Papers by Jennifer Hoffman
HIV Therapy, 2010
As a result of successful antiretroviral treatment over the last 20 years, HIV has become more of... more As a result of successful antiretroviral treatment over the last 20 years, HIV has become more of a chronic disease for practitioners to manage, requiring careful, but routine, clinical monitoring. Laboratory markers, such as the HIV-1 RNA viral load and CD4 cell count, are regularly used for patient management in addition to predicting disease progression and/or treatment outcomes. The HIV viral load is considered to be the gold standard for evaluating treatment success, although it is often limited by the cost. Furthermore, in certain cases, there is a mismatch between an undetectable viral load (<50 copies/ml) and the absence of immune reconstitution, which can be confusing to both the treatment provider and patient. In this review, the utility of the CD4 count as a predictor for HIV disease progression in patients not on therapy is evaluated, as well as a method for monitoring a patient’s response to therapy. Its use in predicting immune reconstitution in patients initiating ...
AIDS research and human retroviruses, Aug 19, 2017
Risk of HIV acquisition varies, and some individuals are highly HIV-1-exposed, yet, persistently ... more Risk of HIV acquisition varies, and some individuals are highly HIV-1-exposed, yet, persistently seronegative (HESN). The immunologic mechanisms contributing to this phenomenon are an area of intense interest. As immune activation and inflammation facilitate disease progression in HIV-1-infected persons and gastrointestinal-associated lymphoid tissue is a highly susceptible site for transmission, we hypothesized that reduced gut mucosal immune reactivity may contribute to reduced HIV-1 susceptibility in HESN men with a history of numerous rectal sexual exposures. To test this, we used ex vivo mucosal explants from freshly acquired colorectal biopsies from healthy control and HESN subjects who were stimulated with specific innate immune ligands and inactivated whole pathogens. Immune reactivity was then assessed via cytokine arrays and proteomic analysis. Mucosal immune cell compositions were quantified via immunohistochemistry. We found that explants from HESN subjects produced less...
AIDS Research and Human Retroviruses, 2014
Seminal plasma HIV-1 RNA level is an important determinant of the risk of HIV-1 sexual transmissi... more Seminal plasma HIV-1 RNA level is an important determinant of the risk of HIV-1 sexual transmission. We investigated potential associations between seminal plasma cytokine levels and viral concentration in the seminal plasma of HIV-1-infected men. This was a prospective, observational study of paired blood and semen samples from 18 HIV-1 chronically infected men off antiretroviral therapy. HIV-1 RNA levels and cytokine levels in seminal plasma and blood plasma were measured and analyzed using simple linear regressions to screen for associations between cytokines and seminal plasma HIV-1 levels. Forward stepwise regression was performed to construct the final multivariate model. The median HIV-1 RNA concentrations were 4.42 log 10 copies/ml (IQR 2.98, 4.70) and 2.96 log 10 copies/ml (IQR 2, 4.18) in blood and seminal plasma, respectively. In stepwise multivariate linear regression analysis, blood HIV-1 RNA level (p < 0.0001) was most strongly associated with seminal plasma HIV-1 RNA level. After controlling for blood HIV-1 RNA level, seminal plasma HIV-1 RNA level was positively associated with interferon (IFN)-c (p = 0.03) and interleukin (IL)-17 (p = 0.03) and negatively associated with IL-5 (p = 0.0007) in seminal plasma. In addition to blood HIV-1 RNA level, cytokine profiles in the male genital tract are associated with HIV-1 RNA levels in semen. The Th1 and Th17 cytokines IFN-c and IL-17 are associated with increased seminal plasma HIV-1 RNA, while the Th2 cytokine IL-5 is associated with decreased seminal plasma HIV-1 RNA. These results support the importance of genital tract immunomodulation in HIV-1 transmission.
Journal of Pediatric and Adolescent Gynecology, 2007
which is used to treat a variety of childhood cancers. New and highly experimental modalities for... more which is used to treat a variety of childhood cancers. New and highly experimental modalities for fertility preservation call for evidence-based estimates of a child's risk of ovarian failure, in order to properly counsel patients and families. By evaluating the ovarian function and reproductive outcomes in long-term cancer survivors exposed to CYC, we hope to identify patient and treatment characteristics associated with an elevated risk for ovarian dysfunction. Methods: This pilot study is a retrospective chart review utilizing a database developed by the Long-Term Cancer Survivor Clinic at our institution. Female patients over the age of 18 with remote exposure to CYC for the treatment of childhood cancer were identified and exposure and outcome characteristics were abstracted from paper and electronic medical records. Results: From over 1,000 patients in the Long-Term Cancer Survivor Clinic database, 77 were identified as being females over the age of 18 with a history of CYC exposure. 24 patients (31%) were over the age of 12 at the time of diagnosis and thus presumed to be post-pubertal during treatment. The most common diagnoses were acute lymphoid leukemia (29%), neuroblastoma (16%) and lymphoma (13%). Only 35 patients (45%) had any recorded follicular stimulating hormone (FSH) values, which indicate ovarian failure when elevated. There was no correlation between cumulative CYC exposure and elevated FSH values. These preliminary findings, however, are limited by the small number of patients with recorded FSH values. Conclusions: Assessment of ovarian function and prognosis regarding fertility following cancer therapy in children and adolescents is an understudied area. We hope that an expanded evaluation of ovarian function and reproductive outcomes for cancer survivors cared for at our institution will lead to a more evidence-based approach to counseling our patients.
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Papers by Jennifer Hoffman