Angela M Caliendo

Rhode Island Hospital, Providence, Rhode Island, United States

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Publications (129)533.15 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Behavioral change interventions have demonstrated short-term efficacy in reducing sexually transmitted infection (STI)/human immunodeficiency virus (HIV) risk behaviors; however, few have demonstrated long-term efficacy.
    JAMA Pediatrics 08/2014; · 4.28 Impact Factor
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    ABSTRACT: Invasive aspergillosis is a difficult to diagnose infection with high mortality that affects high risk groups such as patients with neutropenia and hematologic malignancies.
    Journal of clinical microbiology. 08/2014;
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    ABSTRACT: To determine whether rhinovirus (RV) species is associated with more severe clinical illness in adults.
    American Journal of Clinical Pathology 08/2014; 142(2):165-72. · 2.88 Impact Factor
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    ABSTRACT: Invasive fungal infections constitute a serious threat to an ever-growing population of immunocompromised individuals and other individuals at risk. Traditional diagnostic methods, such as histopathology and culture, which are still considered the gold standards, have low sensitivity, which underscores the need for the development of new means of detecting fungal infectious agents. Indeed, novel serologic and molecular techniques have been developed and are currently under clinical evaluation. Tests like the galactomannan antigen test for aspergillosis and the β-glucan test for invasive Candida spp. and molds, as well as other antigen and antibody tests, for Cryptococcus spp., Pneumocystis spp., and dimorphic fungi, have already been established as important diagnostic approaches and are implemented in routine clinical practice. On the other hand, PCR and other molecular approaches, such as matrix-assisted laser desorption ionization (MALDI) and fluorescence in situ hybridization (FISH), have proved promising in clinical trials but still need to undergo standardization before their clinical use can become widespread. The purpose of this review is to highlight the different diagnostic approaches that are currently utilized or under development for invasive fungal infections and to identify their performance characteristics and the challenges associated with their use.
    Clinical microbiology reviews. 07/2014; 27(3):490-526.
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    ABSTRACT: Piperacillin-tazobactam (PTZ) is known to cause false-positive results in the Platelia™ Aspergillus EIA, due to contamination with galactomannan (GM). We tested 32 lots of PTZ and 27 serum specimens from patients receiving PTZ. GM was not detected in lots; one serum (3.7%) was positive. PTZ formulations commonly used in the United States today appear to be a rare cause for false-positive GM results.
    Journal of clinical microbiology 04/2014; · 4.16 Impact Factor
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    ABSTRACT: Research to develop and validate novel methods for diagnosis of aspergillosis based on detection of galactomannan requires use of clinical specimens that have been stored frozen. Data that galactomannan remains stable when frozen are scant. The objective of this study was to determine the stability of galactomannan in clinical specimens stored at -20°C that were resulted positive in the Platelia™ Aspergillus enzyme immunoassay when initially tested. Prospective real-time testing of serum and bronchoalveolar lavage (BAL) fluid pools from positive and negative patient specimens showed no decline in galactomannan index (GMI) over 11 months at -20° C, and no development of positive reactions in the negative control pool. Retrospective testing of positive specimens that had been stored at -20° C for 5 years showed that 28 of 30 serum (N=15) or BAL (N=15) specimens remained positive. These findings support the use of frozen serum or BAL specimens stored for at least five years in evaluation of diagnostic tests based on detection of galactomannan.
    Journal of clinical microbiology 04/2014; · 4.16 Impact Factor
  • Jeannette Guarner, Charles E Hill, Angela M Caliendo
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    ABSTRACT: Objectives: To increase awareness in pathology residents of different career choices and familiarize them with the job market. Methods: For 3 years, community pathologists and faculty members participated in half-day panels that residents attended voluntarily. Panelists presented their professional life experiences and shared advice. We showcase the implementation and resident evaluation of these panels. Results: Panelists were rated as outstanding or excellent for relevance. Residents chose the following themes as most useful: visualizing the array of practices (community, part-time, public health, and others), careers that follow unexpected courses and people taking advantage of opportunities as they happen, knowing that not having a definitive direction is frequent, and finding out what different practices look for when they are hiring. Conclusions: Career planning is a neglected aspect of pathology residency training, and panels in which pathologists present their experiences are helpful to prepare residents for what lies ahead.
    American Journal of Clinical Pathology 04/2014; 141(4):478-81. · 2.88 Impact Factor
  • Audrey F Jackson, Angela M Caliendo
    Clinical Infectious Diseases 02/2014; · 9.37 Impact Factor
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    ABSTRACT: In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians.
    Clinical Infectious Diseases 12/2013; 57 Suppl 3:S139-70. · 9.37 Impact Factor
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    ABSTRACT: Commutability of quantitative reference materials has proven important for reliable and accurate results in clinical chemistry. As international reference standards and commercially produced calibration material have become available to address the variability of viral load assays, the degree to which such materials are commutable and the effect of commutability on assay concordance have been questioned. To investigate this, 60 archived clinical plasma samples, previously tested positive for cytomegalovirus (CMV) were retested by five different laboratories, each using a different quantitative CMV PCR assay. Results from each laboratory were calibrated both with lab-specific quantitative CMV standards (Lab Standards) and with common, commercially available standards (CMV Panel). Pairwise analyses among laboratories were performed using mean results from each clinical sample, calibrated first with Lab Standards and then with the CMV Panel. Commutability of the CMV Panel was determined based on difference plots for each laboratory pair showing plotted values of standards that were within the 95% prediction intervals for the clinical specimens. Commutability was demonstrated for 6 of 10 laboratory pairs using the CMV Panel. In half of these pairs, use of the CMV Panel improved quantitative agreement compared to use of Lab Standards. Two of four laboratory pairs for which the CMV Panel was non-commutable showed reduced quantitative agreement when that panel was used as a common calibrator. Commutability of calibration material varies across different quantitative PCR methods. Use of a common, commutable quantitative standard can improve agreement across different assays; use of a non-commutable calibrator can reduce agreement among laboratories.
    Journal of clinical microbiology 09/2013; · 4.16 Impact Factor
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    ABSTRACT: : This trial evaluated the efficacy of an HIV-intervention condition, relative to a health-promotion condition, in reducing incidence of nonviral sexually transmitted infections (STIs; Chlamydia, gonorrhea, and trichomoniasis), oncogenic human papillomavirus (HPV) subtypes 16 and 18, sexual concurrency, and other HIV-associated behaviors over a 12-month period. : Randomized-controlled trial. Data analysts blinded to treatment allocation. : Kaiser Permanente, GA. : A random sample of 848 African American women. : The two 4-hour HIV intervention sessions were based on Social Cognitive Theory and the Theory of Gender and Power. The intervention was designed to enhance participants' self-sufficiency and attitudes and skills associated with condom use. The HIV intervention also encouraged STI testing and treatment of male sex partners and reducing vaginal douching and individual and male partner concurrency. : Incident nonviral STIs. : In generalized estimating equations' analyses, over the 12-month follow-up, participants in the HIV intervention, relative to the comparison, were less likely to have nonviral incident STIs (odds ratio [OR] = 0.62; 95% confidence interval [CI]: 0.40 to 0.96; P = 0.033) and incident high-risk HPV infection (OR = 0.37; 95% CI: 0.18 to 0.77; P = 0.008) or concurrent male sex partners (OR = 0.55; 95% CI: 0.37 to 0.83; P = 0.005). In addition, intervention participants were less likely to report multiple male sex partners, more likely to use condoms during oral sex, more likely to inform their main partner of their STI test results, encourage their main partner to seek STI testing, report that their main partner was treated for STIs, and report not douching. : This is the first trial to demonstrate that an HIV intervention can achieve reductions in nonviral STIs, high-risk HPV, and individual concurrency.
    JAIDS Journal of Acquired Immune Deficiency Syndromes 06/2013; 63 Suppl 1:S36-43. · 4.65 Impact Factor
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    ABSTRACT: Abstract Objective: To longitudinally assess the association between plasma viral load (PVL) and genital tract human immunodeficiency virus (GT HIV) RNA among HIV-1 infected women changing highly active antiretroviral therapy (HAART) because of detectable PVL on current treatment. Methods: Women were eligible for the study if they had detectable PVL (defined as two consecutive samples with PVL>1000 copies/mL) and intended to change their current HAART regimen at the time of enrollment. Paired plasma and GT HIV-1 RNA were measured prospectively over 3 years. Longitudinal analyses examined rates of GT HIV-1 RNA shedding and the association with PVL. Results: Sixteen women were followed for a median of 11 visits contributing a total of 205 study visits. At study enrollment, all had detectable PVL and 69% had detectable GT HIV-1 RNA. Half of the women changed to a new HAART regimen with ≥3 active antiretroviral drugs. The probability of having detectable PVL ≥30 days after changing HAART was 0.56 (95% CI: 0.37 to 0.74). Fourteen women (88%) had detectable PVL on a follow-up visit ≥30 or 60 days after changing HAART; and 12 women (75%) had detectable GT HIV-1 RNA on a follow-up visit ≥30 or 60 days after changing HAART. When PVL was undetectable, GT shedding occurred at 11% of visits, and when PVL was detectable, GT shedding occurred at 47% of visits. Conclusions: Some treatment-experienced HIV-infected women continue to have detectable virus in both the plasma and GT following a change in HAART, highlighting the difficulty of viral suppression in this patient population.
    Journal of Women s Health 03/2013; · 1.42 Impact Factor
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    ABSTRACT: Background. Cytomegalovirus (CMV) load measurement is used to assess the efficacy of treatment of CMV disease, but lacks standardization. Using the WHO international standard for reporting, we correlated viral load with CMV disease resolution.Methods. CMV load was quantified in plasma using a test calibrated to the WHO standard. Three predictive rules were pre-defined to determine association between CMV DNAemia and outcome: 1) pre-treatment CMV DNA of <18,200 (4.3&emsp14;log(10)) IU/mL; 2) viral load declines of 1.0, 1.5, 2.0, and 2.5&emsp14;log(10) IU/mL from baseline at d7, 14, and 21 of treatment; and 3) viral suppression <137 (2.1&emsp14;log(10)) IU/mL at d7, 14, and 21. Analysis was performed using Cox proportional hazard models.Results. Of 267 patients, 251 had CMV disease resolution by day 49 of treatment. Patients with pre-treatment CMV DNA of <18,200 (4.3&emsp14;log(10)) IU/mL had faster time to disease resolution (adjusted hazard ratio, AHR, 1.56; P=.001). Patients with CMV load suppression (<137 IU/mL [<2.1&emsp14;log(10)]) at d7, 14, and 21 had faster times to clinical disease resolution (respectively, AHR=1.61, 1.73, 1.64, with P=0.005, <0.001, <0.001). Relative CMV load reductions from baseline were not significantly associated with faster resolution of CMV disease.Conclusions. Patients with pre-treatment CMV DNA of <18,200 (4.3&emsp14;log(10)) IU/mL are 1.5 times more likely to have CMV disease resolution. CMV suppression (<137 [2.1&emsp14;log(10)] IU/mL), as measured by a test calibrated to the WHO standard, is predictive of clinical response to antiviral treatment.
    Clinical Infectious Diseases 02/2013; · 9.37 Impact Factor
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    ABSTRACT: BACKGROUND:: Limited health literacy is a known barrier to medication adherence among people living with HIV. Adherence improvement interventions are urgently needed for this vulnerable population PURPOSE:: This study tested the efficacy of a pictograph-guided adherence skills building counseling intervention for limited literacy adults living with HIV METHODS:: Men and women living with HIV and receiving antiretroviral therapy (ART, N=446) who scored below 90% correct on a test of functional health literacy were partitioned into marginal and lower literacy groups and randomly allocated to one of three adherence-counseling conditions: (a) pictograph-guided adherence counseling, (b) standard adherence counseling, or (c) general health improvement counseling. Participants were followed for 9-months post-intervention with unannounced pill count adherence and blood plasma viral load as primary endpoints RESULTS:: Preliminary analyses demonstrated the integrity of the trial and more than 90% of participants were retained. Generalized estimating equations showed significant interactions between counseling conditions and levels of participant health literacy across outcomes. Participants with marginal health literacy in the pictograph-guided and standard-counseling conditions demonstrated greater adherence and undetectable HIV viral loads compared to general health counseling. In contrast and contrary to hypotheses, participants with lower health literacy skills in the general health improvement counseling demonstrated greater adherence compared to the two adherence counseling conditions. CONCLUSIONS.: Patients with marginal literacy skills benefit from adherence counseling regardless of pictographic tailoring and patients with lower literacy skills may require more intensive or provider directed interventions.
    JAIDS Journal of Acquired Immune Deficiency Syndromes 01/2013; · 4.65 Impact Factor
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    ABSTRACT: BACKGROUND: Since switching to the COBAS(®) AmpliPrep/COBAS(®) TaqMan(®) HIV-1 Test, v. 1.0 from the Amplicor HIV-1 Monitor Test, v. 1.5, an increase in detectable viral load results was noted. We were concerned that this was due to the use of Plasma Preparation Tubes (PPT) in this test. OBJECTIVE: To assess the impact of different pre-analytical processing conditions on HIV-1 viral load results on the COBAS(®) AmpliPrep/COBAS(®) TaqMan(®) HIV-1 Test. STUDY DESIGN: Sixty-three HIV-infected patients were consented and had 3 PPTs and 1 K(2)EDTA drawn for HIV-1 viral load testing. Three methods of PPT processing were compared against the referent K(2)EDTA tube which was spun at 1100×g for 20min, poured off and frozen; PPT1 was refrigerated with an additional centrifugation prior to testing, PPT2 was processed similarly to EDTA, and PPT3 was centrifuged, frozen and centrifuged again prior to testing. RESULTS: PPT1 and PPT3 yielded results that were most similar to the referent EDTA processing, with a concordance correlation coefficient (CCC) of 0.80 and 0.85, compared to PPT2 with CCC of 0.37. Both PPT1 and PPT3 involved additional centrifugation prior to testing. In 26 patients with residual samples from the PPT2 processing, 9 (34.6%) were found to have the presence of proviral DNA, which likely contributed to the elevated HIV-1 RNA viral loads in these individuals. CONCLUSION: PPTs can be used in the COBAS(®) AmpliPrep/COBAS(®) TaqMan(®) HIV-1 Test with an additional centrifugation in order to avoid misleading elevated HIV-1 RNA viral loads that may change patient management.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 01/2013; · 3.12 Impact Factor
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    ABSTRACT: Twelve laboratories evaluated candidate material for an Aspergillus DNA calibrator. The DNA material was quantified using limiting dilution analysis; the mean concentration was determined to be 1.73 × 1010 units/mL. The calibrator can be used to standardize aspergillosis diagnostic assays which detect and/or quantify nucleic acid
    Journal of Clinial Microbiology. 01/2013;
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    ABSTRACT: Quantitative real-time PCR has been widely implemented for clinical viral load testing, but a lack of standardization and relatively poor precision has hindered its usefulness. Digital PCR offers highly precise, direct quantification without requiring a calibration curve. Performance characteristics of real-time PCR were compared to those of droplet digital PCR (ddPCR) for cytomegalovirus (CMV) viral load testing. Ten-fold serial dilutions of the World Health Organization (WHO) and the National Institute of Standards and Technology (NIST) CMV quantitative standards were tested, together with the AcroMetrix® CMV tc Panel (Life Technologies, Carlsbad, CA) and 50 human plasma specimens. Each method was evaluated using all three standards for quantitative linearity, lower limit of detection (LOD), and accuracy. Quantitative correlation, mean viral load, and variability were compared. Real-time PCR showed somewhat higher sensitivity than ddPCR (LOD of 3 log(10)versus 4 log(10)copies and IU/mL for NIST and WHO standards). Both methods showed a high degree of linearity and quantitative correlation, for standards (R(2)≥ 0.98 in each of 6 regression models) and clinical samples (R(2)=0.93) across their detectable ranges. For higher concentrations, ddPCR showed less variability than RT-PCR for the WHO standards and Acrometrix standards (p< 0.05). RT-PCR showed less variability and greater sensitivity than did ddPCR in clinical samples. Both digital and real-time PCR provide accurate CMV viral load data over a wide linear dynamic range. Digital PCR may provide an opportunity to reduce quantitative variability currently seen using real-time PCR, but methods need to be further optimized to match the sensitivity of real-time PCR.
    Journal of clinical microbiology 12/2012; · 4.16 Impact Factor
  • Angela M Caliendo
    Clinical Infectious Diseases 10/2012; · 9.37 Impact Factor
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    ABSTRACT: Our objective was to test the hypothesis that treatment for trichomoniasis among HIV-infected women not taking antiretrovirals in South Africa would be associated with decreased HIV genital shedding. HIV-infected women presenting for routine HIV care were screened for trichomoniasis using self-collected vaginal swabs with a rapid point-of-care immunochromatographic antigen test. Women testing positive were offered enrollment into a prospective cohort study, if they had documented HIV infection, were aged 18 to 50 years, and were not receiving antiretroviral therapy. Recent use of postexposure prophylaxis or antibiotic therapy, active genital ulcers, or systemic illness were exclusion criteria. Cervical swabs were collected for gonococcal and chlamydial testing, and those testing positive were excluded. Women were treated with directly observed oral therapy with 2 g of oral metronidazole. A follow-up visit was scheduled 1 month after therapy, and partner letters were provided. Paired cervical wicks and plasma were collected for viral load measurement. In all, 557 women were screened. Sixty tested positive for trichomoniasis, 10 subsequently met exclusion criteria, and 4 were lost to follow-up. Of 46 women evaluated at follow-up, 37 (80.4%) were cured. Plasma viral load was not significantly different after therapy (P = 0.93). Genital tract viral load decreased by 0.5 log10 (P < 0.01). The mean genital tract viral load (log10) decreased from 4.66 (<3.52-6.46) to 4.18 (<3.52-6.48) (P < 0.01) after therapy. Screening and treatment of vaginal trichomoniasis decrease genital shedding of HIV among South African women not receiving antiretrovirals at 1 month after therapy.
    Sexually transmitted diseases 08/2012; 39(8):638-42. · 2.58 Impact Factor
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    ABSTRACT: Although clinical microbiology testing facilitates both public health surveillance of infectious diseases and patient care, research on testing patterns is scant. We surveyed hospital laboratories in Georgia to assess their diagnostic testing practices. Using e-mail, all directors of hospital laboratories in Georgia were invited to participate. The survey focused on timing and location of diagnostic testing in 2006 for 6 reportable diseases: giardiasis, legionellosis, meningococcal disease, pertussis, Rocky Mountain spotted fever, and West Nile virus disease. Of 141 laboratories, 62 (44%) responded to the survey. Hospitals varied widely in their use of diagnostic testing in 2006, with 95.1% testing for meningococcal disease, but only 66.1% and 63.3% testing for legionellosis and West Nile virus disease, respectively. Most laboratories (91%) performed gram stain/culture to diagnose meningococcal disease in-house and 23% performed ova and parasite panels for giardiasis were conducted in-house. Fewer than 11% of laboratories performed in-house testing for the remaining diseases. Laboratories affiliated with small hospitals (≤100 beds) were more likely to send specimens for outside testing compared with laboratories associated with large hospitals (>250 beds). Median turnaround time for ova and parasite panel testing for giardiasis was significantly shorter for in-house testing (1.0 days) than within-system (2.25 days) or outside laboratory (3.0 days) testing (P = .0003). No laboratories reported in-house testing for meningococcal disease, pertussis, or Rocky Mountain spotted fever using polymerase chain reaction. Many hospitals did not order diagnostic tests for important infectious diseases during 2006, even for relatively common diseases. In addition, hospital laboratories were unlikely to perform diagnostic testing in-house; sending specimens to an outside laboratory may result in substantial delays in receiving results. These unsettling findings have adverse implications for both patient care and public health surveillance; they indicate an immediate need to study nationally the use and timeliness of clinical microbiologic testing.
    Journal of public health management and practice: JPHMP 07/2012; 18(4):E4-E10. · 0.96 Impact Factor

Publication Stats

2k Citations
533.15 Total Impact Points

Institutions

  • 2014
    • Rhode Island Hospital
      Providence, Rhode Island, United States
  • 2012–2014
    • Alpert Medical School - Brown University
      • • Department of Medicine
      • • Department of Obstetrics and Gynecology
      Providence, Rhode Island, United States
  • 1997–2014
    • Brown University
      • • Department of Medicine
      • • Department of Obstetrics and Gynecology
      • • Division of Infectious Diseases
      Providence, Rhode Island, United States
  • 2011–2013
    • St. Jude Children's Research Hospital
      • Department of Pathology
      Memphis, Tennessee, United States
    • Johns Hopkins Medicine
      • Department of Pathology
      Baltimore, Maryland, United States
  • 2001–2013
    • Emory University
      • • Department of Pathology and Laboratory Medicine
      • • Department of Hematology and Medical Oncology
      • • Department of Behavioral Sciences and Health Education
      Atlanta, Georgia, United States
    • University Medical Center Utrecht
      Utrecht, Utrecht, Netherlands
  • 2008–2012
    • University of Connecticut
      • Department of Psychology
      Storrs, CT, United States
    • Georgia Department of Public Health
      Marietta, Georgia, United States
  • 2009
    • University of Washington Seattle
      • Department of Obstetrics and Gynecology
      Seattle, WA, United States
  • 2006–2008
    • Lifespan
      Providence, Rhode Island, United States
  • 2005–2008
    • University of Kentucky
      • • College of Public Health
      • • Department of Health Behavior
      Lexington, KY, United States
  • 1995–2002
    • Massachusetts General Hospital
      • Microbiology Laboratory
      Boston, MA, United States