Brian Epling
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View article: Idiopathic CD4+ Lymphocytopenia Is Associated with Alterations of the Gut Microbiome
Idiopathic CD4+ Lymphocytopenia Is Associated with Alterations of the Gut Microbiome Open
Background Idiopathic CD4 lymphocytopenia (ICL) is a rare immunodeficiency disorder characterized by low circulating CD4+ T cells (<300 cells/μl) in the absence of HIV or any other immunosuppressive condition or therapy. Patients with I…
View article: Infection‐Associated Immune Reconstitution Inflammatory Syndrome in Hematopoietic Cell Transplantation
Infection‐Associated Immune Reconstitution Inflammatory Syndrome in Hematopoietic Cell Transplantation Open
Immune reconstitution inflammatory syndrome (IRIS) is a well‐recognized complication in people with HIV (PWH) starting antiretroviral therapy (ART), but data on IRIS in hematopoietic cell transplantation (HCT) recipients are limited. To ad…
View article: Plasma mcfDNA Sequencing May Improve Usual Care Diagnostics to Detect HHV-8 Among Outpatient People with Advanced HIV
Plasma mcfDNA Sequencing May Improve Usual Care Diagnostics to Detect HHV-8 Among Outpatient People with Advanced HIV Open
Background: Human herpesvirus-8 (HHV-8), or Kaposi sarcoma (KS)-associated herpesvirus (KSHV), causes severe disease in people with profound immunosuppression. Yet, diagnosing KS can be challenging given the diverse manifestations and curr…
View article: Impact of Anti-CD4 Autoantibodies on Immune Reconstitution in People With Advanced HIV
Impact of Anti-CD4 Autoantibodies on Immune Reconstitution in People With Advanced HIV Open
Background Despite suppressive antiretroviral therapy (ART), 15%–30% of people with human immunodeficiency virus (HIV) experience a limited recovery of CD4 T cells. Although autoantibodies against the CD4 receptor have previously been iden…
View article: Perplexing paradoxical reactions: navigating the complexity of protracted tuberculosis meningitis—a case report
Perplexing paradoxical reactions: navigating the complexity of protracted tuberculosis meningitis—a case report Open
Tuberculous meningitis (TBM) has considerable mortality and morbidity, and it often presents therapeutic challenges when complicated by paradoxical reactions (PRs). Here, the clinical course of four cases of TBM patients complicated by PRs…
View article: Prevalence of anti-lymphocyte IgM autoantibodies driving complement activation in COVID-19 patients
Prevalence of anti-lymphocyte IgM autoantibodies driving complement activation in COVID-19 patients Open
Introduction COVID-19 patients can develop autoantibodies against a variety of secreted and membrane proteins, including some expressed on lymphocytes. However, it is unclear what proportion of patients might develop anti-lymphocyte antibo…
View article: Prolonged Mpox Disease in People With Advanced HIV: Characterization of Mpox Skin Lesions
Prolonged Mpox Disease in People With Advanced HIV: Characterization of Mpox Skin Lesions Open
We report 3 complicated and prolonged cases of mpox in people with advanced human immunodeficiency virus (HIV) not on antiretroviral therapy (ART) at mpox diagnosis. Multiple medical countermeasures were used, including prolonged tecovirim…
View article: 2701. Mycobacterial Immune Reconstitution Inflammatory Syndrome Following Hematopoietic Cell Transplantation for GATA2 Deficiency
2701. Mycobacterial Immune Reconstitution Inflammatory Syndrome Following Hematopoietic Cell Transplantation for GATA2 Deficiency Open
Background Immune reconstitution inflammatory syndrome (IRIS) was first described in patients with HIV and opportunistic infections starting antiretroviral therapy, but may be seen following hematopoietic cell transplantation (HCT) in pati…
View article: Long-term Outcomes of Patients With HIV and <i>Pneumocystis jirovecii</i> Pneumonia in the Antiretroviral Therapy Era
Long-term Outcomes of Patients With HIV and <i>Pneumocystis jirovecii</i> Pneumonia in the Antiretroviral Therapy Era Open
Background Pneumocystis jirovecii pneumonia (PCP) is one of the most frequent opportunistic infections in people with HIV (PWH). However, there are limited data on long-term outcomes of PCP in the antiretroviral therapy (ART) era. Methods …
View article: Lack of Evidence for a Role of ACE-2 Polymorphisms as a Bedside Clinical Prognostic Marker of COVID-19
Lack of Evidence for a Role of ACE-2 Polymorphisms as a Bedside Clinical Prognostic Marker of COVID-19 Open
The novel SARS-CoV-2 coronavirus causes a severe respiratory syndrome referred to as coronavirus disease (COVID-19). The angiotensin-converting enzyme 2 (ACE-2) plays an important role as a cellular receptor for SARS-CoV-2 and is largely e…
View article: Clinical, Virologic, and Immunologic Evaluation of Symptomatic Coronavirus Disease 2019 Rebound Following Nirmatrelvir/Ritonavir Treatment
Clinical, Virologic, and Immunologic Evaluation of Symptomatic Coronavirus Disease 2019 Rebound Following Nirmatrelvir/Ritonavir Treatment Open
Background Nirmatrelvir/ritonavir, the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) protease inhibitor, reduces the risk of hospitalization and death by coronavirus disease 2019 (COVID-19) but has been associated with…
View article: Cefiderocol and the Need for Higher-Quality Evidence: Methods Matter for Patients
Cefiderocol and the Need for Higher-Quality Evidence: Methods Matter for Patients Open
Falcone et al. (1) raise important questions regarding the role of cefiderocol in managing carbapenem-resistant Acinetobacter baumannii (CRAB) infections. The authors note the randomized controlled CREDIBLE-CR trial (RCT) that demonstrated…
View article: COVID-19 redux: clinical, virologic, and immunologic evaluation of clinical rebound after nirmatrelvir/ritonavir
COVID-19 redux: clinical, virologic, and immunologic evaluation of clinical rebound after nirmatrelvir/ritonavir Open
Clinical rebound of COVID-19 after nirmatrelvir/ritonavir treatment has been reported. We performed clinical, virologic, and immune measurements in seven patients with symptomatic rebound, six after nirmatrelvir/ritonavir treatment and one…