Publications by authors named "R A Peck"
Background: People living with HIV (PLWH) have a higher prevalence of diastolic dysfunction and left ventricular hypertrophy (LVH) in cross-sectional studies. Longitudinal data are lacking, especially from Africa.
Objectives: The aim was to examine: 1) the incidence of diastolic dysfunction in PLWH compared to community controls in Tanzania; 2) the progression of diastolic function and LVH in PLWH after antiretroviral therapy initiation; and 3) traditional, endemic, and HIV-specific risk factors for diastolic function and LVH.
Rationale & Objective: Longitudinal research on chronic kidney disease (CKD) in sub-Saharan Africa is sparse, especially among people living with HIV (PLWH). We evaluated the incidence of CKD among PLWH compared with HIV-uninfected controls in Tanzania.
Study Design: Prospective cohort study.
Background: There is high post-hospital discharge mortality among persons with HIV who are hospitalized, and post-hospital survival is strongly associated with early HIV clinic linkage, clinic attendance, and antiretroviral therapy adherence. The Daraja intervention, a context-tailored case management strategy implemented and tested through a randomized trial in Tanzania, was associated with improved HIV clinic linkage, retention, and ART initiation and adherence.
Methods: We conducted in-depth interviews (IDIs) in a sub-sample of 40 study participants (20 control and 20 intervention) 12 months after enrollment into the trial to gain an in-depth understanding of the barriers to HIV care engagement and the perceived mechanisms through which the Daraja intervention impacted these barriers.
Article Synopsis
- Cardiovascular disease (CVD) is a leading cause of premature death among people living with HIV (PLWH), especially in resource-limited settings like Sub-Saharan Africa.
- A study analyzed cardiovascular health profiles of 995 participants (492 PLWH and 503 HIV-uninfected) in Mwanza, Tanzania, using modified definitions and Poisson regressions.
- While PLWH showed better metrics in body mass index, blood pressure, and cholesterol, they had higher smoking rates and lower physical activity, indicating that CVD prevention efforts should prioritize smoking cessation and increasing physical activity levels.
Lipoarabinomannan (LAM) is a promising target biomarker for diagnosing subclinical and clinical tuberculosis (TB). Urine LAM (uLAM) testing using rapid diagnostic tests (RDTs) has been approved for people living with HIV (PLWH), however there is limited data regarding uLAM levels in HIV-negative (HIV-ve) adults with clinical TB. We conducted a clinical study of adults presenting with clinical TB-related symptoms at the National Lung Hospital in Hanoi, Vietnam.
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