Ramesh Paranjape - Academia.edu (original) (raw)

Papers by Ramesh Paranjape

Sexually Transmitted Infections, Jul 1, 2011

Sexually Transmitted Infections, Jul 1, 2013

Oral sessions Results Seropositivity for any of the 15 HPV types was 65.7%, any of the 11 hr-HPV ... more Oral sessions Results Seropositivity for any of the 15 HPV types was 65.7%, any of the 11 hr-HPV types 59.2%, and any of the four lr-HPV types 33.1%. Antibodies against multiple HPV types were more common (45.3%) than against single HPV types (20.4%). Antibodies against at least one of the four vaccine HPV types (HPV 6, 11, 16, and 18) were detected in 40.8% women. Among hr-HPV types seropositivity was the highest for HPV 16 (25.2%) and among lr-HPV types for HPV 6 (19.1%). Age-specific seropositivity for HPV 16 was the highest among 30-39 years old women (29.6%) and decreased with increasing age to 14.0% among 60-64 years old women (p = 0.014). Seropositivity for any of the hr-HPV among women with pathological cytology was 76.8% and those negative for intraepithelial lesion or malignancy 58.3% (p < 0.001). Conclusion Our results show a substantial burden of lifetime sexual exposure to these 15 HPV types before the introduction of vaccination and also a relatively high cumulative exposure to at least one of the four vaccine HPV types. Thus, vaccination of females before sexual debut with a quadrivalent HPV vaccine has a potential to contribute to a substantial reduction of the burden of cervical infections and cervical cancer as well as some other HPV related morbidity, including genital warts. Our data also present the baseline for monitoring HPV long-term vaccination impact.

The Author(s) 2015. This article is published with open access at Springerlink.com Abstract Using... more The Author(s) 2015. This article is published with open access at Springerlink.com Abstract Using data from a cross-sectional bio-behav-ioral survey conducted among men who have sex with men (n = 3833) in India, we examined differences related to HIV-related sexual risk, HIV/STI prevalence and inter-vention exposures between men who have sex with men and women (MSMW, 35 % of the sample) and men who have sex with men only (MSMO). Among MSMW, 93 % reported having female regular partners, 14 % had female paid partners, and all types of male partners (regular 55 %; casual 77.1 %; paying 47 %; paid 19 %). Logistic regres-sion revealed that MSMW had higher odds of being aged 26 years and above (AOR 4.45, 95 % CI 3.66–5.42), lower odds of inconsistently using condoms with male partners (AOR 0.82, 95 % CI 0.67–0.98) and lower odds of having kothi (feminine/mostly receptive) identity (AOR 0.07, 95 % CI 0.06–0.09). HIV intervention exposure and HIV/ STI prevalence did not differ significantly...

Indian Journal of Medical Research, Supplement

Background & objectives: Since 2003, Avahan the India AIDS Initiative, has been working with fema... more Background & objectives: Since 2003, Avahan the India AIDS Initiative, has been working with female sex workers (FSW) in Andhra Pradesh (AP), Maharashtra (MH) and Tamil Nadu (TN) using a package of preventive services. Two rounds (R1 and R2) of Integrated Behavioural and Biological Assessment (IBBA) surveys were done to measure changes in condom use and prevalence of sexually transmitted infections (STIs) among female sex workers (FSWs) in the three Southern States. Methods: Two rounds of bio-behavioural surveys were conducted among FSWs in selected districts of AP, MH and TN during 2005-2007 and 2009, respectively. Survey districts and methodology were consistent across rounds. Participants were selected through two stage conventional cluster sampling from fixed sites and time-location cluster sampling from floating groups. Information on sexual behaviour was collected by face-to-face interview. Participants provided urine and blood samples for testing of STIs. Results: At aggregat...

Indian Journal of Sexually Transmitted Diseases and AIDS, 2014

International Journal of STD & AIDS, 2003

Efforts to prevent HIV transmission from mother to infants in settings like India may benefit fro... more Efforts to prevent HIV transmission from mother to infants in settings like India may benefit from the availability of reliable methods for rapid and simple HIV screening. Data from India on the reliability of rapid HIV test kits are limited and there are no data on the use of rapid HIV tests for screening of pregnant women. Pregnant women attending an antenatal clinic and delivery room in Pune agreed to participate in an evaluation of five rapid HIV tests, including (a) a saliva brush test (Oraquick HIV-1/2, Orasure Technologies Inc.), (b) a rapid plasma test (Oraquick HIV-1/2) and (c) three rapid finger prick tests (Oraquick HIV-1/2; HIV-1/2 Determine, Abbott; NEVA HIV-1/2 Cadila). Results of the rapid tests were compared with three commercial plasma enzyme immunoassay (EIA) tests (Innotest HIV AB EIA, Lab systems/ELISCAN HIV AB EIA, UBI HIV Ab EIA). Between September 2000 and October 1, 2001, 1258 pregnant women were screened for HIV using these rapid tests. Forty-four (3.49%) of the specimens were HIV-antibody-positive by at least two plasma EIA tests. All of the rapid HIV tests demonstrated excellent specificity (96-100%). The sensitivity of the rapid tests ranged from 75-94%. The combined sensitivity and specificity of a two-step algorithm for rapid HIV testing was excellent for a number of combinations of the five rapid finger stick tests. In this relatively low HIV prevalence population of pregnant women in India, the sensitivity of the rapid HIV tests varied, when compared to a dual EIA algorithm. In general, the specificity of all the rapid tests was excellent, with very few false positive HIV tests. Based upon these data, two different rapid HIV tests for screening pregnant women in India would be highly sensitive, with excellent specificity to reliably prevent inappropriate use of antiretroviral therapy for prevention of vertical HIV transmission.

Journal of Global Infectious Diseases, 2011

Cytokine, 2005

Proinflammatory and regulatory cytokines have been implicated to play important role in immunopat... more Proinflammatory and regulatory cytokines have been implicated to play important role in immunopathology of HIV and tuberculosis (TB) infection. Capacity of unstimulated and mitogen-stimulated peripheral blood mononuclear cells (PBMCs) to secrete cytokines (interleukin (IL)-2, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), IL-4, IL-10 and IL-6) was estimated for 15 HIV-TB coinfected patients, 22 HIV seropositives without TB, 32 HIV negative TB patients, and 36 healthy subjects. Dually infected patients had suppression of both Th1 and Th2 cytokine secretion as evidenced by significantly lower production of IL-2, IFN-gamma and TNF-alpha as well as IL-4 and IL-10. Production of IL-2 and TNF-alpha was significantly decreased only in case of HIV infection. Significantly higher IL-6 secretion was found in unstimulated cultures in dually infected patients. The mitogen induced cytokine secretion was generally lower in HIV-TB coinfected patients indicating profound perturbation of both Th1 and Th2 responses.

Culture, Health & Sexuality, 2007

This paper describes the experiences and concerns of women participating in a short-term AZT inte... more This paper describes the experiences and concerns of women participating in a short-term AZT intervention feasibility study to prevent mother-to-child HIV transmission at three sites in India. The study used qualitative methods to examine the experiences of 31 women during late pregnancy, delivery and at post-natal visits. It also elicited the perspectives of 19 healthcare providers. Frequent visits required during late-pregnancy and the post-natal period presented concerns for the women in the study. Women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s understanding of the long-term implications of participating in the intervention study was poor, and living with uncertainty about the HIV status of the newborn was a major concern. The provision of psychosocial support is essential in future intervention studies and should be incorporated on an ongoing basis. Networking with women-centred support groups may be helpful in enabling women to gain the long-term benefits of this type of intervention.

AIDS Research and Human Retroviruses, 2004

Although HIV-1 subtype C is the most prevalent subtype worldwide, data on subtype C viruses are r... more Although HIV-1 subtype C is the most prevalent subtype worldwide, data on subtype C viruses are rather limited. Very little information is available on the complete HIV-1 subtype C gag sequences from India. We report full-length gag (p55) sequences from six Indian early seroconverters. The samples were collected within few weeks of seroconversion and may represent immunologically naive viruses. The comparison of p55 sequences with other Indian and non-Indian subtype C sequences as well as with nonsubtype C sequences obtained from the Los Alamos database revealed gag as a well-conserved region of the HIV genome (range: 84-95%). The phylogenetic tree indicated that the sequences compared here cluster together within clade C. Two epitopes in the p24 region of the gag gene were subtype C specific while many epitopes in the same region were also present in other clades. The data on HIV-1 subtype C full-length gag sequences would be useful in the design and evaluation of effective subtype C-based HIV vaccines.

AIDS Research and Human Retroviruses, 2007

Genetic analysis of HIV-1 sequences circulating in different parts of India have shown that the p... more Genetic analysis of HIV-1 sequences circulating in different parts of India have shown that the predominant proportion of HIV-1 subtypes circulating in India is type C and a small fraction are subtypes A, B, E, and CRFs. We sequenced the HIV-1 LTR promoter region of seven subtype C and five subtype A isolates obtained from two major cities in India. Sequence analysis of the complete promoter and TAR regions revealed conserved subtype-specific variability in several major binding sites. Three NF-kappaB sites were present in all subtype C isolates and two isolates contained an insertion in the MFNLP. The transcriptional activity of one of these isolates may have been hindered due to this insertion. Despite the apparent variability between the LTRs we did not observe any significant difference in the transcriptional activity between subtype C and subtype A. To our knowledge, this is the first study characterizing the genetic structure and functional attributes of subtype A LTRs from India.

AIDS Research and Human Retroviruses, 2008

The majority of the HIV drug resistance (HIVDR) testing studies have focused on subtype B virus. ... more The majority of the HIV drug resistance (HIVDR) testing studies have focused on subtype B virus. The predominance of subtype C in the Indian subcontinent along with greater access to antiretroviral therapy (ART) necessitates studies on HIVDR genotyping. We determined the prevalence of mutations associated with protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI), and nonnucleoside reverse transcriptase inhibitors (NNRTI) from plasma of 40 antiretroviral drug-naive study participants in Indian HIV-1 pol gene sequences. Of these, 36 sequences belonged to subtype C, two to subtype A1, and two were subtype A1C recombinants. The heterosexual route was the most common route of transmission. Drug resistance-associated mutations were observed in 10% (4/40) of the study participants. The resistance mutation observed in the protease gene was V82A, whereas in the RT gene, M41L, D67N, M184V, and A98G were documented. This is the first study reporting major protease mutations by genotyping in ART-naive individuals from western India.

AIDS Research and Human Retroviruses, 2010

AIDS Research and Human Retroviruses, 2002

Anti-HIV-1-specific T cell responses in early HIV-1 infection have been found to be important in ... more Anti-HIV-1-specific T cell responses in early HIV-1 infection have been found to be important in deciding the course of disease progression. But there are few data concerning nonsubtype B HIV infection. HIV-1 subtype C is the most prevalent subtype in India. HIV-1 Gag-specific T cell responses in 12 Indian subjects with recent HIV-1 infection were characterized by an ELISpot assay at two consecutive visits and their correlation with plasma viral load and CD4 1 T lymphocyte counts was studied. Ten of the 12 subjects demonstrated T cell responses to either one or both Gag B and C peptides, on at least one visit. Five of 10 responders showed a consistent response (response at both visits): 4 exhibited a Gag C-specific consistent response and 1 showed a consistent response to Gag B. The remaining five patients, showing response at only one of the two visits, were considered inconsistent responders. None of the individuals showed a consistent response to both B and C Gag peptides. Marginally significant correlation was observed between consistency of the response and lower plasma viral load (p 5 0.062). The subtype-specific Gag C response was also found to be correlated with lower viral load as compared with the response to Gag B (r 5 20.336, p 5 0.054 for subtype C and r 5 20.234, p 5 0.13 for subtype B). The data suggest that the patients exhibiting consistent subtype-specific responses to HIV-1 Gag might have better control of viral replication in early HIV infection.

AIDS, 2008

In four states in southern India we explored the determinants of HIV prevalence among female sex ... more In four states in southern India we explored the determinants of HIV prevalence among female sex workers (FSW), as well as factors associated with district-level variations in HIV prevalence among FSW. Data from cross-sectional surveys in 23 districts were analysed, with HIV prevalence as the outcome variable, and sociodemographic and sex work characteristics as predictor variables. Multilevel logistic regression was applied to identify factors that could explain variations in HIV prevalence among districts. HIV prevalence among the 10 096 FSW surveyed was 14.5% (95% confidence interval 14.0-15.4), with a large interdistrict variation, ranging from 2% to 38%. Current marital status and the usual place of solicitation emerged as important factors that determine individual probability of being HIV positive, as well as the HIV prevalence within districts. In multivariate analysis, compared with home-based FSW, the odds of being HIV positive was greater for brothel-based FSW [adjusted odds ratio (AOR) 2.17, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;or= 0.001] and for public place-based FSW (AOR 1.32, P = 0.005). Unmarried FSW and those who were widowed/divorced/separated, or from the devadasi tradition, had higher odds of being HIV positive (AOR 1.79, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;or= 0.001 and 1.98, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001, respectively), than those currently married. The estimated district level variance in HIV prevalence was lowest (0.152) for brothel-based unmarried FSW, followed by brothel-based widowed/divorced/separated or devadasi FSW (0.192). Heterogeneity in the organization and structure of sex work is an important determinant of variations in HIV prevalence among FSW across districts in India, much more so than the districts themselves. This understanding should help to improve the design of HIV preventive interventions.

HIV-1 subtype C is predominant in India and globally. In the present study, we analyze HIV-1 subt... more HIV-1 subtype C is predominant in India and globally. In the present study, we analyze HIV-1 subtype C regulatory protein Nef sequences from five recent Indian seroconvcrters and live long-term survivors (LTSs) for variability at crucial functional domains. .Sequence analysis suggested the pos.<ibility of using regulatory gene sequences for viral subtyping and evolutionary studies apart from structural genes In the phylogenetic tree. Indian /if/sequenccs segregated away from other reported subtype C sequences, fonning an Indian subcladc within subtype C. Our studies also suggested no evidence for the association of truncated Nef with slow progression of disease, as all LTSs had intact Nef. We could identify some variations in ju.xtapositions to crucial functional domains, especially in .seroconverter seqiiences, when conipaiiiig them with others. In phylogenetic analysis, specilically for the base-pair regions 411-428 and 478-525, our seroconverter sequences segregated away from ...