Imperial College London

Dr Jonathan Underwood

Faculty of MedicineDepartment of Medicine

Honorary Clinical Research Fellow
 
 
 
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Contact

 

+44 (0)20 3312 1466jonathan.underwood Website CV

 
 
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Location

 

Winston Churchill WingSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

34 results found

Pool E, Winston A, Bagkeris E, Vera JH, Mallon P, Sachikonye M, Post FA, Pozniak A, Boffito M, Anderson J, Williams I, Johnson M, Burgess L, Sabin CA, Pharmacokinetic and Clinical Observations in People over Fifty POPPY study teamet al., 2019, High-risk behaviours, and their associations with mental health, adherence to antiretroviral therapy and HIV parameters, in HIV-positive men who have sex with men., HIV Med, Vol: 20, Pages: 131-136

OBJECTIVES: To investigate the patterns and frequency of multiple risk behaviours (alcohol, drugs, smoking, higher risk sexual activity) among men who have sex with men (MSM) living with HIV. METHODS: Cross sectional study. RESULTS: 147 out of 819 HIV-positive MSM exhibited a high-risk phenotype (defined as >3 of smoking, excess alcohol, sexually transmitted infection and recent recreational drug use). This phenotype was associated with younger age, depressive symptoms and <90% adherence in multivariable logistic regression. CONCLUSION: In a cohort of MSM, a small, but significant proportion exhibited multiple concurrent risk behaviours.

JOURNAL ARTICLE

Francesco DD, Verboeket SO, Underwood J, Bagkeris E, Wit FW, Mallon PWG, Winston A, Reiss P, Sabin CA, Pharmacokinetic and Clinical Observations in PeoPle Over fiftY POPPY study and the AGEhIV Cohort Studyet al., 2018, Patterns of Co-occurring Comorbidities in People Living With HIV., Open Forum Infect Dis, Vol: 5, ISSN: 2328-8957

Background: The aims of this study were to identify common patterns of comorbidities observed in people living with HIV (PLWH), using a data-driven approach, and evaluate associations between patterns identified. Methods: A wide range of comorbidities were assessed in PLWH participating in 2 independent cohorts (POPPY: UK/Ireland; AGEhIV: Netherlands). The presence/absence of each comorbidity was determined using a mix of self-reported medical history, concomitant medications, health care resource use, and laboratory parameters. Principal component analysis (PCA) based on Somers' D statistic was applied to identify patterns of comorbidities. Results: PCA identified 6 patterns among the 1073 POPPY PLWH (85.2% male; median age [interquartile range {IQR}], 52 [47-59] years): cardiovascular diseases (CVDs), sexually transmitted diseases (STDs), mental health problems, cancers, metabolic disorders, chest/other infections. The CVDs pattern was positively associated with cancer (r = .32), metabolic disorder (r = .38), mental health (r = .16), and chest/other infection (r = .17) patterns (all P < .001). The mental health pattern was correlated with all the other patterns (in particular cancers: r = .20; chest/other infections: r = .27; both P < .001). In the 598 AGEhIV PLWH (87.6% male; median age [IQR], 53 [48-59] years), 6 patterns were identified: CVDs, chest/liver, HIV/AIDS events, mental health/neurological problems, STDs, and general health. The general health pattern was correlated with all the other patterns (in particular CVDs: r = .14; chest/liver: r = .15; HIV/AIDS events: r = .31; all P < .001), except STDs (r = -.02; P = .64). Conclusions: Comorbidities in PLWH tend to occur in nonrandom patterns, reflecting known pathological mechanisms and shared risk factors, but also suggesting potential previously unknown mechanisms. Their identification may assist in adequately addressing the pathophysiology of increasingly prevalent multimorbidity in PLWH.

JOURNAL ARTICLE

Underwood J, Cole JH, Leech R, Sharp DJ, Winston Aet al., 2018, Multivariate Pattern Analysis of Volumetric Neuroimaging Data and Its Relationship With Cognitive Function in Treated HIV Disease, JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol: 78, Pages: 429-436, ISSN: 1525-4135

JOURNAL ARTICLE

Cole JH, Caan MWA, Underwood J, De Francesco D, van Zoest RA, Wit FWNM, Mutsaerts HJMM, Leech R, Geurtsen GJ, Portegies P, Majoie CBLM, van der Loeff MFS, Sabin CA, Reiss P, Winston A, Sharp DJet al., 2018, No Evidence for Accelerated Aging-Related Brain Pathology in Treated Human Immunodeficiency Virus: Longitudinal Neuroimaging Results From the Comorbidity in Relation to AIDS (COBRA) Project, CLINICAL INFECTIOUS DISEASES, Vol: 66, Pages: 1899-1909, ISSN: 1058-4838

JOURNAL ARTICLE

Underwood J, De Francesco D, Leech R, Sabine CA, Winston Aet al., 2018, Medicalising normality? Using a simulated dataset to assess the performance of different diagnostic criteria of HIV-associated cognitive impairment, PLOS ONE, Vol: 13, ISSN: 1932-6203

JOURNAL ARTICLE

De Francesco D, Winston A, Choi JY, van Zoest RA, Underwood J, Schouten J, Ku NS, Kim WJ, Reiss P, Sabin CAet al., 2018, Determinants of cognitive function differ in a European and a Korean cohort, Publisher: WILEY, Pages: S75-S75, ISSN: 1464-2662

CONFERENCE PAPER

Francesco DD, Underwood J, Vera JH, Bagkeris E, Asboe D, Mallon PWG, Post FA, Johnson M, Williams I, Boffito M, Greliak P, Anderson J, Sabin CA, Winston Aet al., 2018, Associations between cognitive function and cardiovascular risk factors: differences between people with HIV and HIV-negative controls, Publisher: WILEY, Pages: S10-S11, ISSN: 1464-2662

CONFERENCE PAPER

De Francesco D, Wit FW, Cole JH, Kootstra NA, Winston A, Sabin CA, Underwood J, van Zoest RA, Schouten J, Kooij KW, Prins M, Guaraldi G, Caan MWA, Burger D, Franceschi C, Libert C, Buerkie A, Reiss Pet al., 2018, The 'COmorBidity in Relation to AIDS' (COBRA) cohort: Design, methods and participant characteristics, PLOS ONE, Vol: 13, ISSN: 1932-6203

JOURNAL ARTICLE

Ferretti F, Mora-Peris B, Underwood J, Waldman A, Everitt A, Winston Aet al., 2018, Cognitive Impairment in a Clinical Setting., J Acquir Immune Defic Syndr, Vol: 77, Pages: e10-e13

JOURNAL ARTICLE

Ferretti F, Mora-Peris B, Underwood J, Waldman A, Everitt A, Winston Aet al., 2018, Cognitive Impairment in a Clinical Setting, JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol: 77, Pages: E10-E13, ISSN: 1525-4135

JOURNAL ARTICLE

van Zoest RA, Underwood J, De Francesco D, Sabin CA, Cole JH, Wit FW, Caan MWA, Kootstra NA, Fuchs D, Zetterberg H, Majoie CBLM, Portegies P, Winston A, Sharp DJ, Gisslen M, Reiss Pet al., 2018, Structural Brain Abnormalities in Successfully Treated HIV Infection: Associations With Disease and Cerebrospinal Fluid Biomarkers, JOURNAL OF INFECTIOUS DISEASES, Vol: 217, Pages: 69-81, ISSN: 0022-1899

JOURNAL ARTICLE

Underwood J, Cole JH, Caan M, De Francesco D, Leech R, van Zoest RA, Su T, Geurtsen GJ, Schmand BA, Portegies P, Prins M, Wit FWNM, Sabin CA, Majoie C, Reiss P, Winston A, Sharp DJet al., 2017, Gray and White Matter Abnormalities in Treated Human Immunodeficiency Virus Disease and Their Relationship to Cognitive Function, CLINICAL INFECTIOUS DISEASES, Vol: 65, Pages: 422-432, ISSN: 1058-4838

JOURNAL ARTICLE

Booiman T, Wit FW, Maurer I, De Francesco D, Sabin CA, Harskamp AM, Prins M, Garagnani P, Pirazzini C, Franceschi C, Fuchs D, Gisslen M, Winston A, Reiss P, Kootstra NAet al., 2017, High Cellular Monocyte Activation in People Living With Human Immunodeficiency Virus on Combination Antiretroviral Therapy and Lifestyle-Matched Controls Is Associated With Greater Inflammation in Cerebrospinal Fluid, OPEN FORUM INFECTIOUS DISEASES, Vol: 4, ISSN: 2328-8957

JOURNAL ARTICLE

Underwood J, Cresswell F, Salam AP, Keeley AJ, Cleland C, John L, Davidson RNet al., 2017, Complications of miliary tuberculosis: low mortality and predictive biomarkers from a UK cohort, BMC INFECTIOUS DISEASES, Vol: 17, ISSN: 1471-2334

JOURNAL ARTICLE

Cole JH, Underwood J, Caan MWA, De Francesco D, van Zoest RA, Leech R, Wit FWNM, Portegies P, Geurtsen GJ, Schmand BA, van der Loeff MFS, Franceschi C, Sabin CA, Majoie CBLM, Winston A, Reiss P, Sharp DJet al., 2017, Increased brain-predicted aging in treated HIV disease, NEUROLOGY, Vol: 88, Pages: 1349-1357, ISSN: 0028-3878

JOURNAL ARTICLE

Underwood J, Leech R, Winston A, Sabin C, De Francesco Det al., 2017, Medicalising normality? Using a simulated dataset to assess the performance of different diagnostic criteria of cognitive impairment, Publisher: WILEY, Pages: 40-41, ISSN: 1464-2662

CONFERENCE PAPER

Chhabra S, Underwood J, Cole JH, Waldman A, Sharp DJ, Winston A, Sabin Cet al., 2017, Clinical research cerebral MRI findings in HIV positive subjects and appropriate controls, BHIVA annual conference, Publisher: WILEY, Pages: 10-10, ISSN: 1464-2662

CONFERENCE PAPER

Yilmaz A, Blennow K, Hagberg L, Nilsson S, Price RW, Schouten J, Spudich S, Underwood J, Zetterberg H, Gisslen Met al., 2017, Neurofilament light chain protein as a marker of neuronal injury: review of its use in HIV-1 infection and reference values for HIV-negative controls, EXPERT REVIEW OF MOLECULAR DIAGNOSTICS, Vol: 17, Pages: 761-770, ISSN: 1473-7159

JOURNAL ARTICLE

De Francesco D, Underwood J, Post FA, Vera JH, Williams I, Boffito M, Sachikonye M, Anderson J, Mallon PWG, Winston A, Sabin CAet al., 2016, Defining cognitive impairment in people-living-with-HIV: the POPPY study, BMC INFECTIOUS DISEASES, Vol: 16, ISSN: 1471-2334

JOURNAL ARTICLE

Underwood J, De Francesco D, Post FA, Vera JH, Williams I, Boffito M, Mallon PW, Anderson J, Sachikonye M, Sabin C, Winston A, Pharmacokinetic and Clinical Observations in People Over Fifty POPPY study groupet al., 2016, Associations between cognitive impairment and patient-reported measures of physical/mental functioning in older people living with HIV, HIV Medicine, Vol: 18, Pages: 363-369, ISSN: 1464-2662

OBJECTIVES: While cognitive impairment is frequently reported in HIV-positive individuals and has historically been associated with poorer functional outcomes, the associations between cognitive impairment and patient-reported outcome measures (PROMs) in contemporary cohorts are unclear. METHODS: We tested cognitive function using a computerized battery (CogState(™) ) in 290 HIV-positive and 97 HIV-negative individuals aged ≥ 50 years participating in the Pharmacokinetic and Clinical Observations in People Over Fifty (POPPY) study. Participants completed questionnaires detailing physical and mental health [Short Form Health Survey (SF-36)], cognitive function [European AIDS Clinical Society (EACS) questions], activities of daily living [Lawton Instrumental Activities of Daily Living (IADL)], depression [Patient Depression Questionnaire (PHQ-9) and Centres for Epidemiologic Studies Depression scale (CES-D)], falls and sexual desire. Cognitive impairment was defined using the Frascati criteria, global deficit score (GDS) and multivariate normative comparison (MNC). In the HIV-positive group, the classification performances of the different definitions of cognitive impairment and dichotomized questionnaire results were calculated. RESULTS: The prevalence of cognitive impairment in the HIV-positive group was 34.5% (GDS), 30.0% (Frascati) and 22.1% (MNC), with only 2% diagnosed with HIV-associated dementia. In general, the associations between cognitive impairment and PROMs were weak regardless of the definition used: mean c-statistics were 0.543 (GDS), 0.530 (MNC) and 0.519 (Frascati). Associations were similar using the global T-score to define cognitive impairment. Summary health scores (SF-36) were lower, but only significantly so for those with cognitive impairment identified using MNC, for both mental health (61.4 vs. 75.8; P = 0.03) and physical health (60.9 vs. 75.0; P = 0.03). CONCLUSIONS: The associations between cognitive impairment and PROMs were wea

JOURNAL ARTICLE

De Francesco D, Underwood J, Boffito M, Post F, Mallon P, Vera J, Williams I, Anderson J, Johnson M, Sabin C, Winston Aet al., 2016, Cognitive function and depression in HIV-positive individuals and matched controls, JOURNAL OF THE INTERNATIONAL AIDS SOCIETY, Vol: 19, ISSN: 1758-2652

JOURNAL ARTICLE

Underwood J, Winston A, 2016, Guidelines for Evaluation and Management of Cognitive Disorders in HIV-Positive Individuals, CURRENT HIV/AIDS REPORTS, Vol: 13, Pages: 235-240, ISSN: 1548-3568

JOURNAL ARTICLE

Mora-Peris B, Stevens E, Ferretti F, Underwood J, Taylor S, Winston Aet al., 2016, Evolution of changes in cognitive function after the initiation of antiretroviral therapy, AIDS RESEARCH AND THERAPY, Vol: 13, ISSN: 1742-6405

JOURNAL ARTICLE

Thornhill J, Underwood J, Kuldanek K, Mahay K, Fidler S, Frater J, Hopkins E, Meyerowitz J, Fox J, Nwokolo N, Whitlock G, Mackie N, Porter Ket al., 2016, Impact of timing of ART on HIV DNA; findings from HEATHER, an observational cohort study, Publisher: WILEY-BLACKWELL, Pages: 11-11, ISSN: 1464-2662

CONFERENCE PAPER

Underwood J, Cole J, Sharp D, Winston A, Leech R, Majoie C, Caan M, De Francesco D, van Zoest R, Geurtsen G, Schmand B, Wit F, Reiss P, Sabin Cet al., 2016, Brain MRI changes associated with poorer cognitive function despite suppressive antiretroviral therapy, Publisher: WILEY-BLACKWELL, Pages: 6-6, ISSN: 1464-2662

CONFERENCE PAPER

Scott J, Underwood J, Garvey LJ, Mora-Peris B, Winston Aet al., 2016, A comparison of two post-processing analysis methods to quantify cerebral metabolites measured via proton magnetic resonance spectroscopy in HIV disease, BRITISH JOURNAL OF RADIOLOGY, Vol: 89, ISSN: 0007-1285

JOURNAL ARTICLE

Winston A, Underwood J, 2015, Plasma Biomarkers of HIV-associated Cognitive Disease., EBioMedicine, Vol: 3, Pages: 12-13

JOURNAL ARTICLE

Underwood J, 2015, Cognitive deficits persist in the combination antiretroviral era: Preliminary results from the Co-morBidity in Relation to AIDS (COBRA) collaboration London cohort, 12th International Symposium on the Neurobiology and Neuroendocrinology of Aging, Publisher: PERGAMON-ELSEVIER SCIENCE LTD, Pages: 104-104, ISSN: 0531-5565

CONFERENCE PAPER

Winston A, Underwood J, 2015, Emerging concepts on the use of antiretroviral therapy in older adults living with HIV infection, CURRENT OPINION IN INFECTIOUS DISEASES, Vol: 28, Pages: 17-22, ISSN: 0951-7375

JOURNAL ARTICLE

Underwood J, Robertson KR, Winston A, 2015, Could antiretroviral neurotoxicity play a role in the pathogenesis of cognitive impairment in treated HIV disease?, AIDS, Vol: 29, Pages: 253-261, ISSN: 0269-9370

JOURNAL ARTICLE

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