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Mehri Sadri McKellar

Mehri Sadri McKellar

Professor of Medicine
Medicine, Infectious Diseases
mehri.mckellar@duke.edu
Duke Box 102359, Durham, NC 27710
Rm 175, Hanes House, Box 102359, Durham, NC 27710

Selected Publications

Bictegravir/emtricitabine/tenofovir alafenamide in adults with HIV-1 and end-stage kidney disease on chronic haemodialysis.

Journal Article HIV Med · February 2025 INTRODUCTION: Treatment for people with HIV-1 and end-stage kidney disease (ESKD) on haemodialysis (HD) has previously required complex dose-adjusted regimens, with limited data on the use of a single-tablet regimen in this population. Our aim was to asses ... Full text Link to item Cite

Rapid viral suppression using integrase inhibitors during acute HIV-1 infection.

Journal Article J Antimicrob Chemother · January 3, 2025 BACKGROUND: Antiretroviral therapy (ART) is recommended for all individuals with HIV infection, including those with acute HIV-1 infection (AHI). While recommendations are similar to those for chronic infection, efficacy data regarding treatment of acute H ... Full text Link to item Cite

PrEP knowledge and perceptions among women living in North Carolina public housing communities.

Journal Article PLoS One · 2025 Women in low-income communities are disproportionately affected by HIV yet have been largely left out of efforts to raise awareness about pre-exposure prophylaxis (PrEP). To inform future awareness campaigns, we assessed women's current knowledge of and at ... Full text Link to item Cite

Engagement in Care, Awareness, and Interest in Long-Acting Injectable Anti-Retroviral Therapy.

Journal Article AIDS Behav · October 2024 Long Acting Injectable (LAI) therapy to treat HIV is an alternative to daily oral medications. The success of early roll-out of LAI to eligible patients requires a better understanding of patients' awareness and interest in this novel therapy. We administe ... Full text Link to item Cite

Providing medication for opioid use disorder and HIV pre-exposure prophylaxis at syringe services programs via telemedicine: a pilot study.

Journal Article Harm Reduct J · March 26, 2024 BACKGROUND: People who inject drugs (PWID) are at high risk for opioid overdose and infectious diseases including HIV. We piloted PARTNER UP, a telemedicine-based program to provide PWID with medication for opioid use disorder (MOUD) with buprenorphine/nal ... Full text Link to item Cite

Provider perspectives on screening and treatment for opioid use disorder and mental health in HIV care: A qualitative study.

Journal Article PLoS One · 2024 BACKGROUND: HIV, opioid use disorder (OUD), and mental health challenges share multiple syndemic risk factors. Each can be effectively treated with routine outpatient appointments, medication management, and psychosocial support, leading implementers to co ... Full text Link to item Cite

Cardiometabolic Parameters 3 Years After Switch to Dolutegravir/Lamivudine vs Maintenance of Tenofovir Alafenamide-Based Regimens

Journal Article Open Forum Infectious Diseases · July 1, 2023 Background: Cardiometabolic outcomes were investigated 3 years after switching to the 2-drug regimen dolutegravir/lamivudine (DTG/3TC) vs continuing 3-/4-drug tenofovir alafenamide (TAF)-based regimens in a multicenter phase 3 noninferiority study based on ... Full text Cite

Leveraging Policy Changes Made in Response to COVID-19 to Advance Telehealth and Novel Treatment Approaches for People Who Use Opioids: Qualitative Perspectives From Two Rural North Carolina Counties.

Journal Article N C Med J · July 2023 BACKGROUND: The COVID-19 pandemic has been a catalyst for telehealth services for people who use opioids; however, the data show dramatic increases in opioid overdose deaths and ongoing lack of treatment options in North Carolina, particularly among rural ... Full text Link to item Cite

A survey of South Carolina pharmacists' readiness to prescribe human immunodeficiency virus pre-exposure prophylaxis.

Journal Article J Am Coll Clin Pharm · April 2023 INTRODUCTION: HIV pre-exposure prophylaxis (PrEP) is largely underutilized in the Southern United States. Given their community presence, pharmacists are well positioned to provide PrEP within rural, Southern regions. However, pharmacists' readiness to pre ... Full text Link to item Cite

Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care.

Journal Article South Med J · April 2023 OBJECTIVES: The opioid overdose epidemic is escalating. Increasing access to medications for opioid use disorder in primary care is crucial. The impact of the US Department of Health and Human Services' policy change removing the buprenorphine waiver train ... Full text Link to item Cite

Participant perceptions on the acceptability and feasibility of a telemedicine-based HIV PrEP and buprenorphine/naloxone program embedded within syringe services programs: a qualitative descriptive evaluation.

Journal Article Harm Reduct J · December 3, 2022 BACKGROUND: People who inject drugs (PWID) are at risk for HIV and opioid overdose. We piloted PARTNER UP, a telemedicine-based program to provide PWID with access to both oral pre-exposure prophylaxis (PrEP) for HIV prevention and medication for opioid us ... Full text Link to item Cite

Feasibility, Acceptability, and Preliminary Efficacy of a Gamified Mobile Health Contingency Management Intervention for PrEP Adherence Among Black MSM.

Journal Article AIDS Behav · October 2022 Oral HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV. However, low adherence is common and undermines these protective effects. This is particularly relevant for groups with disproportionately higher rates of HIV, including Black men who ... Full text Link to item Cite

Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic.

Journal Article AIDS Res Hum Retroviruses · April 2022 HIV pre-exposure prophylaxis (PrEP) is poorly utilized in the southern United States. We examined PrEP retention in care and sexually transmitted infections (STIs) through a retrospective review of the Duke University PrEP Clinic from January 1, 2015 to Oc ... Full text Link to item Cite

Perceptions on HIV Pre-Exposure Prophylaxis Among Urgent Care Clinicians in the Southern United States.

Journal Article Curr HIV Res · 2022 BACKGROUND: Underutilization of HIV pre-exposure prophylaxis (PrEP) in the Southern United States (US) is well-documented. Urgent care (UC) centers are positioned as communityfacing access points to PrEP, but the feasibility of integrating PrEP services in ... Full text Link to item Cite

Perspectives of Black women in the United States on salon-based intervention to promote the uptake of pre-exposure prophylaxis (PrEP) for HIV.

Journal Article J Clin Nurs · November 2021 AIMS AND OBJECTIVES: To understand Black women's perspectives on a pre-exposure prophylaxis (PrEP) education intervention in a salon setting. BACKGROUND: Black women have a significant lifetime risk of acquiring HIV. Pre-exposure prophylaxis (PrEP) is an e ... Full text Link to item Cite

Case Report: Reversal of Integrase Inhibitor- and Tenofovir Alafenamide-Related Weight Gain After Switching Back to Efavirenz/Emtricitabine/Tenofovir DF.

Journal Article Open Forum Infect Dis · August 2021 We report a case of substantial weight gain in a virologically suppressed patient with HIV after changing his antiretroviral therapy from efavirenz/emtricitabine/tenofovir DF to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide with subsequent ra ... Full text Link to item Cite

Awareness and acceptability of HIV pre-exposure prophylaxis (PrEP) among students at two historically Black universities (HBCU): a cross-sectional survey.

Journal Article BMC Public Health · May 19, 2021 BACKGROUND: Despite young African American adults (ages 18-24) being among the highest risk groups for HIV infection, little is known about their awareness of HIV pre-exposure prophylaxis (PrEP) - a once daily pill shown to be > 90% effective in preventing ... Full text Open Access Link to item Cite

Examining the Potential of Pre-exposure Prophylaxis (PrEP) for HIV Prevention in a Community Sample of Persons Who Use Stimulants Living in the Southern United States.

Journal Article AIDS Behav · May 2021 Pre-exposure prophylaxis (PrEP), a highly effective HIV prevention strategy, is currently underutilized by several at-risk groups, including both persons who inject drugs and those who use drugs via other routes. Stimulant use is associated with increased ... Full text Link to item Cite

Preexposure Prophylaxis Outcomes in an Urban Community in North Carolina: Discontinuation of Care and Sexually Transmitted Infections.

Journal Article Sex Transm Dis · March 1, 2021 BACKGROUND: Few studies have examined long-term outcomes among persons who initiate preexposure prophylaxis (PrEP) in the South, including PrEP discontinuation and sexually transmitted infection (STI) rates. METHODS: Care discontinuation (>6 months without ... Full text Link to item Cite

Efficacy, pharmacokinetics and neurocognitive performance of dual, NRTI-sparing antiretroviral therapy in acute HIV-infection.

Journal Article AIDS (London, England) · November 2020 ObjectivesThe aim of this study was to evaluate penetration of antiretrovirals into compartments and efficacy of a dual, NRTI-sparing regimen in acute HIV infection (AHI).DesignSingle-arm, open-label pilot study of participants with AHI i ... Full text Cite

Testing for HIV infection in the emergency departments of 2 hospitals in the Southeastern United States

Journal Article JACEP Open · August 1, 2020 Background: In 2006, the Centers for Disease Control and Prevention (CDC) recommended non-targeted, opt-out HIV screening in all healthcare settings, including emergency departments (EDs). Multiple HIV testing programs have been implemented in EDs across t ... Full text Cite

Public Awareness of HIV Pre-Exposure Prophylaxis in Durham, North Carolina: Results of a Community Survey.

Journal Article N C Med J · 2019 BACKGROUND Adoption of HIV pre-exposure prophylaxis (PrEP) remains limited among populations at greatest risk for HIV acquisition. This study aims to assess awareness of PrEP among individuals in Durham, North Carolina, which has one of the highest rates o ... Full text Link to item Cite

Racial Differences in Change in Physical Functioning in Older Male Veterans with HIV.

Journal Article AIDS Res Hum Retroviruses · 2019 Little is known about longitudinal change in physical functioning of older African American/Black and White HIV-infected persons. We examined up to 10 years of data on African American (N = 1,157) and White (N = 400) men with HIV infection and comparable H ... Full text Link to item Cite

Safety of elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide in HIV-1-infected adults with end-stage renal disease on chronic haemodialysis: an open-label, single-arm, multicentre, phase 3b trial.

Journal Article Lancet HIV · December 13, 2018 BACKGROUND: Current treatment for HIV-infected individuals with renal failure on haemodialysis frequently requires complex regimens with multiple pills. A daily single-tablet regimen of coformulated elvitegravir, cobicistat, emtricitabine, and tenofovir al ... Full text Link to item Cite

Low Levels of Physical Activity Among Older Persons Living with HIV/AIDS Are Associated with Poor Physical Function.

Journal Article AIDS Res Hum Retroviruses · November 2018 Antiretroviral therapy (ART) has prolonged lives of persons living with HIV/AIDS (PLWHA), resulting in greater incidence of aging-related diseases and disability. Physical activity (PA) is recommended for healthy aging, but little is known about PA in olde ... Full text Link to item Cite

Canary in the Coal Mine? Transmitted Mutations Conferring Resistance to All Integrase Strand Transfer Inhibitors in a Treatment-Naive Patient.

Journal Article Open Forum Infect Dis · November 2018 Transmitted drug resistance to the integrase strand transfer inhibitor (INSTI) class of antiretrovirals is very rare. We present a case of a treatment-naive female patient with human immunodeficiency virus harboring resistance to all INSTIs, including bict ... Full text Open Access Link to item Cite

Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial.

Journal Article JMIR Mhealth Uhealth · September 10, 2018 BACKGROUND: Pre-exposure prophylaxis (PrEP) provides a strong preventative benefit to individuals at risk for HIV. While PrEP adherence is highly correlated with its efficacy, adherence rates are variable both across and within persons. OBJECTIVE: The obje ... Full text Link to item Cite

Seroconversion on preexposure prophylaxis: a case report with segmental hair analysis for timed adherence determination.

Journal Article AIDS · June 1, 2018 OBJECTIVE: We describe the third case report of seroconversion with multidrug resistant (MDR)-HIV despite pre-exposure prophylaxis (PrEP) with emtricitabine (FTC) and tenofovir (TFV) disoproxil (TDF). DESIGN: Case report. METHODS: PrEP adherence was assess ... Full text Link to item Cite

An educational initiative in response to identified PrEP prescribing needs among PCPs in the Southern U.S.

Journal Article AIDS Care · May 2018 Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, but many primary care physicians (PCPs) have not incorporated PrEP into practice. While PrEP may be a key strategy to reducing high HIV transmission rates in the southern US, knowledge ... Full text Link to item Cite

Health Care Utilization Behaviors Predict Disengagement From HIV Care: A Latent Class Analysis.

Journal Article Open Forum Infect Dis · May 2018 BACKGROUND: The traditional definition of engagement in HIV care in terms of only clinic attendance and viral suppression provides a limited understanding of how persons living with HIV (PLWH) interact with the health care system. METHODS: We conducted a r ... Full text Open Access Link to item Cite

Development and validation of an electronic medical record (EMR)-based computed phenotype of HIV-1 infection.

Journal Article J Am Med Inform Assoc · February 1, 2018 BACKGROUND: Electronic medical record (EMR) computed algorithms allow investigators to screen thousands of patient records to identify specific disease cases. No computed algorithms have been developed to detect all cases of human immunodeficiency virus (H ... Full text Link to item Cite

HIV Preexposure Prophylaxis Implementation at Local Health Departments: A Statewide Assessment of Activities and Barriers.

Journal Article J Acquir Immune Defic Syndr · January 1, 2018 BACKGROUND: Expanding access to HIV preexposure prophylaxis (PrEP) could help reduce rates of HIV infection in the United States. This study characterizes activities and barriers to PrEP implementation at local health departments (LHDs) in North Carolina ( ... Full text Link to item Cite

Sexual orientation differences in HIV testing motivation among college men.

Journal Article J Am Coll Health · April 2017 OBJECTIVE: To investigate sexual orientation differences in college men's motivations for HIV testing. PARTICIPANTS: 665 male college students in the Southeastern United States from 2006 to 2014. METHODS: Students completed a survey on HIV risk factors and ... Full text Link to item Cite

Diminished physical function in older HIV-infected adults in the Southeastern U.S. despite successful antiretroviral therapy.

Journal Article PLoS One · 2017 BACKGROUND: As antiretroviral therapy efficacy improves, HIV is gradually being recognized more as a chronic disease within the aging HIV-infected population. While these individuals are surviving into old age, they may, however, be experiencing "accelerat ... Full text Link to item Cite

Fixed-dose combination emtricitabine/tenofovir/efavirenz initiated during acute HIV infection; 96-week efficacy and durability.

Journal Article AIDS · November 28, 2016 BACKGROUND: Updated guidelines recommend immediate antiretroviral treatment (ART) during acute HIV infection (AHI), but efficacy data on regimens during AHI are limited. METHODS: We provide final data on a prospective, single-arm 96-week open-label study o ... Full text Link to item Cite

History of AIDS in HIV-Infected Patients Is Associated With Higher In-Hospital Mortality Following Admission for Acute Myocardial Infarction and Stroke.

Journal Article J Infect Dis · June 15, 2016 BACKGROUND: Although human immunodeficiency virus (HIV)-infected persons are at increased risk for major cardiovascular events, short-term prognosis after these events is unclear. METHODS: To determine the association between HIV infection and acute myocar ... Full text Link to item Cite

Dendritic Cell Immunotherapy for HIV-1 Infection Using Autologous HIV-1 RNA: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Journal Article J Acquir Immune Defic Syndr · May 1, 2016 BACKGROUND: The genomic heterogeneity of HIV-1 impedes the ability of consensus sequences in vaccines to elicit effective antiviral immune responses. AGS-004 amplifies translation-competent RNA molecules encoding for Gag, Rev, Vpr, and Nef from the patient ... Full text Link to item Cite

Safety and efficacy of the HIV-1 attachment inhibitor prodrug BMS-663068 in treatment-experienced individuals: 24 week results of AI438011, a phase 2b, randomised controlled trial.

Journal Article Lancet HIV · October 2015 BACKGROUND: BMS-663068 is an oral prodrug of BMS-626529, an attachment inhibitor that binds to HIV-1 gp120, blocking viral attachment to host CD4 cells. AI438011 is an ongoing trial investigating the efficacy, safety, and dose-response of BMS-663068 in tre ... Full text Link to item Cite

Diagnosing HIV infection in primary care settings: missed opportunities.

Journal Article AIDS Patient Care STDS · July 2013 In the United States, 20% of HIV-infected persons are unaware of their diagnosis. Improved application of HIV screening recommendations in healthcare settings may facilitate diagnosis. Clinical patient data and previous healthcare visits were reviewed from ... Full text Link to item Cite

Acute HIV-1 infection in the Southeastern United States: a cohort study.

Journal Article AIDS Res Hum Retroviruses · January 2013 In 1998 a collaboration between Duke University and the University of North Carolina, Chapel Hill (UNC) was founded to enhance identification of persons with acute HIV-1 infection (AHI). The Duke-UNC AHI Research Consortium Cohort consists of patients ≥18 ... Full text Link to item Cite

Role of the CD4 count in HIV management

Journal Article HIV Therapy · January 1, 2010 As a result of successful antiretroviral treatment over the last 20 years, HIV has become more of a chronic disease for practitioners to manage, requiring careful, but routine, clinical monitoring. Laboratory markers, such as the HIV-1 RNA viral load and C ... Full text Cite

HIV testing in the emergency department

Journal Article AIDS Reader · October 20, 2009 Cite

Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation

Journal Article Journal of Pediatric Infectious Diseases · June 25, 2008 There is a paucity of knowledge about perinatally infected human immunodeficiency virus (HIV) positive children surviving into their adolescent years, especially from sub-Saharan Africa. Although studies have described the effects of the disease on the phy ... Cite

Pediatric HIV infection: the state of antiretroviral therapy.

Journal Article Expert Rev Anti Infect Ther · April 2008 Pediatric HIV/AIDS has become less of a problem in resource-rich countries as the number of perinatal infections has reduced dramatically since the advent of antiretrovirals, resulting in the effective prevention of mother-to-child transmission. In resourc ... Full text Link to item Cite

HIV care and treatment for children in resource-limited settings.

Journal Article Expert Rev Anti Infect Ther · April 2008 Although efforts to combat the HIV epidemic have focused on the perinatal reduction of HIV transmission, many children are still being infected with HIV in resource-limited settings. Access to HIV care, cotrimoxazole and antiretroviral therapy (ART) for HI ... Full text Link to item Cite

The medical management of central nervous system infections in Uganda and the potential impact of an algorithm-based approach to improve outcomes.

Journal Article Int J Infect Dis · November 2007 BACKGROUND: In sub-Saharan Africa, HIV has increased the spectrum of central nervous system (CNS) infections. The etiological diagnosis is often difficult. Mortality from CNS infections is higher in sub-Saharan Africa compared to Western countries. This st ... Full text Link to item Cite

Fatal granulomatous Acanthamoeba encephalitis mimicking a stroke, diagnosed by correlation of results of sequential magnetic resonance imaging, biopsy, in vitro culture, immunofluorescence analysis, and molecular analysis.

Journal Article J Clin Microbiol · November 2006 Amebic infections involving the central nervous system are rare and difficult to diagnose. Magnetic resonance imaging (MRI) at timed intervals may be helpful, where scans reveal enhancing lesions and increased signal. We report a unique case of granulomato ... Full text Link to item Cite