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Author Carolyn Wester

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Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases - United States, 2009-2018.

A Blythe Ryerson, Sarah Schillie, Laurie K Barker, Benjamin A Kupronis, Carolyn Wester,

INTRODUCTION:Hepatitis C is a leading cause of death from liver disease in the United States. Acute hepatitis C infection is often asymptomatic, and >50% of cases will progress to chronic infection, which can be life-threatening. Hepatitis C can be diagnosed with a blood test and is curable, yet new cases ... Read more >>

MMWR Morb. Mortal. Wkly. Rep. (MMWR. Morbidity and mortality weekly report)
[2020, 69(14):399-404]

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Using an Established Outbreak Response Plan and Molecular Epidemiology Methods in an HIV Transmission Cluster Investigation, Tennessee, January-June 2017.

Lindsey Sizemore, Mary-Margaret Fill, Samantha A Mathieson, Jennifer Black, Meredith Brantley, Kelly Cooper, Joy Garrett, William M Switzer, Philip J Peters, Carolyn Wester,

INTRODUCTION:In April 2017, the Tennessee Department of Health (TDH) was notified of an increase in the number of persons newly diagnosed with HIV in eastern Tennessee in the same month. Two were identified as persons with a history of injection drug use (IDU) and named each other as syringe-sharing partners, ... Read more >>

Public Health Rep (Public health reports (Washington, D.C. : 1974))
[2020, 135(3):329-333]

Cited: 0 times

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Hepatitis C Testing Among Perinatally Exposed Infants.

Susan M Lopata, Elizabeth McNeer, Judith A Dudley, Carolyn Wester, William O Cooper, James G Carlucci, Claudia M Espinosa, William Dupont, Stephen W Patrick,

BACKGROUND:Hepatitis C virus (HCV) prevalence doubled among pregnant women from 2009 to 2014, reaching 3.4 per 1000 births nationwide. Infants exposed to HCV may acquire HCV by vertical transmission. National guidelines recommend that infants exposed to HCV be tested; however, it is unclear if these recommendations are being followed. Our ... Read more >>

Pediatrics (Pediatrics)
[2020, 145(3):]

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Pregnancy Status, Risk Factors, and Opportunities for Referral to Care Among Reproductive-Aged Women With Newly Reported Chronic Hepatitis C Virus Infection in Tennessee.

Cassandra Oliver, Jennifer Black, Shannon De Pont, Lindsey Sizemore, Carolyn Wester,

OBJECTIVES:From 2006 through 2012, the number of acute hepatitis C virus (HCV) infections increased 364% among persons aged ≤30, including reproductive-aged women, in Central Appalachian states. Outreach to reproductive-aged women with newly diagnosed HCV infection affords a unique opportunity to provide counseling, further testing, and linkage to treatment. We modeled ... Read more >>

Public Health Rep (Public health reports (Washington, D.C. : 1974))
[2020, 135(1):90-96]

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Trends and Disparities in Mortality and Progression to AIDS in the Highly Active Antiretroviral Therapy Era: Tennessee, 1996-2016.

Peter F Rebeiro, April C Pettit, Lindsey Sizemore, Samantha A Mathieson, Carolyn Wester, Aaron Kipp, Bryan E Shepherd, Timothy R Sterling,

Objectives. To use statewide surveillance data to examine trends and disparities in mortality and progression from HIV to AIDS comprehensively in Tennessee over the past 20 years.Methods. Individuals diagnosed with HIV in Tennessee from 1996 to 2016 were identified through the Tennessee Department of Health Enhanced HIV/AIDS Reporting System. Clinical ... Read more >>

Am J Public Health (American journal of public health)
[2019, 109(9):1266-1272]

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Retrospective Surveillance of Perinatal Hepatitis C Virus Exposure – Tennessee, 2013-2017.

Heather E. Wingate, Lindsey Sizemore, Jennifer Black, Zachary Heth, Carolyn Wester,

Online J Public Health Inform (Online journal of public health informatics)
[2019, 11(1):]

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Notes from the Field: Acute Hepatitis A Virus Infection Among Previously Vaccinated Persons with HIV Infection - Tennessee, 2018.

Julia Brennan, Kelly Moore, Lindsey Sizemore, Samantha A Mathieson, Carolyn Wester, John R Dunn, William Schaffner, Timothy F Jones,

MMWR Morb. Mortal. Wkly. Rep. (MMWR. Morbidity and mortality weekly report)
[2019, 68(14):328-329]

Cited: 0 times

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Use of Social Network Strategy Among Young Black Men Who Have Sex With Men for HIV Testing, Linkage to Care, and Reengagement in Care, Tennessee, 2013-2016.

Shanell L McGoy, April C Pettit, Melissa Morrison, Leah R Alexander, Phadre Johnson, Brandon Williams, Darion Banister, Mary K Young, Carolyn Wester, Peter F Rebeiro,

OBJECTIVES:Tennessee was 1 of 8 states that received funding from the Care and Prevention in the United States Demonstration Project, which aimed to reduce HIV-related morbidity and mortality among racial/ethnic and sexual minority populations. The objective of this study was to describe implementation of a social network strategy (SNS) program, ... Read more >>

Public Health Rep (Public health reports (Washington, D.C. : 1974))
[2018, 133(2_suppl):43S-51S]

Cited: 2 times

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Tennessee's In-state Vulnerability Assessment for a "Rapid Dissemination of Human Immunodeficiency Virus or Hepatitis C Virus Infection" Event Utilizing Data About the Opioid Epidemic.

Michael Rickles, Peter F Rebeiro, Lindsey Sizemore, Paul Juarez, Mitchell Mutter, Carolyn Wester, Melissa McPheeters,

Background:Knowing which factors contribute to county-level vulnerability to a human immunodeficiency virus (HIV)/hepatitis C virus (HCV) outbreak, and which counties are most vulnerable, guides public health and clinical interventions. We therefore examined the impact of locally available indicators related to the opioid epidemic on prior national models of HIV/HCV outbreak ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2018, 66(11):1722-1732]

Cited: 2 times

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The 2013 HIV Continuum of Care in Tennessee: Progress Made, but Disparities Persist.

Carolyn Wester, Peter F Rebeiro, Thomas J Shavor, Bryan E Shepherd, Shanell L McGoy, Benn Daley, Melissa Morrison, Sten H Vermund, April C Pettit,

We measured patient engagement in the human immunodeficiency virus (HIV) continuum of care in Tennessee after implementation of enhanced surveillance activities to assess progress toward 2015 statewide goals. We also examined subgroup disparities to identify groups at risk for poor outcomes.We estimated linkage to care, retention in care, and viral ... Read more >>

Public Health Rep (Public health reports (Washington, D.C. : 1974))
[2016, 131(5):695-703]

Cited: 5 times

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The aetiology of diarrhoea, pneumonia and respiratory colonization of HIV-exposed infants randomized to breast- or formula-feeding.

Rebecca M Zash, Roger L Shapiro, Jean Leidner, Carolyn Wester, Alexander J McAdam, Richard L Hodinka, Ibou Thior, Claire Moffat, Joseph Makhema, Kenneth McIntosh, Max Essex, Shahin Lockman,

Diarrhoea and pneumonia are common causes of childhood death in sub-Saharan Africa but there are few studies describing specific pathogens.The study aimed to describe the pathogens associated with diarrhoea, pneumonia and oropharyngeal colonization in children born to HIV-infected women (HIV-exposed infants).The Mashi Study randomized 1200 HIV-infected women and their infants ... Read more >>

Paediatr Int Child Health (Paediatrics and international child health)
[2016, 36(3):189-197]

Cited: 4 times

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Low-frequency nevirapine (NVP)-resistant HIV-1 variants are not associated with failure of antiretroviral therapy in women without prior exposure to single-dose NVP.

Valerie F Boltz, Yajing Bao, Shahin Lockman, Elias K Halvas, Mary F Kearney, James A McIntyre, Robert T Schooley, Michael D Hughes, John M Coffin, John W Mellors, ,

Low-frequency nevirapine (NVP)-resistant variants have been associated with virologic failure (VF) of initial NVP-based combination antiretroviral therapy (cART) in women with prior exposure to single-dose NVP (sdNVP). We investigated whether a similar association exists in women without prior sdNVP exposure.Pre-cART plasma was analyzed by allele-specific polymerase chain reaction to quantify ... Read more >>

J. Infect. Dis. (The Journal of infectious diseases)
[2014, 209(5):703-710]

Cited: 20 times

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Nevirapine- versus lopinavir/ritonavir-based initial therapy for HIV-1 infection among women in Africa: a randomized trial.

Shahin Lockman, Michael Hughes, Fred Sawe, Yu Zheng, James McIntyre, Tsungai Chipato, Aida Asmelash, Mohammed Rassool, Sylvester Kimaiyo, Douglas Shaffer, Mina Hosseinipour, Lerato Mohapi, Francis Ssali, Margret Chibowa, Farida Amod, Elias Halvas, Evelyn Hogg, Beverly Alston-Smith, Laura Smith, Robert Schooley, John Mellors, Judith Currier, ,

Nevirapine (NVP) is widely used in antiretroviral treatment (ART) of HIV-1 globally. The primary objective of the AA5208/OCTANE trial was to compare the efficacy of NVP-based versus lopinavir/ritonavir (LPV/r)-based initial ART.In seven African countries (Botswana, Kenya, Malawi, South Africa, Uganda, Zambia, and Zimbabwe), 500 antiretroviral-naïve HIV-infected women with CD4<200 cells/mm(3) ... Read more >>

PLoS Med. (PLoS medicine)
[2012, 9(6):e1001236]

Cited: 30 times

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HIV-related research in correctional populations: now is the time.

Josiah D Rich, David A Wohl, Curt G Beckwith, Anne C Spaulding, Nathaniel E Lepp, Jacques Baillargeon, Adrian Gardner, Ann Avery, Frederick L Altice, Sandra Springer, ,

The incarcerated population has increased to unprecedented levels following the 1970 US declaration of war on illicit drug use. A substantial proportion of people with or at risk for HIV infection, including those with substance use and mental health disorders, have become incarcerated. The overlapping epidemics of incarceration and HIV ... Read more >>

Curr HIV/AIDS Rep (Current HIV/AIDS reports)
[2011, 8(4):288-296]

Cited: 21 times

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Children who acquire HIV infection perinatally are at higher risk of early death than those acquiring infection through breastmilk: a meta-analysis.

Renaud Becquet, Milly Marston, François Dabis, Lawrence H Moulton, Glenda Gray, Hoosen M Coovadia, Max Essex, Didier K Ekouevi, Debra Jackson, Anna Coutsoudis, Charles Kilewo, Valériane Leroy, Stefan Z Wiktor, Ruth Nduati, Philippe Msellati, Basia Zaba, Peter D Ghys, Marie-Louise Newell, ,

Assumptions about survival of HIV-infected children in Africa without antiretroviral therapy need to be updated to inform ongoing UNAIDS modelling of paediatric HIV epidemics among children. Improved estimates of infant survival by timing of HIV-infection (perinatally or postnatally) are thus needed.A pooled analysis was conducted of individual data of all ... Read more >>

PLoS ONE (PloS one)
[2012, 7(2):e28510]

Cited: 65 times

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Prevalence of human papillomavirus genotypes and associated cervical squamous intraepithelial lesions in HIV-infected women in Botswana.

Iain J Macleod, Belinda O'Donnell, Sikhulile Moyo, Shahin Lockman, Roger L Shapiro, Mukendi Kayembe, Erik van Widenfelt, Joseph Makhema, M Essex, Carolyn Wester,

Human papillomaviruses (HPV) constitute one of the most prevalent sexually transmitted infections and are the etiological agents for invasive cervical cancer, the predominant cancer among women in Botswana. However, the prevalence of HPV genotypes in Botswana has yet to be reported. One hundred thirty-nine endocervical swabs were taken at baseline ... Read more >>

J. Med. Virol. (Journal of medical virology)
[2011, 83(10):1689-1695]

Cited: 17 times

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Antiretroviral therapies in women after single-dose nevirapine exposure.

Shahin Lockman, Michael D Hughes, James McIntyre, Yu Zheng, Tsungai Chipato, Francesca Conradie, Fred Sawe, Aida Asmelash, Mina C Hosseinipour, Lerato Mohapi, Elizabeth Stringer, Rosie Mngqibisa, Abraham Siika, Diana Atwine, James Hakim, Douglas Shaffer, Cecilia Kanyama, Kara Wools-Kaloustian, Robert A Salata, Evelyn Hogg, Beverly Alston-Smith, Ann Walawander, Eva Purcelle-Smith, Susan Eshleman, James Rooney, Sibtain Rahim, John W Mellors, Robert T Schooley, Judith S Currier, ,

Peripartum administration of single-dose nevirapine reduces mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) but selects for nevirapine-resistant virus.In seven African countries, women infected with HIV-1 whose CD4+ T-cell counts were below 200 per cubic millimeter and who either had or had not taken single-dose nevirapine at least 6 ... Read more >>

N. Engl. J. Med. (The New England journal of medicine)
[2010, 363(16):1499-1509]

Cited: 80 times

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Minor resistant variants in nevirapine-exposed infants may predict virologic failure on nevirapine-containing ART.

Iain J MacLeod, Christopher F Rowley, Ibou Thior, Carolyn Wester, Joseph Makhema, Max Essex, Shahin Lockman,

Single-dose nevirapine (sdNVP) is widely used to prevent mother-to-child transmission (PMTCT) of HIV-1. This may result in NVP resistance in both mother and infant. The significance of low levels of NVP resistance mutations in infants treated with NVP-containing antiretroviral treatment (ART) is unknown.To determine the presence of pre-treatment NVP resistance ... Read more >>

J. Clin. Virol. (Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology)
[2010, 48(3):162-167]

Cited: 26 times

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HIV-1 subtype C-infected individuals maintaining high viral load as potential targets for the "test-and-treat" approach to reduce HIV transmission.

Vladimir Novitsky, Rui Wang, Hermann Bussmann, Shahin Lockman, Marianna Baum, Roger Shapiro, Ibou Thior, Carolyn Wester, C William Wester, Anthony Ogwu, Aida Asmelash, Rosemary Musonda, Adriana Campa, Sikhulile Moyo, Erik van Widenfelt, Madisa Mine, Claire Moffat, Mompati Mmalane, Joseph Makhema, Richard Marlink, Peter Gilbert, George R Seage, Victor DeGruttola, M Essex,

The first aim of the study is to assess the distribution of HIV-1 RNA levels in subtype C infection. Among 4,348 drug-naïve HIV-positive individuals participating in clinical studies in Botswana, the median baseline plasma HIV-1 RNA levels differed between the general population cohorts (4.1-4.2 log(10)) and cART-initiating cohorts (5.1-5.3 log(10)) ... Read more >>

PLoS ONE (PloS one)
[2010, 5(4):e10148]

Cited: 33 times

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Risk factors for early and late transmission of HIV via breast-feeding among infants born to HIV-infected women in a randomized clinical trial in Botswana.

Roger L Shapiro, Laura Smeaton, Shahin Lockman, Ibou Thior, Raabya Rossenkhan, Carolyn Wester, Lisa Stevens, Claire Moffat, Peter Arimi, Patrick Ndase, Aida Asmelash, Jean Leidner, Vladimir Novitsky, Joseph Makhema, Max Essex,

Risk factors for mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) via breast-feeding were evaluated in a randomized trial. HIV-infected women and their infants received zidovudine as well as single-dose nevirapine or placebo. Infants were randomized to formula-feed (FF) or breast-feed (BF) in combination with zidovudine prophylaxis. Of 1116 at-risk ... Read more >>

J. Infect. Dis. (The Journal of infectious diseases)
[2009, 199(3):414-418]

Cited: 14 times

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Viral load and CD4+ T-cell dynamics in primary HIV-1 subtype C infection.

Vladimir Novitsky, Elias Woldegabriel, Lemme Kebaabetswe, Raabya Rossenkhan, Busisiwe Mlotshwa, Caitlin Bonney, Mariel Finucane, Rosemary Musonda, Sikhulile Moyo, Carolyn Wester, Erik van Widenfelt, Joseph Makhema, Stephen Lagakos, M Essex,

Most knowledge of primary HIV-1 infection is based on subtype B studies, whereas the evolution of viral parameters in the early phase of HIV-1 subtype C infection is not well characterized.The kinetics of viral RNA, proviral DNA, CD4+ T-cell count, and subsets of CD4+ T cells expressing CCR5 or CXCR4 ... Read more >>

J. Acquir. Immune Defic. Syndr. (Journal of acquired immune deficiency syndromes (1999))
[2009, 50(1):65-76]

Cited: 31 times

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Hematologic and hepatic toxicities associated with antenatal and postnatal exposure to maternal highly active antiretroviral therapy among infants.

Woong Hwan Bae, Carolyn Wester, Laura M Smeaton, Roger L Shapiro, Shahin Lockman, Kenneth Onyait, Ibou Thior, Max Essex,

To assess hematologic and hepatic toxicities associated with in utero and breastfeeding exposure to maternal highly active antiretroviral therapy (HAART) among infants in Botswana.A nested cohort study within a randomized clinical trial (the Mashi Study). Laboratory toxicities among infants born to women who initiated HAART before delivery were compared with ... Read more >>

AIDS (AIDS (London, England))
[2008, 22(13):1633-1640]

Cited: 27 times

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Infant morbidity, mortality, and breast milk immunologic profiles among breast-feeding HIV-infected and HIV-uninfected women in Botswana.

Roger L Shapiro, Shahin Lockman, Soyeon Kim, Laura Smeaton, Jeremy T Rahkola, Ibou Thior, Carolyn Wester, Claire Moffat, Peter Arimi, Patrick Ndase, Aida Asmelash, Lisa Stevens, Monty Montano, Joseph Makhema, Max Essex, Edward N Janoff,

BACKGROUND: Infants of human immunodeficiency virus (HIV)-infected women have high mortality, but the immunologic integrity and protection afforded by the breast milk of HIV-infected women is unknown. METHODS: We determined morbidity and mortality by 24 months among breast-fed infants of 588 HIV-infected and 137 HIV-uninfected women followed-up in a clinical ... Read more >>

J. Infect. Dis. (The Journal of infectious diseases)
[2007, 196(4):562-569]

Cited: 82 times

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Response to antiretroviral therapy after a single, peripartum dose of nevirapine.

Shahin Lockman, Roger L Shapiro, Laura M Smeaton, Carolyn Wester, Ibou Thior, Lisa Stevens, Fatima Chand, Joseph Makhema, Claire Moffat, Aida Asmelash, Patrick Ndase, Peter Arimi, Erik van Widenfelt, Loeto Mazhani, Vladimir Novitsky, Stephen Lagakos, Max Essex,

BACKGROUND: A single dose of nevirapine during labor reduces perinatal transmission of human immunodeficiency virus type 1 (HIV-1) but often leads to viral nevirapine resistance mutations in mothers and infants. METHODS: We studied the response to nevirapine-based antiretroviral treatment among women and infants who had previously been randomly assigned to ... Read more >>

N. Engl. J. Med. (The New England journal of medicine)
[2007, 356(2):135-147]

Cited: 239 times

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Pregnancy rates and birth outcomes among women on efavirenz-containing highly active antiretroviral therapy in Botswana.

Hermann Bussmann, C William Wester, Carolyn N Wester, Bright Lekoko, Okechukwu Okezie, Ann Muir Thomas, S M Victor DeGruttola, Joseph Makhema, Max Essex, Richard G Marlink,

BACKGROUND: Millions of HIV-infected women in developing countries are in need of safe and highly effective antiretroviral therapy. Pregnancy rates are usually high in developing countries, and efavirenz (EFV) use in women of childbearing age is of concern because of its potential teratogenicity. METHODS: As part of a prospective study ... Read more >>

J. Acquir. Immune Defic. Syndr. (Journal of acquired immune deficiency syndromes (1999))
[2007, 45(3):269-273]

Cited: 38 times

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