Publications by authors named "Balagopal A"

Background: Hepatitis C virus (HCV) infects nearly one-fourth of people with HIV (PWH). The role of direct-acting antivirals (DAAs) on immune activation in PWH and HCV is poorly understood.

Methods: We quantified plasma HCV RNA and CXCL10 in persons with HCV mono- versus HIV/HCV co-infection receiving Sofosbuvir-Velpatasvir.

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Unlabelled: Hypoxemia in coronavirus disease 2019 (COVID-19) patients is not solely due to alveolar damage but can also involve factors like vascular shunts, such as pulmonary arteriovenous malformation, contributing to persistent hypoxemia. We report a case of a 59-year-old male, with COVID-19 pneumonia, requiring high-flow respiratory support, who later was also diagnosed with a large pulmonary arteriovenous fistula, which probably worsened because of COVID-19 infection.

Learning Points: Hypoxemia in coronavirus disease 2019 (COVID-19) patients is multifaceted not only with alveolar damage but also with other factors such as vascular shunts, like pulmonary arteriovenous malformation.

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The presence of the HIV-1 reservoir, a group of immune cells that contain intact, integrated, and replication-competent proviruses, is a major challenge to cure HIV-1. HIV-1 reservoir cells are largely unaffected by the cytopathic effects of viruses, antiviral immune responses, or antiretroviral therapy (ART). The HIV-1 reservoir is seeded early during HIV-1 infection and augmented during active viral replication.

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Background: People with HIV (PWH) who are coinfected with hepatitis B virus (HBV) have a higher risk of mortality compared with PWH alone. Populations such as people who inject drugs (PWID) and men who have sex with men (MSM) are particularly at high risk for HBV acquisition; yet, limited epidemiological data from these populations exist on HBV prevalence from low- and middle-income country settings (LMICs).

Methods: We characterized the prevalence and correlates of HBV serological markers in a sample of PWID and MSM with HIV recruited across 15 Indian cities using hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs).

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The hepatitis B virus (HBV) infects hepatocytes and hijacks host cellular mechanisms for its replication. Host proteins can be frontline effectors of the cell's defense and restrict viral replication by impeding multiple steps during its intracellular lifecycle. This review summarizes many of the well-described restriction factors, their mechanisms of restriction, and counteractive measures of HBV, with a special focus on viral transcription.

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After recovery from a hepatitis B virus (HBV) infection, reactivation can occur with immunosuppression; thus, it is assumed that replication competent HBV persists in the liver. We sought to detect persistent HBV from 13 people with spontaneous recovery. We quantified HBV DNA and RNA in core liver biopsy specimens (median, 1.

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Article Synopsis
  • - Osteopetrosis (OP) is a rare hereditary bone disorder characterized by excessive bone density due to faulty bone resorption by osteoclasts, leading to a variety of clinical issues.
  • - The disorder can cause serious complications if not identified and treated early, as demonstrated in a case of a female patient with chronic draining sinus and a fracture in the jaw.
  • - Early diagnosis of OP could have allowed for more conservative management of the patient’s symptoms and prevented further complications.
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Background And Purpose: Radiation-induced erectile dysfunction (RiED) commonly affects prostate cancer patients, prompting clinical trials across institutions to explore dose-sparing to internal-pudendal-arteries (IPA) for preserving sexual potency. IPA, challenging to segment, isn't conventionally considered an organ-at-risk (OAR). This study proposes a deep learning (DL) auto-segmentation model for IPA, using Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) or CT alone to accommodate varied clinical practices.

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Aims And Background: Extracorporeal membrane oxygenation (ECMO) is a mode of extracorporeal therapy to support oxygenation of patients with severe cardiac or respiratory failure. Studies have shown that acute kidney injury (AKI) can worsen the outcome in these patients. This study aims to assess the incidence and outcome of AKI in patients on ECMO support.

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Epilepsy is an enduring predisposition of the brain to generate epileptic seizures and has a worldwide incidence of 21-24 per 100,000 cases among children. Epilepsy is a multifactorial disease; however, certain risk factors are predicted to increase its incidence. Abnormal brain development during prenatal life, particularly during the last trimester, is considered to play a crucial role in the development of certain neurological disorders.

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The latent viral reservoir (LVR) remains a major barrier to HIV-1 curative strategies. It is unknown whether receiving a liver transplant from a donor with HIV might lead to an increase in the LVR because the liver is a large lymphoid organ. We found no differences in intact provirus, defective provirus, or the ratio of intact to defective provirus between recipients with ART-suppressed HIV who received a liver from a donor with (n = 19) or without HIV (n = 10).

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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare inherited disease that presents with neurologic manifestations such as stroke, psychiatric disturbances, migraine, and cognitive decline. We report a case of a previously well 27-year-old lady presenting with new onset confusion four weeks postpartum. On examination, there was right-sided weakness and tremors.

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Background: Nucleos(t)ide analogues (NUCs) rarely cure chronic hepatitis B (CHB) because they do not eliminate covalently closed circular deoxyribonucleic acid, the stable replication template. In hepatitis B e antigen (HBeAg)-positive CHB during NUCs, HBV-infected cells decline slowly and are transcriptionally silenced. Whether these occur in HBeAg-negative CHB is unknown.

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Background: Mathematical models explain how antivirals control viral infections. Hepatitis C virus (HCV) treatment results in at least 2 phases of decline in viremia. The first phase reflects clearance of rapidly produced virions.

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Background: Control of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission requires understanding SARS-CoV-2 replication dynamics.

Methods: We developed a multiplexed droplet digital polymerase chain reaction (ddPCR) assay to quantify SARS-CoV-2 subgenomic RNAs (sgRNAs), which are only produced during active viral replication, and discriminate them from genomic RNAs (gRNAs). We applied the assay to specimens from 144 people with single nasopharyngeal samples and 27 people with >1 sample.

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Background: It is important to maintain the safety of blood products by avoiding the transfusion of units with known and novel viral pathogens. It is unknown whether COVID-19 convalescent plasma (CCP) may contain pathogenic viruses (either newly acquired or reactivated) that are not routinely screened for by blood centers.

Methods: The DNA virome was characterized in potential CCP donors (n = 30) using viral genome specific PCR primers to identify DNA plasma virome members of the Herpesviridae [Epstein Barr Virus (EBV), cytomegalovirus (CMV), human herpesvirus 6A/B, human herpesvirus 7] and Anelloviridae [Torque teno viruses (TTV), Torque teno mini viruses (TTMV), and Torque teno midi viruses (TTMDV)] families.

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Purpose: To present a concept called artificial intelligence-assisted contour editing (AIACE) and demonstrate its feasibility.

Materials And Methods: The conceptual workflow of AIACE is as follows: Given an initial contour that requires clinician editing, the clinician indicates where large editing is needed, and a trained deep learning model uses this input to update the contour. This process repeats until a clinically acceptable contour is achieved.

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Neuroendocrine prostate cancer (NEPC) represents a highly aggressive form of prostate tumors. NEPC results from trans-differentiated castration-resistant prostate cancer (CRPC) with increasing evidence indicating that the incidence of NEPC often results from the adaptive response to androgen deprivation therapy. Recent studies have shown that a subset of NEPC exhibits overexpression of the oncogene along with the loss of tumor suppressing TP53 and RB1 activities.

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We report a search for nonstandard neutrino interactions (NSI) using eight years of TeV-scale atmospheric muon neutrino data from the IceCube Neutrino Observatory. By reconstructing incident energies and zenith angles for atmospheric neutrino events, this analysis presents unified confidence intervals for the NSI parameter ε_{μτ}. The best-fit value is consistent with no NSI at a p value of 25.

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The focus of hepatitis B functional cure, defined as sustained loss of hepatitis B virus (HBV) surface antigen (HBsAg) and HBV DNA from blood, is on eliminating or silencing the intranuclear template for HBV replication, covalently closed circular DNA (cccDNA). However, HBsAg also derives from HBV DNA integrated into the host genome (iDNA). Little is known about the contribution of iDNA to circulating HBsAg with current therapeutics.

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Purpose: Typically, the current dose prediction models are limited to small amounts of data and require retraining for a specific site, often leading to suboptimal performance. We propose a site-agnostic, three-dimensional dose distribution prediction model using deep learning that can leverage data from any treatment site, thus increasing the total data available to train the model. Applying our proposed model to a new target treatment site requires only a brief fine-tuning of the model to the new data and involves no modifications to the model input channels or its parameters.

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