Publications by authors named "Bhagani S"

Article Synopsis
  • The study assessed bone mineral density (BMD) in older HIV-positive individuals in Kenya as they enrolled in a clinical trial, focusing on participants aged 60 and above.
  • A total of 296 Black African participants were included, with findings indicating a high prevalence of osteoporosis (37.5%) and osteopenia (47.3%) among them, alongside calculated fracture risks.
  • The research highlighted challenges in diagnosing osteoporosis due to limited access to dual-energy x-ray absorptiometry (DXA) in Kenya, showing a negative correlation between fracture risk probabilities and femoral neck BMD.
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Objectives: The survival rate of people with HIV admitted to intensive care units (ICUs) is approaching that of people without HIV. We conducted a matched-cohort study of people with and without HIV admitted to ICU at a large hospital to compare short-term mortality, during 2000-2019.

Methods: People with HIV were matched to people without HIV (1:2) on age, sex, admission year and Acute Physiology and Chronic Health Evaluation (APACHE)-II score.

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  • Biomarker guided therapy can enhance treatment for COVID-19 patients, with a focus on evaluating the effectiveness of point-of-care (POC) antibody tests in this context.* -
  • Two POC tests, LumiraDX and RightSign, were assessed for their reliability and ease of use against a standard test, with both showing moderate agreement but differing in accuracy and usability.* -
  • The RightSign test was found to be easier to use and more effective at identifying patients without antibodies compared to the LumiraDX test, despite both tests being associated with clinical outcomes.*
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Objectives: People with HIV are at increased risk for metabolic dysfunction-associated steatohepatitis (MASH). Although sex differences are documented in the general population, their role in the context of HIV is less understood.

Methods: This was a multicentre cohort study including people with HIV without viral hepatitis coinfection.

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Background And Aims: HBV and HIV coinfection is a common occurrence globally, with significant morbidity and mortality. Both viruses lead to immune dysregulation including changes in natural killer (NK) cells, a key component of antiviral defense and a promising target for HBV cure strategies. Here we used high-throughput single-cell analysis to explore the immune cell landscape in people with HBV mono-infection and HIV/HBV coinfection, on antiviral therapy, with emphasis on identifying the distinctive characteristics of NK cell subsets that can be therapeutically harnessed.

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Purpose: Although changes in circulating tumour DNA (ctDNA) in breast cancer are well described, the kinetics of their fluctuations has not been described over short timescales. We investigated ctDNA dynamics during alternating cycles of chemotherapy and hormonal treatment in pre-treated patients with oestrogen receptor-positive metastatic breast cancer.

Methods: Patients received alternating, 9-week cycles of eribulin and aromatase inhibitors (AIs).

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  • People with HIV (PWH) admitted to ICUs have a higher risk of mortality, with this study analyzing data from 2000-2019 to focus on 1-year post-ICU admission mortality trends.
  • Among 221 PWH admitted, 108 died within a year, but the overall 1-year mortality risk decreased by 10% annually, adjusted to 7% when accounting for various factors like age and CD4+ count.
  • The findings stress a decline in post-ICU mortality rates over time, indicating a need for further research and ongoing care support for PWH after they're discharged from the hospital.
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Purpose: Gut barrier dysfunction is a pivotal pathophysiological alteration in cirrhosis and end-stage liver disease, which is further aggravated during and after the operational procedures for liver transplantation (LT). In this review, we analyze the multifactorial disruption of all major levels of defense of the gut barrier (biological, mechanical, and immunological) and correlate with clinical implications.

Methods: A narrative review of the literature was performed using PubMed, PubMed Central and Google from inception until November 29th, 2023.

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Bacteremia and endocarditis are two clinical syndromes that, for decades, were managed exclusively with parenteral antimicrobials, irrespective of a given patient's clinical condition, causative pathogen, or its antibiotic susceptibility profile. This clinical approach, however, was based on low-quality data and outdated expert opinions. When a patient's condition has improved, gastrointestinal absorption is not compromised, and an oral antibiotic regimen reaching adequate serum concentrations is available, a switch to oral antibacterials can be applied.

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Article Synopsis
  • The study investigates how the gender and ethnicity of panel members influence audience engagement at a large European hybrid conference, focusing on participation trends among attendees.
  • It involves an observational study during the European AIDS Clinical Society conference, collecting data on audience questions and panel demographics to identify patterns in participation.
  • Results show that men and individuals from white ethnic groups predominantly asked questions, with less diverse panels leading to lower engagement, highlighting the need for improved diversity and inclusion in future conferences for better participation.
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Background & Aims: Short duration treatment may aid HCV elimination among key populations. This study evaluated the efficacy of glecaprevir-pibrentasvir for 4 weeks among people with recent HCV infection.

Methods: In this single-arm multicentre international trial, adults with recent HCV (duration of infection <12 months) received glecaprevir-pibrentasvir 300 mg-120 mg daily for 4 weeks.

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Acute lung injury in COVID-19 results in diffuse alveolar damage with disruption of the alveolar-capillary barrier, coagulation activation, alveolar fibrin deposition and pulmonary capillary thrombi. Nebulized recombinant tissue plasminogen activator (rt-PA) has the potential to facilitate localized thrombolysis in the alveolar compartment and improve oxygenation. In this proof-of-concept safety study, adults with COVID-19-induced respiratory failure and a <300 mmHg PaO/FiO (P/F) ratio requiring invasive mechanical ventilation (IMV) or non-invasive respiratory support (NIRS) received nebulized rt-PA in two cohorts (C1 and C2), alongside standard of care, between 23 April-30 July 2020 and 21 January-19 February 2021, respectively.

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Introduction: Exploration of sexual and drug use behaviours following treatment for recent hepatitis C virus (HCV) is limited. This analysis modelled behavioural trajectories following treatment for recent HCV and assessed reinfection.

Methods: Participants treated for recent HCV in an international trial (enrolled 2017-2019) were followed at 3-monthly intervals for up to 2 years to assess longitudinal behaviours.

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Article Synopsis
  • The study analyzes ICU admission outcomes for people with HIV (PWH) at a UK referral center from 2000 to 2019, highlighting a significant decrease in mortality rates over the years.
  • Among 221 PWH, the study found in-ICU mortality at 29% and in-hospital mortality at 38.5%, with lower respiratory tract infections being the most common reason for admission.
  • Despite adjustments for various patient factors, mortality rates continued to decline, suggesting improvements in critical care and patient health due to advances in treatment.
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Objective: Reinfection poses a challenge to hepatitis C virus (HCV) elimination. This analysis assessed incidence of, and factors associated with reinfection among people treated for recent HCV (duration of infection <12 months).

Methods: Participants treated for recent HCV (primary infection or reinfection) in an international randomized trial were followed at 3-monthly intervals for up to 2 years to assess for reinfection.

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Background: There is a paucity of data on kidney impairment among older people living with HIV (PLWH). We evaluated kidney function among PLWH age ≥ 60 years on first-line antiretroviral (ARV) therapy during screening for a clinical trial in Kenya.

Methods: The bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) Elderly Study is an open-label, randomized, active-controlled, non-inferiority trial conducted at two sites in Kenya.

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Background: Microelimination of the hepatitis C virus (HCV) among men who have sex with men (MSM) could be complicated by continuous external introductions and the emergence of phylogenetic clusters harbouring clinically significant resistance-associated substitutions (RAS). To investigate international clustering and the prevalence and transmission of RAS, we aimed to analyse whole-genome HCV sequences from MSM with a recently acquired infection who participated in a large, international HCV treatment trial.

Methods: For this whole-genome analysis, we obtained HCV sequences from 128 MSM who had acquired HCV within the past 12 months and were participating in the REACT trial.

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Background And Aims: People living with HIV (PLWH) are at high risk for advanced chronic liver disease and related adverse outcomes. We aimed to validate the prognostic value of non-invasive scores based on liver stiffness measurement (LSM) and on markers of portal hypertension (PH), namely platelets and spleen diameter, in PLWH.

Methods: We combined data from eight international cohorts of PLWH with available non-invasive scores, including LSM and the composite biomarkers liver stiffness-spleen size-to-platelet ratio score (LSPS), LSM-to-Platelet ratio (LPR) and PH risk score.

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Background: Nonalcoholic fatty liver disease (NAFLD) is frequent in people with human immunodeficiency virus (PWH). The Fibroscan-aspartate aminotransferase (FAST) score was developed to identify patients with nonalcoholic steatohepatitis (NASH) and significant fibrosis. We investigated prevalence of NASH with fibrosis and the value of FAST score in predicting clinical outcomes in PWH.

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Article Synopsis
  • Late diagnosis of HIV significantly contributes to higher in-ICU mortality rates, with 28% of patients having recent late diagnosis linked to worse health outcomes.
  • A study analyzed data from 2000 to 2019, finding that in-ICU mortality was 27%, with those diagnosed late facing a 38% mortality rate compared to 22% for those diagnosed earlier.
  • The research indicates that 17.08% of in-ICU deaths are attributable to recent late diagnosis, underlining the need for enhanced HIV testing and earlier diagnosis in healthcare.
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Background: Using direct-acting antivirals (DAAs) for recently acquired hepatitis C virus (RAHCV) infections, particularly in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), dramatically reduced the incidence of hepatitis C. However, implementation into clinical practice is challenging. The aim of this study was to analyze spontaneous clearance (SC) rates of RAHCV and to identify predictors of SC.

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Background: Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection.

Objective: To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone.

Design: Double-blind, randomized, placebo-controlled, clinical trial.

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