Publications by authors named "D Ashkin"
Background: Cluster and contact investigations aim to identify and treat individuals with tuberculosis (TB) and latent TB infection (LTBI). Although genotyped cluster investigations may be superior to contact investigations in generating additional epidemiological links, this may not necessarily translate into reducing infections. Here, we investigated the impact of genotyped cluster investigations compared to standard contact investigations on the LTBI care cascade in a low incidence setting.
View Article and Find Full Text PDFArticle Synopsis
- The Beijing genotype of Mycobacterium tuberculosis (Mtb) shows no significant difference in transmissibility compared to non-Beijing strains, with slight variances in LTBI prevalence.
- The study analyzed 4,457 TB patients and their 20,448 contacts in Florida over 14 years, concluding that older age, male sex, and certain exposures increase LTBI risk.
- However, the Beijing strain was linked to a higher rate of TB case clustering, indicating it may be more involved in spreading within communities rather than being more transmissible overall.
Background: Concern for drug-drug interactions leading to treatment failure and drug-resistant strains have discouraged clinicians from attempting concomitant treatment of hepatitis C virus (HCV) and tuberculosis (TB). Increased metabolism of direct-acting antivirals (DAAs) by rifamycins has hindered concurrent use. Development of an assay for ledipasvir and sofosbuvir (LDV/SOF) serum concentrations for therapeutic drug monitoring (TDM) can ensure adequate therapy.
View Article and Find Full Text PDFArticle Synopsis
- Rifampin-resistant tuberculosis is a major global health issue, with treatment initiation rates low and often poor outcomes; a 6-month BPaL regimen shows high efficacy but initial high doses of linezolid led to significant side effects.
- Data collected from patients treated with BPaL between October 2019 and April 2022 revealed that 97.1% completed treatment, with only a small percentage experiencing relapse or significant adverse effects, largely due to careful dose adjustments of linezolid.
- The study concludes that the BPaL regimen, especially with individualized linezolid dosing and monitoring, has significantly improved treatment for rifampin-resistant tuberculosis, allowing for shorter treatment durations compared to past guidelines.