts in Patients with Advanced HIV Type 1 Infection? AIDS Research And Human Retroviruses 2001, 17: 1099-1105. PMID: 11522179, DOI: 10.1089/088922201316912709.Peer-Reviewed Original ResearchConceptsHIV-1 RNA levelsHIV-1 disease progressionBaseline HIV-1 RNA levelsT-lymphocyte countsT lymphocytesDisease progressionLymphocyte countRNA levelsCells/Prognostic informationHigh baseline HIV-1 RNA levelsHIV type 1 RNA levelsPlasma HIV-1 RNA levelsSubsequent HIV-1 disease progressionAdvanced HIV-1 diseaseHIV Type 1 InfectionConditional logistic regression analysisDisease progression independentHIV-1 diseaseAdditional prognostic informationAdditional prognostic valueType 1 infectionCase-control studyLogistic regression analysisClinical statusWeight and body composition in a cohort of HIV-positive men and women
Forrester J, Spiegelman D, Woods M, Knox T, Fauntleroy J, Gorbach S. Weight and body composition in a cohort of HIV-positive men and women. Public Health Nutrition 2001, 4: 743-747. PMID: 11415480, DOI: 10.1079/phn200099.Peer-Reviewed Original ResearchPredictors of intrauterine and intrapartum transmission of HIV-1 among Tanzanian women
Fawzi W, Msamanga G, Renjifo B, Spiegelman D, Urassa E, Hashemi L, Antelman G, Essex M, Hunter D. Predictors of intrauterine and intrapartum transmission of HIV-1 among Tanzanian women. AIDS 2001, 15: 1157-1165. PMID: 11416718, DOI: 10.1097/00002030-200106150-00011.Peer-Reviewed Original ResearchConceptsViral loadHIV-1HIV-1-infected pregnant womenLower genital tract infectionMaternal CD4 cell countVertical transmissionLower genital infectionsMaternal viral loadCD4 cell countGenital tract infectionHIV disease progressionHIV-1 infectionWeeks of gestationPrevention of transmissionIntrapartum transmissionIntrauterine transmissionGenital infectionTract infectionsSustained clearanceClinical stagePregnant womenPrenatal careDisease progressionCopies/Vitamin supplements
2000
Relation of lean body mass to health-related quality of life in persons with HIV.
Wilson I, Roubenoff R, Knox T, Spiegelman D, Gorbach S. Relation of lean body mass to health-related quality of life in persons with HIV. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2000, 24: 137-46. PMID: 10935689, DOI: 10.1097/00126334-200006010-00008.Peer-Reviewed Original ResearchConceptsGeneral health perceptionPhysical functionHealth-related qualityLean body massHigher lean body massHealth perceptionAssociated with better physical functionClinical impact of interventionsHealth-related quality of lifeDiverse population of personsBioimpedance analysisPatient self-reportBody massImpact of interventionsPopulation of personsCross-sectional analysisQuality of lifeIncreased LBMSelf-reportDiverse populationsEnergy/fatigueMultivariate modelHIVCD4 countHIV infectionRelation of Lean Body Mass to Health-Related Quality of Life in Persons With HIV
Wilson I, Roubenoff R, Knox T, Spiegelman D, Gorbach S. Relation of Lean Body Mass to Health-Related Quality of Life in Persons With HIV. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2000, 24: 137-146. DOI: 10.1097/00042560-200006010-00008.Peer-Reviewed Original ResearchConceptsLean body massHigher lean body massGeneral health perceptionEnergy/fatiguePhysical functioningHealth perceptionBetter general health perceptionBioimpedance analysisDesign Cross-sectional analysisMeasures of HRQLHealth-related qualityBody massLast monthBetter physical functioningQuality of lifeCross-sectional analysisCD4 countHIV infectionMean ageClinical impactMultivariable modelHIVCells/Number of daysWomenPredictors of CD4+ lymphocyte count among HIV-Seropositive and HIV-Seronegative pregnant women in Dar Es Salaam, Tanzania
Kapiga SH, Mwakagile D, Spiegelman D, Msamanga GI, Hunter D, Fawzi WW. Predictors of CD4+ lymphocyte count among HIV-Seropositive and HIV-Seronegative pregnant women in Dar Es Salaam, Tanzania. East African Medical Journal 2000, 77: 206-11. PMID: 12858905, DOI: 10.4314/eamj.v77i4.46622.Peer-Reviewed Original ResearchMeSH KeywordsAdultCD4 Lymphocyte CountFemaleHIV InfectionsHIV SeronegativityHIV SeropositivityHIV-1HumansPregnancyPregnancy Complications, InfectiousTanzaniaConceptsHIV-seropositive womenCells/mm3Erythrocyte sedimentation rateHIV-seronegative pregnant womenWhite blood countLymphocyte countPredictors of CD4Pregnant womenHIV-seropositiveMost HIV-seropositive womenTotal white blood countHaematological indicesReduction of CD4HIV-seronegative womenT lymphocyte subsetsClinical stage 1Age 25 yearsDar es SalaamAverage age 25 yearsAsymptomatic womenBlood countSocio-demographic characteristicsCD4Blood samplesHR increase