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Biomedical subjects

Kathleen M Weber

Publications and source records attributed to Kathleen M Weber.

3 recordsLinked to original sources

Sex Differences in Human Immunodeficiency Virus Persistence and Reservoir Size During Aging.

BACKGROUND: Sex differences in human immunodeficiency virus (HIV) reservoir dynamics remain underexplored. METHODS: Longitudinal samples from virally suppressed midlife women (n = 59, median age 45 years) and age-matched men (n&#x2005;=&#x2005;31) were analyzed retrospectively. At each time point, we measured sex hormones (by means of enzyme-linked immunosorbent assay) and cellular HIV DNA and RNA (by means of digital droplet polymerase chain reaction). Number of inducible HIV RNA+ cells, which provides an upper estimate of the replication-competent reservoir, was quantified longitudinally in a different subset of 14 women, across well-defined reproductive stages. Mixed-effects models included normalized reservoir outcomes and sex, time since antiretroviral therapy (ART) initiation, and the sex-by-time interaction as predictors. RESULTS: At ART initiation, women and men had median (interquartile range [IQR]) CD4+ T-cell counts of 204/&#x3bc;L (83-306/&#x3bc;L) versus 238/&#x3bc;L (120-284/&#x3bc;L), respectively; median ages of 45 (42-48) versus 47 (43-51) years; and median follow-up times of 79.2/&#x3bc;L (60.5-121.1/&#x3bc;L) versus 66.2/&#x3bc;L (43.2-80.6/&#x3bc;L) months. We observed a significant decline of total HIV DNA over time in both men and women (P&#x2005;<&#x2005;.01). However, the rates of change differed significantly between the sexes (P&#x2005;<&#x2005;.01), with women having a significantly slower rate of decline than men, more pronounced with age. By contrast, the levels of inducible HIV RNA increased incrementally over time in women during reproductive aging (P&#x2005;<&#x2005;.01). CONCLUSIONS: In contrast to men, in whom the HIV reservoir steadily declines with aging, the HIV reservoir in women is more dynamic. Total HIV DNA (including intact and defective genomes) declines more slowly in women than in men, while the inducible HIV RNA+ reservoir, which is highly enriched in replication-competent virus, increases in women after menopause.

Aging↗

The deaf athlete.

Deaf and hard of hearing athletes have few documented related medical problems. Hearing loss has multiple causes. A portion of those with a hearing loss consider themselves part of the Deaf community, a community with a unique language and culture. Athletes may have assistive devices to enhance their ability to perceive auditory cues, whereas in deaf sport competitions, common auditory cues may be made visible. There are athletic organizations whose missions are to provide a sport and social venue specific to the deaf population. Having a better understanding and appreciation of the Deaf community will help sports medicine physicians to work more effectively with this population.

Activities of Daily Living↗

Initiation of regular marijuana use among a cohort of women infected with or at risk for HIV in the Women's Interagency HIV Study (WIHS).

Our study sought to determine the incidence of weekly marijuana use among HIV-infected and uninfected women, to identify correlates of weekly marijuana use, and to test its association with stage of HIV disease and type of HIV treatment received. A total of 2059 HIV-positive and 569 HIV-negative women from 6 sites were recruited between 1994 and 1995 and followed through 2000. After excluding women who reported weekly marijuana use at baseline, 2050 women were included in the analysis. The incidence rate for initiating marijuana was calculated and survival analysis was performed to determine the correlates of initiating weekly marijuana use. Three hundred and three women initiated weekly marijuana use within 5.5 years of the baseline visit, yielding a cumulative incidence (CI) of 14.8%. There was no significant difference in weekly marijuana use initiation between HIV-infected (CI = 14.5%) and HIV-uninfected women (CI = 16.0%). Younger age and having more sex partners was associated with incident weekly marijuana use among both infected and uninfected women. While undetectable viral load was associated with lower incidence rate (p < 0.001, RH = 0.44) and wasting syndrome with higher incidence (p < 0.01, relative hazard [RH] = 3.1), CD4 count was not. Compared to receiving no AIDS treatment at all, women who received basic combination antiretroviral therapy had significantly higher incidence of weekly marijuana use (p < 0.001, RH = 1.93), while highly active antiretroviral therapy (HAART) receivers had significantly lower incidence (p < 0.001, RH = 0.24). In summary, among HIV-infected women, the incidence of weekly marijuana use was associated with only one marker of HIV disease stage and HAART was associated with lower initiation rate of weekly marijuana use.

Adolescent↗