Publications by authors named "M J Lain"

Biofilm-associated microorganisms can cause many infections and are an important cause of resistance to several antimicrobials. The antibiotic crisis has led to a pressing need for new therapeutic tools. Ambroxol is frequently used as a mucolytic agent in respiratory diseases with increased mucus production.

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EPIICAL (Early treated Perinatally HIV-Infected individuals: Improving Children's Actual Life) is a consortium of European and non-European research-driven organizations inter-connected with the aim of establishing a clinical and experimental platform for the early identification of novel therapeutic strategies for the pediatric Human Immunodeficiency Virus (HIV). Within the EPIICAL project, several pediatric clinical studies were conducted, requiring the collection and transfer of biological samples and associated data across boundaries within and outside Europe. To ensure compliance with the applicable rules on pediatric data and sample transfer and to support the efforts of academic partners, which may not always have the necessary expertise and resources in place for designing, managing and conducting multi-national studies, the consortium established a dedicated expert Working Group.

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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.

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Article 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.
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Analytical treatment interruption (ATI) is widely acknowledged as an essential component of studies to advance our understanding of HIV cure, but discussion has largely been focused on adults. To address this gap, we reviewed evidence related to the safety and utility of ATI in paediatric populations. Three randomised ATI trials using CD4 T-cell and clinical criteria to guide restart of antiretroviral therapy (ART) have been conducted.

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