Voriconazole pharmacokinetics following HSCT: results from the BMT CTN 0101 trial.
Journal of Antimicrobial Chemotherapy 71(8):2234 (2016)
Voriconazole is a first-line agent for the prevention and treatment of a number of invasive fungal diseases. Relatively little is known about the relationship between drug exposure and the prevention of invasive fungal infections.
A pharmacokinetic-pharmacodynamic substudy was performed as part ...
Zika Virus and Microcephaly.
New England Journal of Medicine 374(10):984 (2016)
Zika virus has been sweeping through South and Central America, with more than a million suspected cases during the past few months, along with a substantial increase in reporting of infants born with microcephaly.(1),(2) Thus far, the two outbreaks have largely been epidemiologically associated...
Assessment of the Safety and Immunogenicity of 2 Novel Vaccine Platforms for HIV-1 Prevention: A Randomized Trial.
Annals of Internal Medicine 164(5):313 (2016)
A prophylactic HIV-1 vaccine is a global health priority.
To assess a novel vaccine platform as a prophylactic HIV-1 regimen.
Randomized, double-blind, placebo-controlled trial. Both participants and study personnel were blinded to treatment allocation. (ClinicalTrials.gov: NCT01215149).
Utility of in-house fluconazole disk diffusion susceptibility testing in the treatment of candidemia.
Diagnostic Microbiology and Infectious Disease 84(3):223 (2016)
Among 302 first candidemia episodes, 210 (69.6%) were initially treated with an echinocandin or polyene (E/P) antifungal drug. In 137 (72.5%) patients with fluconazole-susceptible isolates, treatment was changed to fluconazole based on disk diffusion susceptibility testing. Clinical outcomes wer...
An Avid Imitator.
Journal of Clinical Medicine Research 8(3):257 (2016)
We present a case of disseminated cryptococcal disease, coexisting with and mimicking lymphoma. Determination of serum cryptococcal antigen should be considered for lymphopenic patients with hematologic malignancies, presenting with unexplained fever, and/or lymphadenopathy and/or pulmonary find...
Vaccination With Heterologous HIV-1 Envelope Sequences and Heterologous Adenovirus Vectors Increases T-Cell Responses to Conserved Regions: HVTN 083.
Journal of Infectious Diseases 213(4):541 (2016)
Increasing the breadth of human immunodeficiency virus type 1 (HIV-1) vaccine-elicited immune responses or targeting conserved regions may improve coverage of circulating strains. HIV Vaccine Trials Network 083 tested whether cellular immune responses with these features are induced by prime-boo...
Dissecting Polyclonal Vaccine-Induced Humoral Immunity against HIV Using Systems Serology.
Cell 163(4):988 (2015)
While antibody titers and neutralization are considered the gold standard for the selection of successful vaccines, these parameters are often inadequate predictors of protective immunity. As antibodies mediate an array of extra-neutralizing Fc functions, when neutralization fails to predict pro...
Pneumocystis jiroveci pneumonia (PCP) in patients receiving neoadjuvant and adjuvant anthracycline-based chemotherapy for breast cancer: incidence and risk factors.
Breast Cancer Research and Treatment 154(2):359 (2015)
Opportunistic infection with Pneumocystis jiroveci pneumonia (PCP) has not been recognized as a significant complication of early-stage breast cancer treatment. However, we have observed an increase in PCP incidence among patients receiving chemotherapy for early-stage breast cancer. Herein we i...
Screening and Monitoring for Infectious Complications When Immunosuppressive Agents Are Studied in the Treatment of Autoimmune Disorders.
Journal of the Pediatric Infectious Diseases So... 4(3):198 (2015)
Significant progress has been made in the development, investigation, and clinical application of immunosuppressive agents to treat a variety of autoimmune disorders. The expansion of clinical applications of these new agents requires the performance of large multicenter clinical trials. These l...
HIV-1 VACCINES. Diversion of HIV-1 vaccine-induced immunity by gp41-microbiota cross-reactive antibodies.
Science 349(6249):aab1253 (2015)
An HIV-1 DNA prime vaccine, with a recombinant adenovirus type 5 (rAd5) boost, failed to protect from HIV-1 acquisition. We studied the nature of the vaccine-induced antibody (Ab) response to HIV-1 envelope (Env). HIV-1-reactive plasma Ab titers were higher to Env gp41 than to gp120, and reperto...
Induction of HIV-1-specific mucosal immune responses following intramuscular recombinant adenovirus serotype 26 HIV-1 vaccination of humans.
Journal of Infectious Diseases 211(4):518 (2015)
Defining mucosal immune responses and inflammation to candidate human immunodeficiency virus type 1 (HIV-1) vaccines represents a current research priority for the HIV-1 vaccine field. In particular, it is unclear whether intramuscular immunization can elicit immune responses at mucosal surfaces...
Ebola in West Africa at one year--from ignorance to fear to roadblocks.
New England Journal of Medicine 372(6):563 (2015)
It has been a year since the first case associated with the current Ebola virus outbreak in West Africa was identified and just over 8 months since we first started reporting on the outbreaks that stemmed from that patient in Guinea.1 Today's posts at NEJM.org include an anniversary up...
Risk factors for invasive fungal disease in heart transplant recipients.
The Journal of Heart and Lung Transplantation 34(2):227 (2015)
Heart transplant (HT) recipients are at risk for invasive fungal disease (IFD), a morbid and potentially fatal complication.
We performed a retrospective cohort study to evaluate the incidence and risk factors for IFD in HT recipients from 1995 to 2012 at a single center. IFD cases were classifi...
Out of Africa--caring for patients with Ebola.
New England Journal of Medicine 371(25):2430 (2014)
Although the Ebola virus was recognized in 1976,1 until now Ebola virus disease (EVD) had been confined to remote areas in Africa, occurring in discrete outbreaks. Even with the thousands of cases in the current outbreak, most cases occur in areas where tragically few resources are ava...
A breath fungal secondary metabolite signature to diagnose invasive aspergillosis.
Clinical Infectious Diseases 59(12):1733 (2014)
Invasive aspergillosis (IA) remains a leading cause of mortality in immunocompromised patients, in part due to the difficulty of diagnosing this infection.
Using thermal desorption-gas chromatography/mass spectrometry, we characterized the in vitro volatile metabolite profile of Aspergillus fumi...
Hepatitis B virus screening and potential reactivation in patients undergoing treatment for cancer.
Journal of the National Comprehensive Cancer Ne... 12(12):1655 (2014)
Ebola and quarantine.
New England Journal of Medicine 371(21):2029 (2014)
The governors of a number of states, including New York and New Jersey, recently imposed 21-day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease. We understand their motivation fo...
Reply to "Insufficient demonstration of long-term stability of Aspergillus galactomannan".
Journal of Clinical Microbiology 52(11):4119 (2014)
Phase I/II randomized trial of safety and immunogenicity of LIPO-5 alone, ALVAC-HIV (vCP1452) alone, and ALVAC-HIV (vCP1452) prime/LIPO-5 boost in healthy, HIV-1-uninfected adult participants.
Clinical and Vaccine Immunology 21(11):1589 (2014)
Finding an effective human immunodeficiency virus type 1 (HIV-1) vaccine remains a major global health priority. In a phase I/II, placebo-controlled trial, healthy, HIV-1-negative adults were randomized to receive one of 5 vaccine regimens: LIPO-5 (combination of 5 lipopeptides) alone (250 μg), ...
Ebola--an ongoing crisis.
New England Journal of Medicine 371(15):1458 (2014)