Publications by authors named "A Violari"
For the 1.6 million adolescents currently living with HIV, adherence to antiretroviral therapy (ART) is vitally important for reducing HIV-associated morbidity and mortality, and for preventing onward HIV transmission. Unfortunately, ART adherence is particularly low among adolescents.
View Article and Find Full Text PDFBackground: The neonatal immune system is uniquely poised to generate broadly neutralizing antibodies (bnAbs) and thus infants are ideal for evaluating HIV vaccine candidates. We present the design and safety of a novel glucopyranosyl lipid A (GLA)-stable emulsion (SE) adjuvant admixed with a first-in-infant CH505 transmitter-founder (CH505TF) gp120 immunogen designed to induce precursors for bnAbs against HIV.
Methods: HVTN 135 is a phase I randomized, placebo-controlled trial of CH505TF+GLA-SE or placebo.
In this work our aim was to identify early biomarkers in plasma samples associated with mortality in children with perinatal HIV treated early in life, to potentially inform early intervention targeting this vulnerable group. 20/215 children (9.3%) with perinatal HIV, enrolled within 3 months of age died prematurely within the first year of the study, despite early ART initiation.
View Article and Find Full Text PDFArticle Synopsis
- The study examined outcomes for infants with perinatally-acquired HIV who started early ART in South Africa, Mozambique, and Mali, focusing on mortality, viral suppression, and engagement in care over three years.
- Out of 215 infants monitored, the 1-year death probability was 10%, which rose to 12% by the second and third years, with high baseline viral load identified as a significant risk factor for mortality.
- Of the children, only 42% maintained sustained viral control for a year, with adherence to ART deemed optimal in 81% of visits, although lower adherence was linked to female sex at birth, younger diagnosis age, and adverse maternal social circumstances.