Theodore Ruel, MD

My long-term career goal is to optimize the health outcomes of infant and children living in resource limited settings. The current focus of my research is the optimization of treatment outcomes of children living with human immunodeficiency virus (HIV) infection. I serve as co-chair of the NIH/DHHS Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children that publishes treatment guidelines for children in the USA, and vice-chair to the Pediatric AIDS Working Group at the World Health Organization. Within the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT), I serve as Chair of the Treatment Scientific Committee and co-chair of P1093, a protocol establishing dosing and safety of Dolutegravir in children. I am also the principal investigator of the NICHD-funded study called The Treating Infants Early Study (TIES), which that enrolling infants who start treatment within the first weeks of life to look at safety, virologic decay, latent reservoir establishment. In Africa, I have been involved several trials looking that treatment of malaria and HIV in children, and now lead a cluster randomized trial of a multi-level intervention to improve outcomes in youth living with HIV in rural Kenya and Uganda. I continue to work broader issues of maternal child health through an NGO that I co-founded, now called Global Strategies.
Education
Fellowship, 06/2009 - Pediatric Infectious Disease, University of California, San Francisco
Residency, 06/2003 - Pediatrics, University of California, San Francisco
M.D., 06/2000 - Medicine, Yale University, School of Medicine
Websites
Publications
  1. Advancing the prevention and treatment of HIV in children: priorities for research and development.
  2. What babies need: accelerating access to current and novel antiretroviral drugs in neonates through pharmacokinetic studies.
  3. "I was still very young": agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda.
  4. Two or more significant life-events in 6-months are associated with lower rates of HIV treatment and virologic suppression among youth with HIV in Uganda and Kenya.
  5. Pharmacokinetics, safety, tolerability, and antiviral activity of dolutegravir dispersible tablets in infants and children with HIV-1 (IMPAACT P1093): results of an open-label, phase 1-2 trial.
  6. Targeted newborn metabolomics: prediction of gestational age from cord blood.
  7. Emergence of Resistance in HIV-1 Integrase With Dolutegravir Treatment in a Pediatric Population From the IMPAACT P1093 Study.
  8. A Mobile Health App (WYZ) for Engagement in Care and Antiretroviral Therapy Adherence Among Youth and Young Adults Living With HIV: Single-Arm Pilot Intervention Study.
  9. Implementation of a Newborn Clinical Decision Support Software (NoviGuide) in a Rural District Hospital in Eastern Uganda: Feasibility and Acceptability Study.
  10. Gestational age dating using newborn metabolic screening: A validation study in Busia, Uganda.
  11. Infant sex modifies associations between placental malaria and risk of malaria in infancy.
  12. Adolescent participation in HIV research: consortium experience in low and middle-income countries and scoping review.
  13. Pharmacokinetics and safety of early nevirapine-based antiretroviral therapy for neonates at high risk for perinatal HIV infection: a phase 1/2 proof of concept study.
  14. Impact of intermittent preventive treatment of malaria in pregnancy with dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine on the incidence of malaria in infancy: a randomized controlled trial.
  15. Population-level viral suppression among pregnant and postpartum women in a universal test and treat trial.
  16. Long-Term Safety and Efficacy of Dolutegravir in Treatment-Experienced Adolescents With Human Immunodeficiency Virus Infection: Results of the IMPAACT P1093 Study.
  17. Anemia and Micronutrient Status during Pregnancy, and Their Associations with Obstetric and Infant Outcomes among HIV-Infected Ugandan Women Receiving Antiretroviral Therapy.
  18. Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study.
  19. The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda.
  20. Monthly Sulfadoxine–Pyrimethamine Versus Dihydroartemisinin-Piperaquine for Intermittent Preventive Treatment of Malaria in Pregnancy.
  21. Prioritising the most needed paediatric antiretroviral formulations: the PADO4 list.
  22. HIV Testing and Treatment with the Use of a Community Health Approach in Rural Africa.
  23. Intermittent preventive treatment with dihydroartemisinin-piperaquine and risk of malaria following cessation in young Ugandan children: a double-blind, randomised, controlled trial.
  24. Metagenomic next-generation sequencing of samples from pediatric febrile illness in Tororo, Uganda.
  25. WYZ: a pilot study protocol for designing and developing a mobile health application for engagement in HIV care and medication adherence in youth and young adults living with HIV.
  26. Monthly sulfadoxine-pyrimethamine versus dihydroartemisinin-piperaquine for intermittent preventive treatment of malaria in pregnancy: a double-blind, randomised, controlled, superiority trial.
  27. Eliminating perinatal HIV in the United States: mission possible?
  28. Delivering integrated care after sexual violence in the Democratic Republic of the Congo.
  29. Mobile, Population-wide, Hybrid HIV Testing Strategy Increases Number of Children Tested in Rural Kenya and Uganda.
  30. Early Adopters of Human Immunodeficiency Virus Preexposure Prophylaxis in a Population-based Combination Prevention Study in Rural Kenya and Uganda.
  31. Maternal or neonatal infection: association with neonatal encephalopathy outcomes.
  32. Gaps in the Child Tuberculosis Care Cascade in 32 Rural Communities in Uganda and Kenya.
  33. Absence of neurocognitive disadvantage associated with paediatric HIV subtype A infection in children on antiretroviral therapy.
  34. Predictors of Retention in HIV Care Among Youth (15-24) in a Universal Test-and-Treat Setting in Rural Kenya.
  35. High rates of viral suppression in adults and children with high CD4+ counts using a streamlined ART delivery model in the SEARCH trial in rural Uganda and Kenya.
  36. Intermittent Preventive Treatment With Dihydroartemisinin-Piperaquine for the Prevention of Malaria Among HIV-Infected Pregnant Women.
  37. Antiretroviral Therapy With Efavirenz Accentuates Pregnancy-Associated Reduction of Dihydroartemisinin-Piperaquine Exposure During Malaria Chemoprevention.
  38. Growth Recovery Among HIV-infected Children Randomized to Lopinavir/Ritonavir or NNRTI-based Antiretroviral Therapy.
  39. High levels of retention in care with streamlined care and universal test and treat in East Africa.
  40. Malaria burden in a birth cohort of HIV-exposed uninfected Ugandan infants living in a high malaria transmission setting.
  41. Increased adolescent HIV testing with a hybrid mobile strategy in Uganda and Kenya.
  42. Implementation of a neonatal transcutaneous bilirubin screening programme in rural India.
  43. Brief Report: Food Insufficiency Is Associated With Lack of Sustained Viral Suppression Among HIV-Infected Pregnant and Breastfeeding Ugandan Women.
  44. Implementation of a neonatal transcutaneous bilirubin screening programme in rural India.
  45. A clinical approach to elimination of perinatal HIV transmission in resource-rich settings.
  46. Quality of inpatient pediatric case management for four leading causes of child mortality at six government-run Ugandan hospitals.
  47. Hair concentrations of antiretrovirals predict viral suppression in HIV-infected pregnant and breastfeeding Ugandan women.
  48. The effect of malnutrition on the pharmacokinetics and virologic outcomes of lopinavir, efavirenz and nevirapine in food insecure HIV-infected children in Tororo, Uganda.
  49. Efficacy and safety of lopinavir/ritonavir versus efavirenz-based antiretroviral therapy in HIV-infected pregnant Ugandan women.
  50. Household food insecurity, maternal nutritional status, and infant feeding practices among HIV-infected Ugandan women receiving combination antiretroviral therapy.
  51. Risk factors for preterm birth among HIV-infected pregnant Ugandan women randomized to lopinavir/ritonavir- or efavirenz-based antiretroviral therapy.
  52. Increased morbidity in early childhood among HIV-exposed uninfected children in Uganda is associated with breastfeeding duration.
  53. Artemisinin-based combination therapies are efficacious and safe for treatment of uncomplicated malaria in HIV-infected Ugandan children.
  54. Virologic and immunologic outcomes of HIV-infected Ugandan children randomized to lopinavir/ritonavir or nonnucleoside reverse transcriptase inhibitor therapy.
  55. Maternal or neonatal infection: association with neonatal encephalopathy outcomes.
  56. Hair and plasma data show that lopinavir, ritonavir, and efavirenz all transfer from mother to infant in utero, but only efavirenz transfers via breastfeeding.
  57. Neonatal mortality in HIV-exposed infants born to women receiving combination antiretroviral therapy in Rural Uganda.
  58. Prevalence of asymptomatic parasitemia and gametocytemia among HIV-infected Ugandan children randomized to receive different antiretroviral therapies.
  59. Antiretroviral agents and prevention of malaria in HIV-infected Ugandan children.
  60. Track A Basic Science.
  61. 289 The Effect of Perinatal Infection on Neurodevelopmental outcome in Newborns with Hypoxic-Ischemic Encephalopathy.
  62. Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.
  63. Neurocognitive and motor deficits in HIV-infected Ugandan children with high CD4 cell counts.
  64. Virologic suppression in nevirapine-exposed HIV-infected infants initiating antiretroviral therapy in rural Uganda.
  65. Sex differences in HIV RNA level and CD4 cell percentage during childhood.
  66. Early virologic failure and the development of antiretroviral drug resistance mutations in HIV-infected Ugandan children.
  67. Short-term risk of HIV disease progression and death in Ugandan children not eligible for antiretroviral therapy.
  68. Novel application of Locked Nucleic Acid chemistry for a Taqman assay for measuring diverse human immunodeficiency virus type 1 subtypes.
  69. Effect of trimethoprim-sulphamethoxazole on the risk of malaria in HIV-infected Ugandan children living in an area of widespread antifolate resistance.
  70. HIV-subtype A is associated with poorer neuropsychological performance compared with subtype D in antiretroviral therapy-naive Ugandan children.
  71. Dynamics of T cell activation accompanying CD4 recovery in antiretroviral treated HIV-infected Ugandan children.
  72. The Distribution and Immune Profile of T Cell Subsets in HIV-Infected Children from Uganda.
  73. HIV RNA suppression among HIV-infected Ugandan children with measles.
  74. High risk of neutropenia in HIV-infected children following treatment with artesunate plus amodiaquine for uncomplicated malaria in Uganda.
  75. Profile of T cell immune responses in HIV-infected children from Uganda.
  76. Effects of trimethoprim-sulfamethoxazole and insecticide-treated bednets on malaria among HIV-infected Ugandan children.
  77. The potential role of rodents in the enzootic cycle of Rift Valley fever virus in Senegal.
  78. Tissue distribution and prevalence of Wolbachia infections in tsetse flies, Glossina spp.
  79. Facilitation at the sexually differentiated laryngeal synapse of Xenopus laevis.