Surasak Wiboonchutikul

Ministry of Public Health, Thailand, Krung Thep, Bangkok, Thailand

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Publications (5)11.4 Total impact

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    ABSTRACT: A prospective study to evaluate immune status against diphtheria and immunologic response after tetanus-diphtheria (Td) booster vaccination was conducted in 250 Thai health care workers (HCWs). A protective antibody was found in 89.2% of the HCWs (95% confidence interval [CI], 83.3%-91.5%) before receipt of the Td booster vaccination, compared with 97.2% (95% CI, 95.1%-99.3%) after receipt of the first dose of booster (P < .001). The mean antibody level against diphtheria increased from 0.39 IU/mL (95% CI, 0.35-0.44 IU/mL) before the Td booster vaccination to 1.20 IU/mL (95% CI, 1.12-1.29 IU/mL) after the vaccination (P < .001). Td booster vaccination should be considered for Thai HCWs to maintain immunity against diphtheria, which still circulates in Thailand.
    American journal of infection control 04/2014; · 3.01 Impact Factor
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    ABSTRACT: Vitamin D plays role in bone health and the regulation of the immune system. A cross-sectional study of serum 25-hydroxyvitamin D (25[OH]D) levels was conducted among HIV-1-infected Thai patients to determine the prevalence and associated factors of low vitamin D levels (25[OH]D <30 ng/mL) in tropical setting. 25-Hydroxyvitamin D was measured by liquid chromatography/tandem mass spectrometry. Of 178 patients, 58% received antiretroviral therapy at median (interquartile range [IQR]) duration of 7.4 (5.9-8.5) years. The prevalence of 25(OH)D deficiency (<20 ng/mL) and insufficiency (20-29.9 ng/mL) was 26.8% and 44.9%, respectively. Multivariate analysis showed that receiving efavirenz (EFV) was significantly associated with low vitamin D status (odds ratio = 3.60; 95% confidence interval, 1.06-12.15, P <.05). The mean (±standard deviation) level of 25(OH)D in patients receiving and not receiving EFV was 22.9 (6.6) and 28.6 (10.7) ng/mL, respectively, (P <.05). Low vitamin D status is common and needs to be assessed among HIV-infected patients including tropical residents especially when EFV is used.
    Journal of the International Association of Physicians in AIDS Care (JIAPAC) 01/2012; 11(5):305-10.
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    ABSTRACT: Protease inhibitor (PI) resistance-associated mutations (RAMs) are commonly observed in PI-naïve patients who infected with HIV-1 subtype A/E. Few data are available on the genetic mechanisms of PI resistance in non-B HIV-1. This study was aimed to compare PI-RAMs between PI-naïve and -experienced patients and determine PI resistance in each group. Genotypic resistance testing was conducted among a cohort of HIV-1-infected patients who were diagnosed with virologic failure. We studied 137 patients of whom 75 patients were in PI-naïve group and 62 patients in PI-experienced group. Median CD4 cell count and HIV-1 RNA at virologic failure were 169 cells/mm³ and 14,100 copies/mL, respectively. The clinical characteristics between 2 groups were similar (p>0.05) except for the duration of antiretroviral therapy (ART) which was shorter in PI-naïve group (31.5 vs. 46.8 months, p=0.028). Proportion of patients with primary PI-RAMs was 2.7% in PI-naïve and 19% in PI-experienced groups (p=0.002). The most common primary PI-RAMs in the latter group were V82A (10%), I54V (7%) and G48V (4.8%). Proportion of patients with secondary PI-RAMs in the corresponding groups was 99% and 98%, respectively (p=1.000). The most common secondary PI-RAMs in both groups were M36I (91%), H69K (34%) and L89M (30%). In conclusion, primary PI-RAMs are observed exclusively among PI-experienced patients whereas secondary PI-RAMs are equally found in both PI-naïve and PI-experienced patients. Further studies to define virologic response of HIV-1 subtype A/E to various PIs and clinical validation of PI-RAMs in HIV-1 subtype A/E are essentially needed.
    Current HIV research 07/2010; 8(6):456-60. · 1.98 Impact Factor
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    ABSTRACT: Non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens have been extensively used for treatment of HIV infection in resource-limited settings. Treatment options after failing an initial regimen are limited because of cross-resistance of NNRTIs. To determine the factors associated with reduced response to etravirine among patients with virological failure. A retrospective study was conducted. We stratified patients into two groups by the total weighted scores of etravirine-resistance-associated mutations (ETV-RAMs), highest response (score 0-2, N=123) and intermediate and reduced response (score > or =2.5, N=61). Factors associated with a score of > or =2.5 were evaluated. There were 184 patients with mean (SD) age of 42 (9) years old and 60% were males. Of all, 68% used NNRTI in the failing regimen and 51% used stavudine/lamivudine as a backbone. Common ETV-RAMs included Y181C (27%), G190A (17%), and K101E (10%). Higher proportion of K101E, K101P, Y181C, G190S, and M230L were found in patients with a score of > or =2.5 (p<0.05, all). By univariate logistic regression, using protease inhibitor (OR 0.22, 95% CI 0.07-0.67), nevirapine (OR 10.56, 95% CI 4.04-27.74), and efavirenz (OR 2.91, 95% CI 1.01-2.51) in the current regimen were associated with a score of > or =2.5. By multiple logistic regression, only using nevirapine was associated with a score of > or =2.5 (OR 7.61, 95% CI 2.40-24.06). Using nevirapine in the failing regimen was associated with intermediate and reduced response to ETV. The recommendation of using nevirapine as a preferred NNRTI should be re-considered in resource-limited settings where efavirenz is accessible.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 02/2010; 47(4):330-4. · 3.12 Impact Factor
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    ABSTRACT: Tipranavir-resistance associated mutations (TPV-RAMs) are often observed among patients with HIV-1 subtype A/E infection. Data regarding TPV resistance in subtype A/E is still limited. To determine the prevalence of TPV-RAMs among protease inhibitor-naïve, HIV-1 subtype A/E infected patients. Genotypic resistance testing was conducted among HIV-1-infected patients who were PI-naïve. We studied 112 patients (mean age, 40.7 years; 58% male). Median CD4 cell count and HIV-1 RNA were 192cells/mm(3) and 4.2logcopies/mL, respectively. Ninety-three patients (83%) infected with subtype A/E; the others had subtype B. The most common TPV-RAMs were M36I (88%), H69K (61%), and I13V (48%). Median number of TPV-RAMs was 3 mutations. Patients with subtype A/E had higher prevalence of I13V (54% vs. 21%, P=0.011), M36I (96% vs. 53%, P<0.001), H69K (68% vs. 26%, P=0.001), and >2 TPV-RAMs (62% vs. 21%, P=0.002). In multivariate analysis, only subtype A/E was associated with the occurrence of >2 TPV-RAMs (OR 9.83; 95%CI, 1.95-39.57; P=0.006). TPV-RAMs previously described by IAS-USA are commonly observed in PI-naïve patients with HIV-1 subtype A/E infection. Further studies to define virologic response of subtype A/E to TPV and clinical validation of TPV-RAMs in HIV-1 subtype A/E are essentially needed.
    Journal of Clinical Virology 09/2008; 43(3):284-6. · 3.29 Impact Factor

Publication Stats

12 Citations
11.40 Total Impact Points

Institutions

  • 2014
    • Ministry of Public Health, Thailand
      • Department of Disease Control
      Krung Thep, Bangkok, Thailand
  • 2012
    • Mahidol University
      • Department of Medicine (Ramathibodi)
      Bangkok, Bangkok, Thailand