About

Amit Achhra is not explicitly listed with a detailed biography on the provided page. The page primarily lists team members, faculty, and collaborators involved in infectious diseases and substance use disorders research at Yale School of Medicine. Therefore, there is no specific biographical information available for Professor Amit Achhra in the provided text.

Research topics

• Medicine
• Computer Science
• Virology
• Gerontology
• Radiology
• Pathology
• Intensive care medicine
• Internal medicine
• Environmental health
• Pediatrics

Selected publications

• Combined Use of Ibalizumab and Lenacapavir for the Treatment of Multidrug-resistant HIV-1: A Case Series

  Clinical Infectious Diseases · 2025-10-31

  articleOpen access

  BACKGROUND: Some individuals with human immunodeficiency virus (HIV-1) have acquired multidrug-resistant (MDR) strains of HIV and/or are nonadherent to antiretroviral (ARV) medication. Injectable ARVs can provide salvage therapy for those with limited therapeutic options and may be preferred by some people with HIV (PWH). Real-world evidence may contribute to a more comprehensive understanding of the barriers to adherence and the utility of injectable ARVs in PWH. Currently, there is a lack of data on combined use of injectable ibalizumab (IBA) and lenacapavir (LEN) with optimized background regimen (OBR). METHODS: A retrospective observational study examined medical charts from people with MDR HIV across 8 facilities in the United States. All PWH used a combination of both IBA + LEN ± OBR for at least 6 months. Viral loads and CD4+ counts were collected. RESULTS: A total of 21 PWH were included. Four-class resistance at baseline was reported in 38.1% of PWH. Within 12 to 24 weeks of combined IBA + LEN treatment, a median reduction of -2710 copies/mL HIV RNA was observed. Median increase to CD4+ count was 67.5 cells/mm3 within 4 to 44 weeks of treatment initiation. Few intolerances required changes to treatment. Therapy with IBA + LEN continued for an average of 30 months and 20 months, respectively. CONCLUSIONS: In this small group of individuals with MDR HIV who were heavily treatment-experienced and/or faced adherence challenges, the use of IBA + LEN ± OBR was well tolerated and led to clinically significant reductions in viral loads and improvements in CD4+ counts.

  PublisherOA PDFDOI

• Corrigendum to “Long-term impact of immediate versus deferred antiretroviral therapy on kidney health in people with HIV.” Kidney International 2024;106:136–144

  Kidney International · 2024-11-20

  erratumOpen access
  PublisherOA PDFDOI

• Five-Year Evaluation of an Anal Cancer Screening Program in Men Who Have Sex With Men With HIV at 2 Academic Center Clinics

  Clinical Infectious Diseases · 2024-11-04 · 5 citations

  articleOpen access1st author

  BACKGROUND: Guidelines recommend annual anal cytology-based squamous cell carcinoma of anus (SCCA) screening for men who have sex with men with HIV aged ≥35 years (eligible population). The recommended threshold for high-resolution anoscopy (HRA) depends on its availability: low-threshold (any abnormal cytology) if availability is high and high-threshold (high-grade squamous intraepithelial lesion [HSIL] on cytology) if availability is low. METHODS: This was a retrospective chart review (2018-2022) at academic HIV clinics. We evaluated (1) 5-year uptake of cytology-based SCCA screening in the eligible population and (2) estimated HSIL detection rate based on our current low-threshold criteria, and if high-threshold criteria were used for HRA referral. RESULTS: Of 432 eligible individuals, only 219 (50.7%) had at least 1 and only 113 (26%) had >1 SCCA screening tests in a median follow-up of 4 years. Seventy-four (17.1%) individuals had at least 1 abnormal anal cytology during follow-up, of whom 56 (75.6%) underwent HRA. Increasing age (≥57 years) and history of smoking negatively correlated with ever receiving screening. Anal cytology (365 tests in 206 individuals) showed 17.5% "unsatisfactory" and 26.8% with any abnormal cytology (zero with HSIL) triggering HRA referral. Only 34 individuals (7.8% of screening eligible) were ever detected with HSIL. Strictly using high-threshold criteria for HRA referral would have led to no HRA or HSIL detection. CONCLUSIONS: We noted poor uptake of screening over time, particularly in older age groups. Importantly, anal cytology performed poorly as a triage test for HRA referral, with high rates of "unsatisfactory" samples and low sensitivity for detecting HSIL.

  PublisherOA PDFDOI

• Acute Hepatitis due to Primary Human Immunodeficiency Virus Infection

  Open Forum Infectious Diseases · 2024-03-22 · 1 citations

  articleOpen accessSenior authorCorresponding

  The acute retroviral syndrome may present with diverse systemic manifestations and laboratory abnormalities. Here we present a rare case of primary human immunodeficiency virus (HIV) infection causing severe acute hepatitis. Liver histopathology demonstrated a pattern of lymphocytic inflammation consistent with acute hepatitis, high levels of HIV proviral DNA were detected within liver tissue, and immunofluorescence showed HIV p24 antigen within immune and parenchymal cells including hepatocytes. We review the literature pertaining to HIV infection of cell compartments within the liver and discuss the implications for HIV-associated acute liver disease.

  PublisherOA PDFDOI

• Long-term impact of immediate versus deferred antiretroviral therapy on kidney health in people with HIV

  Kidney International · 2024 · 3 citations

  • Medicine
  • Intensive care medicine
  • Pediatrics

  ). Results were similar in models adjusted for baseline covariates associated with CKD, including UACR and APOL1 genotype. Similarly, there was no significant difference between treatment arms in incidence of confirmed UACR 30 mg/g or more (odds ratio 1.13; 95% confidence interval 0.85, 1.51). Thus, our findings provide the most definitive evidence to date in support of the long-term safety of early ART with respect to kidney health.

  PublisherDOI

• 1538. Is there value in performing yearly screening for latent tuberculosis infection by interferon-gamma release assay among patients living with HIV in non-endemic settings?

  Open Forum Infectious Diseases · 2023-11-27

  articleOpen access

  Abstract Background People with HIV (PWH) are at increased risk of reactivation of tuberculosis (TB) from latent tuberculosis infection (LTBI). Current guidelines recommend all PWH be initially screened for LTBI with either interferon-gamma release assays (IGRA) or tuberculin skin testing (TST). Also, repeat screening is recommended in either PWH with CD4 count < 200 cells/mm3 after initial negative screen or any PWH with new TB exposure risk. Despite such guideline, there are centers that continue to screen LTBI in all PWH with annual IGRA testing. Our study evaluated the utility of universal yearly LTBI screening by IGRA among PWH in non-endemic settings. Methods A retrospective chart review of PWH in care from 2017-2021 at two urban academic medical centers. Demographics and annual IGRA results were collected. Patients were further stratified into three groups based on IGRA seroconversion: those with negative to positive (Group A), indeterminate to positive (Group B), and negative to indeterminate (Group C). Data for 3 groups, included risk factors for TB, chest imaging results, HIV data, and treatment. Descriptive statistics, chi-square, and Welch’s ANOVA were performed. Results A total of 2694 PWH were in care, comprised of 66% male, 50% Black, and 23% LatinX. Of the 2694, 2255 (84%) had a negative baseline IGRA. Seventy-two patients (2.7%) had IGRA seroconversion: 39 in Group A, 1 in Group B, and 32 in Group C (Table 1). Group A had lower CD4 counts (p=0.04) and higher HIV viral loads (p=0.03) than Group C. Only 12 PWH (0.5%) with negative baseline IGRA developed new LTBI, with an incidence 1.1 cases/1000 patient-years. Of these, 8 PWH (67%) had ≥ 1 TB risk factor and none had CD4< 200. Travel to endemic region (33%) was most common risk factor. Among those with new LTBI, N=6/7 had confirmation of LTBI with repeat positive IGRA after initial seroconversion. Nine (75%) patients completed LTBI treatment and none developed tuberculosis. Features of patients with conversion to a positive or indeterminate QuantiFERON Conclusion In two large diverse clinics in non-TB endemic settings, the true incidence of developing LTBI in PWH was rare among those with negative baseline IGRA. Due to low yield of cases with universal annual screening, our findings support the targeted approach recommended by current guidelines. Disclosures Michael Virata, MD, Gilead Sciences: Advisor/Consultant|Janssen: Advisor/Consultant|ViiV Healthcare: Advisor/Consultant

  PublisherOA PDFDOI

• 1478. Evaluation Of Anal Cancer Screening Program in men who have sex with men (MSM) persons with HIV (PWH) At Two academic center HIV Clinics 2018-2022

  Open Forum Infectious Diseases · 2023-11-27

  articleOpen access1st authorCorresponding

  Abstract Background Treatment of anal dysplasia has been shown to reduce incidence of squamous cell carcinoma of the anus (SCCA) in PWH, particularly in MSM. Annual anal cytology (PAP) has been offered for SCCA screening since ∼2010 at our urban academic center ambulatory HIV clinics, and those with abnormal PAP (atypical squamous cells of undetermined significance (ASCUS), or Anal Intraepithelial Neoplasia (AIN) 1-3) are referred for high-resolution anoscopy (HRA) and dysplasia treatment. Evaluation of screening cascade can help better understand and improve SCCA screening protocols. Methods We performed a retrospective chart review (2018-2022) on MSM PWH, age 35 and older, enrolled at our two HIV clinics who had at least one clinic visit by 12/31/2019. Of total eligible for SCCA screening, we calculated proportion of those engaged (received at least one screening (PAP or HRA)) and retained (received at least one subsequent screening) in care. Characteristics of people who did not engage in screening were evaluated by logistic regression. Results A total of 432 individuals were eligible for SCCA screening. The median [interquartile range] age was 57 [48-62] years, 97% were on antiretroviral therapy, 28% were Blacks, 62% had history of smoking, and 24% had a prior history of anal dysplasia. A total of 219 (50.7%) engaged in screening, and only 113 (26%) were retained (Figure-1). Seventy-four individuals had at least one abnormal PAP during follow-up, of which 35 (47%) received HRA at least once. In multivariable analysis, older age and history of smoking negatively correlated with engagement while history of anal dysplasia positively correlated with engagement (table-1). Race (Blacks vs other) and type of insurance (public/private) did not correlate with engagement. Conclusion We noted high rates of loss of engagement and retention in SCCA screening even in PWH highly engaged in HIV care. Older MSM PWH, who are at higher risk of SCCA, were less likely to be engaged in screening. Disclosures Michael D. Virata, MD, FACP, Gilead Sciences: Advisor/Consultant|Janssen: Advisor/Consultant|ViiV Healthcare: Advisor/Consultant

  PublisherOA PDFDOI

• Contrasting Cases of HIV Vasculopathy Associated Fusiform Aneurysms

  The Neurohospitalist · 2022 · 1 citations

  • Medicine
  • Pathology
  • Radiology

  Background: We present two cases to highlight the spectrum of severity and outline instructive clinical courses. Results: The combination of both fusiform abnormalities and Moyamoya, discussed in our first case has not been previously described. In comparison, our second case actually demonstrated improvement in vasculopathy after nine-months of antiretroviral therapy (ART) adherence.

  PublisherOA PDFDOI

• Assessing Cardiovascular Risk in People Living with HIV: Current Tools and Limitations

  Current HIV/AIDS Reports · 2021 · 63 citations

  1st authorCorresponding
  • Computer Science
  • Medicine
  • Gerontology
  PublisherOA PDFDOI

• Sex‐based differences in antiretroviral therapy initiation, switching and treatment interruptions: global overview from the International Epidemiologic Databases to Evaluate AIDS (IeDEA)

  Journal of the International AIDS Society · 2018-06-01 · 23 citations

  articleOpen access

  INTRODUCTION: In 2015, the World Health Organization recommended that all HIV-infected individuals consider ART initiation as soon as possible after diagnosis. Sex differences in choice of initial ART regimen, indications for switching, time to switching and choice of second-line regimens have not been well described. The aims of this study were to describe first-line ART and CD4 count at ART initiation by sex, calendar year and region, and to analyse time to change or interruption in first-line ART, according to sex in each region. METHODS: Participating cohorts included: Southern, East and West Africa (IeDEA-Africa), North America (NA-ACCORD), Caribbean, Central/South America (CCASAnet) and Asia-Pacific including Australia (IeDEA Asia-Pacific). The primary outcomes analysed for each region and according to sex were choice of initial ART, time to switching and time to discontinuation of the first-line regimen. RESULTS AND DISCUSSION: The combined cohort data set comprised of 715,252 participants across seven regions from low- to high-income settings. The median CD4 count at treatment initiation was lower in men compared with women in nearly all regions and time periods. Women from North America and Southern Africa were more likely to switch ART compared to men (p < 0.001) with approximately 90% of women reporting a major change after 10 years in North America. Overall, after 8 years on ART, >50% of HIV- positive men and women from Southern Africa, East Africa, South and Central America remained on their original regimen. Men were more likely to have a treatment interruption compared with women in low- and middle-income countries from the Asia/Pacific region (p < 0.001) as were men from Southern Africa (p < 0.001). Greater than 75% of men and women did not report a treatment interruption after 10 years on ART from all regions except North America and Southern Africa. CONCLUSIONS: There are regional variations in the ART regimen commenced at baseline and rates of major change and treatment interruption according to sex. Some of this is likely to reflect changes in local and international antiretroviral guideline recommendations but other sex-specific factors such as pregnancy may contribute to these differences.

  PublisherOA PDFDOI

Frequent coauthors

• Janaki Amin

  Macquarie University

  15 shared

• Matthew Law

  National University of Singapore

  12 shared

• Lene Ryom

  Hvidovre Hospital

  10 shared

• Fabrice Bonnet

  Bordeaux Population Health

  8 shared

• Jialun Zhou

  Guangdong Pharmaceutical University

  7 shared

• Jens Lundgren

  Rigshospitalet

  7 shared

• Andrew Phillips

  University College London

  6 shared

• Lene Ryom-Nielson

  University of Copenhagen

  6 shared

Labs

• Yale Clinical & Community Research (YCCR)PI

Education

• M.D.

  NYP/Weill-Cornell

• Ph.D., Infectious diseases/HIV

  Massachusetts