Lori Ellen Fantry

Interests

Research

My research interests include HIV and cancer, HIV and cardiovascular disease, HIV and women, HIV and osteoporosis, HIV Pre-Exposure Prophylaxis, and access to care in under-served populations.

Teaching

My teaching interests include primary care of HIV, HIV and women, HIV and opportunistic infections, HIV and chronic diseases, adult vaccines, sexually transmitted infections, and syphilis.

Courses

Scholarly Contributions

Chapters

• Fantry, L. (2016). Gynecologic Infections. In University of Maryland Medical Center Antibiotic Guidelines(pp 34-42). Maryland: University of Maryland Medical Center.
• Fantry, L. (2016). Chronic Infections of the Small Intestine. In Yamada's Atlas of Gastroenterology, fifth edition(pp 177-183). Wiley-Blackwell.
• Fantry, L. (2015). Treponema Pallidum. In Antimicrobial Therapy and Vaccines, 3rd edition. Baltimore: Williams & Wilkins.
• Fantry, G. T., Fantry, L. E., & James, S. P. (2009). Chronic Infections of the Small Intestine. In Textbook of Gastroenterology, 5th edition.(pp 1225-1244). Philadelphia: Lippincott. doi:10.1002/9781444303254.ch49
  More info

  Description of infections i the small intestine
• Fantry, L. (2008). Chronic Infections of the Small Intestine. In Textbook of Gastroenterology, 2 Volume Set(pp 1225-44). Wiley-Blackwell; 5 edition (December 3, 2008).
• Fantry, L. (2009). Chronic Infections of the Small Intestine. In Atlas of Gastroenterology, 4th Edition(pp 318-2615). Wiley-Blackwell.
• Fantry, L. (2004). Hepatitis B. In The Health Care of Homeless Persons: A Manual of Communicable Diseases & Common Problems in Shelters & on the Streets(pp 35-39). Boston: The Boston Health Care for the Homeless Program (2004).
• Fantry, L. (2004). Hepititis A. In The Health Care of Homeless Persons: A Manual of Communicable Diseases & Common Problems in Shelters & on the Streets(pp 29-33). Boston: The Boston Health Care for the Homeless Program.
• Fantry, L. (2003). Chronic Infections of the Small Intestine. In Atlas of Gastroenterology, 3rd edition(pp 323-330). Philadelphia: J.B. Lippincott.
• Fantry, L. (2003). Chronic Infections of the Small Intestine. In Textbook of Gastroenterology, 4th edition(pp 1561-1580). Philadelphia: J.B. Lippincott.
• Fantry, L. (2002). Treponema Pallidum. In Antimicrobial Therapy and Vaccines(pp 749-758). Baltimore: Williams & Wilkins.
• Fantry, L. (1999). Ambulatory Care for the HIV-Infected Patient. In Principles of Ambulatory Medicine, 5th Edition(pp 425-456). Baltimore: Williams & Wilkins.
• Fantry, L. (1999). Chronic Infections of the Small Intestine. In Atlas of Gastroenterology, 2nd Edition(pp 276-279). Philadelphia: Lippincott.
• Fantry, L. (1999). Chronic Infections of the Small Intestine. In The Textbook of Gastroenterology, 3rd Edition(pp 1641-1659). Philadelphia: Lippincott.
• Fantry, L. (1999). Treponema Pallidum. In Antimicrobial Therapy and Vaccines, 1st Edition(pp 462-471). Williams & Wilkins.
• Fantry, L. (1995). Ambulatory Care for the HIV-Infected Patient. In Principles of Ambulatory Medicine (4th Edition). Baltimore: Williams & Wilkins.
• Fantry, L. (1992). Tuberculin Positivity among the Homeless. In Journal of Health Care for the Poor and Underserved(pp 263-269). Baltimore: Johns Hopkins University Press.
• Fantry, L. (1991). Hepatitis A.. In The Manual of Common Communicable Diseases in Shelters(pp 115-121). Boston: Boston Health Care for the Homeless Program.
• Fantry, L. (1991). Hepatitis B In:. In The Manual of Common Communicable Diseases in Shelters(pp 179-193). Boston Health Care for the Homeless Program.

Journals/Publications

• Burrowes, S. A., Zisman, E., Fantry, L. E., Bui, Q., Wu, A., Sorkin, J., Miller, M., & Bagchi, S. (2025). Changes in Atherosclerotic Cardiovascular Disease Risk Scores in a Predominantly Black Cohort with HIV and Associated Comorbidities: A Preliminary Study. Cardiology (Switzerland), 150(Issue 2). doi:10.1159/000540526
  More info

  Introduction: People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores. Methods: We conducted a preliminary study using retrospective analysis of PWH, between 40 and 75 years old, seen at the Evelyn Jordan Center with at least two routine HIV visits. We collected clinical and demographic data and calculated the ASCVD risk scores using the Pooled Cohort Equation. Exploratory analyses examined change in risk score categories over time. Final adjusted analysis examined factors associated with change in continuous risk scores over time. Results: Our sample included 187 PWH; 166 were black/ African American and 79 were female. We found no significant change in ASCVD risk score over time. The risk score was significantly higher in PWH with hepatitis C (7.34%; 95% CI: 2.59, 12.09; p = 0.003) and trended higher in those with dual hepatitis B/C and hepatitis B compared to those without hepatitis (p = 0.07). Conclusion: We found that ASCVD risk did not change over a 4-year period among predominantly black young PWH, but infection with hepatitis C and dual hepatitis B/C were associated with higher ASCVD risk scores. Our findings illustrate the need for further longitudinal studies evaluating change in cardiovascular disease (CVD) risk and investigating viral hepatitis as an added potential contributor to increased CVD risk in highrisk, vulnerable populations.
• Demontigny Avila, D., Rabe, B., Aravagiri, A., Joseph, M., Lim, J. R., Naveed, M., Rappel, R., Villanueva, B., Khandekar, M., Zinkeng, A., Yates, S., & Fantry, L. E. (2025). The Effect of Using a Standardized Questionnaire on Sexual History Documentation and Testing to Diagnose Gonorrhea and Chlamydia Among Men Who Have Sex With Men With Human Immunodeficiency Virus. Sexually Transmitted Diseases, 52(Issue 5). doi:10.1097/olq.0000000000002119
  More info

  Background: Most Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT) infections in men who have sex with men (MSM) are diagnosed at extragenital sites. However, testing at these sites is often lacking. The purpose of this study was to determine if a standardized questionnaire administered by physicians and clinical assistants improves documentation of sex activity and increases extragenital testing and diagnoses of GC and CT among MSM. Methods: A standardized sexual history questionnaire was implemented on 11/1/2022. Electronic medical records of 664 MSM with human immunodeficiency virus, including 1064 encounters, were reviewed to compare preimplementation and postimplementation sexual history documentation, adequacy of documentation, extragenital GC and CT testing, and GC and CT diagnoses. Analysis included χ2 and exact tests and logistic regression adjusting for physician cluster effects. Results: The standardized questionnaire was used by 53.7% of physicians and 85.9% of coordinators. Documentation of whether sexual activity occurred increased from 79.3% (95% confidence interval [CI], 0.758-0.828) in the preintervention pre-COVID-19 period to 95.2% (95% CI, 0.925-0.970) in the postintervention period with an adjusted odds ratio of 4.7 (95% CI, 2.7-8.8). Specific questions about anal and oral sex increased from 42.0% to 88.1% (P < 0.001) and 23.7% to 88.7% (P < 0.001), respectively. Anal and pharyngeal testing increased from 14.4% to 20.2% (P = 0.040) and 17.2% to 23.3% (P = 0.045), respectively. Conclusions: This study demonstrates that using a standardized questionnaire during clinical encounters can improve documentation of sexual activity and testing for GC and CT at extragenital sites.
• Grinspoon, S. K., Zanni, M. V., Triant, V. A., Kantor, A., Umbleja, T., Diggs, M. R., Chu, S. M., Fitch, K. V., Currier, J. S., Bloomfield, G. S., Casado, J. L., de la Peña, M., Fantry, L. E., Gardner, E., Aberg, J. A., Malvestutto, C. D., Fichtenbaum, C. J., Lu, M. T., Ribaudo, H. J., & Douglas, P. S. (2025). Performance of the pooled cohort equations and D:A:D risk scores among individuals with HIV in a global cardiovascular disease prevention trial: a cohort study leveraging data from REPRIEVE. The Lancet HIV, 12(Issue 2). doi:10.1016/s2352-3018(24)00276-5
  More info

  Background: Risk estimation is an essential component of cardiovascular disease prevention among people with HIV. We aimed to characterise how well atherosclerotic cardiovascular disease (ASCVD) risk scores used in clinical guidelines perform among people with HIV globally. Methods: In this prospective cohort study leveraging REPRIEVE data, we included participants aged 40–75 years, with low-to-moderate traditional cardiovascular risk, not taking statin therapy. REPRIEVE participants were enrolled from sites in 12 countries across Global Burden of Disease Study (GBD) regions. We assessed the performance of the pooled cohort equations (PCE) risk score for ASCVD and the data-collection on adverse effects of anti-HIV drugs (D:A:D) risk score. We calculated C statistics, observed-to-expected (OE) event ratios, and Greenwood–Nam–D'Agostino goodness-of-fit (GND) statistics, overall and in subgroups by race, sex, and GBD regions (clustering low-income and middle-income countries and high-income countries). We did a recalibration for PCE risk score among people with HIV in high-income countries. REPRIEVE was registered with ClinicalTrials.gov, NCT02344290. Findings: We included 3893 participants, recruited between March 26, 2015, and July 31, 2019. The median age was 50 years (IQR 45–55), with 2684 (69%) male and 1209 (31%) female participants. 1643 (42%) were Black or African American, 1346 (35%) participants were White, 566 (15%) were Asian, and 338 (9%) were recorded as other race. Overall, discrimination of the PCE risk score was moderate (C statistic 0·72 [95% CI 0·68–0·76]) and calibration was good (OE event ratio 1·11; GND p=0·87). However, calibration suggested overprediction of risk in low-income and middle-income countries and corresponding underprediction in high-income countries. When restricted to high-income countries, we found underprediction (OE event ratio >1·0) among women (2·39) and Black or African American participants (1·64). Findings were similar for the D:A:D risk score (C statistic 0·71 [0·65–0·77]; OE event ratio 0·89; p=0·68). Improved calibration of the PCE risk score in high-income countries was achieved by multiplying the original score by 2·8 in Black or African American women, 2·6 in women who were not Black or African American, and 1·25 in Black or African American men. Interpretation: Among the global cohort of people with HIV in REPRIEVE, the PCE risk score underpredicted cardiovascular events in women and Black or African American men in high-income countries and overpredicted cardiovascular events in low-income and middle-income countries. Underprediction in subgroups should be considered when using the PCE risk score to guide statin prescribing for cardiovascular prevention among people with HIV in high-income countries. Additional research is needed to develop risk scores accurate in predicting ASCVD among people with HIV in low-income and middle-income countries. Funding: US National Institutes of Health, Kowa Pharmaceuticals America, Gilead Sciences, and ViiV Healthcare.
• Burrowes, S. A., Zisman, E., Fantry, L. E., Bui, Q., Wu, A., Sorkin, J., Miller, M., & Bagchi, S. (2024). Changes in Atherosclerotic Cardiovascular Disease Risk Scores in a Predominantly Black Cohort with HIV and Associated Comorbidities: A Preliminary Study. Cardiology, 1-9.
  More info

  People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores.
• Watanabe, M., Davidson, L., Smith, P., Castellucio, P. F., Jergovic, M., Uhrlaub, J. L., Smithey, M. J., Fantry, L. E., Dechambre, B., Wilson, R. C., Knox, K. C., Ren, J., Stowe, R. P., Weinstock, G., Twigg, H., & Nikolich, J. Ž. (2024). Anti-cytomegalovirus antibody levels stratify human immune profiles across the lifespan. GeroScience, 46(5), 4225-4242.
  More info

  Human cytomegalovirus (hCMV) is a ubiquitous latent persistent herpesvirus infecting 60-90% of the population worldwide. hCMV carriage in immunocompetent people is asymptomatic; thus, hCMV can be considered a component of normative aging. However, hCMV powerfully modulates many features of the immune, and likely other, systems and organs. Questions remain as to how hCMV carriage affects the human host. We used anti-CMV antibody titers as a stratifying criterion to examine the impact of "intensity" of hCMV infection as a potential biomarker of aging, inflammation, and immune homeostasis in a cohort of 247 participants stratified into younger (21-40 years) and older (> 65 years of age) groups. We showed that anti-CMV antibody titers increased with age and directly correlated to increased levels of soluble tumor necrosis factor (sTNFR) I in younger but not older participants. CD8 + cell numbers were reduced in the older group due to the loss in CD8 + T naïve (Tn) cells. In CMV carriers and, in particular, in anti-CMV Ab-high participants, this loss was mitigated or reversed by an increase in the numbers of CD8 + T effector memory (Tem) and T effector memory reexpressing CD45RA (Temra) cells. Analysis of CD38, HLA-DR, and CD57 expression revealed subset (CD4 or CD8)-specific changes that correlated with anti-CMV Ab levels. In addition, anti-CMV Ab levels predicted anti-CMV CD8 T cell responsiveness to different CMV open reading frames (ORFs) selectively in older participants, which correlated to the transcriptional order of expression of specific CMV ORFs. Implications of these results for the potential predictive value of anti-CMV Ab titers during aging are discussed.
• Watanabe, M., Davidson, L., Smith, P., Castellucio, P., Jergovic, M., Uhrlaub, J., Smithey, M., Fantry, L., Dechambre, B., Wilson, R., Knox, K., Ren, J., Stowe, R., Weinstock, G., Twigg, H., & Nikolich, J. (2024). Anti-cytomegalovirus antibody levels stratify human immune profiles across the lifespan. GeroScience, 46(5). doi:10.1007/s11357-024-01124-0
  More info

  Human cytomegalovirus (hCMV) is a ubiquitous latent persistent herpesvirus infecting 60–90% of the population worldwide. hCMV carriage in immunocompetent people is asymptomatic; thus, hCMV can be considered a component of normative aging. However, hCMV powerfully modulates many features of the immune, and likely other, systems and organs. Questions remain as to how hCMV carriage affects the human host. We used anti-CMV antibody titers as a stratifying criterion to examine the impact of “intensity” of hCMV infection as a potential biomarker of aging, inflammation, and immune homeostasis in a cohort of 247 participants stratified into younger (21–40 years) and older (> 65 years of age) groups. We showed that anti-CMV antibody titers increased with age and directly correlated to increased levels of soluble tumor necrosis factor (sTNFR) I in younger but not older participants. CD8 + cell numbers were reduced in the older group due to the loss in CD8 + T naïve (Tn) cells. In CMV carriers and, in particular, in anti-CMV Ab-high participants, this loss was mitigated or reversed by an increase in the numbers of CD8 + T effector memory (Tem) and T effector memory reexpressing CD45RA (Temra) cells. Analysis of CD38, HLA-DR, and CD57 expression revealed subset (CD4 or CD8)-specific changes that correlated with anti-CMV Ab levels. In addition, anti-CMV Ab levels predicted anti-CMV CD8 T cell responsiveness to different CMV open reading frames (ORFs) selectively in older participants, which correlated to the transcriptional order of expression of specific CMV ORFs. Implications of these results for the potential predictive value of anti-CMV Ab titers during aging are discussed.
• deMontigny Avila, D., Rabe, B., Aravagiri, A., Joseph, M., Lim, J. R., Naveed, M., Rappel, R., Villanueva, B., Khandekar, M., Zinkeng, A., Yates, S., & Fantry, L. E. (2024). The Effect of Using a Standardized Questionnaire on Sexual History Documentation and Testing to Diagnose Gonorrhea and Chlamydia Among Men Who have Sex with Men with HIV. Sexually transmitted diseases.
  More info

  Background: Most Neisseria gonorrhoea (GC) and Chlamydia trachomatis (CT) infections in men who have sex with men (MSM) are diagnosed at extragenital sites. However, testing at these sites is often lacking. The purpose of this study was to determine if a standardized questionnaire administered by physicians and clinical assistants improves documentation of sex activity and increases extragenital testing and diagnoses of GC and CT among MSM.Methods: A standardized sexual history questionnaire was implemented on 11/1/2022. Electronic medical records of 664 MSM with HIV, including 1064 encounters, were reviewed to compare pre- and post- implementation sexual history documentation, adequacy of documentation, extragenital GC and CT testing, and GC and CT diagnoses. Analysis included Chi-square and exact tests and logistic regression adjusting for physician cluster effects.Results: The standardized questionnaire was used by 53.7% of physicians and 85.9% of coordinators. Documentation of whether sexual activity occurred increased from 79.3% [95%confidence interval (CI) 0.758- 0.828] in the pre-intervention pre-COVID-19 period to 95.2% (95% CI 0.925-0.970) in the post-intervention period with an adjusted odds ratio of 4.7 (95% CI 2.7-8.8). Specific questions about anal and oral sex increased from 42.0% to 88.1% (p < 0.001) and 23.7% to 88.7% (p < 0.001), respectively. Anal and pharyngeal testing increased from 14.4% to 20.2% (p = 0.040) and 17.2% to 23.3% (p = 0.045), respectively.Conclusions: This study demonstrates that using a standardized questionnaire during clinical encounters can improve documentation of sexual activity and testing for GC and CT at extragenital sites.
• Bedrick, E. J., Fantry, L. E., Fisher, J. M., Guido, A. A., Gupte, R., Joseph, M., Lim, J. R., Loveland, M. G., Madhivanan, P., Nandamuri, P., & Sadoway, D. (2022). 2092. Update on PrEP Knowledge and Attitudes Among Adults Attending Public Health Clinics in Southern Arizona. Open Forum Infectious Diseases, 9(Supplement_2). doi:10.1093/ofid/ofac492.1714
  More info

  Abstract Background In 2019, there were 284,464 individuals taking HIV pre-exposure prophylaxis (PrEP), representing 23.4% of the 1.2 million individuals who met indications for PrEP [1]. Uptake is particularly poor among women and Hispanics. Methods Written questionnaires were administered from November 2021 through April 2022 to patients attending public health clinics in Southern Arizona which provided women’s health, family planning, rapid HIV testing, and sexually transmitted infections (STI) services. Individuals who did not speak or read English were offered the questionnaire in Spanish. Data collected was compared to data collected in 2017 [2]. Results Of the 587 participants were 63% female and 68% Hispanic (Table 1). Their median age was 29 (Table 1). Most participants perceived themselves at lowest risk of acquiring HIV (66%) (Table 1). When asked “Before today, did you know that there was a pill that can prevent HIV infection?” 50% of all participants answered yes in 2022 compared to 20% in 2017 (P=0) (Figure 1). Among females, 45% had prior knowledge of PrEP in 2022 compared to 12% in 2017 (P=0). Although an improvement, this prior knowledge of PrEP remains lower in females compared to males (45% vs 57%, P=< 0.007) (Figure 1). In 2022, 98 participants completed the questionnaire in Spanish, of which 39% had prior knowledge of PrEP compared to 52% of the 489 participants who completed the questionnaire in English (P=0.02596) (Figure 1). A pill taken every 28 days was the most desired (36%) modality for PrEP, followed by a daily pill (27%) (Figure 2). Most participants expressed acceptance of visits and STI testing every 3 months, and only 26% of participants indicated they would be concerned about family or friends finding out they were on PrEP (Table 1). Table 1.Patient CharacteristicsDemographics, risk factors, and perceived risk of participants completing surveys in Spanish, English, and combined.Figure 1.Prior Knowledge of PrEPPercent answering yes when asked "Before today, did you know that there was a pill that can prevent HIV infection?" for all participants in 2017 and 2022 (blue bars), for Spanish surveys and English surveys in 2022 (orange bars), and for gender (gold bars).Figure 2.Preferred Modality of PrEPPreferred modality of PrEP amongst 2022 survey participants. Conclusion Our study shows a significant increase in knowledge of PrEP awareness in the population from 20% to 50% between 2017 and 2022. Unfortunately, there were stark contrasts in awareness between Spanish monolinguistic and English-speaking patients, and between females and males. This demonstrates at-risk groups that may benefit from increased PrEP awareness interventions. Furthermore, despite increased knowledge of PrEP, a prevailing barrier for PrEP uptake may be that patients often underestimate their risks for acquiring HIV. Disclosures All Authors: No reported disclosures.
• Fantry, L. (2021). Antiretroviral Laboratory Monitoring and Implications for HIV Clinical Care in the Era of COVID-19 and Beyond.. AIDS Res Hum Retroviruses, 37(2021 Apr;37(4):), 297-303. doi:0.1089/AID.2020.0263
  More info

  York LD, Fisher JM, Malladi L, August AA, Ellis KE, Marquez JL, Kaveti A, Khachatryan M, Paz MK, Adams MD, Bedrick EJ,
• Fantry, L., & Rokkam, V. (2021). COVID-19 Reinfection in An Immunosuppressed Patient Without An Antibody Response.. Am J Med Sci, 362(1), 103. doi:0.1016/j.amjms.2021.02.003
• York, L. D., Fisher, J. M., Malladi, L., August, J. A., Ellis, K. E., Marquez, J. L., Kaveti, A., Khachatryan, M., Paz, M. K., Adams, M. D., Bedrick, E. J., & Fantry, L. E. (2021). Antiretroviral Laboratory Monitoring and Implications for HIV Clinical Care in the Era of COVID-19 and Beyond. AIDS research and human retroviruses, 37(4), 297-303.
  More info

  In the era of COVID-19, providers are delaying laboratory testing in people with HIV (PWH). The purpose of this study was to examine the clinical significance of renal, liver, and lipid testing. We reviewed the charts of 261 PWH who initiated care at an academic HIV clinic between January 1, 2016 and December 21, 2018. Analysis included one-sided binomial exact tests and multiple linear, Poisson, and Beta regression models. The most common abnormality was a glomerular filtration rate (GFR)
• York, L. D., Fisher, J. M., Malladi, L., August, J. A., Ellis, K. E., Marquez, J. L., Kaveti, A., Khachatryan, M., Paz, M. K., Adams, M. D., Bedrick, E. J., & Fantry, L. E. (2021). Antiretroviral Laboratory Monitoring and Implications for HIV Clinical Care in the Era of COVID-19 and beyond. AIDS Research and Human Retroviruses, 37(Issue 4). doi:10.1089/aid.2020.0263
  More info

  In the era of COVID-19, providers are delaying laboratory testing in people with HIV (PWH). The purpose of this study was to examine the clinical significance of renal, liver, and lipid testing. We reviewed the charts of 261 PWH who initiated care at an academic HIV clinic between January 1, 2016 and December 21, 2018. Analysis included one-sided binomial exact tests and multiple linear, Poisson, and Beta regression models. The most common abnormality was a glomerular filtration rate (GFR)
• Aberg, J. A., Abrams-downey, A. J., Adams, S. L., Badal-faesen, S., Baraiaetxaburu, J., Baranauskas, A., Bares, S. H., Bedimo, R., Bennet, J., Berenguer, J., Bernardino, J. I., Bloomfield, G. S., Brock, J. B., Brumfield, J. K., Burke, D. J., Carreres, M., Casado, J. L., Castro, J. G., Chaudhary, R., , Chiang, V., et al. (2020). Patterns of Antiretroviral Therapy Use and Immunologic Profiles at Enrollment in the REPRIEVE Trial.. The Journal of infectious diseases, 222(Suppl 1), S8-S19. doi:10.1093/infdis/jiaa259
  More info

  Patterns of antiretroviral therapy (ART) use and immunologic correlates vary globally, and contemporary trends are not well described..The REPRIEVE trial (Randomized Trial to Prevent Vascular Events in HIV) enrolled persons with human immunodeficiency virus (HIV) who were aged 40-75 years, receiving ART, and had low-to-moderate cardiovascular disease risk. ART use was summarized within Global Burden of Disease (GBD) super-regions, with adjusted linear and logistic regression analyses examining associations with immune parameters and key demographics..A total of 7770 participants were enrolled, with a median age of 50 years (interquartile range, 45-55 years); 31% were female, 43% were black or African American, 15% were Asian, 56% had a body mass index >25 (calculated as weight in kilograms divided by height in meters squared), and 49% were current or former smokers. The median CD4 T-cell count was 620/µL (interquartile range, 447-826/ µ L), and the median duration of prior ART use, 9.5 years (5.3-14.8) years. The most common ART regimens were nucleoside/nucleotide reverse-transcriptase inhibitor (NRTI) plus nonnucleoside reverse-transcriptase inhibitor (43%), NRTI plus integrase strand transfer inhibitor (25%), and NRTI plus protease inhibitor (19%). Entry ART varied by GBD region, with shifts during the trial enrollment period. In adjusted analyses, entry CD4 cell count and CD4/CD8 ratio were associated with GBD region, sex, entry regimen, duration of ART, and nadir CD4 cell count; CD4 and CD8 cell counts were also associated with body mass index and smoking status..There were substantial variations in ART use by geographic region and over time, likely reflecting the local availability of specific medications, changes in treatment guidelines and provider/patient preferences. The analyses of CD4 cell counts and CD4/CD8 ratios may provide valuable insights regarding immune correlates and outcomes in people living with HIV..NCT02344290.
• Adams, M., August, J., Bedrick, E. J., Ellis, K. E., Fantry, L. E., Fisher, J. M., Kaveti, A., Khachatryan, M., Malladi, L., Marquez, J., Paz, M. K., & York, L. (2020). 927. Antiretroviral Laboratory Monitoring and Implications for HIV Clinical Care in the Era of COVID-19 and Beyond. Open Forum Infectious Diseases, 7(Supplement_1), S497-S497. doi:10.1093/ofid/ofaa439.1113
  More info

  Background: In the era of COVID-19, providers are delaying laboratory testing in people with HIV (PWH). The purpose of this study was to examine the clinical significance of renal, liver, and lipid...
• Connick, E., & Fantry, L. E. (2020). The Internist's Role in Ending the HIV Epidemic in the United States.. The American journal of medicine, 133(1), 12-13. doi:10.1016/j.amjmed.2019.04.051
• Fisher, J. M., Sprowl, K. M., Adelus, M. L., Bedrick, E. J., Drake, T. M., Fantry, L. E., Guido, A. A., Perez-velez, C. M., & Shende, T. C. (2020). PrEP Knowledge and Attitudes Among Adults Attending Public Health Clinics in Southern Arizona.. Journal of community health, 45(2), 400-406. doi:10.1007/s10900-019-00758-y
  More info

  HIV pre-exposure prophylaxis (PrEP) is underutilized among Hispanics, women, and low-income individuals. To better understand PrEP barriers in this population, questionnaires were administered to 500 patients attending public health clinics in southern Arizona which provide family planning and sexually transmitted infections care. Sixty-three percent believed that they had no risk of HIV infection. When asked "Before today, did you know that there was a pill that can prevent HIV infection?" 80% of persons answered no. Among women, 88% answered no to this question. As expected, individuals with a higher perceived HIV risk (OR 1.76) or one HIV risk factor (OR 5.85) had a higher probability of knowledge. Among survey participants 87% would take a daily pill, 91% would visit a health-care provider every 3 months, and 92% would have laboratory testing every 3 months. Fifty-four percent would not be afraid or embarrassed if friends or family knew they were taking PrEP. Seventy-two percent would take PrEP despite temporary nausea. Sixty-two percent would pay ≥ $40 every 3 months for PrEP. Lack of knowledge, rather than patient attitudes, is the more important barrier to wider utilization of PrEP among individuals, especially women, attending public health clinics in Southern Arizona. Future efforts need to focus on education and access to PrEP in underserved populations including women and Hispanics.
• Fantry, L. E., & Connick, E. (2019). The Internist's Role in Ending the HIV Epidemic in the United States. The American journal of medicine.
• Shende, T. C., Fisher, J. M., Perez-Velez, C. M., Guido, A. A., Sprowl, K. M., Drake, T. M., Adelus, M. L., Bedrick, E. J., & Fantry, L. E. (2019). PrEP Knowledge and Attitudes Among Adults Attending Public Health Clinics in Southern Arizona. Journal of community health.
  More info

  HIV pre-exposure prophylaxis (PrEP) is underutilized among Hispanics, women, and low-income individuals. To better understand PrEP barriers in this population, questionnaires were administered to 500 patients attending public health clinics in southern Arizona which provide family planning and sexually transmitted infections care. Sixty-three percent believed that they had no risk of HIV infection. When asked "Before today, did you know that there was a pill that can prevent HIV infection?" 80% of persons answered no. Among women, 88% answered no to this question. As expected, individuals with a higher perceived HIV risk (OR 1.76) or one HIV risk factor (OR 5.85) had a higher probability of knowledge. Among survey participants 87% would take a daily pill, 91% would visit a health-care provider every 3 months, and 92% would have laboratory testing every 3 months. Fifty-four percent would not be afraid or embarrassed if friends or family knew they were taking PrEP. Seventy-two percent would take PrEP despite temporary nausea. Sixty-two percent would pay ≥ $40 every 3 months for PrEP. Lack of knowledge, rather than patient attitudes, is the more important barrier to wider utilization of PrEP among individuals, especially women, attending public health clinics in Southern Arizona. Future efforts need to focus on education and access to PrEP in underserved populations including women and Hispanics.
• Bagchi, S., Burrowes, S. A., Fantry, L. E., Hossain, M. B., Tollera, G. H., Kottilil, S., Pauza, C. D., Miller, M., Baumgarten, M., & Redfield, R. R. (2017). Factors associated with high cardiovascular risk in a primarily African American, urban HIV-infected population. SAGE pen medicine, 5, 2050312117725644.
  More info

  To determine factors associated with increased risk of developing cardiovascular disease in a high-risk patient population.
• Charurat, M., Cullen, N. R., Fantry, L. E., Fisher, L. H., Innis, E. K., Kang, M., Nowak, R. G., Riedel, D. J., Riner, A. N., Riner, A., Stafford, K. A., Wang, E. W., & Yimgang, D. P. (2016). P-B19 Colorectal neoplastic lesions in HIV-infected patients compared to non-HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes, 71(Supplement 1), 81. doi:10.1097/01.qai.0000479735.44323.57
  More info

  Introduction: Non-AIDS defining cancers are the second leading cause of death in HIV-infected individuals, and colorectal cancer is the fourth leading cancer among HIV-infected individuals. The optimal approach to colorectal cancer screening in HIV-infected individuals is yet to be defined. Methods: We collected clinical data and colonoscopy results on 263 HIV-infected patients matched with 657 non-HIV-infected patients on age, race, and sex to compare the prevalence, type, and location of colorectal neoplastic lesions. Frequency distributions and descriptive statistics were used to characterize the study population. The primary exposure was HIV infection, and the primary outcome was any adenoma or adenocarcinoma. Logistic regression models were used to estimate odds ratios with 95% confidence intervals (CI). Results: HIV-infected patients were less likely to have any adenoma (22% vs. 27.9%, P = 0.04), tubular adenomas >10 mm (0.4% vs. 2.9%, P = 0.02), and serrated adenomas (0.0% vs. 2.6%, P ≤ 0.01). There was no difference in the prevalence of adenocarcinoma in HIV-infected patients compared to non-HIV-infected individuals (1.5% vs. 0.8%, P = 0.29). The lower risk of any adenoma remained after controlling for age, sex, smoking status, body mass index (BMI), and diabetes mellitus [adjusted odds ratio (aOR), 0.61; 95% (CI): 0.43 to 0.88]. When stratified by diabetes mellitus, HIV-infected patients without diabetes mellitus had the lowest risk (aOR, 0.47; 95% CI: 0.31 to 0.71). Conclusions: HIV- infected patients had a lower prevalence of colorectal neoplastic lesions, including high risk adenomas, than non-HIV-infected patients. Earlier screening for colorectal cancer is not indicated in this population.
• Fantry, L. E., & Cleghorn, F. R. (2016). HHV-6 infection in patients with HIV-1 infection and disease. The AIDS reader, 9(3), 198-203, 221.
  More info

  Human herpesvirus 6 (HHV-6) is among the most widespread of the human herpesviruses. In immunocompetent children, it causes exanthem subitum, febrile episodes without skin rash, and non-Epstein-Barr and non-cytomegalovirus infectious mononucleosis. HHV-6 has also been associated with clinical disease in bone marrow and solid organ transplant recipients. Its potential role in HIV-1-associated clinical syndromes is now being recognized and evaluated. In this review, we describe the virus, the pathogenesis of HHV-6-associated disease, and the diagnostic tests used to differentiate active from latent infection. We then discuss possible clinical manifestations of HHV-6 in HIV-1-infected patients, how to evaluate the need for treatment, and which pharmacologic agents are potentially useful. There is no consensus on these issues in the medical community, and HHV-6 is not now included among indicator infections for the diagnosis of AIDS.
• Fantry, L. E., Nowak, R. G., Fisher, L. H., Cullen, N. R., Yimgang, D. P., Stafford, K. A., Riedel, D. J., Kang, M., Innis, E. K., Riner, A., Wang, E. W., & Charurat, M. E. (2016). Colonoscopy Findings in HIV-Infected Men and Women from an Urban U.S. Cohort Compared with Non-HIV-Infected Men and Women. AIDS research and human retroviruses, 32(9), 860-7.
  More info

  As HIV-infected patients live longer, non-AIDS-defining cancers are now a major cause of morbidity and mortality. The purpose of this study was to compare the prevalence, type, and location of colorectal neoplastic lesions found on colonoscopy in HIV-infected patients from an urban U.S. cohort with non-HIV-infected patients.
• Sowah, L. A., Buchwald, U. K., Riedel, D. J., Gilliam, B. L., Khambaty, M., Fantry, L., Spencer, D. E., Weaver, J., Taylor, G., Skoglund, M., Amoroso, A., & Redfield, R. R. (2016). Anal Cancer Screening in an Urban HIV Clinic: Provider Perceptions and Practice. Journal of the International Association of Providers of AIDS Care, 14(6), 497-504.
  More info

  In this article, we sought to understand the perceptions and practice of providers on anal cancer screening in HIV-infected patients. Providers in an academic outpatient HIV practice were surveyed. Data were analyzed to determine the acceptability and perceptions of providers on anal Papanicolaou tests. Survey response rate was 55.3% (60.7% among male and 47.4% among female providers). One-third of the providers had received screening requests from patients. Female providers had higher self-rated comfort with anal Papanicolaou tests, with a mean score of 7.1 (95% confidence interval [CI] 4.7-9.5) compared to 3.6 (95% CI 1.5-5.7) for male providers, P = .02. Sixty-seven percent of male providers and 37.5% of female providers would like to refer their patients for screening rather than perform the test themselves. Only 54.2% of our providers have ever performed anal cytology examination. Our survey revealed that not all providers were comfortable performing anal cancer screening for their patients.
• Amoroso, A., Buchwald, U. K., Fantry, L. E., Gilliam, B. L., Khambaty, M., Redfield, R. R., Riedel, D. J., Skoglund, M., Sowah, L. A., Spencer, D. E., Taylor, G., & Weaver, J. (2015). Anal Cancer Screening in an Urban HIV Clinic: Provider Perceptions and Practice.. Journal of the International Association of Providers of AIDS Care, 14(6), 497-504. doi:10.1177/2325957415601504
  More info

  In this article, we sought to understand the perceptions and practice of providers on anal cancer screening in HIV-infected patients. Providers in an academic outpatient HIV practice were surveyed. Data were analyzed to determine the acceptability and perceptions of providers on anal Papanicolaou tests. Survey response rate was 55.3% (60.7% among male and 47.4% among female providers). One-third of the providers had received screening requests from patients. Female providers had higher self-rated comfort with anal Papanicolaou tests, with a mean score of 7.1 (95% confidence interval [CI] 4.7-9.5) compared to 3.6 (95% CI 1.5-5.7) for male providers, P = .02. Sixty-seven percent of male providers and 37.5% of female providers would like to refer their patients for screening rather than perform the test themselves. Only 54.2% of our providers have ever performed anal cytology examination. Our survey revealed that not all providers were comfortable performing anal cancer screening for their patients.
• Bagchi, S., Burrowes, S. A., Burrowes, S., Fantry, L. E., Faram, R., Faramand, P. P., Hossain, S. B., Hossain, M. B., Kottilil, S., Miller, M., Patel, P., & Redfield, R. R. (2015). Underutilization of Statins for Prevention of Cardiovascular Disease among Primarily African-American HIV-Infected Patients. Journal of AIDS and Clinical Research, 6(9), 1-6. doi:10.4172/2155-6113.1000499
  More info

  Background: Studies have consistently demonstrated that statin therapy reduces CHD-related mortality, but HIVinfected individuals are frequently undertreated for hyperlipidemia. Therefore, we sought to: 1. determine whether the numbers of patients recommended for statin therapy differed using the 2004 and 2013 guidelines; 2. evaluate the proportion of recommended patients who were actually receiving statins; and 3. evaluate the factors associated with statin prescription. Methods: Conducted cross-sectional analysis of a retrospective cohort. 100 patients receiving care at an academic inner-city HIV clinic in 2008 were reviewed. The atherosclerotic vascular disease (ASCVD) risk score was calculated using the 2013 Pooled Cohort Equation and the 2004 and 2013 guidelines were applied to evaluate numbers of patients recommended for statin therapy. Proportions were used to report patients receiving statins among those who were recommended for treatment and several unadjusted logistic regression analyses were performed to identify factors associated with utilization of statins in recommended patients. Results: 81 participants were included in the final analysis. Substantially larger numbers of HIV-infected individuals were recommended to receive statin therapy for CHD risk reduction when applying the 2013 guidelines compared to the 2004 guidelines, but less than half received statins for primary prevention as recommended. Prescription of statins was not associated with either ASCVD risk score or many traditional CHD risk factors. Diabetes mellitus was associated with increased odds of receiving statin therapy whereas hepatitis C co-infection and current smoking status were associated with decreased odds of receiving statins. Conclusions: There is an increased, large and unmet need to increase statin use for prevention of CHD. Underutilization of statins was most pronounced among HIV-hepatitis C co-infected patients and HIV-infected smokers.
• Dickinson, S. A., & Fantry, L. E. (2002). Use of dual-energy x-ray absorptiometry (DXA) scans in HIV-infected patients. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002), 11(4), 239-44.
  More info

  Multiple studies have demonstrated increased rates of osteopenia and osteoporosis in HIV-infected patients but there have been no published studies on current screening practices. We conducted a retrospective chart review of 2924 patients attending an urban HIV clinic. Thirty patients (1%) had dual-energy x-ray absorptiometry (DXA) scans. Patients undergoing DXA scans were more likely to be older, women, and have nondetectable HIV viral load and CD4 count ≥200. The most frequently cited indications for screening were perimenopausal or postmenopausal status and HIV infection. Of the patients screened, 96% had osteopenia or osteoporosis with a median T-score of -1.9 and a median of 3.8 osteoporosis risk factors in addition to HIV.  Of the 20 practitioners in the clinic, only 7 had patients with screening DXA scans. DXA scans are underutilized in the HIV population given the high rate of osteopenia and osteoporosis detected in this study.
• Fisher, L. H., Stafford, K. A., Fantry, L. E., Gilliam, B. L., & Riedel, D. J. (2015). Cancer Knowledge and Opportunities for Education Among HIV-Infected Patients in an Urban Academic Medical Center. Journal of cancer education : the official journal of the American Association for Cancer Education, 30(2), 319-26.
  More info

  HIV-infected patients frequently present with advanced stage cancer. It is possible that late stage presentation may be related to lack of cancer knowledge and/or barriers to care. Questionnaires were administered to 285 adult HIV-infected patients to evaluate knowledge of cancer risk factors and symptoms and barriers to care between 2011 and 2012. Differences in mean and percent scores by group were assessed using a t test for independent samples and chi-square analysis, respectively. Respondents were predominantly male (64%), African-American (86%), and low income (60% 
• Hodowanec, A., Nayak, S., Charurat, M., Vaughan, L., Kanno, M., & Fantry, L. (2012). Prevalence of asymptomatic bacterial sexually transmitted infections in hospitalized HIV patients in Baltimore City. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002), 11(1), 16-9.
  More info

  Sexually transmitted infections (STIs) are known to promote the transmission of HIV. Diagnosing these infections can identify patients engaging in high-risk behaviors and provides an opportunity for intervention and education. The Centers for Disease Control and Prevention (CDC) recommends STI screening as part of routine HIV care. Ninety HIV-infected inpatients admitted to the University of Maryland Hospital were screened for gonorrhea, chlamydia, and syphilis. None of the nucleic acid amplification probes were positive for gonorrhea, and 1 was positive for chlamydia. A total of 8 rapid plasma reagin (RPR) tests were positive, 2 of which are believed to be associated with new infection or treatment failure. Rapid plasma reagin positivity was found to be associated with men who have sex with men (MSM), low CD4 count, and high HIV viral load. Routine inpatient screening for asymptomatic STIs in HIV-infected patients may be beneficial, particularly patients not engaged in routine outpatient care.
• Lafferty, M. K., Fantry, L., Bryant, J., Jones, O., Hammoud, D., Weitzmann, M. N., Lewis, G. K., Garzino-Demo, A., & Reid, W. (2014). Elevated suppressor of cytokine signaling-1 (SOCS-1): a mechanism for dysregulated osteoclastogenesis in HIV transgenic rats. Pathogens and disease, 71(1), 81-9.
  More info

  Accelerated bone loss leading to osteopenia, osteoporosis, and bone fracture is a major health problem that is increasingly common in human immunodeficiency virus (HIV)-infected patients. The underlying pathogenesis is unclear but occurs in both treatment naïve and individuals receiving antiretroviral therapies. We developed an HIV-1 transgenic rat that exhibits many key features of HIV disease including HIV-1-induced changes in bone mineral density (BMD). A key determinant in the rate of bone loss is the differentiation of osteoclasts, the cells responsible for bone resorption. We found HIV-1 transgenic osteoclast precursors (OCP) express higher levels of suppressor of cytokine signaling-1 (SOCS-1) and TNF receptor-associated factor 6 (TRAF6) and are resistant to interferon-gamma (IFN-γ) mediated suppression of osteoclast differentiation. Our data suggest that dysregulated SOCS-1 expression by HIV-1 transgenic OCP promotes osteoclastogenesis leading to the accelerated bone loss observed in this animal model. We propose that elevated SOCS-1 expression in OCP antagonizes the inhibitory effects of IFN-γ and enhances receptor activator of NF-kB ligand (RANKL) signaling that drives osteoclast differentiation and activation. Understanding the molecular mechanisms of HIV-associated BMD changes has the potential to detect and treat bone metabolism disturbances early and improve the quality of life in patients.
• Riedel, D. J., Mwangi, E. I., Fantry, L. E., Alexander, C., Hossain, M. B., Pauza, C. D., Redfield, R. R., & Gilliam, B. L. (2013). High cancer-related mortality in an urban, predominantly African-American, HIV-infected population. AIDS (London, England), 27(7), 1109-17.
  More info

  To determine mortality associated with a new cancer diagnosis in an urban, predominantly African-American, HIV-infected population.
• Fantry, L. E., Gilliam, B. L., Hossain, M. B., Pauza, C. D., Redfield, R. R., & Riedel, D. J. (2012). F4 Characteristics and Outcomes of HIV-Infected Patients Diagnosed With Cancer in an Urban Setting. Journal of Acquired Immune Deficiency Syndromes, 59(Supplement 1), 87. doi:10.1097/01.qai.0000413818.19555.93
• Gilliam, B. L., Chan-Tack, K. M., Qaqish, R. B., Rode, R. A., Fantry, L. E., & Redfield, R. R. (2006). Successful treatment with atazanavir and lopinavir/ritonavir combination therapy in protease inhibitor-susceptible and protease inhibitor-resistant HIV-infected patients. AIDS Patient Care and STDs, 20(Issue 11). doi:10.1089/apc.2006.20.745
  More info

  The combination of atazanavir (ATV) plus lopinavir/ritonavir (LPV/r) has been used in practice. However, clinical data supporting its use are limited. The objective of this study was to evaluate the efficacy and tolerability of regimens with ATV + LPV/r in protease inhibitor (PD-susceptible and PI-resistant patients. A retrospective review of 2703 charts was performed to identify all patients who received ATV + LPV/r. From June 2003 to January 2005, 33 patients received ATV + LPV/r with nucleoside reverse trancriptase inhibitors (NRTIs) for 3 months or more. Virologic success (HIV-RNA < 400 copies per milliliter) was achieved in 30 patients (91%) in a median of 10 weeks (range, 2-68). Nineteen of the 23 patients (83%) who had ultrasensitive viral load (VL) assays were nondetectable. Among patients with 6 or more protease resistance (PR) mutations (PI-resistant), 11 of 14 (79%) achieved virologic success. Eleven of those received phenotypic testing (10 Virtual Phenotype, VircoLab, Baltimore, MD). Despite predicted phenotypic resistance to ATV (6 patients) and LPV/r (7 patients), virologic success was achieved in 4 of 6 (67%) and 4 of 7 (57%), respectively. The 3 PI-resistant patients who were virologic failures had extensive prior LPV/r use, 8-11 PR mutations, and predicted phenotypic resistance to LPV/r, but 2 of 3 had CD4 increases with ATV + LPV/r. Overall, 28 patients (85%) continue to tolerate ATV + LPV/r for a median of 32 weeks follow-up (range, 12-76). Combination ATV + LPV/r with NRTIs appears safe, tolerable, and efficacious in PI-resistant patients (≥6 PR mutations) and predicted phenotypic resistance to ATV and LPV/r. Further studies of ATV + LPV/r in HIV-treatment are warranted. © Mary Ann Liebert, Inc.
• Gilliam, B. L., Chan-Tack, K. M., Qaqish, R. B., Rode, R. A., Fantry, L. E., & Redfield, R. R. (2006). Successful treatment with atazanavir and lopinavir/ritonavir combination therapy in protease inhibitor-susceptible and protease inhibitor-resistant HIV-infected patients. AIDS patient care and STDs, 20(11), 745-59.
  More info

  The combination of atazanavir (ATV) plus lopinavir/ritonavir (LPV/r) has been used in practice. However, clinical data supporting its use are limited. The objective of this study was to evaluate the efficacy and tolerability of regimens with ATV + LPV/r in protease inhibitor (PI)-susceptible and PI-resistant patients. A retrospective review of 2703 charts was performed to identify all patients who received ATV + LPV/r. From June 2003 to January 2005, 33 patients received ATV + LPV/r with nucleoside reverse transcriptase inhibitors (NRTIs) for 3 months or more. Virologic success (HIV-RNA < 400 copies per milliliter) was achieved in 30 patients (91%) in a median of 10 weeks (range, 2-68). Nineteen of the 23 patients (83%) who had ultrasensitive viral load (VL) assays were nondetectable. Among patients with 6 or more protease resistance (PR) mutations (PI-resistant), 11 of 14 (79%) achieved virologic success. Eleven of those received phenotypic testing (10 Virtual Phenotype, VircoLab, Baltimore, MD). Despite predicted phenotypic resistance to ATV (6 patients) and LPV/r (7 patients), virologic success was achieved in 4 of 6 (67%) and 4 of 7 (57%), respectively. The 3 PI-resistant patients who were virologic failures had extensive prior LPV/r use, 8-11 PR mutations, and predicted phenotypic resistance to LPV/r, but 2 of 3 had CD4 increases with ATV + LPV/r. Overall, 28 patients (85%) continue to tolerate ATV + LPV/r for a median of 32 weeks follow-up (range, 12-76). Combination ATV + LPV/r with NRTIs appears safe, tolerable, and efficacious in PI-resistant patients (>/=6 PR mutations) and predicted phenotypic resistance to ATV and LPV/r. Further studies of ATV + LPV/r in HIV-treatment are warranted.
• Fantry, L. E., Zhan, M., Taylor, G. H., Sill, A. M., & Flaws, J. A. (2005). Age of menopause and menopausal symptoms in HIV-infected women. AIDS patient care and STDs, 19(11), 703-11.
  More info

  The objective of this study was to examine the median age of menopause, factors associated with postmenopausal status, and the prevalence of menopausal symptoms in HIV-infected women. We surveyed 120 HIV-infected women between 40 and 57 years old who attended an inner city infectious diseases clinic. Ninety-five percent of the women surveyed were African American and almost half of the women (44%) had used methadone, heroin, cocaine, marijuana, or a combination of these drugs within the past 6 months. Eighty-seven percent had smoked cigarettes at least some time during their life and 45% drank alcohol between the ages of 40 and 49 years old. Thirty women were postmenopausal (having no menstrual periods in the previous 12 consecutive months), 31 were perimenopausal (having 1-11 periods within the previous 12 months), and 59 were premenopausal (having 12 or more periods within the previous 12 months). The median age of menopause was 50 years old (95% confidence interval = 49, 53). In a multivariate model, methadone use within the past 6 months was associated with postmenopausal status. We did not find an association between postmenopausal status and body mass index, number of pregnancies, CD4 cell counts, HIV viral load, individual and grouped antiretroviral therapies, cigarette smoking, and current or past oral contraceptive use. In multivariate analysis, postmenopausal status was associated with hot flashes and cocaine use was associated with vaginal dryness.
• Mehta, S., & Fantry, L. (2005). Gastrointestinal infections in the immunocompromised host. Current opinion in gastroenterology, 21(1), 39-43.
  More info

  Infections of the gastrointestinal tract are an important cause of morbidity and mortality in immunocompromised patients. This review summarizes the most important articles published between July 2003 and June 2004 in the pathogenesis, diagnosis, and treatment of gastrointestinal infections in the immunocompromised host.
• Sajadi, M. M., Fantry, G. T., & Fantry, L. E. (2004). A Czech researcher and Pneumocystis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 39(2), 218, 270-1.
• Cade, W. T., Fantry, L. E., Nabar, S. R., & Keyser, R. E. (2003). Decreased peak arteriovenous oxygen difference during treadmill exercise testing in individuals infected with the human immunodeficiency virus. Archives of physical medicine and rehabilitation, 84(11), 1595-603.
  More info

  To determine if arteriovenous oxygen difference was lower in asymptomatic individuals with human immunodeficiency virus (HIV) infection than in sedentary but otherwise healthy controls.
• Cade, W. T., Fantry, L. E., Nabar, S. R., Shaw, D. K., & Keyser, R. E. (2003). A comparison of Qt and a-vO2 in individuals with HIV taking and not taking HAART. Medicine and science in sports and exercise, 35(7), 1108-17.
  More info

  The aim of this study was to determine whether highly active antiretroviral therapy (HAART), rather than the direct effect of HIV infection, limits peripheral muscle oxygen extraction-utilization (a-vO(2)) in individuals infected with the human immunodeficiency virus (HIV).
• Cade, W. T., Fantry, L. E., Nabar, S. R., Shaw, D. K., & Keyser, R. E. (2003). Impaired oxygen on-kinetics in persons with human immunodeficiency virus are not due to highly active antiretroviral therapy. Archives of physical medicine and rehabilitation, 84(12), 1831-8.
  More info

  To determine the effects of human immunodeficiency virus (HIV) and highly active antiretroviral therapy (HAART) on oxygen on-kinetics in HIV-positive persons.
• Fantry, L. (2003). Gastrointestinal infections in the immunocompromised host. Current opinion in gastroenterology, 19(1), 37-41.
  More info

  Persons with HIV infection, leukemia, lymphoma, solid organ and bone marrow transplants, and inherited immune deficiencies as well as those on immunosuppressive drugs are at high risk for infections of the gastrointestinal tract. Pathogenic as well as opportunistic viruses, bacteria, fungi, and protozoa cause infections in the esophagus, stomach, small intestine, and large intestine. Symptoms may be mild but more often are severe and even life threatening. This article reviews what is new in the field of gastrointestinal infections in the immunocompromised host during the past year. I will place specific emphasis on articles that are most pertinent to clinical care.
• Fantry, L. E. (2003). Protease inhibitor-associated diabetes mellitus: a potential cause of morbidity and mortality. Journal of acquired immune deficiency syndromes (1999), 32(3), 243-4.
• Cade, W. T., Fantry, L. E., Keyser, R. E., & Nabar, S. R. (2002). ATTENUATED PEAK TISSUE OXYGEN EXTRACTION IN INDIVIDUALS INFECTED WITH HIV.. Medicine and Science in Sports and Exercise, 34(5), S135. doi:10.1097/00005768-200205001-00753
• Fantry, L. (2002). Gastrointestinal infections in the immunocompromised host. Current opinion in gastroenterology, 18(1), 34-9.
  More info

  Immunocompromised patients, including patients with AIDS, solid organ and bone marrow transplant recipients, patients with leukemia and lymphoma, patients with inherited immune deficiencies, and patients on immunosuppressive therapy for a variety of disorders, are at risk for infections-particularly opportunistic infections, which, by definition, do not infect the healthy host. All systems of the body, including the gastrointestinal tract, are susceptible. The esophagus, stomach, small intestine, and large intestine are sites of infection for viruses, bacteria, fungi, and protozoa. Symptoms can range in severity from fevers of unknown etiology to life-threatening hemorrhage and perforation. This review summarizes recent case reports, clinical studies, and reviews pertaining to pathogens that uniquely cause disease, more frequently cause disease, or cause more severe disease in the immunocompromised host than in the immunocompetent host.
• Fantry, L. E., & Staecker, H. (2002). Vertigo and abacavir. AIDS patient care and STDs, 16(1), 5-7.
  More info

  Vertigo can cause significant morbidity and make a person unable to perform activities of daily life. A human immunodeficiency virus (HIV)-infected patient experienced vertigo while taking abacavir that resolved immediately on cessation of therapy. The mechanism by which abacavir appeared to be associated with vertigo in this patient is unknown.
• Fantry, L. E., & Sun, C. J. (2002). Mycobacterium avium complex-associated cholecystitis in an HIV-infected woman. AIDS patient care and STDs, 16(5), 201-4.
  More info

  Mycobacterium avium complex (MAC) is commonly associated with fever, fatigue, nausea, diarrhea, and cytopenias related to invasion of the intestine and bone marrow. Infection and clinical disease has been reported in other organs as well. We report the first case of cholecystitis associated with MAC infection of the gallbladder.
• Bartholomew, C., Blattner, W. A., Cao, K., Cleghorn, F. R., Demarest, J. F., Edwards, J., Fantry, L. E., Greenberg, M. L., Hoffman, T. L., Jack, N., Mahabir, B., O'brien, T. R., Ottinger, J. S., & Weinhold, K. J. (2001). Immunologic and virologic analyses of an acutely HIV type 1-infected patient with extremely rapid disease progression.. AIDS research and human retroviruses, 17(14), 1333-44. doi:10.1089/08892220152596597
  More info

  The immunologic and virologic factors that impact on the rate of disease progression after acute infection with human immunodeficiency virus (HIV) type 1 are poorly understood. A patient with an extraordinarily rapid disease course leading to AIDS-associated death within 6 months of infection was studied intensively for the presence of anti-HIV immune reactivities as well as changes in the genetic and biologic properties of virus isolates. Although altered humoral responses were evident, the most distinctive immunologic feature was a nearly complete absence of detectable HIV-specific CTL responses. In addition to a rapid decline in CD3+CD4+ cells, elevated percentages of CD8+CD45RA+ and CD8+CD57+ cells and diminished CD8+CD45R0+ and CD8+CD28+ cells were evident. Primary viral isolates recovered throughout the course of infection exhibited limited sequence diversity. Cloned viral envelopes were found to have unusually broad patterns of coreceptor usage for cell-cell fusion, although infectivity studies yielded no evidence of infection via these alternative receptors. The infectivity studies demonstrated that these isolates and their envelopes maintained an R5 phenotype throughout the course of disease. The absence of demonstrable anti-HIV CTL reactivities, coupled with a protracted course of seroconversion, highlights the importance of robust HIV-specific immune responses in the control of disease progression.
• Fantry, L. (2001). Gastrointestinal infections in the immunocompromised host. Current Opinion in Gastroenterology, 17(1), 40-45.
  More info

  The gastrointestinal tract is a common site of infection in the opportunistic host. Pathogens range from highly virulent organisms, which infect people with well functioning immune systems as well as people with poorly functioning immune systems, to opportunistic organisms, which infect only those with impaired immune systems. Viruses, bacteria, fungi, and protozoa lead to disease that can be especially severe, debilitating, and difficult to treat in the immunocompromised host. Yet in this era of highly active antiretroviral therapy for HIV-infected patients and strategies to reduce immunosuppression in transplant and oncology patients, appropriate diagnostic tests and treatment can both improve the quality of life and decrease mortality. In this article, I review the changing pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment of gastrointestinal infections in the immunocompromised host.
• Fantry, L. E. (2001). Management of tuberculosis. The New England journal of medicine, 345(20), 1501-2.
• Fantry, L. E., & Leiner, S. (2001). Management of tuberculosis.. The New England journal of medicine, 345(20), 1501-2. doi:10.1056/nejm200111153452016
• Leiner, S., Blumberg, H., Del Rio, C., Fantry, L., Meissner, P., Coulter, J., & Small, P. (2001). Management of tuberculosis [3] (multiple letters). New England Journal of Medicine, 345(20). doi:10.1056/NEJM200111153452016
• Fantry, L. (2000). Gastrointestinal infections in the immunocompromised host. Current Opinion in Gastroentergology, 16(1), 45-50.
  More info

  Infectious diseases of the gastrointestinal tract continue to be an important source of morbidity and mortality. Viruses, bacteria, fungi, and protozoa that infect normal hosts also infect the gastrointestinal tract in immunocompromised hosts. Disease caused by these pathogens may be more severe and more difficult to treat in immunocompromised hosts. In addition, pathogens that rarely cause disease in normal hosts cause significant disease in immunosuppressed hosts. Diagnostic decisions need to take into account expected pathogens and response to therapy. Treatment decisions must be based on the findings of diagnostic procedures; expected pathogens; and recent data suggesting that highly active antiretroviral therapy, with its ability to reconstitute immune function, is an essential component of treatment. This review summarizes the most important developments made in the pathogenesis, clinical presentation, diagnosis, and treatment of gastrointestinal infections in immunocompromised hosts in the past year.
• Fantry, L. (2000). Gastrointestinal infections in the immunocompromised host. Current Opinion in Gastroenterology, 16(Issue 1). doi:10.1097/00001574-200001000-00008
  More info

  Infectious diseases of the gastrointestinal tract continue to be an important source of morbidity and mortality. Viruses, bacteria, fungi, and protozoa that infect normal hosts also infect the gastrointestinal tract in immunocompromised hosts. Disease caused by these pathogens may be more severe and more difficult to treat in immunocompromised hosts. In addition, pathogens that rarely cause disease in normal hosts cause significant disease in immunosuppressed hosts. Diagnostic decisions need to take into account expected pathogens and response to therapy. Treatment decisions must be based on the findings of diagnostic procedures; expected pathogens; and recent data suggesting that highly active antiretroviral therapy, with its ability to reconstitute immune function, is an essential component of treatment. This review summarizes the most important developments made in the pathogenesis, clinical presentation, diagnosis, and treatment of gastrointestinal infections in immunocompromised hosts in the past year. (C) 2000 Lippincott Williams and Wilkins, Inc.
• Cleghorn, F. R., Fantry, L. E., & Fr, C. (1999). HHV-6 infection in patients with HIV-1 infection and disease.. The AIDS reader, 9(3), 198-203, 221.
  More info

  Human herpesvirus 6 (HHV-6) is among the most widespread of the human herpesviruses. In immunocompetent children, it causes exanthem subitum, febrile episodes without skin rash, and non-Epstein-Barr and non-cytomegalovirus infectious mononucleosis. HHV-6 has also been associated with clinical disease in bone marrow and solid organ transplant recipients. Its potential role in HIV-1-associated clinical syndromes is now being recognized and evaluated. In this review, we describe the virus, the pathogenesis of HHV-6-associated disease, and the diagnostic tests used to differentiate active from latent infection. We then discuss possible clinical manifestations of HHV-6 in HIV-1-infected patients, how to evaluate the need for treatment, and which pharmacologic agents are potentially useful. There is no consensus on these issues in the medical community, and HHV-6 is not now included among indicator infections for the diagnosis of AIDS.
• Fantry, L., & Cleghorn, F. (1999). HHV-6 infection in patients with HIV-1 infection and disease. AIDS Reader, 9(3).
  More info

  Human herpesvirus 6 (HHV-6) is among the most widespread of the human herpesviruses. In immunocomponent children, it causes exanthem subitum, febrile episodes without skin rash, and non-Epstein-Barr and non- cytomegalovirus infectious mononucleosis. HHV-6 has also been associated with clinical disease in bone marrow and solid organ transplant recipients. Its potential role in HIV-1-associated clinical syndromes is now reorganized and evaluated. In this review, we describe the virus, the pathogenesis of HHV-6- associated disease, and the diagnostics tests used to differentiate active from latent infection. We then discuss possible clinical manifestations of HHV-6 in HIV-1-infected patients, how to evaluated the need for treatment, and which pharmacologic agents are potentially useful. There is no consensus on these issues in the medical community, and HHV-6 is not now included among indicator infections for the diagnosis of AIDS.
• Fantry, L., Tramont, E. C., Marra, C. M., Rolfs, R. T., Radolf, J. D., Augenbraun, M. H., & Joesoef, M. R. (1997). Treatment of early syphilis [5] (multiple letters). New England Journal of Medicine, 337(Issue 23). doi:10.1056/nejm199712043372317
• Fantry, L. (1996). Early Intervention for Human Immunodeficiency Virus in Baltimore Sexually Transmitted Diseases Clinics: Impact on Gonorrhea Incidence in Patients Infected With HIV. Sex Transmitted Disease, 23(5), 370-377.
  More info

  Conclusions: Providing clinical care to persons with HIV may facilitate the reduction of high-risk behaviors that lead to incident STDs and further HIV transmission.
• Auwaerter, P. G., Fantry, L. E., Jonge, E. D., & Lederman, H. M. (1995). Immunodeficiency and elevated CD4 T lymphocyte counts in two patients coinfected with human immunodeficiency virus and human lymphotropic virus type I.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 21(6), 1466-8. doi:10.1093/clinids/21.6.1466
  More info

  We describe two patients who were coinfected with human immunodeficiency virus (HIV) and human T-cell lymphotropic virus (HTLV) type I. They had clinical evidence of immunodeficiency (anergy, oral candidiasis, and disseminated herpes zoster) despite having elevated CD4 T lymphocyte counts (range, 2,450-5,292/mm3). We conclude that CD4 lymphocyte counts may not be reliable markers of immunologic competence in patients coinfected with HIV and HTLV-I.
• Fantry, L. (1995). Immunodeficiency and Elevated CD4+ Cell Counts in Two Patients Co-Infected with HIV and HTLV-1.. Clinical Infectious Disease, 21(6), 1466-8.
  More info

  Lori Fantry, Eric De Jonge, Paul G. Auwaerter, & Lederman, H. (1995). Immunodeficiency and Elevated CD4 T Lymphocyte Counts in Two Patients Coinfected with Human Immunodeficiency Virus and Human Lymphotropic Virus Type I. Clinical Infectious Diseases, 21(6), 1466-1468. Retrieved from http://www.jstor.org/stable/4459106
• Neims, S. R., Fantry, L. E., & Lee, E. U. (1992). Tuberculin positivity among the homeless. Journal of health care for the poor and underserved, 3(2), 263-9.
• Neims, S. R., Fantry, L. E., & Lee, E. U. (1992). Tuberculin positivity among the homeless.. Journal of health care for the poor and underserved, 3(Issue 2). doi:10.1353/hpu.2010.0490
• Fantry, L. (1990). Stuttering and Acquired Immunodeficiency Syndrome. JAMA: The Journal of the American Medical Association, 263(Issue 1). doi:10.1001/jama.1990.03440010036022

Poster Presentations

• Lim, J., Fisher, J. M., Sadoway, D., Gupte, R., Nandemi, P., Joseph, M., Loveland, M., Guido, A., Madhivanan, P. P., Bedrick, E. J., & Fantry, L. E. (2022, Fall semester). Update on PrEP Knowledge and Attitudes Among Adults Attending Public Health Clinics in Southern Arizona. ID Week. Washington, DC: Infectious Disease Society of America.
  More info

  Study of PrEP knowledge
• Lim, J., Fisher, J. M., Sadoway, D., Gupte, R., Nandemi, P., Joseph, M., Loveland, M., Guido, A., Madhivanan, P. P., Bedrick, E. J., & Fantry, L. E. (2022, Fall semester). Update on PrEP Knowledge and Attitudes Among Adults Attending Public Health Clinics in Southern Arizona. ID Week. Washington, DC: Infectious Disease Society of America.
  More info

  Study of PrEP knowledge
• Fantry, L., & Gurm, G. (2010, July). Poor renal function and low CD4 count associated with cyocardial ischemia in HIV patients. XIII International AIDS Conference,. Vienna Austria.
• Fantry, L., Pons, S., & Anderson, E. (2007, June). Has Your Partner Been Tested? Counseling and Testing in an HIV Primary Care Clinic. The American Conference for Treatment of HIV. Dallas TX: The American Conference for Treatment of HIV.
• Fantry, L., Gilliam, B. L., Chan-Tack, K. M., Qaqish, R. B., Rode, R. B., & Redfield, R. R. (2005, Oct). Successful Treadment with Atazanavir (ATV) and Lopinavir/ritonavir (LPV/r) Combination Theraphy in Protease Inhibitor (PI)- Susceptible and PI-Resistant HIV-Infected Patients. IDWeek 2005. San Francisco, CA: Infectious Disease Society of America.
• Fantry, L., Wolff, T., & Taylor, G. (2004, April). The Use of HPV in HIV-Infected Women with ASCUS Pap. Eighth International Conference on Malignancies in AIDS and Other Immunodeficiencies. Bethesda, MD: National Cancer Institute.
• Fantry, L., Zhan, M., Taylor, G., Sill, A. M., & Flaws, J. A. (2004, July). Menopause and HIV-Infected Women. XV International AIDS Conference. Bangkok Thailand: International AIDS Society.

Reviews

• Fantry, L. (1999. HHV-6 infection in patients with HIV-1 infection and disease.(pp 198-203). The AIDS Reader.