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BACKGROUND In the Strategies for Management of Anti-Retroviral Therapy trial, all-cause mortality was higher for participants randomized to intermittent, CD4-guided antiretroviral treatment (ART) (drug conservation [DC]) than continuous ART (viral suppression [VS]).We hypothesized that increased HIV-RNA levels following ART interruption induced activation(More)
BACKGROUND In March 1999, an outbreak of encephalitis and pneumonia occurred in workers at an abattoir in Singapore. We describe the clinical presentation and the results of investigations in these patients. METHODS Clinical and laboratory data were collected by systemic review of the case records. Serum and cerebrospinal fluid (CSF) samples were tested(More)
BACKGROUND The impact that malnutrition at the time of starting antiretroviral therapy (ART) has on survival and the CD4 count response is not known. METHODS A retrospective cohort study of patients attending the national HIV referral centre in Singapore who had a CD4 count less than 250 cells/microL and a measurement of body weight performed at the time(More)
Strain typing using variable-number tandem repeats of mycobacterial interspersed repetitive units (MIRU-VNTR) is a powerful tool for studying the epidemiology and genetic relationships of Mycobacterium tuberculosis isolates. For this study, isolates from 291 patients in Singapore were genotyped by this method. One hundred sixty-six distinct MIRU-VNTR(More)
BACKGROUND The SMART study was a trial of intermittent use of antiretroviral therapy (ART) (drug conservation [DC]) versus continuous use of ART (viral suppression [VS]) as a strategy to reduce toxicities, including cardiovascular disease (CVD) risk. We studied the predictive value of high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and(More)
OBJECTIVES To evaluate the long-term safety and efficacy of the combination of hydroxychloroquine, hydroxyurea and didanosine. METHODS We recruited antiretroviral-naive patients with viral loads less than 100 000 HIV-1 RNA copies/mL and CD4 counts greater than 150 cells/microL. All patients received hydroxychloroquine (200 mg), hydroxyurea (500 mg) and(More)
BACKGROUND Dengue fever is a frequent cause of admission to hospital in South East Asia, however many of the clinical characteristics and abnormalities on laboratory investigations at presentation are found in other common infections. OBJECTIVES To describe the clinical and laboratory features of dengue fever and other common febrile illnesses in(More)
An outbreak of disease due to Neisseria meningitidis serogroup W135 (W135) occurred in 2000 and 2001 among pilgrims returning from the annual Islamic pilgrimage to Saudi Arabia (the Hajj) and in their contacts. For the Hajj in 2000, the attack rate of W135 disease was 25 cases per 100,000 pilgrims. After the introduction of quadrivalent meningococcal(More)
BACKGROUND Skin disorders are extremely common and cause significant morbidity in human immunodeficiency virus (HIV)-infected individuals. There are few data on their prevalence and association with CD4 counts in Asians. AIM To evaluate the prevalence of skin disorders in ambulatory HIV-infected individuals attending a specialized skin clinic in Singapore(More)
BACKGROUND The Mycobacterium tuberculosis Beijing genotype is biologically different from other genotypes. We aimed to clinically and immunologically compare human tuberculosis caused by Beijing and non-Beijing strains. METHODS Pulmonary tuberculosis patients were prospectively enrolled and grouped by their M. tuberculosis genotypes. The clinical(More)