Department of Epidemiology

A new journal article, published in the New England Journal of Medicine details the findings of a study lead by Lawrence Appel, MD, MPH, Professor in the Department of Epidemiology. The study, titled the African-American Study of Kidney Disease and Hypertension (AASK), followed 1,094 hypertensive African-Americans with chronic kidney disease. Among patients with higher amounts of protein in their urine, the study found that a lower blood-pressure target may slow kidney disease progression.

“This is not a panacea. We have a lot more to figure out. But our evidence suggests that we have a way to at least delay or possibly even prevent end-stage kidney disease in some patients,” Dr. Appel notes.

Read the full article.

A new review of published data found that most children treated with highly active antiretroviral therapy, or HAART, who remain susceptible to vaccine-preventable disease, respond well to revaccination.

William Moss, MD, MPH, associate professor of Epidemiology and senior author of the review notes, “Most children on HAART responded to revaccination, although immune reconstitution was not sufficient to ensure long-term immunity for some children. Because of the progressive effects of HIV infection on the ability of the immune system to mount an effective response, many infected children have poorer responses to vaccines than do uninfected children. In addition, fewer children infected with HIV achieve protective immunity, and those who do might experience greater and more rapid waning of immunity. These results suggest that children on HAART would benefit from revaccination, but levels of protective immunity might need to be monitored and some children may need additional vaccine doses to maintain protective immunity.”

The review, published in September’s Lancet Infectious Diseases, examines 38 published studies, assessing short and long-term immune response to vaccination and whether HIV-infected children have protective immunity.

“Continued efforts are needed to identify and treat HIV-infected children at younger ages and at earlier stages of disease,” notes Catherine Sutcliffe, PhD, research associate in the Department of Epidemiology and lead author of the review.

Read the JHSPH Press Release