Imperial College London

ProfessorAlanWinston-OKeefe

Faculty of MedicineDepartment of Infectious Disease

Professor of Genito-Urinary Medicine
 
 
 
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Contact

 

+44 (0)20 3312 1603a.winston

 
 
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Location

 

Winston Churchill WingSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
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353 results found

Heskin J, Belfield A, Milne C, Brown N, Walters Y, Scott C, Bracchi M, Moore LS, Mughal N, Rampling T, Winston A, Nelson M, Duncan S, Jones R, Price DA, Mora-Peris Bet al., 2022, Transmission of monkeypox virus through sexual contact - A novel route of infection., J Infect, Vol: 85, Pages: 334-363

Journal article

Nikolaichuk M, Mocroft A, Wandeler G, Szlavik J, Gottfredsson M, Reikvam DH, Svedhem V, Elinav H, Laguno M, Mansinho K, Devitt E, Chkhartishvili N, Behrens G, Bogner J, Viard J-P, Winston A, Benfield T, Leen C, Fursa O, Rockstroh J, Peters L, EuroSIDA study groupet al., 2022, Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study., HIV Med

OBJECTIVES: Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study. METHODS: At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications ('red shading' in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs. RESULTS: Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3-8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40-7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08-0.65) for 2015-2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55). CONCLUSION: In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interact

Journal article

Ogbe A, Pace M, Bittaye M, Tipoe T, Adele S, Alagaratnam J, Aley PK, Ansari MA, Bara A, Broadhead S, Brown A, Brown H, Cappuccini F, Cinardo P, Dejnirattisai W, Ewer KJ, Fok H, Folegatti PM, Fowler J, Godfrey L, Goodman AL, Jackson B, Jenkin D, Jones M, Longet S, Makinson RA, Marchevsky NG, Mathew M, Mazzella A, Mujadidi YF, Parolini L, Petersen C, Plested E, Pollock KM, Rajeswaran T, Ramasamy MN, Rhead S, Robinson H, Robinson N, Sanders H, Serrano S, Tipton T, Waters A, Zacharopoulou P, Barnes E, Dunachie S, Goulder P, Klenerman P, Screaton GR, Winston A, Hill AVS, Gilbert SC, Carroll M, Pollard AJ, Fidler S, Fox J, Lambe T, Frater Jet al., 2022, Durability of ChAdOx1 nCoV-19 vaccination in people living with HIV, JCI INSIGHT, Vol: 7

Journal article

Ryom L, De Miguel R, Cotter AG, Podlekareva D, Beguelin C, Waalewijn H, Arribas JR, Mallon PWG, Marzolini C, Kirk O, Bamford A, Rauch A, Molina JM, Kowalska JD, Guaraldi G, Winston A, Boesecke C, Cinque P, Welch S, Collins S, Behrens GMNet al., 2022, Major revision version 11.0 of the European AIDS Clinical Society Guidelines 2021, HIV MEDICINE, Vol: 23, Pages: 849-858, ISSN: 1464-2662

Journal article

Pollock KM, Cheeseman HM, Szubert AJ, Libri V, Boffito M, Owen D, Bern H, O'Hara J, McFarlane LR, Lemm N-M, McKay PF, Rampling T, Yim YTN, Milinkovic A, Kingsley C, Cole T, Fagerbrink S, Aban M, Tanaka M, Mehdipour S, Robbins A, Budd W, Faust SN, Hassanin H, Cosgrove CA, Winston A, Fidler S, Dunn DT, McCormack S, Shattock RJ, COVAC1 study Groupet al., 2022, Safety and immunogenicity of a self-amplifying RNA vaccine against COVID-19: COVAC1, a phase I, dose-ranging trial, EClinicalMedicine, Vol: 44, ISSN: 2589-5370

Background: Lipid nanoparticle (LNP) encapsulated self-amplifying RNA (saRNA) is a novel technology formulated as a low dose vaccine against COVID-19. Methods: A phase I first-in-human dose-ranging trial of a saRNA COVID-19 vaccine candidate LNP-nCoVsaRNA, was conducted at Imperial Clinical Research Facility, and participating centres in London, UK, between 19th June to 28th October 2020. Participants received two intramuscular (IM) injections of LNP-nCoVsaRNA at six different dose levels, 0.1-10.0μg, given four weeks apart. An open-label dose escalation was followed by a dose evaluation. Solicited adverse events (AEs) were collected for one week from enrolment, with follow-up at regular intervals (1-8 weeks). The binding and neutralisation capacity of anti-SARS-CoV-2 antibody raised in participant sera was measured by means of an anti-Spike (S) IgG ELISA, immunoblot, SARS-CoV-2 pseudoneutralisation and wild type neutralisation assays. (The trial is registered: ISRCTN17072692, EudraCT 2020-001646-20). Findings: 192 healthy individuals with no history or serological evidence of COVID-19, aged 18-45 years were enrolled. The vaccine was well tolerated with no serious adverse events related to vaccination. Seroconversion at week six whether measured by ELISA or immunoblot was related to dose (both p<0.001), ranging from 8% (3/39; 0.1μg) to 61% (14/23; 10.0μg) in ELISA and 46% (18/39; 0.3μg) to 87% (20/23; 5.0μg and 10.0μg) in a post-hoc immunoblot assay. Geometric mean (GM) anti-S IgG concentrations ranged from 74 (95% CI, 45-119) at 0.1μg to 1023 (468-2236) ng/mL at 5.0μg (p<0.001) and was not higher at 10.0μg. Neutralisation of SARS-CoV-2 by participant sera was measurable in 15% (6/39; 0.1μg) to 48% (11/23; 5.0μg) depending on dose level received. Interpretation: Encapsulated saRNA is safe for clinical development, is immunogenic at low dose levels but failed to induce 100% seroconversion. Modifications to optimis

Journal article

Ulfhammer G, Eden A, Antinori A, Brew BJ, Calcagno A, Cinque P, De Zan V, Hagberg L, Lin A, Nilsson S, Oprea C, Pinnetti C, Spudich S, Trunfio M, Winston A, Price RW, Gisslen Met al., 2022, Cerebrospinal Fluid Viral Load Across the Spectrum of Untreated Human Immunodeficiency Virus Type 1 (HIV-1) Infection: A Cross-Sectional Multicenter Study, CLINICAL INFECTIOUS DISEASES, Vol: 75, Pages: 493-502, ISSN: 1058-4838

Journal article

Thakrar J, Rae C, Cercignani M, Winston A, Vera-Rojas Jet al., 2021, Brain connectivity and patient-reported outcomes in people with human immunodeficiency virus with symptoms of insomnia, switching integrase inhibitor-based antiretroviral therapy, 34th European-College-of-Neuropsychopharmacology (ECNP) Congress on Early Career Scientists in Europe, Publisher: ELSEVIER, Pages: S160-S161, ISSN: 0924-977X

Conference paper

Alagaratnam J, De Francesco D, Zetterberg H, Heslegrave A, Toombs J, Kootstra NA, Underwood J, Gisslen M, Reiss P, Fidler S, Sabin CA, Winston Aet al., 2021, Correlation between cerebrospinal fluid and plasma neurofilament light protein in treated HIV infection: results from the COBRA study, JOURNAL OF NEUROVIROLOGY, Vol: 28, Pages: 54-63, ISSN: 1355-0284

Journal article

Chan TY-H, De Zan V, Gregg A, Alagaratnam J, Gerevini S, Antinori A, Monforte AD, Saracino A, Trunfio M, Everitt A, Rackstraw S, Marta M, Calcagno A, Cinque P, Winston Aet al., 2021, The symptomatology of cerebrospinal fluid HIV RNA escape: a large case-series, AIDS, Vol: 35, Pages: 2341-2346, ISSN: 0269-9370

Journal article

Morphett K, Puljevic C, Boyd M, Bonevski B, Gilks C, Borland R, Courtney R, Mcrobbie H, Baker P, Winston A, Baker AL, Matthews G, Chatfield M, Farrell M, Mattick RP, Ferguson S, Blakely T, Hall WD, Gartner Cet al., 2021, A PRAGMATIC RANDOMISED PARTIAL CROSSOVER CLINICAL TRIAL OF NICOTINE VAPORISERS ADDED TO STANDARD CARE FOR SMOKING CESSATION AND RELAPSE PREVENTION AMONG PRIORITY POPULATIONS WITH COMORBIDITIES, Publisher: WILEY, Pages: S15-S15, ISSN: 0959-5236

Conference paper

Mora-Peris B, Keegan MR, Penchala SD, Vera JH, Underwood J, Khan M, Herrera C, Fuchs D, Boasso A, Khoo S, Winston Aet al., 2021, Cerebral function parameters in people with HIV switching integrase inhibitors: a randomized controlled trial, HIV RESEARCH & CLINICAL PRACTICE, Vol: 22, Pages: 151-159, ISSN: 2578-7489

Journal article

Campbell L, Barbini B, Burling K, Cromarty B, Hamzah L, Johnson M, Jones R, Samarawickrama A, Williams D, Winston A, Post FAet al., 2021, Safety of Tenofovir Alafenamide in People With HIV Who Experienced Proximal Renal Tubulopathy on Tenofovir Disoproxil Fumarate, JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol: 88, Pages: 214-219, ISSN: 1525-4135

Journal article

Asad H, Collins IJ, Goodall RL, Crichton S, Hill T, Doerholt K, Foster C, Lyall H, Post FA, Welch S, Winston A, Sabin CA, Judd A, Collaborative HIV Paediatric Study CHIPS Steering Committee, the UK Collaborative HIV Cohort UK CHIC Study Steering Committeeet al., 2021, Mortality and AIDS-defining events among young people following transition from paediatric to adult HIV care in the UK, HIV Medicine, Vol: 22, Pages: 631-640, ISSN: 1464-2662

OBJECTIVES: To investigate risk of AIDS and mortality after transition from paediatric to adult care in a UK cohort of young people with perinatally acquired HIV. METHODS: Records of people aged ≥ 13 years on 31 December 2015 in the UK paediatric HIV cohort (Collaborative HIV Paediatric Study) were linked to those of adults in the UK Collaborative HIV Cohort (CHIC) cohort. We calculated time from transition to a new AIDS event/death, with follow-up censored at the last visit or 31 December 2015, whichever was the earliest. Cumulative incidence of and risk factors for AIDS/mortality were assessed using Kaplan-Meier and Cox regression. RESULTS: At the final paediatric visit, the 474 participants [51% female, 80% black, 60% born outside the UK, median (interquartile range) age at antiretroviral therapy (ART) initiation = 9 (5-13) years] had a median age of 18 (17-19) years and CD4 count of 471 (280-663) cell/μL; 89% were prescribed ART and 60% overall had a viral load ≤ 400 copies/mL. Over median follow-up in adult care of 3 (2-6) years, 35 (8%) experienced a new AIDS event (n = 25) or death (n = 14) (incidence = 1.8/100 person-years). In multivariable analyses, lower CD4 count at the last paediatric visit [adjusted hazard ratio = 0.8 (95% confidence interval: 0.7-1.0)/100 cells/μL increment] and AIDS diagnosis in paediatric care [2.7 (1.4-5.5)] were associated with a new AIDS event/mortality in adult care. CONCLUSIONS: Young people with perinatally acquired HIV transitioning to adult care with markers of disease progression in paediatric care experienced poorer outcomes in adult care. Increased investment in multidisciplinary specialized services is required to support this population at high risk of morbidity and mortality.

Journal article

Alagaratnam J, Stohr W, Toombs J, Heslegrave A, Zetterberg H, Gisslen M, Pett S, Nelson M, Clarkem A, Nwokolo N, Johnson MA, Khan M, Hanke T, Kopycinski J, Dorrell L, Fox J, Kinloch S, Underwood J, Pace M, Fratert J, Winston A, Fidler Set al., 2021, No evidence of neuronal damage as measured by neurofilament light chain in a HIV cure study utilising a kick-and-kill approach, JOURNAL OF VIRUS ERADICATION, Vol: 7, ISSN: 2055-6640

Journal article

Pasternak AO, Vroom J, Kootstra NA, Wit FWNM, de Bruin M, De Francesco D, Bakker M, Sabin CA, Winston A, Prins JM, Reiss P, Berkhout Bet al., 2021, Non-nucleoside reverse transcriptase inhibitor-based combination antiretroviral therapy is associated with lower cell- associated HIV RNA and DNA levels compared to protease inhibitor-based therapy, eLife, Vol: 10, Pages: 1-21, ISSN: 2050-084X

Background:It remains unclear whether combination antiretroviral therapy (ART) regimens differ in their ability to fully suppress human immunodeficiency virus (HIV) replication. Here, we report the results of two cross-sectional studies that compared levels of cell-associated (CA) HIV markers between individuals receiving suppressive ART containing either a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI).Methods:CA HIV unspliced RNA and total HIV DNA were quantified in two cohorts (n = 100, n = 124) of individuals treated with triple ART regimens consisting of two nucleoside reverse transcriptase inhibitors (NRTIs) plus either an NNRTI or a PI. To compare CA HIV RNA and DNA levels between the regimens, we built multivariable models adjusting for age, gender, current and nadir CD4+ count, plasma viral load zenith, duration of virological suppression, NRTI backbone composition, low-level plasma HIV RNA detectability, and electronically measured adherence to ART.Results:In both cohorts, levels of CA HIV RNA and DNA strongly correlated (rho = 0.70 and rho = 0.54) and both markers were lower in NNRTI-treated than in PI-treated individuals. In the multivariable analysis, CA RNA in both cohorts remained significantly reduced in NNRTI-treated individuals (padj = 0.02 in both cohorts), with a similar but weaker association between the ART regimen and total HIV DNA (padj = 0.048 and padj = 0.10). No differences in CA HIV RNA or DNA levels were observed between individual NNRTIs or individual PIs, but CA HIV RNA was lower in individuals treated with either nevirapine or efavirenz, compared to PI-treated individuals.Conclusions:All current classes of antiretroviral drugs only prevent infection of new cells but do not inhibit HIV RNA transcription in long-lived reservoir cells. Therefore, these differences in CA HIV RNA and DNA levels by treatment regimen suggest that NNRTIs are more potent in suppressing HIV residual replication than PIs, whi

Journal article

Hunt M, Khosla R, Sabin C, Winston A, Payne Bet al., 2021, Mito-Flow: a novel assay for T-cell mitochondrial dysfunction in ageing and HIV, Publisher: WILEY, Pages: 4-4, ISSN: 1464-2662

Conference paper

Frater J, Ewer KJ, Ogbe A, Pace M, Adele S, Adland E, Alagaratnam J, Aley PK, Ali M, Ansari MA, Bara A, Bittaye M, Broadhead S, Brown A, Brown H, Cappuccini F, Cooney E, Dejnirattisai W, Dold C, Fairhead C, Fok H, Folegatti PM, Fowler J, Gibbs C, Goodman AL, Jenkin D, Jones M, Makinson R, Marchevsky NG, Mujadidi YF, Nguyen H, Parolini L, Petersen C, Plested E, Pollock KM, Ramasamy MN, Rhead S, Robinson H, Robinson N, Rongkard P, Ryan F, Serrano S, Tipoe T, Voysey M, Waters A, Zacharopoulou P, Barnes E, Dunachie S, Goulder P, Klenerman P, Screaton GR, Winston A, Hill AVS, Gilbert SC, Pollard AJ, Fidler S, Fox J, Lambe T, Watson MEE, Song R, Cicconi P, Minassian AM, Bibi S, Kerridge S, Singh N, Green CM, Douglas AD, Lawrie AM, Clutterbuck EAet al., 2021, Safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 in HIV infection: a single-arm substudy of a phase 2/3 clinical trial, The Lancet HIV, Vol: 8, Pages: e474-e485, ISSN: 2352-3018

BackgroundData on vaccine immunogenicity against SARS-CoV-2 are needed for the 40 million people globally living with HIV who might have less functional immunity and more associated comorbidities than the general population. We aimed to explore safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine in people with HIV.MethodsIn this single-arm open-label vaccination substudy within the protocol of the larger phase 2/3 trial COV002, adults aged 18–55 years with HIV were enrolled at two HIV clinics in London, UK. Eligible participants were required to be on antiretroviral therapy (ART), with undetectable plasma HIV viral loads (<50 copies per mL), and CD4 counts of more than 350 cells per μL. A prime-boost regimen of ChAdOx1 nCoV-19, with two doses was given 4–6 weeks apart. The primary outcomes for this substudy were safety and reactogenicity of the vaccine, as determined by serious adverse events and solicited local and systemic reactions. Humoral responses were measured by anti-spike IgG ELISA and antibody-mediated live virus neutralisation. Cell-mediated immune responses were measured by ex-vivo IFN-γ enzyme-linked immunospot assay (ELISpot) and T-cell proliferation. All outcomes were compared with an HIV-uninfected group from the main COV002 study within the same age group and dosing strategy and are reported until day 56 after prime vaccination. Outcomes were analysed in all participants who received both doses and with available samples. The COV002 study is registered with ClinicalTrials.gov, NCT04400838, and is ongoing.FindingsBetween Nov 5 and Nov 24, 2020, 54 participants with HIV (all male, median age 42·5 years [IQR 37·2–49·8]) were enrolled and received two doses of ChAdOx1 nCoV-19. Median CD4 count at enrolment was 694·0 cells per μL (IQR 573·5–859·5). No serious adverse events occurred. Local and systemic reactions occurring during the first 7 days after prime va

Journal article

De Francesco D, Wang X, Dickinson L, Underwood J, Bagkeris E, Babalis DS, Mallon PWG, Post FA, Vera JH, Sachikonye M, Williams I, Khoo S, Sabin CA, Winston A, Boffito Met al., 2021, Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV, PLoS One, Vol: 16, Pages: 1-10, ISSN: 1932-6203

ObjectivesTo investigate the associations of plasma lamivudine (3TC), abacavir (ABC), emtricitabine (FTC) and tenofovir (TFV) concentrations with cognitive function in a cohort of treated people with HIV (PWH).MethodsPharmacokinetics (PK) and cognitive function (Cogstate, six domains) data were obtained from PWH recruited in the POPPY study on either 3TC/ABC or FTC/tenofovir disoproxil fumarate (TDF)-containing regimens. Association between PK parameters (AUC0-24: area under the concentration-time curve over 24 hours, Cmax: maximum concentration and Ctrough: trough concentration) and cognitive scores (standardized into z-scores) were evaluated using rank regression adjusting for potential confounders.ResultsMedian (IQR) global cognitive z-scores in the 83 PWH on 3TC/ABC and 471 PWH on FTC/TDF were 0.14 (-0.27, 0.38) and 0.09 (-0.28, 0.42), respectively. Higher 3TC AUC0-24 and Ctrough were associated with better global z-scores [rho = 0.29 (p = 0.02) and 0.27 (p = 0.04), respectively], whereas higher 3TC Cmax was associated with poorer z-scores [rho = -0.31 (p<0.01)], independently of ABC concentrations. Associations of ABC PK parameters with global and domain z-scores were non-significant after adjustment for confounders and 3TC concentrations (all p’s>0.05). None of the FTC and TFV PK parameters were associated with global or domain cognitive scores.ConclusionsWhilst we found no evidence of either detrimental or beneficial effects of ABC, FTC and TFV plasma exposure on cognitive function of PWH, higher plasma 3TC exposures were generally associated with better cognitive performance although higher peak concentrations were associated with poorer performance.

Journal article

Alagaratnam J, von Widekind S, De Francesco D, Underwood J, Edison P, Winston A, Zetterberg H, Fidler Set al., 2021, Correlation between CSF and blood neurofilament light chain protein: A systematic review and meta-analysis, BMJ Open Neurology, Vol: 3, ISSN: 2632-6140

Objective To assess the overall pooled correlation coefficient estimate between cerebrospinal fluid (CSF) and blood neurofilament light (NfL) protein.Methods We searched Medline, Embase and Web of Science for published articles, from their inception to 9 July 2019, according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies reporting the correlation between CSF and blood NfL in humans were included. We conducted a random-effects meta-analysis to calculate the overall pooled correlation coefficient estimate, accounting for correlation technique and assay used. Heterogeneity was assessed using the I2 statistic test. In sensitivity analyses, we calculated the pooled correlation coefficient estimate according to blood NfL assay: single-molecule array digital immunoassay (Simoa), electrochemiluminescence (ECL) assay or ELISA.Results Data were extracted from 36 articles, including 3961 paired CSF and blood NfL samples. Overall, 26/36 studies measured blood NfL using Simoa, 8/36 ECL, 1/36 ELISA and 1 study reported all three assay results. The overall meta-analysis demonstrated that the pooled correlation coefficient estimate for CSF and blood NfL was r=0.72. Heterogeneity was significant: I2=83%, p<0.01. In sensitivity analyses, the pooled correlation coefficient was similar for studies measuring blood NfL using Simoa and ECL (r=0.69 and r=0.68, respectively) but weaker for ELISA (r=0.35).Conclusion Moderate correlations are demonstrated between CSF and blood NfL, especially when blood NfL was measured using Simoa and ECL. Given its high analytical sensitivity, Simoa is the preferred assay for measuring NfL, especially at low or physiological concentrations, and this meta-analysis supports its use as the current most advanced surrogate measure of CSF NfL.PROSPERO registration number CRD42019140469

Journal article

De Francesco D, Sabin CA, Winston A, Mallon PWG, Anderson J, Boffito M, Doyle ND, Haddow L, Post FA, Vera JH, Sachikonye M, Redline S, Kunisaki KMet al., 2021, Agreement between self-reported and objective measures of sleep in people with HIV and lifestyle-similar HIV-negative individuals, AIDS, Vol: 35, Pages: 1051-1060, ISSN: 0269-9370

Journal article

Nightingale S, Dreyer AJ, Gisslen M, Winston A, Joska JAet al., 2021, Response to: Asymptomatic neurocognitive impairment is a risk for symptomatic decline over a 3-year study period, AIDS, Vol: 35, Pages: 1152-1153, ISSN: 0269-9370

Journal article

Nightingale S, Dreyer AJ, Saylor D, Gisslen M, Winston A, Joska JAet al., 2021, Moving on From HAND: Why We Need New Criteria for Cognitive Impairment in Persons Living With Human Immunodeficiency Virus and a Proposed Way Forward, CLINICAL INFECTIOUS DISEASES, Vol: 73, Pages: 1113-1118, ISSN: 1058-4838

Journal article

Shiva F, Short C-E, Goldmeier D, Winston Aet al., 2021, Predictive value of neurological symptoms in persons with suspected neurosyphilis, SEXUALLY TRANSMITTED INFECTIONS, Vol: 98, Pages: 228-229, ISSN: 1368-4973

Journal article

Nelson M, Winston A, Hill A, Mngqibisa R, Bassa A, Orkin C, Rassool M, Rodgers A, Teal V, Kumar S, Teppler Het al., 2021, Efficacy, safety and central nervous system effects after switch from efavirenz/tenofovir/emtricitabine to doravirine/tenofovir/lamivudine, AIDS, Vol: 35, Pages: 759-767, ISSN: 0269-9370

Journal article

De Francesco D, Sabin CA, Winston A, Rueschman MN, Doyle ND, Anderson J, Vera JH, Boffito M, Sachikonye M, Mallon PWG, Haddow L, Post FA, Redline S, Kunisaki KMet al., 2021, Sleep health and cognitive function among people with and without HIV: the use of different machine learning approaches, SLEEP, Vol: 44, ISSN: 0161-8105

Journal article

Beanland A, Alagaratnam J, Goffe C, Bailey A, Dosekun O, Petersen C, Ayap W, Garvey LJ, Walsh J, Mackie NE, Winston Aet al., 2021, Objective and subjective rapid frailty screening tools in people with HIV, HIV Medicine, Vol: 22, Pages: 146-150, ISSN: 1464-2662

OBJECTIVES: As people with HIV (PWH) age, the prevalence of frailty increases. Rapid screening tests to identify frailty within HIV outpatient settings are required to identify at-risk individuals. We undertook a service evaluation to assess three short frailty assessments in PWH. METHODS: We assessed two objective [gait speed (GS), timed-up-and-go test (TUGT)] and one subjective [the self-reported health questionnaire (SRH)] frailty screening tools in PWH aged > 40 years attending a single HIV outpatient department. Factors associated with positive frailty screening tests (defined as GS < 0.8 m/s, TUGT ≥ 10 s and SRH score < 6) were assessed using logistic regression models. ETHICAL CONSIDERATIONS: This was a service evaluation and was approved as a service evaluation by the Imperial College Healthcare NHS trust HIV clinical research committee (February 2020). All participants were given verbal information and were able to terminate the screening tests at any time. RESULTS: Of 84 PWH approached, 80 individuals completed all screening tests (median age = 56 years, range: 40-80) with a positive frailty screening prevalence in 19%, 33% and 20% for GS, TUGT and SRH, respectively. All tests were considered acceptable to participants. Factors statistically significantly associated with frailty included age (GS and TUGT), detectable HIV RNA (TUGT), number of comorbidities (GS and TUGT), presence of polypharmacy (GS and TUGT) and total number of concomitant medication (GS and SRH). CONCLUSIONS: Rates of positive screening tests for frailty are dependent on screening tool used, with all three tools being acceptable to participants. Objective measures of frailty screening (GS and TUGT) are more closely associated with clinical parameters than is a subjective measure of frailty screening (SRH).

Journal article

Baker V, Nkhoma K, Trevelion R, Roach A, Winston A, Sabin C, Bristowe K, Harding Ret al., 2021, "I have failed to separate my HIV from this pain": the challenge of managing chronic pain among people with HIV, AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV, ISSN: 0954-0121

Journal article

Kunisaki KM, De Francesco D, Sabin CA, Winston A, Mallon PWG, Anderson J, Bagkeris E, Boffito M, Doyle N, Haddow L, Post FA, Sachikonye M, Vera J, Khalil W, Redline Set al., 2021, Sleep Disorders in Human Immunodeficiency Virus: A Substudy of the Pharmacokinetics and Clinical Observations in People Over Fifty (POPPY) Study, OPEN FORUM INFECTIOUS DISEASES, Vol: 8, ISSN: 2328-8957

Journal article

De Francesco D, Underwood J, Anderson J, Boffito M, Post FA, Sachikonye M, Mallon PWG, Haddow L, Vera JH, Kunisaki KM, Sabin CA, Winston Aet al., 2020, Correlation between computerised and standard cognitive testing in people with HIV and HIV-negative individuals, AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV, Vol: 33, Pages: 1296-1307, ISSN: 0954-0121

Journal article

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