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Richard Barfield

Biostatistician, Senior
Biostatistics & Bioinformatics
Duke Box 2721, Durham, NC 27710
2424 Erwin Road Suite 1106, 11028A Hock Plaza, Durham, NC 27705

Selected Publications


Promoting Re-engagement in HIV Care after Emergency Department Visit by Leveraging Clinical Informatics at a Southern Academic Medical Center.

Journal Article AIDS Res Hum Retroviruses · December 2025 Retaining persons with HIV (PWH) in HIV care and ensuring access to antiretroviral therapy are crucial for reducing HIV transmission and enhancing health outcomes. HIV care engagement rates in the United States have plateaued over the last decade, indicati ... Full text Open Access Link to item Cite

A rhesus macaque model of congenital cytomegalovirus infection reveals a spectrum of vertical transmission outcomes.

Journal Article Commun Biol · November 24, 2025 Congenital cytomegalovirus (cCMV) is the leading infectious cause of birth defects worldwide, yet immune determinants of protection to inform maternal vaccine design remain elusive due to the lack of a translational animal model. Here, we characterized the ... Full text Link to item Cite

Identifying correlates of viral rebound timing and viral control in SHIV-infected infant macaques after ART interruption.

Journal Article Sci Transl Med · October 29, 2025 Evaluation of HIV cure strategies requires antiretroviral therapy (ART) interruption, but ethical and clinical considerations make this difficult in children. Here, we used a pediatric preclinical model of simian-HIV (SHIV) infection to uncover features as ... Full text Link to item Cite

Opinions and Concerns Surrounding Long-Acting Injectable (LAI) and Oral HIV Pre-exposure Prophylaxis (PrEP) Among Current and Former LAI and Oral PrEP Users.

Journal Article AIDS Behav · October 2025 Long-acting injectable (LAI) pre-exposure prophylaxis (PrEP) has potential to increase PrEP uptake and adherence. However, most studies investigating opinions about LAI PrEP were done prior to its approval. We administered a cross-sectional electronic surv ... Full text Link to item Cite

The pentameric complex is not required for congenital CMV transmission in seronegative rhesus macaques.

Journal Article Sci Transl Med · March 12, 2025 Congenital cytomegalovirus (cCMV) is the leading infectious cause of neonatal neurological impairment worldwide, but the viral factors enabling vertical spread across the placenta remain undetermined. The pentameric complex (PC), composed of the subunits g ... Full text Link to item Cite

Rhesus Cytomegalovirus-encoded Fcγ-binding glycoproteins facilitate viral evasion from IgG-mediated humoral immunity.

Journal Article Nat Commun · January 31, 2025 Human cytomegalovirus (HCMV) encodes four viral Fc-gamma receptors (vFcγRs) that counteract antibody-mediated activation in vitro, but their role in infection and pathogenesis is unknown. To examine their in vivo function in an animal model evolutionarily ... Full text Link to item Cite

HIV disclosure in the social networks of adolescents with HIV in Cape Town, South Africa

Journal Article Frontiers in Reproductive Health · January 1, 2025 Background: Little is known about HIV status disclosure within the social networks of adolescents with perinatally-acquired HIV (APHIV) in sub-Saharan Africa, where HIV prevalence is high and stigma surrounding HIV is pervasive. This study employed egocent ... Full text Cite

Evaluating longitudinal cytomegalovirus-specific humoral immune responses and association with DNAemia risk in seropositive lung transplant recipients.

Journal Article JHLT Open · August 2024 BACKGROUND: Cytomegalovirus (CMV) is the most common viral infection among lung transplant recipients and is associated with chronic lung allograft dysfunction. There is a need for better therapeutics as well as biomarkers to enable effective stratificatio ... Full text Link to item Cite

Multivalent cytomegalovirus glycoprotein B nucleoside modified mRNA vaccines did not demonstrate a greater antibody breadth.

Journal Article NPJ Vaccines · February 20, 2024 Human cytomegalovirus (HCMV) remains the most common congenital infection and infectious complication in immunocompromised patients. The most successful HCMV vaccine to date, an HCMV glycoprotein B (gB) subunit vaccine adjuvanted with MF59, achieved 50% ef ... Full text Link to item Cite

Maternal immunity shapes biomarkers of germinal center development in HIV-exposed uninfected infants.

Journal Article Front Immunol · 2024 INTRODUCTION: HIV-exposed uninfected (HEU) infants exhibit elevated pro-inflammatory biomarkers that persist after birth. However, comprehensive assessments of bioprofiles associated with immune regulation and development in pregnant women with HIV (PWH) a ... Full text Link to item Cite

Immune Phenotype and Postoperative Complications After Elective Surgery.

Journal Article Ann Surg · December 1, 2023 OBJECTIVES: To characterize and quantify accumulating immunologic alterations, pre and postoperatively in patients undergoing elective surgical procedures. BACKGROUND: Elective surgery is an anticipatable, controlled human injury. Although the human respon ... Full text Link to item Cite

Prevalence and significance of clonal hematopoiesis of indeterminate potential in lung transplant recipients.

Journal Article BMC Pulm Med · October 30, 2023 BACKGROUND: Clonal hematopoiesis of indeterminate potential (CHIP), the age-related acquisition of somatic mutations that leads to an expanded blood cell clone, has been associated with development of a pro-inflammatory state. An enhanced or dysregulated i ... Full text Link to item Cite

Relationship of maternal cytomegalovirus-specific antibody responses and viral load to vertical transmission risk following primary maternal infection in a rhesus macaque model.

Journal Article PLoS Pathog · October 2023 Cytomegalovirus (CMV) is the most common congenital infection and cause of birth defects worldwide. Primary CMV infection during pregnancy leads to a higher frequency of congenital CMV (cCMV) than maternal re-infection, suggesting that maternal immunity co ... Full text Link to item Cite

Late gene expression-deficient cytomegalovirus vectors elicit conventional T cells that do not protect against SIV.

Journal Article JCI Insight · March 22, 2023 Rhesus cytomegalovirus-based (RhCMV-based) vaccine vectors induce immune responses that protect ~60% of rhesus macaques (RMs) from SIVmac239 challenge. This efficacy depends on induction of effector memory-based (EM-biased) CD8+ T cells recognizing SIV pep ... Full text Link to item Cite

Neuroimaging and immunological features of neurocognitive function related to substance use in people with HIV.

Journal Article J Neurovirol · February 2023 This study sought to identify neuroimaging and immunological factors associated with substance use and that contribute to neurocognitive impairment (NCI) in people with HIV (PWH). We performed cross-sectional immunological phenotyping, neuroimaging, and ne ... Full text Link to item Cite

Multivariate analysis of FcR-mediated NK cell functions identifies unique clustering among humans and rhesus macaques

Conference Frontiers in Immunology · January 1, 2023 Rhesus macaques (RMs) are a common pre-clinical model used to test HIV vaccine efficacy and passive immunization strategies. Yet, it remains unclear to what extent the Fc-Fc receptor (FcR) interactions impacting antiviral activities of antibodies in RMs re ... Full text Cite

Characterization of Plasma Immunoglobulin G Responses in Elite Neutralizers of Human Cytomegalovirus.

Journal Article J Infect Dis · November 1, 2022 BACKGROUND: Human cytomegalovirus (HCMV) is the most common infectious complication of organ transplantation and cause of birth defects worldwide. There are limited therapeutic options and no licensed vaccine to prevent HCMV infection or disease. To inform ... Full text Link to item Cite

Self-assembling peptide nanofiber HIV vaccine elicits robust vaccine-induced antibody functions and modulates Fc glycosylation.

Journal Article Sci Adv · September 23, 2022 To develop vaccines for certain key global pathogens such as HIV, it is crucial to elicit both neutralizing and non-neutralizing Fc-mediated effector antibody functions. Clinical evidence indicates that non-neutralizing antibody functions including antibod ... Full text Link to item Cite

A Multidimensional Bioinformatic Platform for the Study of Human Response to Surgery.

Journal Article Ann Surg · June 1, 2022 OBJECTIVE: To design and establish a prospective biospecimen repository that integrates multi-omics assays with clinical data to study mechanisms of controlled injury and healing. BACKGROUND: Elective surgery is an opportunity to understand both the system ... Full text Link to item Cite

Association between germline variants and somatic mutations in colorectal cancer.

Journal Article Scientific reports · June 2022 Colorectal cancer (CRC) is a heterogeneous disease with evidence of distinct tumor types that develop through different somatically altered pathways. To better understand the impact of the host genome on somatically mutated genes and pathways, we assessed ... Full text Cite

Genetic Regulation of DNA Methylation Yields Novel Discoveries in GWAS of Colorectal Cancer.

Journal Article Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · May 2022 BackgroundColorectal cancer has a strong epigenetic component that is accompanied by frequent DNA methylation (DNAm) alterations in addition to heritable genetic risk. It is of interest to understand the interrelationship of germline genetics, DNA ... Full text Cite

Large-Scale Hypothesis Testing for Causal Mediation Effects with Applications in Genome-wide Epigenetic Studies.

Journal Article Journal of the American Statistical Association · January 2022 In genome-wide epigenetic studies, it is of great scientific interest to assess whether the effect of an exposure on a clinical outcome is mediated through DNA methylations. However, statistical inference for causal mediation effects is challenged by the f ... Full text Cite

HIV envelope antigen valency on peptide nanofibers modulates antibody magnitude and binding breadth.

Journal Article Sci Rep · July 14, 2021 A major challenge in developing an effective vaccine against HIV-1 is the genetic diversity of its viral envelope. Because of the broad range of sequences exhibited by HIV-1 strains, protective antibodies must be able to bind and neutralize a widely mutate ... Full text Link to item Cite

Genetic architectures of proximal and distal colorectal cancer are partly distinct.

Journal Article Gut · July 2021 ObjectiveAn understanding of the etiologic heterogeneity of colorectal cancer (CRC) is critical for improving precision prevention, including individualized screening recommendations and the discovery of novel drug targets and repurposable drug ca ... Full text Cite

Reduced plasmablast frequency is associated with seronegative myasthenia gravis.

Journal Article Muscle Nerve · April 2021 BACKGROUND: The immunopathology of autoimmune seronegative myasthenia gravis (SN MG) is poorly understood. Our objective was to determine immune profiles associated with a diagnosis of SN MG. METHODS: We performed high-dimensional flow cytometry on blood s ... Full text Link to item Cite

Intake of Dietary Fruit, Vegetables, and Fiber and Risk of Colorectal Cancer According to Molecular Subtypes: A Pooled Analysis of 9 Studies.

Journal Article Cancer research · October 2020 Protective associations of fruits, vegetables, and fiber intake with colorectal cancer risk have been shown in many, but not all epidemiologic studies. One possible reason for study heterogeneity is that dietary factors may have distinct effects by colorec ... Full text Cite

A general framework for functionally informed set-based analysis: Application to a large-scale colorectal cancer study.

Journal Article PLoS genetics · August 2020 Genome-wide association studies (GWAS) have successfully identified tens of thousands of genetic variants associated with various phenotypes, but together they explain only a fraction of heritability, suggesting many variants have yet to be discovered. Rec ... Full text Cite

Landscape of somatic single nucleotide variants and indels in colorectal cancer and impact on survival.

Journal Article Nature communications · July 2020 Colorectal cancer (CRC) is a biologically heterogeneous disease. To characterize its mutational profile, we conduct targeted sequencing of 205 genes for 2,105 CRC cases with survival data. Our data shows several findings in addition to enhancing the existi ... Full text Cite

Epigenome-wide association analysis of daytime sleepiness in the Multi-Ethnic Study of Atherosclerosis reveals African-American-specific associations.

Journal Article Sleep · August 1, 2019 STUDY OBJECTIVES: Daytime sleepiness is a consequence of inadequate sleep, sleep-wake control disorder, or other medical conditions. Population variability in prevalence of daytime sleepiness is likely due to genetic and biological factors as well as socia ... Full text Link to item Cite

Associations of variants In the hexokinase 1 and interleukin 18 receptor regions with oxyhemoglobin saturation during sleep.

Journal Article PLoS Genet · April 2019 Sleep disordered breathing (SDB)-related overnight hypoxemia is associated with cardiometabolic disease and other comorbidities. Understanding the genetic bases for variations in nocturnal hypoxemia may help understand mechanisms influencing oxygenation an ... Full text Link to item Cite

A transcriptome-wide association study of 229,000 women identifies new candidate susceptibility genes for breast cancer.

Journal Article Nature genetics · July 2018 The breast cancer risk variants identified in genome-wide association studies explain only a small fraction of the familial relative risk, and the genes responsible for these associations remain largely unknown. To identify novel risk loci and likely causa ... Full text Cite

Transcriptome-wide association studies accounting for colocalization using Egger regression.

Journal Article Genetic epidemiology · July 2018 Integrating genome-wide association (GWAS) and expression quantitative trait locus (eQTL) data into transcriptome-wide association studies (TWAS) based on predicted expression can boost power to detect novel disease loci or pinpoint the susceptibility gene ... Full text Cite

Metastable DNA methylation sites associated with longitudinal lung function decline and aging in humans: an epigenome-wide study in the NAS and KORA cohorts.

Journal Article Epigenetics · January 2018 DNA methylation is an epigenetic regulator of gene transcription, which has been found to be both metastable and variable within human cohort studies. Currently, few studies have been done to identify metastable DNA methylation biomarkers associated with l ... Full text Cite

Testing for the indirect effect under the null for genome-wide mediation analyses.

Journal Article Genetic epidemiology · December 2017 Mediation analysis helps researchers assess whether part or all of an exposure's effect on an outcome is due to an intermediate variable. The indirect effect can help in designing interventions on the mediator as opposed to the exposure and better understa ... Full text Cite

Reclassification of genetic-based risk predictions as GWAS data accumulate.

Journal Article Genome medicine · February 2016 BackgroundDisease risk assessments based on common genetic variation have gained widespread attention and use in recent years. The clinical utility of genetic risk profiles depends on the number and effect size of identified loci, and how stable t ... Full text Cite

Genome-wide association study identifies multiple susceptibility loci for pancreatic cancer.

Journal Article Nat Genet · September 2014 We performed a multistage genome-wide association study including 7,683 individuals with pancreatic cancer and 14,397 controls of European descent. Four new loci reached genome-wide significance: rs6971499 at 7q32.3 (LINC-PINT, per-allele odds ratio (OR) = ... Full text Link to item Cite

Accounting for population stratification in DNA methylation studies.

Journal Article Genetic epidemiology · April 2014 DNA methylation is an important epigenetic mechanism that has been linked to complex diseases and is of great interest to researchers as a potential link between genome, environment, and disease. As the scale of DNA methylation association studies approach ... Full text Cite

Mouse model implicates GNB3 duplication in a childhood obesity syndrome.

Journal Article Proceedings of the National Academy of Sciences of the United States of America · September 2013 Obesity is a highly heritable condition and a risk factor for other diseases, including type 2 diabetes, cardiovascular disease, hypertension, and cancer. Recently, genomic copy number variation (CNV) has been implicated in cases of early onset obesity tha ... Full text Cite

CpGassoc: an R function for analysis of DNA methylation microarray data.

Journal Article Bioinformatics (Oxford, England) · May 2012 SummaryWith the increasing availability of high-density methylation microarrays, there has been growing interest in analysis of DNA methylation data. We have developed CpGassoc, an R package that can efficiently perform the statistical analysis ne ... Full text Cite

MethLAB: A graphical user interface package for the analysis of array-based DNA methylation data

Journal Article Epigenetics · January 1, 2012 Recent evidence suggests that DNA methylation changes may underlie numerous complex traits and diseases. The advent of commercial, array-based methods to interrogate DNA methylation has led to a profusion of epigenetic studies in the literature. Array-base ... Full text Cite

Acute and posttraumatic stress symptoms in a prospective gene x environment study of a university campus shooting.

Journal Article Archives of general psychiatry · January 2012 ContextThe serotonin transporter (SLC6A4) has been associated with several stress-related syndromes including posttraumatic stress disorder (PTSD). The ability to detect meaningful associations is largely dependent on reliable measures of preexist ... Full text Cite