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T C Roach

Publications and source records attributed to T C Roach.

7 recordsLinked to original sources
PubMed2006

Immunological and virological responses to highly active antiretroviral therapy in a non-clinical trial setting in a developing Caribbean country.

OBJECTIVE: Few data exist on the efficacy of antiretroviral therapy in individuals infected with HIV in the Caribbean. We evaluated the virological and immunological responses of HIV-infected adults starting highly active antiretroviral therapy (HAART). DESIGN: This was a prospective observational cohort study. METHODS: A total of 158 antiretroviral-naive patients who initiated HAART between January 2002 and March 2003, and completed at least 6 months of treatment and follow up, were included in the analysis. The response to therapy was assessed by changes in CD4 cell counts and viral loads from baseline. The mean increase in CD4 cell count, the rate of virological success (a viral load of <50 HIV-1 RNA copies/mL) and the rate of immunological success (an increase in CD4 cell count of > or =50 cells/microL over the baseline value) after commencing HAART were measured. RESULTS: In total, 82% of patients (123 of 150) achieved viral loads of <50 copies/mL after 6 months of therapy. Viral success rate after 6 months of HAART was similar irrespective of gender, pre-HAART CD4 cell count and pre-HAART viral load. However, patients older than 40 years were significantly more likely to achieve virological success than those younger than 40 years. At 6 months after starting HAART, 79.5% of patients were estimated to have achieved immunological success and 17.9% had an increase in CD4 cell count of > or =200 cells/microL over the baseline value. The median increase in CD4 cell count for the 156 patients who had CD4 cell counts at baseline and at 6 months of therapy was 122 cells/microL. CONCLUSION: In this cohort of antiretroviral-naive HIV-infected adults, there was a high rate of virological and immunological success after 6 months of HAART, irrespective of the pre-HAART viral load and CD4 cell count.

Adult↗
PubMed1999

Clustering of cases of Mycobacterium fortuitum infection investigated by molecular typing.

Organisms of the Mycobacterium fortuitum complex are recognised but uncommon causes of pulmonary disease, primary cutaneous disease and a wide spectrum of nosocomial infections. M fortuitum was isolated from 20 patients over a 15 month period, with an apparent clustering of isolates occurring from January to March 1994. The molecular epidemiology of this clustering was investigated using an arbitrary primer polymerase chain reaction method (AP-PCR). 21 isolates were studied, which yielded 13 distinct profiles. Multiple isolates from a single patient yielded identical profiles. All of seven isolates recovered during the six week period from January to March 1994 shared a common profile which was distinct from all other isolates, suggesting that a single strain was isolated from specimens from all seven patients. The source of this cluster is uncertain. We can find no epidemiological basis for an episode of cross-infection within the hospital environment, and it is assumed that contamination of the specimens during collection, transport or processing was responsible for the "pseudo-outbreak" of M fortuitum.

AIDS-Related Opportunistic Infections↗
PubMed1997

Severe primary HIV-1 infection among black persons in Barbados.

Descriptions of primary HIV-1 infection have so far been based on Caucasians living in industrialized nations. Due to studies of leptospirosis in the predominantly black population of Barbados, serum was available for patients admitted with acute febrile illnesses to the Queen Elizabeth Hospital (QEH). By searching the medical records of 510 adult patients with known HIV-1 infection we identified 10 patients who had stored serum from an admission for an acute febrile illness that predated or coincided with their first HIV-1-positive test. Serological testing confirmed primary HIV-1 infection in 9 and was suggestive in the 10th patient. The clinical features of these 10 patients were in keeping with previous descriptions of primary HIV-1 infection but differed from leptospirosis cases seen at the QEH. One patient died during his seroconversion illness and another died 3 months after seroconversion. The findings suggest that severe primary HIV-1 infection could be a relatively uncommon occurrence, that the condition may be misdiagnosed, and that cases may not occur until the AIDS epidemic is established.

Barbados↗
PubMed1980

Multiple pleural biopsy with the Abrams needle.

Multiple pleural biopsies (up to 10) were taken with the Abrams needle through a single aspiration site in 55 patients with pleural effusions. A definite positive or suggestive pleural biopsy diagnosis was made in 33 patients (60%). In 32 of the 33 patients the pathological abnormality was confined to only a proportion of the biopsies. Pleural biopsies were positive or suggestive in 26 out of 36 patients (72%) eventually shown to have tumour and seven out of eight patients (88%) with tuberculosis. Small pneumothoraces occurred in four patients and surgical emphysema in two.

Adult↗
PubMed1977

Pleomorphic B cell neoplasm with monoclonal IgA secretion: a case report.

A case of non-myelomatous malignant disease with IgA paraproteinemia is described. A pleomorphic lymphoid/plasmacytoid infiltrate was found in the bone marrow. While the cells studied had some ultrastructural characteristics closer to myelomatosis than Waldenström's macroglobulinemia, immunofluorescence showed IgA in both the cytoplasm and at the cell surface, as seen with IgM in macroglobulinemia but not with IgA in typical IgA myelomatosis. This case illustrates that IgA paraproteinemia may be produced in association with pleomorphic B cell proliferative diseases as well as myelomatosis. There is probably a spectrum of disease states as with IgM paraproteinemia.

Adult↗