Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
Yale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection Recovery And Cerebrospinal Fluid Escape AfterAntiretroviral Therapy Initiation In Acute Hiv-1 InfectionRyan Christopher HandokoFollow this and additional works at: https://elischolar.library.yale.edu/ymtdlRecommended CitationHandoko, Ryan Christopher, 'Cd4+ T Cell Recovery And Cerebrospinal Fluid E Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection scape After Antiretroviral Therapy Initiation In Acute Hiv-1 Infection' (2020). Yale Medicine Thesis Digital Library. 3907.https://elischolar.library.Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
yale.edu/ymtdl/3907This Open Access Thesis is brought to you for free and open access by the School of Medicine at EliScholar - A Digital Platform forYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection - A Digital Platform for Scholarly Publishing at Yale. For more information, please contact elischoiargjyale edu.CD4+ T Cell Recovery and Cerebrospinal Fluid Escape After Antirettovữal Therapy Initiation illAcute HIV-1 InfectionA Thesis Submitted to theYale University School of MedicineHl Partial F Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection ulfillment of the Requirements for theDegree of Doctor in MedicinebyRyan Christopher Handoko2020AbstractIntroduction: Up to 30% of individuals treatedLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
with antiretroviral therapy (ARI ) dining chronic HIV fail to recover CD4 counts to >500 cells him ' and up to 10% have quantifiable HIV RNA in cerebYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection est stage of identifiable infection, acute 111V infection (prior to antibody seroconversion), may limit viral reservoir establishment and systemic immune activation and may improve clinical outcomes. We investigated the frequency, associations, and outcomes of suboptimal CD I recovery (Project 1) an Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection d CSF escape (Project 2) after ART started during acute HIV infection (AHI)Methods: Thai participants with laboratory*confumed diagnosis of .AHI (ITebLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
ig stages I to V) were started immediately on ART and followed longitudinally with blood sampling, neuropsychological and neiuobeliavioral testing, anYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection udy visit to suboptimal recovery (SR: CD4<350 cells nun'), intermediate recovery (IR1 350Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
g at weeks 24 and 96 were assessed for CSF escape. HIV RNA was quantified using Roche Amplicor and COBAS laqMan assay s with a lower limit of quantitaYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection identified as cases of CS1 escape.Results. Project 1: of 304 participants (96° 0 male, median 26 years old) evaluated after median 144 (range 60-420) weeks of ART initiated at median 19 days (range 1-62) post-exposure. 3.6% (n=l 1) had SR. 14.5% (11=44) had IR. and 81.9% (11=249) had CR. Degree of C Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection D4 recovery occurred early following ART. Timing of ART initiation by Fiebig stage did not affect CD4 count dining treatment. Pre-ART CD4 count in SRLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
compared to CR participants was 265 vs 411 cells nmr (p=0 002). Following .ART. the CD8- T cell count (p=0.001) and CD4 'CD8 ratio (p=0.047) were loweYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection .04) in plasma, without differences 111 neuropsychological or psychiatric indices. After adjusting for duration of ART. baseline HIV-RNA, and baseline CD4 count, odds of CD4 recovery < 500 cells nun5 were higher in those with baseline CD4 CDS ratio < 1 (odds ratio 3.2. p=0.01). CHART CD4.'CDS ratio Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection < 1 (odds ratio 2.4. p=0 007). and on-ART CDS count < 500 cells inn? (odds ratio 3.1. p=0.0005).Results. Project 2: 204 participants had paired bloodLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
and CSF sampling 111 at least one visit at baseline, week 24. 01 week 96. The participants weie 98% male (199 204) with median age 26 years and baseliYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection mated infection. At baseline. 126.165 participants (76%) had quantifiable CSF HIV RNA (median 3.13 logic copies inL). At week 24 (11=90). two participants (2%) had quantifiable CSF HIV RNA. with one case of CSF escape identified with plasma HI\’ RNA < 50 copies niL and CSF HIX’ RNA 2.50 logic copies Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection inL. At week 96 (11=55). one participant (2%) had quantifiable CSF HIX' RNA. which did not meet criteria for CSF escape. The two other cases of quantLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
ifiable CSF HIX’ RNA were due to plasma HIX’ RNA > CSF HIX’ RNA. The participant with CSF escape was treatedwith efavirenz. tenofovu. and lamivudme anYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection yperintense focus in the right high frontal white matter. He did not have a lumbar puncture performed at baseline nor at subsequent visits.Conclusions: Despite inunediate and sustained treatment 111 AHI. suboptnnal CD4 recovery IS observed in rare individuals, associated with low pre-ART CD4 count a Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection s well as persistent low CDS count and CD4-CD8 ratio during treatment. While levels of CSF HIV RNA 111 untreated AHI are high, initiating treatment diLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
ning AHI results in a very low rate of CSF escape in the fust two years of ART. The low rate of CSF escape may also be impacted by high levels of adheYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection erm ART U1 early treated individuals.AcknowledgmentsI am first and foremost indebted to my incredible mentor. Serena Spudich. for her selfless dedication of rime and energy, for her thoughtfill attention to developing my skillset and my career, and for the inquisitiveness, compassion, and kindness m Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection odelled as the very clinician, scientist, and mentor I aspire one day to become Without her guidance, my medical school and career trajectory' would hLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
ave been substantially less illuminating, stimulating, and vibrant.I am immensely grateful for the kind mentorship of Payal Patel fol taking me aboardYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection stance with data management, and has been a constant source of joy and friendliness ever since I first joined the gloup. My gratitude extends to additional member's of the spudich group for then collegiality and the delights of working together, including Shelli Farhadian, Rachela Calvi. and Michell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection e ChintanapholI am extremely grateful to my Thai collaborators for hosting me 111 August 2019 and for allowing me to attend the 2019 Bangkok InvestigaLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
tors Meeting. Eugene Kroon. Domi Colby. Phillip Chan, and Robert Paul have been incredible collaborators and teachers throughout my years working withYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T Cell Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection ningfully, for the inspiration they evoke as pediatrician-scientists Thanyawee Puthanakit graciously took me on as a learner of pediatric infectious diseases and HIV at King Chulalongkorn Memorial Hospital while I was in Thailand. Suteeiaporn “Meaw" Pinyakom has been an enormous source of statistica Luận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection l and data support. The HIV-NAT biostatistics team—Steve Ken. Jiratchaya “Kor” Sophonphan. and Tanakom ’’Soin" Apompong—took me in as one of their ownLuận văn Thạc sĩ Cd4+ T Cell Recovery And Cerebrospinal Fluid Escape After Antiretroviral Therapy Initiation In Acute Hiv1 Infection
. showed me the ropes inYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cd4+ T CellGọi ngay
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