Publications by authors named "Willington Amutuhaire"

Article Synopsis
  • The study aimed to investigate blood glucose outcomes in people with HIV (PWH) who have pre-diabetes and are starting treatment with dolutegravir compared to those with normal glucose levels.
  • Researchers conducted a matched cohort study with 44 PWH with pre-diabetes and 88 with normal glucose, measuring changes in fasting and 2-hour blood glucose levels at various points over 48 weeks.
  • Results showed that while those with normal glucose experienced an increase in fasting blood glucose, those with pre-diabetes saw a significant decrease, indicating improvement in glucose metrics, questioning the need for intensive glucose monitoring in the initial months of dolutegravir treatment.
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In this cohort study, we determined time to blood pressure (BP) control and its predictors among hypertensive PLHIV enrolled in integrated hypertension-HIV care based on the World Health Organization (WHO) HEARTS strategy at Mulago Immunosuppression Clinic in Uganda. From August 2019 to March 2020, we enrolled hypertensive PLHIV aged 18 years and initiated Amlodipine 5 mg mono-therapy for BP (140-159)/(90-99) mmHg or Amlodipine 5 mg/Valsartan 80 mg duo-therapy for BP ≥ 160/90 mmHg. Patients were followed with a treatment escalation plan until BP control, defined as BP < 140/90 mmHg.

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Dolutegravir (DTG), an integrase strand transfer inhibitor is currently the recommended first and second line anti-retroviral therapy (ART) anchor agent by the World Health Organization due to its favorable side effect profile, high efficacy and genetic barrier to resistance.Despite its very good side effect profile, there have been multiple case reports of ART experienced patients developing hyperglycemia within weeks to a few months after switching to DTG preceded by weight loss. At population level, however, DTG as well as other integrase inhibitors have been demonstrated to have a reduced risk of incident diabetes mellitus (T2DM) compared to other HIV drug classes.

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Veterans living with HIV have up to twice the risk of atherosclerotic cardiovascular disease (ASCVD) compared to those without HIV. Our study seeks to test a non-physician led virtual self-management implementation strategy to reduce ASCVD risk among people living with HIV (PWH). We aim to conduct a randomized control trial among PWH ( = 300) with a diagnosis of hypertension (HTN) who are enrolled in Veterans Health Administration (VHA) clinics, on suppressive antiretroviral therapy (ART), randomized 1:1 to intervention education control for a 12-month duration.

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Dolutegravir (DTG), an integrase strand transfer inhibitor is currently the recommended first and second line anti-retroviral therapy (ART) anchor agent by the World Health Organization. This followed widespread reports of primary resistance to non-nucleoside reverse transcriptase inhibitors. Despite its very good side effect profile, there have been multiple case reports of ART experienced patients developing hyperglycemia within weeks to a few months after switching to DTG preceded by weight loss.

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Article Synopsis
  • The Uganda Ministry of Health recommends regular blood glucose monitoring for HIV patients with pre-diabetes starting dolutegravir.
  • In a study comparing 44 HIV patients with pre-diabetes to 88 with normal glucose levels, significant changes in fasting blood glucose after 48 weeks were observed.
  • HIV patients with pre-diabetes showed improved blood glucose outcomes over 48 weeks, suggesting that intensive monitoring may not be necessary in the first six months of treatment.
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Article Synopsis
  • Cardiometabolic diseases significantly contribute to health issues in people living with HIV (PWH), yet screening is often neglected in countries like Uganda.
  • A study involving 309 ART-naïve Ugandan adults with HIV found a 13.9% prevalence of metabolic syndrome (MetS), with dyslipidemia being the most common issue.
  • Risk factors for MetS included being over 40 years old and having a CD4 count greater than 200 cells/mm, indicating the need for better monitoring and management of these conditions in similar regions.
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Article Synopsis
  • The study aimed to investigate the risk of developing Type 2 Diabetes Mellitus (T2DM) in ART-naïve Ugandan individuals living with HIV after starting dolutegravir (DTG) treatment for 48 weeks.
  • Among 243 participants, the incidence of T2DM was low, with only 1 case reported, while there was a significant occurrence of pre-diabetes (54 cases). Blood glucose levels showed notable changes, indicating fluctuations independent of traditional T2DM risk factors.
  • The findings suggest that, despite concerns, initiating DTG treatment in this population may not substantially increase T2DM risk within the first year, though monitoring is still advised for those with risk factors.
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In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epidemiological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade.

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The development of Parkinson's disease is accompanied by concurrent activation of caspase-3 and apoptosis of dopaminergic neurons of human patients and rodent models. The role of caspase-3, a final executioner of apoptosis, in the pathogenesis of Parkinson's disease, however, remains to be determined. Here, we show that gene disruption of caspase-3 protects mice from 1-methyle-4-phenyl-1,2,3,6-tetrahmydropyridine (MPTP)-induced Parkinsonian syndrome, as reflected by reversal of MPTP-induced bradykinesia and decreased tyrosine hydroxylase expression in the nigra-striatum.

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