Chicago, IL, United States
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Gonzalez M.,The Ruth thstein Core Center | Precht A.,The Ruth thstein Core Center | Fletcher J.,New York University | Catrambone J.,The Ruth thstein Core Center | And 2 more authors.
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV | Year: 2016

ABSTRACT: The current study describes the development of a short pre-clinic survey that helped multidiscipline providers to elicit patient perspective on barriers to HIV primary care. The survey was piloted with 318 patients returning to care after being lost to care for at least 12 months. Reasons for breaks in care were dependent on age, gender, and race. Concerns about confidentiality in care were more commonly reported by African-American, Latino, and younger patients, while concerns relating to acceptance of diagnosis and side effects were greater for women, African-American, and Latino participants. Further, Intimate Partner Violence (IPV) and transportation were greater concerns for women and younger patients in the sample. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

Huhn G.D.,The Ruth thstein Core Center | Huhn G.D.,Rush University Medical Center | Badri S.,The Ruth thstein Core Center | Badri S.,Rush University Medical Center | And 18 more authors.
AIDS Research and Therapy | Year: 2010

Background: In the HAART era, the incidence of HIV-associated non-Hodgkin lymphoma (NHL) is decreasing. We describe cases of NHL among patients with multi-class antiretroviral resistance diagnosed rapidly after initiating newer-class antiretrovirals, and examine the immunologic and virologic factors associated with potential IRIS-mediated NHL.Methods: During December 2006 to January 2008, eligible HIV-infected patients from two affiliated clinics accessed Expanded Access Program antiretrovirals of raltegravir, etravirine, and/or maraviroc with optimized background. A NHL case was defined as a pathologically-confirmed tissue diagnosis in a patient without prior NHL developing symptoms after starting newer-class antiretrovirals. Mean change in CD4 and log10VL in NHL cases compared to controls was analyzed at week 12, a time point at which values were collected among all cases.Results: Five cases occurred among 78 patients (mean incidence = 64.1/1000 patient-years). All cases received raltegravir and one received etravirine. Median symptom onset from newer-class antiretroviral initiation was 5 weeks. At baseline, the median CD4 and VL for NHL cases (n = 5) versus controls (n = 73) were 44 vs.117 cells/mm3 (p = 0.09) and 5.2 vs. 4.2 log10(p = 0.06), respectively. The mean increase in CD4 at week 12 in NHL cases compared to controls was 13 (n = 5) vs. 74 (n = 50)(p = 0.284). Mean VL log10reduction in NHL cases versus controls at week 12 was 2.79 (n = 5) vs. 1.94 (n = 50)(p = 0.045).Conclusions: An unexpectedly high rate of NHL was detected among treatment-experienced patients achieving a high level of virologic response with newer-class antiretrovirals. We observed trends toward lower baseline CD4 and higher baseline VL in NHL cases, with a significantly greater decline in VL among cases by 12 weeks. HIV-related NHL can occur in the setting of immune reconstitution. Potential immunologic, virologic, and newer-class antiretroviral-specific factors associated with rapid development of NHL warrants further investigation. © 2010 Huhn et al; licensee BioMed Central Ltd.

Khawcharoenporn T.,Rush University Medical Center | Khawcharoenporn T.,The Ruth thstein Core Center | Khawcharoenporn T.,Thammasat University | Zawitz C.,The Ruth thstein Core Center | And 4 more authors.
Journal of Correctional Health Care | Year: 2013

This article describes a retrospective cohort study of HIV-infected jail detainees cared for at the Cook County Jail Clinic (CCJC), Illinois, between January and June 2007. Continuity care engagement (CCE) was defined as being seen at least once within 6 months after release at the designated continuity clinics. Being highly active antiretroviral therapy (HAART) naïve during or prior to detention, no prior HIV care, and detectable viral load at initial CCJC visit were associated with continuity care nonengagement (CCNE), while being HAART naïve during detention was the only independent predictor for CCNE. Identification of at-risk detainees and interventions based on these findings should be considered to improve CCE in this population. © The Author(s) 2012.

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