Bio

Publications


2015

Ásbjörnsdóttir, KH, Slyker JA, Maleche-Obimbo E, Dalton Wamalwa, Phelgona Otieno, Grace C. John-Stewart, Gichuhi CM, John-Stewart G.  2015.  Breastfeeding Is Associated with Decreased Risk of Hospitalization among HIV-Exposed, Uninfected Kenyan Infants., 2015 Sep 30. Journal of human lactation : official journal of International Lactation Consultant Association. Abstract

Human immunodeficiency virus (HIV)-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa, with higher morbidity and mortality than HIV-unexposed infants. HEU infants may experience increased morbidity due to breastfeeding avoidance.

2014

Njuguna, IN, Ambler G, Reilly M, Ondondo B, Kanyugo M, Lohman-Payne B, Christine Gichuhi, Dalton Wamalwa, Borthwick N, Black A, Mehedi S-R, Sun J, Maleche-Obimbo E, Chohan B, John-Stewart GC, Jaoko W, Hanke T.  2014.  PedVacc 002: a phase I/II randomized clinical trial of MVA.HIVA vaccine administered to infants born to human immunodeficiency virus type 1-positive mothers in Nairobi., 2014 Oct 7. Vaccine. 32(44):5801-8. Abstract

A safe, effective vaccine for breastfeeding infants born to HIV-1-positive mothers could complement antiretroviral therapy (ART) for prevention of mother-to-child transmission of HIV-1. To date, only a few HIV-1 vaccine candidates have been tested in infants.

2013

Bork, K, Cames C, Cournil A, Musyoka F, Ayassou K, Naidu K, Mepham S, Christine Gichuhi, Dalton Wamalwa, Read JS, Gaillard P, de Vincenzi I.  2013.  Infant feeding modes and determinants among HIV-1-infected African Women in the Kesho Bora Study., 2013 Jan 1. Journal of acquired immune deficiency syndromes (1999). 62(1):109-18. Abstract

To assess breastfeeding modes and determinants in a prevention of mother-to-child transmission study.

2012

Diener, LC, Slyker JA, Christine Gichuhi, Dalton Wamalwa, Tapia KA, Richardson BA, Dalton Wamalwa, Farquhar C, Overbaugh J, Maleche-Obimbo E, John-Stewart G.  2012.  Performance of the integrated management of childhood illness algorithm for diagnosis of HIV-1 infection among African infants., 2012 Sep 24. AIDS (London, England). 26(15):1935-41. Abstract

Early infant HIV-1 diagnosis and treatment substantially improve survival. Where virologic HIV-1 testing is unavailable, integrated management of childhood illness (IMCI) clinical algorithms may be used for infant HIV-1 screening. We evaluated the performance of the 2008 WHO IMCI HIV algorithm in a cohort of HIV-exposed Kenyan infants.

2009

Gichuhi, S, Bosire R, Mbori-Ngacha D, Christine Gichuhi, Dalton Wamalwa, Dalton Wamalwa, Maleche-Obimbo E, Farquhar C, Wariua G, Phelgona Otieno, Grace C. John-Stewart, John-Stewart GC.  2009.  Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers., 2009 Nov-Dec. Ophthalmic epidemiology. 16(6):337-45. Abstract

To determine the prevalence and correlates of neonatal conjunctivitis in infants born to human immunodeficiency virus type 1 (HIV-1) infected mothers.

2007

Wamalwa, DC, Farquhar C, Obimbo EM, Selig S, Mbori-Ngacha DA, Richardson BA, Overbaugh J, Emery S, Wariua G, Christine Gichuhi, Dalton Wamalwa, Bosire R, John-Stewart G.  2007.  Early response to highly active antiretroviral therapy in HIV-1-infected Kenyan children., 2007 Jul 1. Journal of acquired immune deficiency syndromes (1999). 45(3):311-7. Abstract

To describe the early response to World Health Organization (WHO)-recommended nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line highly active antiretroviral therapy (HAART) in HIV-1-infected Kenyan children unexposed to nevirapine.

M., DRGICHUHICHRISTINE.  2007.  Wamalwa DC, Farquhar C, Obimbo EM, Selig S, Mbori-Ngacha DA, Richardson BA, Overbaugh J, Emery S, Wariua G, Gichuhi C, Bosire R, John-Stewart G.Early response to highly active antiretroviral therapy in HIV-1-infected Kenyan children. J Acquir Immune Defic. Sex Transm Dis. 2007 Jan;34(1):25-9. : African Crop Science Society Abstract
OBJECTIVES: To describe the early response to World Health Organization (WHO)-recommended nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line highly active antiretroviral therapy (HAART) in HIV-1-infected Kenyan children unexposed to nevirapine. DESIGN: Observational prospective cohort. METHODS: HIV-1 RNA level, CD4 lymphocyte count, weight for age z score, and height for age z score were measured before the initiation of HAART and every 3 to 6 months thereafter. Children received no nutritional supplements. RESULTS: Sixty-seven HIV-1-infected children were followed for a median of 9 months between August 2004 and November 2005. Forty-seven (70%) used zidovudine, lamivudine (3TC), and an NNRTI (nevirapine or efavirenz), whereas 25% used stavudine (d4T), 3TC, and an NNRTI. Nevirapine was used as the NNRTI by 46 (69%) children, and individual antiretroviral drug formulations were used by 63 (94%), with only 4 (6%) using a fixed-dose combination of d4T, 3TC, and nevirapine (Triomune; Cipla, Mumbai, India). In 52 children, the median height for age z score and weight for age z score rose from -2.54 to -2.17 (P<0.001) and from -2.30 to -1.67 (P=0.001), respectively, after 6 months of HAART. Hospitalization rates were significantly reduced after 6 months of HAART (17% vs. 58%; P<0.001). The median absolute CD4 count increased from 326 to 536 cells/microL (P<0.001), the median CD4 lymphocyte percentage rose from 5.8% before treatment to 15.4% (P<0.001), and the median viral load fell from 5.9 to 2.2 log10 copies/mL after 6 months of HAART (P<0.001). Among 43 infants, 47% and 67% achieved viral suppression to less than 100 copies/mL and 400 copies/mL, respectively, after 6 months of HAART. CONCLUSION: Good early clinical and virologic response to NNRTI-based HAART was observed in HIV-1-infected Kenyan children with advanced HIV-1 disease.
M., DRGICHUHICHRISTINE, Bosire R, Payne BL, John-Stewart GC, Wariua G, JM M, G W, C G, Wamalwa D, Farquhar C, J R, R G, B L, Mbori-Ngacha DA, Overbaugh J, Farquhar C.  2007.  Breast milk alpha-defensins are associated with HIV type 1 RNA and CC chemokines in breast milk but not vertical HIV type 1 transmission. Sex Transm Dis. 2007 Jan;34(1):25-9. : African Crop Science Society Abstract

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Alpha-defensins are proteins exhibiting in vitro anti-HIV-1 activity that may protect against mother-to-child transmission of HIV-1 via breast milk. Correlates of alpha-defensins in breast milk and transmission risk were determined in a cohort of HIV-1-infected pregnant women in Nairobi followed for 12 months postpartum with their infants. Maternal blood was collected antenatally and at delivery for HIV-1 viral load and infant HIV-1 infection status was determined < 48 h after birth and at months 1, 3, 6, 9, and 12. Breast milk specimens collected at month 1 were assayed for alpha-defensins, HIV-1 RNA, subclinical mastitis, and CC and CXC chemokines. We detected alpha-defensins in breast milk specimens from 108 (42%) of 260 HIV-1-infected women. Women with detectable alpha-defensins (> or =50 pg/ml) had a median concentration of 320 pg/ml and significantly higher mean breast milk HIV-1 RNA levels than women with undetectable alpha-defensins (2.9 log(10) copies/ml versus 2.5 log(10) copies/ml

M., DRGICHUHICHRISTINE.  2007.  High uptake of postpartum hormonal contraception among HIV-1-seropositive women in Kenya.Sex Transm Dis. 2007 Jan;34(1):25-9. Sex Transm Dis. 2007 Jan;34(1):25-9. : African Crop Science Society Abstract
OBJECTIVES: The objectives of this study were to determine patterns of contraceptive utilization among sexually active HIV-1-seropositive women postpartum and to identify correlates of hormonal contraception uptake. GOAL: The goal of this study was to improve delivery of family planning services to HIV-1-infected women in resource-limited settings. STUDY DESIGN: HIV-1-infected pregnant women were followed prospectively in a perinatal HIV-1 transmission study. Participants were referred to local clinics for contraceptive counseling and management. RESULTS: Among 319 HIV-1-infected women, median time to sexual activity postpartum was 2 months and 231 (72%) women used hormonal contraception for at least 2 months during follow-up, initiating use at approximately 3 months postpartum (range, 1-11 months). Overall, 101 (44%) used DMPA, 71 (31%) oral contraception, and 59 (25%) switched methods during follow-up. Partner notification, infant mortality, and condom use were similar between those using and not using contraception. CONCLUSIONS: Using existing the healthcare infrastructure, it is possible to achieve high levels of postpartum hormonal contraceptive utilization among HIV-1-seropositive women.

2005

M., DRGICHUHICHRISTINE.  2005.  Gichuhi C, Obimbo E, Mbori-Ngacha D, Mwatha A, Otieno P, Farquhar C, Wariua G, Wamalwa D, Bosire R, John-Stewart G.Predictors of mortality in HIV-1 exposed uninfected post-neonatal infants at the Kenyatta National Hospital, Nairobi. East Afr Med J. 2005 S. East Afr. Med. J. 2005 Mar;82(9):447-51.. : African Crop Science Society Abstract
{ OBJECTIVES: To identify potential predictors of mortality, to determine mortality rate and to identify prevalent causes of death in a cohort of HIV-1 exposed uninfected infants. DESIGN: Prospective cohort study. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: Three hundred and fifty one HIV-1 exposed uninfected post-neonatal infants who survived to one year of age. RESULTS: Sixteen infants died (post-neonatal mortality rate of 47/1000 live births), 14 (88%) before six months of age. The most frequently identified medical conditions at death included bronchopneumonia, diarrhoea and failure to thrive. In multivariate analysis, prematurity (RR=10.5, 95%CI 3.8-29.1, p<0.001), teenage motherhood (RR=3.6, Cl 1.0-13.2
M., DRGICHUHICHRISTINE.  2005.  Gichuhi C, Obimbo E, Mbori-Ngacha D, Mwatha A, Otieno P, Farquhar C, Waruia G, Wamalwa D,Bosire R, John-Stewart G.Predictors of post-neonatal mortality in HIV-1 exposed uninfected infants in Kenya. East Afr. Med. J. 2005 Mar;82(9):447-51.. East Afr. Med. J. 2005 Mar;82(9):447-51.. : African Crop Science Society Abstract
{ OBJECTIVES: To identify potential predictors of mortality, to determine mortality rate and to identify prevalent causes of death in a cohort of HIV-1 exposed uninfected infants. DESIGN: Prospective cohort study. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: Three hundred and fifty one HIV-1 exposed uninfected post-neonatal infants who survived to one year of age. RESULTS: Sixteen infants died (post-neonatal mortality rate of 47/1000 live births), 14 (88%) before six months of age. The most frequently identified medical conditions at death included bronchopneumonia, diarrhoea and failure to thrive. In multivariate analysis, prematurity (RR=10.5, 95%CI 3.8-29.1, p<0.001), teenage motherhood (RR=3.6, Cl 1.0-13.2

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