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Kumarasamy N, Venkatesh KK, Cecelia AJ, Devaleenol B, Saghayam S, Yepthomi T, Balakrishnan P, Flanigan T, Solomon S, Mayer KH. Gender-based differences in treatment and outcome among HIV patients in South India. J Womens Health (Larchmt) 2008; 17:1471-5. [PMID: 18954236 PMCID: PMC2945934 DOI: 10.1089/jwh.2007.0670] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe gender-based differences in disease progression, treatment, and outcome among patients receiving highly active antiretroviral therapy (HAART) in South India. METHODS Therapy-naïve patients initiating HAART between February 1996 and June 2006 at a tertiary HIV referral center in Chennai, South India, were analyzed using the YRG CARE HIV Observational Database. Patients with 1 year of follow-up after initiating HAART were examined to investigate immunological and clinical outcomes, including the development of adverse events to therapy and opportunistic infections. RESULTS All previously therapy-naïve patients who initiated HAART with at least 1 year of follow-up (n = 1972) were analyzed. At enrollment into care, women had higher CD4 counts, lower hemoglobin, and higher body mass index (BMI) than their male counterparts (p < 0.05). At the time of initiating therapy, women had higher CD4 counts and lower hemoglobin (p < 0.05); women continued to have higher CD4 counts at 12 months (p < 0.05). After 1 year following HAART initiation, significantly more men developed tuberculosis and Pneumocystis jiroveci pneumonia (p < 0.05), more women experienced lactic acidosis and nausea, and more men developed immune reconstitution syndrome (p < 0.05). CONCLUSIONS Significant physiological, immunological, and clinical differences exist between men and women initiating HAART in a resource-limited setting in South India. Future studies should examine whether clinical management strategies should be different for men and women in resource-limited settings.
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Kumarasamy N, Balakrishnan P, Venkatesh K, Srikrishnan A, Cecelia A, Thamburaj E, Solomon S, Mayer K. Prevalence and incidence of sexually transmitted infections among South Indians at increased risk of HIV infection. AIDS Patient Care STDS 2008; 22:677-82. [PMID: 18627276 DOI: 10.1089/apc.2007.0166] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Sexually transmitted infections (STIs) have been identified as cofactors of HIV transmission. Greater understanding of local STI burdens can assist in the development of more effective STI and HIV prevention strategies. The aim of this study is to determine the prevalence and incidence of STIs among South Indian men and women identified to be at increased risk for HIV infection. Individuals at increased risk for HIV infection were enrolled in a prospective longitudinal study in Chennai, India (n = 480) between August 2002 and December 2003. Participants were enrolled from patients seeking services at an sexually transmitted disease (STD) clinic and a confidential HIV testing and counseling program. The most common prevalent STIs were herpes simplex virus (HSV)-2 (50% of women, 29% of men), syphilis (11% of women, 8% of men), and Trichomonas vaginalis (6% of women). At enrollment, women, participants with no schooling, participants with greater than four sex partners, and single participants were found to be at increased risk for HSV-2 infection (p < 0.05). The two most common incident STIs at 12 months were HSV-2 with 12% of men and 8% of women testing positive and hepatitis B with 2% of men and 5% of women testing hepatitis B surface antigen (HBsAg) positive. In this cohort of South Indian men and women with a high background prevalence of HSV-2, suppressive therapy against herpes replication may have a substantial impact in reducing both HSV-2 transmission and HIV acquisition. With the high incidence of STIs, targeted prevention and clinical management strategies among individuals practicing high risk behaviors may help to slow the continued spread of HIV in India.
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Syed Iqbal H, Balakrishnan P, Murugavel KG, Suniti S. Performance characteristics of a new rapid immunochromatographic test for the detection of antibodies to human immunodeficiency virus (HIV) types 1 and 2. J Clin Lab Anal 2008; 22:178-85. [PMID: 18484656 DOI: 10.1002/jcla.20238] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Diagnostic kits for the detection of human immunodeficiency virus (HIV) antibodies have reached an unprecedented number. But choice of an ideal, cost-effective, and rapid test for HIV infection is of immense value for use in developing countries like India, where resources are limited. In this study we have evaluated the performance characteristics of the rapid immunochromatographic HIV test kit First Response HIV 1-2.O. First, the laboratory archived 450 characterized plasma/serum specimens, which were tested on First Response HIV 1-2.O. Second, a total of 134 consecutive voluntary counseling and testing (VCT) specimens were also tested and positive specimens were further confirmed with HIV TRI-DOT. All these VCT specimens were cross-checked with HIV double-enzyme-linked immunosorbent assay (ELISA) (Murex and Vironostika), and the results were matched. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and efficiency of First Response HIV 1-2.O with the 450 characterized specimens was 100% for HIV-1 with reference assay. The results in the VCT algorithm were correlating with double-ELISA. In the HIV-2 analysis, five HIV-2-positive specimens in First Response HIV 1-2.O were found to be HIV-2-indeterminate on Western blot. HIV TRI-DOT was unable to pick up two HIV-2 Western blot-positive specimens. First Response HIV 1-2.O has several advantages: low-cost (U.S. $0.70); only 10 microL of specimen; involves only two steps; room temperature storage; ability to differentiate HIV-1 and 2; and use of whole blood specimen. Hence this test kit could be suitable for initial screening in the HIV testing algorithm in resource-limited settings. J. Clin. Lab. Anal. 22:178-185, 2008. (c) 2008 Wiley-Liss, Inc.
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Kumarasamy N, Venkatesh KK, Cecelia AJ, Devaleenal B, Lai AR, Saghayam S, Balakrishnan P, Yepthomi T, Poongulali S, Flanigan TP, Solomon S, Mayer KH. Spectrum of adverse events after generic HAART in southern Indian HIV-infected patients. AIDS Patient Care STDS 2008; 22:337-44. [PMID: 18422462 DOI: 10.1089/apc.2007.0093] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To determine the incidence of clinically significant adverse events after long-term, fixed-dose, generic highly active antiretroviral therapy (HAART) use among HIV-infected individuals in South India, we examined the experiences of 3154 HIV-infected individuals who received a minimum of 3 months of generic HAART between February 1996 and December 2006 at a tertiary HIV care referral center in South India. The most common regimens were 3TC + d4T + nevirapine (NVP) (54.8%), zidovudine (AZT) + 3TC + NVP (14.5%), 3TC + d4T + efavirenz (EFV) (20.1%), and AZT + 3TC + EFV (5.4%). The most common adverse events and median CD4 at time of event were rash (15.2%; CD4, 285 cells/microL) and peripheral neuropathy (9.0% and 348 cells/microL). Clinically significant anemia (hemoglobin <7 g/dL) was observed in 5.4% of patients (CD4, 165 cells/microL) and hepatitis (clinical jaundice with alanine aminotransferase > 5 times upper limits of normal) in 3.5% of patients (CD4, 260 cells/microL). Women were significantly more likely to experience lactic acidosis, while men were significantly more likely to experience immune reconstitution syndrome (p < 0.05). Among the patients with 1 year of follow-up, NVP therapy was significantly associated with developing rash and d4T therapy with developing peripheral neuropathy (p < 0.05). Anemia and hepatitis often occur within 12 weeks of initiating generic HAART. Frequent and early monitoring for these toxicities is warranted in developing countries where generic HAART is increasingly available.
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Sundaram M, Mohanakrishnan J, Murugavel KG, Shankar EM, Solomon S, Srinivas CN, Solomon SS, Pulimi S, Piwowar-Manning E, Dawson S, Livant E, Kumarasamy N, Balakrishnan P. Ethnic variation in certain hematological and biochemical reference intervals in a south Indian healthy adult population. Eur J Intern Med 2008; 19:46-50. [PMID: 18206601 DOI: 10.1016/j.ejim.2007.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Revised: 04/27/2007] [Accepted: 06/06/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND We established the biochemical and hematological reference intervals among a south Indian healthy adult population attending an HIV referral centre in Chennai, southern India. METHODS In a cross sectional study, 213 study subjects (129 male and 84 female) were studied between March and August 2005. All of the parameters were analyzed using standard hematological and biochemical techniques. RESULTS Certain biochemical (viz. total bilirubin, alanine transaminase, albumin, creatinine, total protein, lipid profile, creatine phosphokinase, uric acid and lactate) and hematological (mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and lymphocyte levels) parameters presented higher upper limits. In addition, the upper limits of white blood cell count, platelet count, hematocrit, red blood cell count and hemoglobin level were low in comparison to the currently reported ranges. CONCLUSION Ethnic variation in reference intervals was observed in certain biochemical and hematological analytes in a south Indian adult population.
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Shankar E, Vignesh R, Barton R, Balakrishnan P, Murugavel K, Velu V, Kownhar H, Lloyd C, Solomon S, Rao U, Kumarasamy N. Hydrothorax in association with Scopulariopsis brumptii in an AIDS patient in Chennai, India. Trans R Soc Trop Med Hyg 2007; 101:1270-2. [DOI: 10.1016/j.trstmh.2007.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 09/05/2007] [Accepted: 09/05/2007] [Indexed: 11/30/2022] Open
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Vignesh R, Balakrishnan P, Shankar E, Murugavel K, Hanas S, Cecelia A, Thyagarajan S, Solomon S, Kumarasamy N, Mayer K. High rate of acquired resistance to tuberculosis among HIV-infected subjects of Chennai, South India. J Infect 2007; 55:e141-2. [DOI: 10.1016/j.jinf.2007.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 08/03/2007] [Accepted: 09/13/2007] [Indexed: 11/16/2022]
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Vignesh R, Balakrishnan P, Shankar EM, Murugavel KG, Hanas S, Cecelia AJ, Thyagarajan SP, Solomon S, Kumarasamy N. High proportion of isosporiasis among HIV-infected patients with diarrhea in southern India. Am J Trop Med Hyg 2007; 77:823-824. [PMID: 17984334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
We investigated 245 diarrheal stool specimens from HIV-positive subjects between January 2003 and December 2006 to determine the etiological role of coproparasites. Parasitic etiology was observed in 91 (37.1%) cases. Isospora belli (26.1%) was the most common parasite followed by Entameba histolytica/dispar (3.3%), Cryptosporidium spp. (2.9%), Giardia intestinalis (1.6%), and Strongyloides stercoralis (1.2%). Interesting trends of significant increase in the number of cases of I. belli and decline in Cryptosporidium spp. were observed during the study period.
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Vignesh R, Cecelia AJ, Murugavel KG, Thyagarajan SP, Hanas S, Solomon S, Kumarasamy N, Balakrishnan P, Shankar EM. High Proportion of Isosporiasis among HIV-Infected Patients with Diarrhea in Southern India. Am J Trop Med Hyg 2007. [DOI: 10.4269/ajtmh.2007.77.823] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Panda S, Kumar MS, Saravanamurthy PS, Mahalingam P, Vijaylakshmi A, Balakrishnan P, Kantesh B, Tamby PA, Jabbar S, Rangaiyan G, Flessenkaemper S, Grosskurth H, Gupte MD. Sexually transmitted infections and sexual practices in injection drug users and their regular sex partners in Chennai, India. Sex Transm Dis 2007; 34:250-3. [PMID: 17414069 DOI: 10.1097/01.olq.0000258485.23066.a6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Measuring sexually transmitted infections (STIs) and sexual practices in injection drug users (IDUs) and their regular sex partners. GOAL Informing HIV intervention programs. DESIGN Cross-sectional. RESULTS One percent IDUs and 2% of their regular female sex partners were syphilis infected; 40% (84/211) and 38% respectively (81/211) were infected with HSV-2. 30% IDUs and 5% of their female regular sex partners were HIV positive. Serodiscordant results for syphilis and HSV-2 were noticed. Women having first sex at age<or=17 years and those who had HIV-positive IDUs as their male sexual partner had two times the odds of having any non-HIV-STI (OR 2.04; 95% CI 1.1-3.8; P=0.02 and OR 2.38; 95% CI 1.1-5.1; P=0.02 respectively) in a multivariate model. Women>or=38 years had seven times the odds of having any non-HIV-STI. CONCLUSION Reaching out to IDUs and their female regular sex partners with modified STI management guideline and promoting women-controlled safer sex measures are needed harm-reduction measures.
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Kumarasamy N, Flanigan TP, Vallabhaneni S, Cecelia AJ, Christybai P, Balakrishnan P, Yepthomi T, Solomon S, Carpenter CCJ, Mayer KH. A randomised control trial of structured interrupted generic antiretroviral therapy versus continuous therapy in HIV-infected individuals in Southern India. AIDS Care 2007; 19:507-13. [PMID: 17453591 DOI: 10.1080/09540120701213849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This randomised control trial, conducted in Chennai, India, compared structured interrupted therapy (SIT) and continuous therapy (CT) in relation to immunologic and virologic outcomes, adverse events (AEs) and cost of therapy. ART-naïve adult HIV1-infected participants with CD4 counts 50-350 cells/mm(3), and plasma viral load (PVL)>5000 copies/mL were enrolled and placed on Indian-manufactured generic ART: zidovudine(AZT)/stavudine(d4T)+lamivudine(3TC)+efavirenz(EFV). After at least six months of continuous therapy, subjects were randomised to SIT (one-week-on/one-week-off cycles) or CT. The primary end-point was the proportion of subjects maintaining CD4>200 cells/mm(3) at six and 12 months after randomisation. Secondary end-points were effective viral suppression (PVL<400 copies/mL), AEs and cost. All analyses used intention-to-treat methodology. Of 40 participants (69% male; mean age 36+/-7; median baseline CD4 and PVL: 162 cell/mm(3)and 259,000 copies/mL), 17 were randomised to SIT and 18 to CT. At randomisation, median CD4s for SIT and CT were 378 cells/mm(3) and 357 cells/mm(3), respectively. All participants had PVL<400 copies/mL at time of randomisation. Median CD4 six months after randomisation was 498 cells/mm(3) and 417 cells/mm(3) for SIT and CT respectively. All participants had CD4>200 cells/mm(3). One participant on CT and two on SIT had sustained PVL>400 copies/mL. There were no serious AEs or deaths. Structured interrupted therapy cost was half of CT. Structured interrupted therapy was effective at maintaining CD4 above 200 cells/mm(3). Adverse events were comparable in both groups, with 50% reduction in cost for SIT. Further research on such strategies may benefit resource-constrained settings.
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Balakrishnan P, Ganesan K, Bhima Shankar PR, Kabra M. Gene symbol: FBN1. Hum Genet 2007; 120:917. [PMID: 17438624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Balakrishnan P, Kabra M, Arora NK, Kalra V. Gene symbol: ATP7B. Hum Genet 2007; 120:908. [PMID: 17438596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Balakrishnan P, Kabra M, Arora NK, Kalra V. Gene symbol: ATP7B. Hum Genet 2007; 120:909. [PMID: 17438598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Balakrishnan P, Kabra M, Arora NK, Kalra V. Gene symbol: ATP7B. Hum Genet 2007; 120:917. [PMID: 17438623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Ibrahim M, Bhandari A, Sandhu JS, Balakrishnan P. Making Sight Affordable (Part I): Aurolab Pioneers Production of Low-Cost Technology for Cataract Surgery. ACTA ACUST UNITED AC 2006. [DOI: 10.1162/itgg.2006.1.3.25] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Iqbal HS, Solomon S, Murugavel KG, Solomon SS, Balakrishnan P. Evaluation and diagnostic usefulness of domestic and imported enzyme-linked immunosorbent assays for detection of human immunodeficiency virus type 1 antibody in India. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2006; 12:1425-8. [PMID: 16339066 PMCID: PMC1317077 DOI: 10.1128/cdli.12.12.1425-1428.2005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Diagnosis of human immunodeficiency virus (HIV) infection is important for patient management and prevention of new infections. The number of test kits available for the detection of HIV antibodies is unprecedented. In order to identify appropriate test kits, we evaluated a variety of commercial kits manufactured abroad as well as in India. The plasma and serum specimens (n=264) were collected from individuals attending the Voluntary Counseling and Testing Centre at the YRG Centre for AIDS and Education. The specimens were used to evaluate six commercially available HIV test kits: Enzaids HIV 1+2, HIV-CheX, Murex HIV-1.2.0, Genscreen HIV 1/2 version 2, Vironostika HIV Uni-Form II Ag/Ab, and CombAids RS Advantage. High sensitivities and specificities (>or=99%) were observed for the Enzaids, Murex, Vironostika, and CombAids assays. HIV-CheX showed the highest number of false-positive and false-negative results. The Genscreen test also gave many false positives. The study indicated that the Enzaids, Murex, and Vironostika enzyme-linked immunosorbent assay kits and the CombAids RS Advantage rapid assay could be used to achieve acceptable results for the detection of HIV antibodies. A combination of two tests is recommended to optimize the efficiency of HIV antibody testing algorithms, especially when evaluation with an HIV Western blot confirmatory test is not possible.
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Shankar EM, Kumarasamy N, Rajan R, Balakrishnan P, Solomon S, Devaleenol B, Rao UA. Aspergillus fumigatus, Pneumocystis jiroveci, Klebsiella pneumoniae & Mycoplasma fermentans co-infection in a HIV infected patient with respiratory conditions from Southern India. Indian J Med Res 2006; 123:181-4. [PMID: 16575119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
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Syed IH, Balakrishnan P, Solomon SS, Murugavel KG, Kumarasamy N, Vidya S, Martin SP, Thyagarajan SP, Mayer KH, Solomon S. HIV-1 western blot assay: What determines an indeterminate status? ACTA ACUST UNITED AC 2005. [PMID: 16272679 DOI: 10.4103/0019-5359.17051] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The Western blot assay is the gold standard for the detection of antibodies to human immunodeficiency virus type 1 (HIV-1). However, indeterminate Western blot reactivity to HIV-1 proteins may occur in individuals, who may not be infected with HIV. AIM This retrospective study was aimed to determine the diagnostic value of the interpretation criteria in relation to commercial kits for HIV-1 diagnosis. METHODS AND MATERIALS A total of 556 serum/plasma specimens collected from high-risk population attending our HIV clinic from 2000-2004 were tested by three different western blot kits: NEW LAV BLOT I (n=244), HIV BLOT 2.2; (n=112), Genetic Systems HIV-1 (n=237). And the results of western blot strips were analyzed using the various interpretation criteria: WHO/NACO, CDC/ ASTPHLD, ARC, FDA, CRSS and JHU. Some specimens were run on more than one kit. RT-PCR assay was performed on 5 specimens, which were indeterminate with LAV BLOT I. RESULTS The discrepancy in LAV BLOT I positive results were between 157(64)-176(72), and indeterminate results were between 44(18) to 63(25). No such variations were observed in genetic systems. There are some HIV negative (by PCR) specimens were indeterminate in LAV BLOT I revealing the kit more sensitive and less effective for diagnostic purpose. CONCLUSION The genetic systems kit is superior to other kits we analyzed and its results are concordant with HIV-1 PCR results. To report, the choice of western blot commercial kit is paramount important than the use of particular interpretation criteria for the diagnosis of HIV-1.
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Kandathil AJ, Kannangai R, David S, Nithyanandam G, Solomon S, Balakrishnan P, Abraham OC, Subramanian S, Rupali P, Verghese VP, Pulimood S, Sridharan G. Comparison of Microcapillary Cytometry Technology and Flow Cytometry for CD4+ and CD8+ T-Cell Estimation. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2005; 12:1006-9. [PMID: 16085920 PMCID: PMC1182191 DOI: 10.1128/cdli.12.8.1006-1009.2005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An alternative technology for the estimation of T cells based on a microcapillary technique (Guava Technologies, Hayward, CA) was compared to FACSCount (Becton Dickinson, San Jose, CA). Samples from 51 human immunodeficiency virus-infected and 21 healthy individuals were tested. The correlation (r) of the two systems for CD4(+) T cells was 0.994, and the coefficient of variation was 6.5%, establishing equable performance between the two technologies.
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Shankar EM, Kumarasamy N, Balakrishnan P, Solomon S, Devaleenol B, Rao UA. Incidence of Mycoplasma Pneumoniae Infection in HIV Infected Patients With Underlying Upper and Lower Respiratory Complaints and Correlation With Various Immunological and Haematological Findings. Retrovirology 2005. [DOI: 10.1186/1742-4690-2-s1-s97] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Syed IH, Balakrishnan P, Solomon SS, Murugavel KG, Kumarasamy N, Vidya S, Martin SP, Thyagarajan SP, Mayer KH, Solomon S. HIV-1 western blot assay: What determines an indeterminate status? INDIAN JOURNAL OF MEDICAL SCIENCES 2005; 59:443-50. [PMID: 16272679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND The Western blot assay is the gold standard for the detection of antibodies to human immunodeficiency virus type 1 (HIV-1). However, indeterminate Western blot reactivity to HIV-1 proteins may occur in individuals, who may not be infected with HIV. AIM This retrospective study was aimed to determine the diagnostic value of the interpretation criteria in relation to commercial kits for HIV-1 diagnosis. METHODS AND MATERIALS A total of 556 serum/plasma specimens collected from high-risk population attending our HIV clinic from 2000-2004 were tested by three different western blot kits: NEW LAV BLOT I (n=244), HIV BLOT 2.2; (n=112), Genetic Systems HIV-1 (n=237). And the results of western blot strips were analyzed using the various interpretation criteria: WHO/NACO, CDC/ ASTPHLD, ARC, FDA, CRSS and JHU. Some specimens were run on more than one kit. RT-PCR assay was performed on 5 specimens, which were indeterminate with LAV BLOT I. RESULTS The discrepancy in LAV BLOT I positive results were between 157(64)-176(72), and indeterminate results were between 44(18) to 63(25). No such variations were observed in genetic systems. There are some HIV negative (by PCR) specimens were indeterminate in LAV BLOT I revealing the kit more sensitive and less effective for diagnostic purpose. CONCLUSION The genetic systems kit is superior to other kits we analyzed and its results are concordant with HIV-1 PCR results. To report, the choice of western blot commercial kit is paramount important than the use of particular interpretation criteria for the diagnosis of HIV-1.
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Reddy SM, Balakrishnan P, Uma S, Thyagarajan SP, Solomon S. Performance of two commercial enzyme-linked immunosorbent assay kits using recombinant glycoprotein G2 antigen for detection of herpes simplex virus type 2 specific antibodies. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2005; 12:359-60. [PMID: 15699434 PMCID: PMC549301 DOI: 10.1128/cdli.12.2.359-360.2005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
For 93 stored serum samples tested by HerpeSelect2 and the Euroimmun enzyme-linked immunosorbent assay for detection of herpes simplex virus type 2-specific immunoglobulin G antibodies, the concordance of positive and negative results was 100%. Moreover, all the results that were equivocal by HerpeSelect2 (negative by Euroimmun) were confirmed as being negative by a Western blot assay.
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Kumarasamy N, Solomon S, Chaguturu SK, Mahajan AP, Flanigan TP, Balakrishnan P, Mayer KH. The safety, tolerability and effectiveness of generic antiretroviral drug regimens for HIV-infected patients in south India. AIDS 2003; 17:2267-9. [PMID: 14523288 DOI: 10.1097/00002030-200310170-00019] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We investigated the safety, tolerability and effectiveness of locally produced generic highly active antiretroviral therapy (HAART) regimens with a chart review conducted at YRG CARE, a tertiary HIV referral centre in India. A total of 333 patients had been on Indian-manufactured generic HAART for at least 3 months. In this cohort, generic HAART was safe, well tolerated and effective at increasing CD4 T-lymphocyte counts in patients with advanced HIV, comparable to the experience with proprietary HAART.
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Rajendran P, Thyagarajan SP, Pramod NP, Joyee AG, Murugavel KG, Balakrishnan P, Hari R, Jeyaseelan L, Kurien T. Serodiagnosis of syphilis in a community: an evaluatory study. Indian J Med Microbiol 2003; 21:179-83. [PMID: 17643014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE To analyse the prevalence of syphilis in the apparently healthy population and to provide data for implementation of the joint STD/HIV control programme, a population based study was undertaken by using 'probability proportional to size' cluster survey method in three randomly chosen districts of Tamil Nadu, India namely Dindigul, Ramnad and Tanjore. METHODS Blood samples were collected from adults (n=1873) aged 15-45 years, from the selected households enrolled in this study. The sera were tested parallelly by rapid plasma reagin (RPR) and Treponema pallidum haemagglutination (TPHA) tests. Reactive samples by RPR and/or TPHA were later analysed by fluorescent treponemal antibody absorption (FTA-ABS) test. RESULTS The prevalence of syphilis in the community of Tamil Nadu as per RPR positivity was 2.7% (50/1873) as against 0.7% by TPHA (13/1873). FTA-ABS positivity was observed in only 12 out of 48 (25%) RPR/TPHA reactive samples tested. By taking the positivity by two of the three tests, the community prevalence of acute ongoing syphilis in Tamil Nadu was determined as 1.1% (20/1873). CONCLUSIONS The results confirmed that no single serological test for syphilis can act as the marker of ongoing acute infection in an apparently healthy population. The study suggests that for specific diagnosis of ongoing syphilis, the FTA-ABS test may be performed along with RPR and TPHA.
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Marx MA, Murugavel KG, Sivaram S, Balakrishnan P, Steinhoff M, Anand S, Thomas DL, Solomon S, Celentano DD. The association of health-care use and hepatitis C virus infection in a random sample of urban slum community residents in southern India. Am J Trop Med Hyg 2003; 68:258-62. [PMID: 12641422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
To determine whether health-care use was associated with prevalent hepatitis C virus (HCV) infection in Chennai, India, 1,947 adults from 30 slum communities were randomly selected to be interviewed about parenteral and sexual risks for HCV infection and to provide biological specimens for HCV and sexually transmitted infection (STI) testing. Prevalent HCV infection was detected in 2.4% of non-injection drug using (IDU) participants. Controlling for other associated factors, and excluding IDU, men who used informal health-care providers were five times as likely to be HCV infected as those who did not use informal providers (Adjusted Odds Ratio, AOR = 5.83; 95% confidence interval [CI]: 1.57, 21.6), a finding not detected in women. More research is needed to determine the extent to which HCV infection is associated with reuse of contaminated injection equipment in health-care settings in developing countries.
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Baumstark AL, Balakrishnan P, Dotrong M, McCloskey CJ, Oakley MG, Boykin DW. Oxygen-17 NMR spectroscopy: torsion angle relationships in aryl carboxylic esters, acids and amides. J Am Chem Soc 2002. [DOI: 10.1021/ja00238a013] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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78
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Balakrishnan P, Boykin DW. Relationship of aromatic nitro group torsion angles with oxygen-17 chemical shift data. J Org Chem 2002. [DOI: 10.1021/jo00219a055] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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79
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Rajendran P, Rajesh PK, Thyagarajan SP, Balakrishnan P, Hari R, Joyee AG, Kurien T, Krishnmurthy P, Jacob V. Asymptomatic malarial parasitaemia in Tamil Nadu. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2001; 49:1161-4. [PMID: 11996435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
AIM The aim of the study was to determine the community prevalence of asymptomatic malarial parasitaemia in the state of Tamil Nadu. METHODS Free medical camps were organised in three randomly selected districts of Tamil Nadu, namely Dindigul, Ramnad and Thanjavur districts in November, 1997. Proportionate to population size cluster survey method was followed to collect peripheral blood smear by finger prick from 30 clusters in each district. Fifteen households were randomly selected from each district with the target age group of 15-45 years. Peripheral blood smears were stained by Leishman's stain and the slides were examined end to end by two independent experts to diagnose malarial parasites. RESULTS The male:female ratio of the population studied was 1:1.6. Asymptomatic malaria was identified in 17 out of 569 individuals screened with a positive rate of 2.9% (CI 1.5-4.3). Out of the 17 malarial positive peripheral smears 15 were P. vivax and only two were P. falciparum with the predominance of gametocyte stage. CONCLUSION This study reaffirms the prevalence of asymptomatic malaria in Tamil Nadu especially with P. vivax.
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Kuncewicz T, Balakrishnan P, Snuggs MB, Kone BC. Specific association of nitric oxide synthase-2 with Rac isoforms in activated murine macrophages. Am J Physiol Renal Physiol 2001; 281:F326-36. [PMID: 11457725 DOI: 10.1152/ajprenal.2001.281.2.f326] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Nitric oxide synthase-2 (NOS2) is responsible for high-output nitric oxide production important in renal inflammation and injury. Using a yeast two-hybrid assay, we identified Rac2, a Rho GTPase member, as a NOS2-interacting protein. NOS2 and Rac2 proteins coimmunoprecipitated from activated RAW 264.7 macrophages. The two proteins colocalized in an intracellular compartment of these cells. Glutathione-S-transferase (GST) pull-down assays revealed that both Rac1 and Rac2 associated with GST-NOS2 and that the NOS2 oxygenase domain was necessary and sufficient for the interaction. [(35)S]methionine-labeled NOS2 interacted directly with GST-Rac2 in the absence of GTP, calmodulin, or NOS2 substrates or cofactors. Stable overexpression of Rac2 in RAW 264.7 cells augmented LPS-induced nitrite generation (~60%) and NOS2 activity (~45%) without measurably affecting NOS2 protein abundance and led to a redistribution of NOS2 to a high-speed Triton X-100-insoluble fraction. We conclude that Rac1 and Rac2 physically interact with NOS2 in activated macrophages and that the interaction with Rac2 correlates with a posttranslational stimulation of NOS2 activity and likely its spatial redistribution within the cell.
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Usha MM, Rajendran P, Thyagarajan SP, Solomon S, Kumarasamy N, Yepthomi T, Rao UA, Pramod NP, Balakrishnan P, Dennis N. Identification of Pneumocystis carinii in induced sputum of AIDS patients in Chennai (Madras). INDIAN J PATHOL MICR 2000; 43:291-6. [PMID: 11218675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Induced sputum samples were collected from 32 AIDS patients with respiratory ailments. Pneumcystis carinii was demonstrated in 9 out of 32 AIDS cases by Indirect Immunofluorescence technique (HF). Four cases were positive by all the three techniques namely Giemsa staining, Toluidine blue staining and IIF, three were positive by both toluidine blue and IIF, and two were positive only by IIF. Among other microbial pathogens, acid fast bacilli was demonstrated in all the P carinii positive cases and Candida albicans in 53% AIDS cases from the induced sputum sample.
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Gill BS, Balakrishnan P, Lumsden GG, Jones PG. Treatment of stephanofilariosis ('earsore') with ivermectin. Vet Parasitol 1991; 40:159-63. [PMID: 1763486 DOI: 10.1016/0304-4017(91)90094-c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Thirty-four adult male buffaloes with clinical signs of 'earsore' were used to determine the efficacy of ivermectin against Stephanofilaria zaheeri. On the basis of parasite counts in skin scrapings, ivermectin was effective as a microfilaricide. Adult parasite counts were reduced, but removal of adults was incomplete. Clinical improvement was recorded in more than half of the treated buffaloes, but constant reinfection meant that meaningful interpretations were not possible.
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Venkatasubramanian N, Lavala D, Balakrishnan P, Polk MB, Banks HD. Cycloadditions of 1,4-Bis-Trimethyl-siloxy-1,3-cyclohexadiene. SYNTHETIC COMMUN 1989. [DOI: 10.1080/00397918908050682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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84
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Ensley HE, Balakrishnan P, Hogan C. Unusual aromatic hydroxylation in the photooxygenation of 1-isopropylidene-2-indanone and related compounds. Tetrahedron Lett 1989. [DOI: 10.1016/s0040-4039(00)99537-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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85
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Boykin DW, Balakrishnan P, Baumstark AL. Natural abundance17O NMR spectroscopy of heterocyclicN-oxides and DiN-oxides. Structural effects. J Heterocycl Chem 1985. [DOI: 10.1002/jhet.5570220410] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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86
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Balakrishnan P, DeVries MF. Sequential Estimation of Machinability Parameters for Adaptive Optimization of Machinability Data Base Systems. ACTA ACUST UNITED AC 1985. [DOI: 10.1115/1.3185980] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mathematical model type machinability data base systems require suitable model building procedures to estimate the model parameters. The estimation procedure should be capable of using subjective prior information about the models and must also be capable of adapting the model parameters to the particular machining environment for which the data are needed. In this paper, the sequential Maximum A Posteriori (MAP) estimation procedure is proposed as the mathematical tool for performing these functions. Mathematical details of this estimation procedure are presented. The advantages of this method over conventional regression analysis are discussed based on the analysis of an experimental tool life data set. Details regarding the selection of the various initial values needed for starting the sequential procedure are presented. The use of prior information about the models in order to improve the parameter estimates is investigated. The adaptive capability of the procedure is analyzed using simulated tool life data. The results of this analysis indicate that the proposed sequential estimation procedure is a valuable tool for estimating machinability parameters and for the adaptive optimization of machinability data base systems.
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Baumstark A, Vasquez P, Balakrishnan P. 17O-enriched α-azohydroperoxides: 17O NMR spectroscopy, 17O-labeling reagents. Tetrahedron Lett 1985. [DOI: 10.1016/s0040-4039(00)94776-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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88
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Balakrishnan P, Baumstark AL, Boykin DW. 17O NMR spectroscopy: Effect of substituents on chemical shifts forp-substituted benzoic acids, methyl benzoates, cinnamic acids and methyl cinnamates. ACTA ACUST UNITED AC 1984. [DOI: 10.1002/mrc.1270221204] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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90
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Kessar S, Singh G, Balakrishnan P. Studies in synthetic photochemistry-I synthesis of naphthaphenanthridine alkaloids. Tetrahedron Lett 1974. [DOI: 10.1016/s0040-4039(01)92230-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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91
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Devi T, Mathew O, Balakrishnan P. A study of diarrhoeal disorders in the Paediatrics Department of S.A.T. Hospital. Indian Pediatr 1969; 6:612-6. [PMID: 5371958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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92
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Meenakshi LV, Balakrishnan P, Kannankutty M, Mathew KT, Ananthanarayan R. Chromoblastomycosis. A short review with report of a case. THE INDIAN PRACTITIONER 1966; 19:449-52. [PMID: 5915645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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93
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Sahadevan MG, Nair NS, Balakrishnan P. Meningitis due to Mima polymorpha. Report of three cases. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1965; 13:719-21. [PMID: 5840520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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94
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Balakrishnan P, Kalra SL. Microbiology of chronic bronchitis. THE INDIAN JOURNAL OF CHEST DISEASES 1965; 7:120-2. [PMID: 5835922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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