M. John Gill's research while affiliated with The University of Calgary and other places

Publications (29)

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
The emergence of dual therapy for antiretroviral (ARV)-experienced persons living with HIV (PWH) offers the opportunity to reduce lifetime exposure to unnecessary ARV drugs while maintaining viral suppression and reducing the cost of care. Our objective, using retrospective analysis of a quality care initiative, was to examine in routine clinical p...
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The COVID-19 pandemic has illustrated the importance of infection tracking. The role of asymptomatic, undiagnosed individuals in driving infections within this pandemic has become increasingly evident. Modern phylogenetic tools that take into account asymptomatic or undiagnosed individuals can help guide public health responses. We finetuned establ...
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HIV infection persists in different tissue reservoirs among people with HIV (PWH) despite effective antiretroviral therapy (ART). In the brain, lentiviruses replicate principally in microglia and trafficking macrophages. The impact of ART on this viral reservoir is unknown. We investigated the activity of contemporary ART in various models of lenti...
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Background: The age-distribution of men who have sex with men (MSM) continues to change in the 'Treat-All' era as effective test-and-treat programs target key-populations. However, the nature of these changes and potential racial heterogeneities remain uncertain. Methods: The PEARL model is an agent-based simulation of MSM in HIV care in the US,...
Article
We aimed to identify “high-cost” patients with HIV (PWH) and determine drivers behind higher costs. All PWH at the Southern Alberta HIV Clinic, Canada, and active in 2017 were included. Sociodemographic, clinical, and healthcare utilization data were collected. The direct care costs from the payers’ perspective including antiretroviral drugs (ARV),...
Article
Despite guidelines, many individuals are not routinely tested for HIV within healthcare settings. Our objective was to quantify and characterize preceding clinical encounters by newly-diagnosed persons living with HIV in southern Alberta, Canada. We discuss the clinical impact of missed HIV testing, and options for remediation. Clinical encounters...
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Background: Following migration from Schistosoma and Strongyloides endemic to non-endemic regions, people remain at high risk for adverse sequelae from these chronic infections. HIV co-infected persons are particularly vulnerable to the serious and potentially fatal consequences of untreated helminth infection. While general screening guidelines e...
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Background The aim of the present study was to calculate a frailty index (FI) in older adults (≥50) living with HIV, search for cross-sectional associations with the FI, and investigate the association between the FI score and two-year mortality. Methods Cross-sectional study with a short-term prospective com-ponent for the determination of two-yea...
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Adherence to antiretroviral therapy (ART) is critical for successful treatment of Human Immunodeficiency Virus (HIV), but comparisons across settings are difficult because adherence is measured in different ways. We examined utility of different adherence measures for identification of patients at risk of viral failure (VF). Eight cohorts in the AR...
Article
Individuals diagnosed with HIV before 1996 had poor prognoses. Few HIV care centers can track patients continuously from the 1980s to present. We determined the sociodemographic, clinical, and health care utilization characteristics of patients diagnosed and followed for >20 years (i.e. long-term HIV/AIDS survivors) to understand what factors contr...
Article
Background: Cutaneous melanoma incidence may be modestly elevated in people with HIV (PWH) versus people without HIV. However, little is known about the relationship of immunosuppression, HIV replication, and antiretroviral treatment (ART) with melanoma risk. Methods: PWH of white race in the North American AIDS Cohort Collaboration on Research...
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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...
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Background: In patients with HIV/AIDS receiving antiretroviral therapy (ART), HIV-1 persistence in brain tissue is a vital and unanswered question. HIV-1 infects and replicates in resident microglia and trafficking macrophages within the brain although the impact of individual ART drugs on viral infection within these brain myeloid cells is unknow...
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...
Article
In the United States 40% of HIV patients are lost to follow-up (LTFU) following linkage to HIV care and an estimated 30–61% of new HIV transmissions are attributed to this group. To characterize those LTFU and healthcare contacts they make, we retrospectively analyzed a large regional HIV cohort in Calgary, Canada, utilizing a province-wide electro...
Article
Sequence analysis of HIV-1 from 440 therapy-naive individuals included within the CASCADE study, who seroconverted within 18 months of the last negative test, identified 65 persons infected with a strain carrying resistance-associated mutations. Population-based sequencing was performed for 20 of these individuals during the therapy-free follow-up...

Citations

... This region has high rates of KSHV cancers in both HIV-positive and negative populations. Belts of high KSHV cancer endemicity extend throughout Africa up into Mediterranean and Western Asian populations and into populations of South America 6,[9][10][11] . In high-income countries of Europe and North America, men who have sex with men (MSM) and organ 1 donor recipients remain at high risk for KSHV-related cancers, and hence targeted vaccination programs could be envisioned 12 . ...
... As it is difficult to obtain a complete transmission network with undetected infections in real situations, we used the transmission networks inferred by Perera's work [27], which used published SARS-CoV-2 genomic data to estimate reasonable transmission networks with the inference of unsampled infection sources. For the gene sequence data, we used the FASTA data, which was also used to infer the transmission network. ...
... In a two-by-two factorial, open-label, noninferiority trial study, DRV-based second line regimen showed effective viral suppression in the population of patients, including patients for whom NRTIs are predicted to have little or no activity [4]. However, DRV show limited HIV suppression in the brain, even with the use of well tolerated combination antiretroviral therapy (cART) [5,6]. A comparative study that involved HIV positive and HIV negative participants from the pre-cART era and cART era showed significant impairment in motor skills, cognitive speed, and verbal fluency, whereas HIV positive patients during cART era showed more memory (learning) and executive function impairment [7]. ...
... So far, none of the studies that projected the number and age structure of PLHIV accounted for the issue of the ART initiation period [10][11][12][13][14][15][16]. In this study, we propose to fill this gap and project the demographic profile of the adult population living with diagnosed HIV (aPLdHIV) in France until 2030. ...
... [24] The observed length of stay of 19.3 days for all patients was similar to what has been reported in similar patients with HIV. [25] This study evaluated outcomes of ICU admission in a cohort of mainly African American patients with poorly controlled HIV infection. Results show that while some HIV-related conditions such as active CMV disease and NHL predict mortality after an ICU admission among PLHIV, the most important predictors are organ system derangements and timeliness in ICU admission during the disease process. ...
... As the HIV/AIDS epidemic enters its fifth decade, aging with the virus has become a priority area of focus due to new HIV diagnoses among older adults and increased life expectancy for people living with HIV. In Canada, approximately half of the population living with HIV is now over fifty (Bourgeois et al., 2017), with 24.6% of new HIV diagnoses in 2017 occurring in this age group (McMillan et al., 2020;Public Health Agency of Canada, 2021). The Canadian provinces of Ontario and Saskatchewan are the setting of this study. ...
... A recent meta-analysis estimated a seroprevalence in immigrants from endemic areas and living in nonendemic areas at approximately 18%, with immigrants from sub-Saharan Africa having the highest prevalence (approximately 24%) [36]. The group of HIV + immigrants showed figures over 20% [37], and that of unaccompanied immigrant minors showed figures of approximately 16% [38]. In addition, in the immigrant group from endemic areas, approximately 40% of diagnosed infections occur in asymptomatic patients [8], which can cause a diagnostic delay [39] and sometimes has serious consequences [40]. ...
... The duration since HIV diagnosis and time since ART initiation are predictors of co-morbidity, and both factors are associated with frailty [36,40]. Frailty is linked to higher mortality rates among older PLWH, and its incidence increases with age, presence of co-morbidities, falls and disability [27,28,67]. The presence of one or more co-morbidities also increases the risk of falls in PLWH [50]. ...
... miRNAs regulate diverse pain-related mediators, protein kinases, and structural proteins along the pain processing pathways. For HIV-associated symptomatic distal sensory polyneuropathy and neuropathic pain, serum miR-455-3p acted as a potential biomarker, possibly targeting multiple genes involved in peripheral neuropathic pain, such as nerve growth factor (NGF) and related genes.82 Brainderived neurotrophic factor (BDNF), another well-recognized pain mediator, is a common miR-1, -183, and -206 target.[83][84][85] ...