Raynell Lang

Raynell Lang
The University of Calgary | HBI · Department of Medicine

Doctor of Medicine

About

53
Publications
2,042
Reads
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299
Citations
Citations since 2017
52 Research Items
299 Citations
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2017201820192020202120222023050100150
2017201820192020202120222023050100150
2017201820192020202120222023050100150
Introduction
Skills and Expertise

Publications

Publications (53)
Article
Objective: To characterize the prevalence of anemia and risk factors between 2007 and 2017 for moderate/severe anemia among people with HIV (PWH) in North America who have initiated antiretroviral therapy (ART). Design: Observational study of participants in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). Method...
Article
Importance: Integrase strand transfer inhibitor (INSTI)-containing antiretroviral therapy (ART) is currently the guideline-recommended first-line treatment for HIV. Delayed prescription of INSTI-containing ART may amplify differences and inequities in health outcomes. Objectives: To estimate racial and ethnic differences in the prescription of I...
Article
Unsuppressed HIV viremia damages immunity and increases the risk for secondary HIV transmission. Successful engagement of persons with HIV (PWH) into care resulting in viral suppression is vital. PWH already engaged in care, who, after achieving viral suppression, experience viral breakthrough episodes (VBEs) with a sequence of suppressed/unsuppres...
Article
Objective: To describe the prevalence of diagnosed depression, anxiety, bipolar disorder, and schizophrenia in people with HIV (PWH) and the differences in HIV care continuum outcomes in those with and without mental health disorders (MHDs). Design: Observational study of participants in the North American AIDS Cohort Collaboration on Research a...
Preprint
Full-text available
Importance: Estimating the medical complexity of people aging with HIV can inform clinical programs and policy to meet future healthcare needs. Objective: To project the prevalence of comorbidities and multimorbidity among people with HIV (PWH) using antiretroviral therapy (ART) in the US through 2030. Design: Agent-based simulation model Setting:...
Article
Importance: Understanding the severity of postvaccination SARS-CoV-2 (ie, COVID-19) breakthrough illness among people with HIV (PWH) can inform vaccine guidelines and risk-reduction recommendations. Objective: To estimate the rate and risk of severe breakthrough illness among vaccinated PWH and people without HIV (PWoH) who experience a breakthr...
Article
Background People with HIV (PWH) are at an increased risk of cardiovascular disease (CVD) with an unknown added impact of hepatitis C virus (HCV) coinfection. We aimed to identify whether HCV coinfection increases the risk of type 1 myocardial infarction (T1MI) and if the risk differs by age. Methods and Results We used data from NA‐ACCORD (North...
Article
Background: We characterized trends in statin eligibility and subsequent statin initiation among people with HIV (PWH) from 2001-2017 and identified predictors of statin initiation between 2014-2017. Setting: PWH participating in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) enrolled in twelve US cohorts collect...
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Full-text available
Background Varicella-zoster virus (VZV) infection disproportionately affects people with HIV (PWH) primarily presenting as Herpes Zoster. However, VZV seroprevalence, its association with zoster, and clinical outcomes, remain understudied in era of modern antiretroviral therapy (ART). We assessed VZV seroprevalence, rates of VZV illness, and associ...
Article
Background: Bloodstream infections (BSIs) among people with human immunodeficiency virus (PWH) remain a poorly studied source of morbidity and mortality. We characterize the epidemiology, microbiology, and clinical outcomes including reinfection, hospitalization, and mortality rates of both community-acquired and hospital-acquired BSI in PWH. Met...
Article
Background In 2012, the United States (US) Department of Health and Human Services updated HIV treatment guidelines to recommend antiretroviral therapy (ART) for all people with HIV (PWH) regardless of CD4 count. We investigated recent trends and disparities in early receipt of ART prescription and subsequent viral suppression (VS). Methods We exa...
Article
Background: Adherence to non-pharmaceutical interventions (NPIs) for COVID-19, including physical distancing, masking, staying home while sick, and avoiding crowded indoor spaces remain critical for limiting the spread of COVID-19. Objective: This study tests the effectiveness of using various persuasive appeals (deontological moral frame, empat...
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Full-text available
Background Bluetooth-enabled smartphone apps have been developed and implemented in different sites globally to help overcome capacity limitations of traditional interview-based COVID-19 contact tracing. Two apps are currently available in Canada: ABTraceTogether exclusively in Alberta and COVID Alert in nine other provinces and territories. This s...
Article
Importance: Recommendations for additional doses of COVID-19 vaccines for people with HIV (PWH) are restricted to those with advanced disease or unsuppressed HIV viral load. Understanding SARS-CoV-2 infection risk after vaccination among PWH is essential for informing vaccination guidelines. Objective: To estimate the rate and risk of breakthrou...
Article
Background Bacterial prostatitis is a highly prevalent infection responsible for significant morbidity among men. The diagnosis and treatment for bacterial prostatitis remains complicated. The difficulty in diagnosis is in part owing to the paucity of high quality evidence that guides a clinician’s physical examination and informs interpretation of...
Preprint
Full-text available
Objective To describe the prevalence of diagnosed depression, anxiety, bipolar disorder, and schizophrenia in people with HIV (PWH) and the differences in HIV care continuum outcomes in those with and without mental health disorders (MHD). Design Observational study of participants in the NA-ACCORD. Methods PWH (≥18 years) contributed data on pre...
Preprint
Full-text available
Importance Understanding the severity of post-vaccination COVID-19 breakthrough illness among people with HIV (PWH) can inform vaccine guidelines and risk-reduction recommendations. Objective Estimate the rate and risk of severe breakthrough illness among vaccinated PWH and people without HIV (PWoH) who experience a breakthrough infection. Design...
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Full-text available
Introduction: We explored associations between sociodemographic factors and public beliefs, behaviors, and information acquisition related to the coronavirus disease 2019 (COVID-19) to identify how the experiences of subpopulations in Canada may vary. Methods: We administered a national online survey through Ipsos Incorporated to adults residing...
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Objectives To understand Canadian’s attitudes and current behaviours towards COVID-19 public health measures (PHM), vaccination and current public health messaging, to provide recommendations for a public health intervention. Design Ten focus groups were conducted with 2–7 participants/group in December 2020. Focus groups were transcribed verbatim...
Preprint
Full-text available
Importance: Recommendations for additional doses of COVID vaccine are restricted to people with HIV who have advanced disease or unsuppressed HIV viral load. Understanding SARS-CoV-2 infection risk post-vaccination among PWH is essential for informing vaccination guidelines. Objective: Estimate the risk of breakthrough infections among fully vaccin...
Article
Full-text available
Adoption of non-pharmaceutical interventions (NPIs) remains critical to curtail the spread of COVID-19. Using self-reported adherence to NPIs in Canada, assessed through a national cross-sectional survey of 4498 respondents, we aimed to identify and characterize non-adopters of NPIs, evaluating their attitudes and behaviours to understand barriers...
Article
Purpose Despite effective antiretroviral therapy, rates of end-stage liver disease (ESLD) remain high. It is not clear whether contemporary antiretrovirals contribute to the risk of ESLD. Methods We included patients from cohorts with validated ESLD data in the North American AIDS Cohort Collaboration on Research and Design. Patients had to initia...
Article
Background The rollout of COVID-19 vaccines has brought vaccine hesitancy to the forefront in managing this pandemic. COVID-19 vaccine hesitancy is fundamentally different from that of other vaccines due to the new technologies being used, rapid development, and widespread global distribution. Attitudes on vaccines are largely driven by online info...
Preprint
BACKGROUND There are concerns that vaccine hesitancy may impede COVID-19 vaccine rollout and prevent the achievement of herd immunity. Vaccine hesitancy is a delay in acceptance or refusal of vaccines despite their availability. OBJECTIVE We aimed to identify which people are more and less likely to take a COVID-19 vaccine, and factors associated...
Article
Background: There are concerns that vaccine hesitancy may impede COVID-19 vaccine rollout and prevent the achievement of herd immunity. Vaccine hesitancy is a delay in acceptance or refusal of vaccines despite their availability. Objective: We aimed to identify which people are more and less likely to take a COVID-19 vaccine, and factors associa...
Article
A previously healthy 55-year-old man presented to hospital with 10 days of progressive dyspnea with fever, night sweats, and a productive cough and no history of recreational drug use or occupational or animal exposures. His wife had developed similar symptoms 2 weeks earlier but had since recovered. Physical exam revealed a new systolic murmur bes...
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Background Public support of public health measures including physical distancing, masking, staying home while sick, avoiding crowded indoor spaces and contact tracing/exposure notification applications remains critical for reducing spread of COVID-19. The aim of our work was to understand current behaviours and attitudes towards public health meas...
Preprint
BACKGROUND The rollout of COVID-19 vaccines has brought vaccine hesitancy to the forefront in managing this pandemic. COVID-19 vaccine hesitancy is fundamentally different from that of other vaccines due to the new technologies being used, rapid development, and widespread global distribution. Attitudes on vaccines are largely driven by online info...
Article
Background Workers supporting adults with intellectual disabilities (ID) experience significant stress in their essential role during COVID‐19 due to the high risk of their clients contracting COVID‐19 and having adverse outcomes. The purpose of the current study was to describe the attitudes of workers towards COVID‐19 vaccination prior to vaccina...
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Full-text available
Public health measures to reduce COVID-19 transmission include masking in public places, physical distancing, staying home when ill, avoiding high-risk locations, using a contact tracing app, and being willing to take a COVID-19 vaccine. However, adoption of these measures varies greatly. We aimed to improve health messaging to increase adherence t...
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Full-text available
Background: Staphylococcal blood stream infections (SBSI) are a significant cause of morbidity and mortality, however there is little data on such infections in persons with HIV (PWH) in the combination antiretroviral therapy era, particularly when divided by species; methicillin-sensitive (MSSA) and methicillin-resistant Staphylococcus aureus (MR...
Article
Transmission of human immunodeficiency virus (HIV) to a family caregiver through a conjunctival blood splash - Raynell Lang, Taj P. Jadavji, Guido van Marle, Jennifer J. Bishop, Kevin Fonseca, M. John Gill
Article
Scientific medical conferences have proliferated in recent years but little data are available to assess their effectiveness in achieving their commonly stated aims “to educate, advance science, and establish evidence-based policy”. The recent expansion of what has been labeled ‘predatory academia’ has heightened concerns about the quality of both...
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Background Baseline genotype antiretroviral resistance testing (GART) were introduced to allow better selection of antiretroviral therapy (ART), minimizing the use of less effective drugs and risk for ongoing transmission of drug-resistant virus. However, the value of baseline GART has recently been questioned due to declining incidence of TDR in t...
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Background: Coccidioides spp. are dimorphic fungi endemic to Central America, regions of South America and southwestern USA. Two species cause most human disease: Coccidioides immitis (primarily California isolates) and Coccidioides posadasii. Coccidioidomycosis is typically acquired through inhalation of soil or dust containing spores. Coccidioid...
Article
Background: We have used a comprehensive HIV population to characterize antiretroviral therapy (ART), drug class selection, pill burden, drug costs and health outcomes over the entire span of the HIV epidemic. Methods: Antiretroviral (ARV) use (drugs, classes, formulations) and both the laboratory and clinical outcomes (HIV-1 RNA, CD4+ T-cell co...
Article
With an ever increasing number of academic conferences being offered and a growing concern regarding the appearance of “predatory conferencing”, the optimal use of one’s “conference time” has become complicated. It is particularly important for medical students and residents, due to both limited time and resources, to choose conferences to achieve...
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Background The incidence of AIDS defining CNS infections declined significantly with HAART; however, the longitudinal change in factors and effects of disease has not been well described. We characterized the changing incidence and outcomes in AIDS defining CNS infections over the past 30 years in the geographically defined, well-characterized sout...
Article
Despite a dramatic decrease in vertical transmission of HIV in the developed world, maternal HIV infection acquired after negative prenatal screening still leaves a window of vulnerability. Through quality assurance programs in two Canadian Provinces, five cases where perinatal HIV transmission occurred despite negative prenatal screening were iden...
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Objectives Syphilis is a global health concern with an estimated 12 million infections occurring annually. Due to the increasing rates of new syphilis infections being reported in patients infected with HIV, and their higher risk for atypical and severe presentations, periodic screening has been recommended as a routine component of HIV care. We ai...
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Background: Exophiala dermatitidis is a melanized fungus isolated from many environmental sources. Infections caused by Exophiala species are typically seen in immunocompromised hosts and manifest most commonly as cutaneous or subcutaneous disease. Systemic infections are exceedingly rare and associated with significant morbidity and mortality CAS...
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Background: Syphilis is a global health concern disproportionately affecting HIV-infected populations. In Alberta, Canada, the incidence of syphilis in the general population has recently doubled with 25% of these infections occurring in HIV-infected patients. The Southern Alberta HIV Clinic (SAC) and Calgary STI Program (CSTI) analyzed the epidem...
Article
Background: Standard diagnostic testing for HIV infection has traditionally relied on a high sensitivity HIV antibody screening test using an enzyme-linked immunosorbent assay (ELISA) followed by a high specificity antibody confirmatory test such as a Western Blot. Recently several of the screening assays have been enhanced with an ability to iden...
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Full-text available
Background Syphilis is an emerging global health concern with an estimated 12 million new infections being documented annually. In individuals with HIV, syphilis presentations may be atypical leading to the recommendation for regular routine screening. This retrospective cohort study aimed to characterize syphilis presentation and serologic feature...
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Full-text available
Hematospermia is a common complaint among patients seen in outpatient urology clinics. The differential diagnosis is broad and includes inflammatory, infectious, neoplastic, structural, systemic, and traumatic causes. The most common infectious causes are uropathogens and sexually transmitted infections. However, with increasing global travel, phys...
Article
Biobanking is increasingly becoming recognized as an emerging resource for enhancing both clinical care and research. Establishing a useful repository of clinical specimens is, however, challenging. Below we discuss the barriers encountered and lessons learned while developing and using a specimen repository integrated into an HIV care program. Sub...

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