Explanipedia

Estrogen Modulation of B Cell Immunity: Implications for <span>HIV</span> Control and Therapeutic Strategies Open

John Kasibante, Todd T. Brown, Jordan E. Lake, Mohamed Abdel‐Mohsen · 2025

Biological sex profoundly impacts HIV acquisition, disease progression, and persistence. Beyond genetic differences, sex hormones such as estrogen play multifaceted roles in shaping immune responses to HIV. However, the precise effects of …

Utility of Cerebrospinal Fluid Protein Levels as a Potential Predictive Biomarker of Disease Severity in HIV-Associated Cryptococcal Meningitis Open

John Kasibante, Eesha Irfanullah, Abduljewad Wele, Elizabeth C Okafor, Kenneth Ssebambulidde , et al. · 2023

Background Cerebrospinal fluid (CSF) protein levels exhibit high variability in HIV-associated cryptococcal meningitis from being normal to markedly elevated. However, the clinical implications of CSF protein levels in cryptococcal meningi…

5-Flucytosine Longitudinal Antifungal Susceptibility Testing of <i>Cryptococcus neoformans</i>: A Substudy of the EnACT Trial Testing Oral Amphotericin Open

Thomas C McHale, Andrew Akampurira, Elliot S. Gerlach, Atukunda Mucunguzi, Melanie R. Nicol , et al. · 2023

Background The EnACT trial was a phase 2 randomized clinical trial conducted in Uganda, which evaluated a novel orally delivered lipid nanocrystal (LNC) amphotericin B in combination with flucytosine for the treatment of cryptococcal menin…

Diagnosis and management of cryptococcal meningitis in HIV-infected adults Open

Thomas C McHale, David R. Boulware, John Kasibante, Kenneth Ssebambulidde, Caleb P Skipper , et al. · 2023

SUMMARY Cryptococcal meningitis is a leading cause of morbidity and mortality globally, especially in people with advanced HIV disease. Cryptococcal meningitis is responsible for nearly 20% of all deaths related to advanced HIV disease, wi…

1490. Predictors of Early Mortality in HIV-associated Tuberculous Meningitis Open

Enock Kagimu, Ananta Bangdiwala, John Kasibante, Mable Kabahubya, Jane Gakuru , et al. · 2023

Background Tuberculous meningitis (TBM) mortality averages at 27% but may reach 70% in HIV co-infection. High MRC severity grade, lower cerebrospinal fluid (CSF) white blood cell count (WBC) count, low weight, low CD4 and low plasma sodium…

Oral Lipid Nanocrystal Amphotericin B for Cryptococcal Meningitis: A Randomized Clinical Trial Open

David R. Boulware, Mucunguzi Atukunda, Enock Kagimu, Abdu K Musubire, Andrew Akampurira , et al. · 2023

Background Amphotericin B is the gold standard treatment for severe mycoses. A new orally delivered, less-toxic formulation of amphotericin has been developed. Methods In our randomized clinical trial, we tested oral lipid nanocrystal (LNC…

869. Oral Encochleated Amphotericin B for Cryptococcal Meningitis: a Phase II Randomized Trial Open

Mucunguzi Atukunda, Enock Kagimu, Morris K Rutakingirwa, Lillian Tugume, Laura Nsangi , et al. · 2022

Background Intravenous (IV) amphotericin B is the gold standard treatment of severe mycoses. A new orally absorbed, less-toxic formulation of amphotericin has been developed (Matinas Biopharma). We evaluated the efficacy of this novel anti…

Distal jejunal obstruction due to Cryptococcus neoformans and rifampicin-resistant Mycobacterium tuberculosis co-infection: A case report Open

John Kasibante, Enock Kagimu, Morris K Rutakingirwa, Samuel Jjunju, Lillian Tugume , et al. · 2022

Therapeutic Lumbar Punctures in Human Immunodeficiency Virus–Associated Cryptococcal Meningitis: Should Opening Pressure Direct Management? Open

Enock Kagimu, Nicole Engen, Kenneth Ssebambulidde, John Kasibante, Tadeo K Kiiza , et al. · 2022

Background Increased intracranial pressure (ICP) frequently complicates cryptococcal meningitis. Therapeutic lumbar punctures (LPs) have acute survival benefits in the first week, and we sought to understand the longer-term survival impact…

Outpatient Cryptococcal Antigen Screening Is Associated With Favorable Baseline Characteristics and Improved Survival in Persons With Cryptococcal Meningitis in Uganda Open

Anna E Levin, Ananta Bangdiwala, Elizabeth Nalintya, Enock Kagimu, John Kasibante , et al. · 2022

Background It is unknown whether persons with symptomatic cryptococcal meningitis detected during routine blood cryptococcal antigen (CrAg) screening have better survival than persons presenting with overt meningitis. Methods We prospectiv…

Diagnostic and Prognostic Value of Cerebrospinal Fluid Lactate and Glucose in HIV-Associated Tuberculosis Meningitis Open

Edwin Nuwagira, Kathy Huppler Hullsiek, Samuel Jjunju, Morris K Rutakingirwa, John Kasibante , et al. · 2022

Tuberculosis meningitis (TBM) is the most severe form of tuberculosis, and its fatality is largely due to delays in diagnosis. The role of CSF lactate has not been evaluated in patients with HIV presenting with signs and symptoms of mening…

Association of Hyponatremia on Mortality in Cryptococcal Meningitis: A Prospective Cohort Open

Lillian Tugume, Ann Fieberg, Kenneth Ssebambulidde, Edwin Nuwagira, Darlisha A Williams , et al. · 2022

Background Sodium abnormalities are frequent in central nervous system infections and may be caused by cerebral salt wasting, syndrome of inappropriate antidiuretic hormone secretion, or medication adverse events. In cryptococcal meningiti…

Integrating central nervous system metagenomics and host response for diagnosis of tuberculosis meningitis and its mimics Open

Prashanth Ramachandran, Akshaya Ramesh, Fiona V. Creswell, Anne E. Wapniarski, Rithwik Narendra , et al. · 2022

Evaluation of the initial 12 months of a routine cryptococcal antigen screening program in reduction of HIV-associated cryptococcal meningitis in Uganda Open

Enock Kagimu, Julius Kiwanuka, Bridget C. Griffith, Derrick Bary Abila, Morris K Rutakingirwa , et al. · 2022

Neurocognitive outcomes of tuberculous meningitis in a primarily HIV-positive Ugandan cohort Open

Carson Quinn, John Kasibante, Alice Namudde, Ananta Bangdiwala, Mable Kabahubya , et al. · 2022

Background: The toll of tuberculous meningitis (TBM) in both mortality and disability is considerable, but advancements in rehabilitation have the potential to improve the functional abilities and the quality of survivors’ lives. However, …

Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis Open

Joseph N Jarvis, David S. Lawrence, David B. Meya, Enock Kagimu, John Kasibante , et al. · 2022

BACKGROUND: Cryptococcal meningitis is a leading cause of human immunodeficiency virus (HIV)-related death in sub-Saharan Africa. Whether a treatment regimen that includes a single high dose of liposomal amphotericin B would be efficacious…

Neurocognitive outcomes of HIV-associated tuberculous meningitis Open

Carson Quinn, John Kasibante, Alice Namudde, Ananta Bangdiwala, Mable Kabahubya , et al. · 2021

Background: The toll of tuberculous meningitis (TBM) in both mortality and disability is considerable, but advancements in rehabilitation have the potential to improve the functional abilities and the quality of survivors’ lives. However, …

Evaluation of the Initial 12 Months of a Routine Cryptococcal Antigen Screening Program in Reduction of HIV-Associated Cryptococcal Meningitis in Uganda Open

Enock Kagimu, Julius Kiwanuka, Bridget C. Griffith, Derrick Bary Abila, Morris K Rutakingirwa , et al. · 2021

Background: Asymptomatic Cryptococcal Antigenemia (CrAg) patients develop meningitis within a month of testing positive. Pre-emptive antifungal therapy can prevent progression to Cryptococcal meningitis(CM). In April 2016, a national CrAg …

038 Resolving infectious meningitis in uganda with metagenomics and host transcriptomics Open

Prashanth Ramachandran, Akshaya Ramesh, Fiona V. Creswell, Annie Wapniarski, Carson Quinn , et al. · 2021

Objectives Tuberculous meningitis(TBM) is a common cause of meningitis in sub-Saharan Africa. CSF PCR with GeneXpert RIF/MTB Ultra is only 70% sensitive for detection of definite/probable TBM. Many infections can mimic TBM. Metageno…

COVID-19 and the HIV care continuum in Uganda: minimising collateral damage Open

Enock Kagimu, Emily Martyn, Jane Gakuru, John Kasibante, Morris K Rutakingirwa , et al. · 2021

The novel coronavirus, SARS-CoV-2, has spread across the world within months of its first description in Wuhan, China in December 2019, resulting in an unprecedented global health emergency. Whilst Europe and North America are the current …

High-Dose Oral and Intravenous Rifampicin for the Treatment of Tuberculous Meningitis in Predominantly Human Immunodeficiency Virus (HIV)-Positive Ugandan Adults: A Phase II Open-Label Randomized Controlled Trial Open

Fiona V Cresswell, David B. Meya, Enock Kagimu, Daniel Grint, Lindsey te Brake , et al. · 2021

Background High-dose rifampicin may improve outcomes of tuberculous meningitis (TBM). Little safety or pharmacokinetic (PK) data exist on high-dose rifampicin in human immunodeficiency virus (HIV) coinfection, and no cerebrospinal fluid (C…

Evaluation of the Dynamiker Cryptococcal Antigen Lateral Flow Assay for the Diagnosis of HIV-Associated Cryptococcosis Open

Richard Kwizera, Denis Omali, Kiiza Kandole Tadeo, John Kasibante, Morris K Rutakingirwa , et al. · 2020

Cryptococcal meningitis is a leading cause of meningitis in sub-Saharan Africa. Given the need for rapid point-of-care testing, we evaluated the diagnostic performance of the Dynamiker cryptococcal antigen (CrAg) lateral flow assay (LFA).

Tuberculosis IRIS: Pathogenesis, Presentation, and Management across the Spectrum of Disease Open

Carson Quinn, Victoria Poplin, John Kasibante, Kyle Yuquimpo, Jane Gakuru , et al. · 2020

Antiretroviral therapy (ART), while essential in combatting tuberculosis (TB) and HIV coinfection, is often complicated by the TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). Depending on the TB disease site and treatm…

A Journey of Hope: giving research participants a voice to share their experiences and improve community engagement around advanced HIV disease in Uganda Open

Fiona V Cresswell, John Kasibante, Emily Martyn, Lillian Tugume, Gavin Stead , et al. · 2020

Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART in people living with HIV. Despite th…

Baseline Serum C-Reactive Protein Level Predicts Mortality in Cryptococcal Meningitis Open

Supavit Chesdachai, Nicole Engen, Joshua Rhein, Lillian Tugume, Tadeo Kiiza Kandole , et al. · 2020

Background C-reactive protein (CRP) is an acute phase protein produced by the liver in response to systemic inflammation. CRP is a helpful surrogate biomarker used for following the progression and resolution of infection. We aimed to dete…

Cerebrospinal Fluid Bacillary Load by Xpert MTB/RIF Ultra Polymerase Chain Reaction Cycle Threshold Value Predicts 2-Week Mortality in Human Immunodeficiency Virus–Associated Tuberculous Meningitis Open

Emily Martyn, Ananta Bangdiwala, Enock Kagimu, Morris K Rutakingirwa, John Kasibante , et al. · 2020

Background The World Health Organization recommends GeneXpert MTB/RIF Ultra (Xpert Ultra), a fully automated polymerase chain reaction (PCR) assay, as the initial tuberculous meningitis (TBM) diagnostic test. The assay’s PCR cycle threshol…

High dose oral rifampicin to improve survival from adult tuberculous meningitis: A randomised placebo-controlled double-blinded phase III trial (the HARVEST study) Open

Suzaan Marais, Fiona V Cresswell, Raph L Hamers, Lindsey H. M. te Brake, Ahmad Rizal Ganiem , et al. · 2020

Background: Tuberculous meningitis (TBM), the most severe form of tuberculosis (TB), results in death or neurological disability in >50%, despite World Health Organisation recommended therapy. Current TBM regimen dosages are based on data …

Tuberculosis preventive therapy (TPT) to prevent tuberculosis co-infection among adults with HIV-associated cryptococcal meningitis: A clinician’s perspective Open

John Kasibante, Morris K Rutakingirwa, Enock Kagimu, Kenneth Ssebambulidde, Jayne Ellis , et al. · 2020

A Journey of Hope: giving research participants a voice to share their experiences and improve community engagement around advanced HIV disease in Uganda Open

Fiona V Cresswell, John Kasibante, Emily Martyn, Lillian Tugume, Gavin Stead , et al. · 2020

Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART in all HIV-positive people. Despite t…

COVID-19 and the HIV care continuum in Uganda: minimising collateral damage Open

Enock Kagimu, Emily Martyn, Jane Gakuru, John Kasibante, Morris K Rutakingirwa , et al. · 2020

The novel coronavirus, SARS-CoV-2, has spread across the world within months of its first description in Wuhan, China in December 2019, resulting in an unprecedented global health emergency. Whilst Europe and North America are the current …

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