David H. Spach

Learn More
A variety of inferential evidence suggests that cytotox-ic T lymphocytes (CTL) can exert substantial anti-HIV activity (1–3), including dramatic reductions in cell-free (4, 5) and cell-associated (6, 7) virus with corresponding increases in CD4 + T cells (5, 8, 9). Still, host-mediated immune responses to HIV generally fail to completely control virus(More)
Bartonellosis remains a major problem in Peru, but many contemporary aspects of this disease have not been adequately described. We examined the cases of 145 symptomatic patients in Lima, Peru, in whom bartonellosis was diagnosed from 1969 through 1992, including 68 patients in the acute (hematic) phase and 77 patients in the eruptive (verruga) phase. In(More)
Bartonella quintana has episodically emerged as a cause of infection among distinct and diverse populations during the 20th century. The organism was first identified as an important human pathogen during World War I when it caused epidemics of louse-borne trench fever that affected an estimated 1 million troops in Europe (1, 2). Trench fever was(More)
Background.  To increase human immunodeficiency virus (HIV) care capacity in our region, we designed a distance mentorship and consultation program based on the Project ECHO (Extension for Community Healthcare Outcomes) model, which uses real-time interactive video to regularly connect community providers with a multidisciplinary team of academic(More)
BACKGROUND Western accredited medical universities can offer graduate-level academic courses to health care workers (HCWs) in resource-limited settings through the Internet. It is not known whether HCWs are interested in these online courses, whether they can perform as well as matriculated students, or whether such courses are educationally or practically(More)
Of the 1.1 million Americans infected with HIV/AIDS, 1 This guide presents a various studies estimate that anywhere from 25-35 percent are rationale for why Ryan coinfected with hepatitis C virus (HCV), or nearly 300,000 persons. 2 HIV/AIDS clinics funded by the Ryan White White clinics should play a HIV/AIDS Program see a significant number of coinfected(More)
We have tracked the in vivo migration and have identified in vivo correlates of cytotoxic T-lymphocyte (CTL) activity in HIV-seropositive subjects infused with autologous gene-marked CD8(+) HIV-specific CTL. The number of circulating gene-marked CTL ranged from 1.6 to 3.5% shortly after infusion to less than 0.5% 2 weeks later. Gene-marked CTL were present(More)
  • 1