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Theodore Ruel, MD

TitleAssociate Professor
SchoolUCSF School of Medicine
DepartmentPediatrics
Address550 16th. Street
San Francisco CA 94158
Phone415-476-9197
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    Collapse Biography 
    Collapse Education and Training
    Yale University, School of Medicine, New Haven, CTM.D.06/2000Medicine
    University of California, San Francisco, San Francisco, CAResidency 06/2003Pediatrics
    University of California, San Francisco , San Francisco, CAFellowship06/2009Pediatric Infectious Disease

    Collapse Overview 
    Collapse Overview
    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 born with human immunodeficiency virus (HIV) infection. I continue to work broader issues of maternal child health through an NGO that I co-founded, now called Global Strategies. I am interested in advancing new agents for the treatment of children and infants living with HIV. I serve as vice-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 an advisor to the Pediatric AIDS Working Group at the World Health Organization, Within the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT), I serve as vice-chair of the Treatment Scientific Committee and co-chair of P1093, the protocol establishing dosing and safety of Dolutegravir in children. I have also become interested in the potential impact of very early treatment on outcomes in perinatally infected infants. I am an investigator on the IMPAACT P1115 that is enrolling early-treated in utero HIV-infected infants from network sites through the world and treating with an aggressive 4 drug regimen. 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 pediatric studies in the SEARCH trial, which tests strategies to diagnosis and successfully treat individuals living with HIV in rural Kenya and Uganda. I continue to work closely with our NGO Global Strategies continues to innovate new ways to optimize HIV and neonatal care in limited resource settings.


    Collapse Research 
    Collapse Research Activities and Funding
    Treating Infants Early Study (TIES)
    NIH/NICHD HHSN275201300003CApr 1, 2015 - Nov 30, 2017
    Role: Principal Investigator
    LOC-IMPAACT Leadership Group
    NIH/NIAID UM1 AI068632Jan 1, 2014 - Nov 30, 2020
    Role: Local site PI for international trials network IMPAACT (Nachman PI)
    Role Description: Vice Chair of Treatment scientific Committee, and Co-chair of P1093 Protocol
    Novel Strategies to Prevent Malaria and Improve HIV Outcomes in Africa
    NIH/NICHD P01 HD059454Aug 1, 2008 - Jun 30, 2018
    Role: Co-investigator
    Role Description: Lead on pediatrics

    Collapse ORNG Applications 
    Collapse Websites
    Collapse In The News
    Collapse Clinical Trials
    Collapse Global Health

    Collapse Bibliographic 
    Collapse Publications
    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
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    1. Brown LB, Ayieko J, Mwangwa F, Owaraganise A, Kwarisiima D, Jain V, Ruel T, Clark T, Black D, Chamie G, Bukusi EA, Cohen CR, Kamya MR, Petersen ML, Charlebois ED, Havlir DV. Predictors of retention in HIV care among youth (15-24) in a universal test-and-treat setting in rural Kenya. J Acquir Immune Defic Syndr. 2017 Apr 06. PMID: 28394821.
      View in: PubMed
    2. Natureeba P, Kakuru A, Muhindo M, Littmann E, Ochieng T, Ategeka J, Koss CA, Plenty A, Charlebois ED, Clark TD, Nzarubara B, Nakalembe M, Cohan D, Rizzuto G, Muehlenbachs A, Ruel T, Jagannathan P, Havlir DV, Kamya MR, Dorsey G. Intermittent Preventive Treatment with Dihydroartemisinin-piperaquine for the Prevention of Malaria among HIV-infected Pregnant Women. J Infect Dis. 2017 Feb 22. PMID: 28329368.
      View in: PubMed
    3. Achan J, Kakuru A, Ikilezi G, Mwangwa F, Plenty A, Charlebois E, Young S, Havlir D, Kamya M, Ruel T. Growth Recovery Among HIV-infected Children Randomized to Lopinavir/Ritonavir or NNRTI-based Antiretroviral Therapy. Pediatr Infect Dis J. 2016 Dec; 35(12):1329-1332. PMID: 27580060.
      View in: PubMed
    4. Kakuru A, Natureeba P, Muhindo MK, Clark TD, Havlir DV, Cohan D, Dorsey G, Kamya MR, Ruel T. Malaria burden in a birth cohort of HIV-exposed uninfected Ugandan infants living in a high malaria transmission setting. Malar J. 2016 Oct 18; 15(1):500. PMID: 27756308.
      View in: PubMed
    5. Kadede K, Ruel T, Kabami J, Ssemmondo E, Sang N, Kwarisiima D, Bukusi E, Cohen CR, Liegler T, Clark TD, Charlebois ED, Petersen ML, Kamya MR, Havlir DV, Chamie G. Increased adolescent HIV testing with a hybrid mobile strategy in Uganda and Kenya. AIDS. 2016 Sep 10; 30(14):2121-6. PMID: 27258399; PMCID: PMC5007167 [Available on 09/10/17].
    6. Brown LB, Havlir DV, Ayieko J, Mwangwa F, Owaraganise A, Kwarisiima D, Jain V, Ruel T, Clark T, Chamie G, Bukusi EA, Cohen CR, Kamya MR, Petersen ML, Charlebois ED, et al. High levels of retention in care with streamlined care and universal test-and-treat in East Africa. AIDS. 2016 Sep 6. PMID: 27603290.
      View in: PubMed
    7. Morgan MC, Kumar GS, Kaiser SV, Seetharam S, Ruel T. Implementation of a neonatal transcutaneous bilirubin screening programme in rural India. Paediatr Int Child Health. 2016 May; 36(2):122-6. PMID: 25844503.
      View in: PubMed
    8. Koss CA, Natureeba P, Nyafwono D, Plenty A, Mwesigwa J, Nzarubara B, Clark TD, Ruel T, Achan J, Charlebois ED, Cohan D, Kamya MR, Havlir DV, Young SL. Brief Report: Food Insufficiency Is Associated With Lack of Sustained Viral Suppression Among HIV-Infected Pregnant and Breastfeeding Ugandan Women. J Acquir Immune Defic Syndr. 2016 Mar 1; 71(3):310-5. PMID: 26397935.
      View in: PubMed
    9. Seidman D, Ruel T, Rahangdale L, Mittal P, Pecci C, Weber S, Goldschmidt R, Cohan D, Levison J. A clinical approach to elimination of perinatal HIV transmission in resource-rich settings. Int J Gynaecol Obstet. 2015 Dec; 131(3):309-10. PMID: 26381200.
      View in: PubMed
    10. Sears D, Mpimbaza A, Kigozi R, Sserwanga A, Chang MA, Kapella BK, Yoon S, Kamya MR, Dorsey G, Ruel T. Quality of inpatient pediatric case management for four leading causes of child mortality at six government-run Ugandan hospitals. PLoS One. 2015; 10(5):e0127192. PMID: 25992620; PMCID: PMC4437786.
    11. Koss CA, Natureeba P, Mwesigwa J, Cohan D, Nzarubara B, Bacchetti P, Horng H, Clark TD, Plenty A, Ruel T, Achan J, Charlebois ED, Kamya MR, Havlir DV, Gandhi M. Hair concentrations of antiretrovirals predict viral suppression in HIV-infected pregnant and breastfeeding Ugandan women. AIDS. 2015 Apr 24; 29(7):825-30. PMID: 25985404; PMCID: PMC4438773 [Available on 04/24/16].
    12. Bartelink IH, Savic RM, Dorsey G, Ruel T, Gingrich D, Scherpbier HJ, Capparelli E, Jullien V, Young SL, Achan J, Plenty A, Charlebois E, Kamya M, Havlir D, Aweeka F. The effect of malnutrition on the pharmacokinetics and virologic outcomes of lopinavir, efavirenz and nevirapine in food insecure HIV-infected children in Tororo, Uganda. Pediatr Infect Dis J. 2015 Mar; 34(3):e63-70. PMID: 25742090; PMCID: PMC4351793 [Available on 03/01/16].
    13. Cohan D, Natureeba P, Koss CA, Plenty A, Luwedde F, Mwesigwa J, Ades V, Charlebois ED, Gandhi M, Clark TD, Nzarubara B, Achan J, Ruel T, Kamya MR, Havlir DV. Efficacy and safety of lopinavir/ritonavir versus efavirenz-based antiretroviral therapy in HIV-infected pregnant Ugandan women. AIDS. 2015 Jan 14; 29(2):183-91. PMID: 25426808; PMCID: PMC4428759 [Available on 01/14/16].
    14. Young SL, Plenty AH, Luwedde FA, Natamba BK, Natureeba P, Achan J, Mwesigwa J, Ruel T, Ades V, Osterbauer B, Clark TD, Dorsey G, Charlebois ED, Kamya M, Havlir DV, Cohan DL. Household food insecurity, maternal nutritional status, and infant feeding practices among HIV-infected Ugandan women receiving combination antiretroviral therapy. Matern Child Health J. 2014 Nov; 18(9):2044-53. PMID: 24585398; PMCID: PMC4419705.
    15. Koss CA, Natureeba P, Plenty A, Luwedde F, Mwesigwa J, Ades V, Charlebois ED, Clark TD, Achan J, Ruel T, Nzarubara B, Kamya MR, Havlir DV, Cohan D. Risk factors for preterm birth among HIV-infected pregnant Ugandan women randomized to lopinavir/ritonavir- or efavirenz-based antiretroviral therapy. J Acquir Immune Defic Syndr. 2014 Oct 1; 67(2):128-35. PMID: 25072616; PMCID: PMC4414017.
    16. Marquez C, Okiring J, Chamie G, Ruel T, Achan J, Kakuru A, Kamya MR, Charlebois ED, Havlir DV, Dorsey G. Increased morbidity in early childhood among HIV-exposed uninfected children in Uganda is associated with breastfeeding duration. J Trop Pediatr. 2014 Dec; 60(6):434-41. PMID: 25145704; PMCID: PMC4303769 [Available on 12/01/15].
    17. Kakuru A, Achan J, Muhindo MK, Ikilezi G, Arinaitwe E, Mwangwa F, Ruel T, Clark TD, Charlebois E, Rosenthal PJ, Havlir D, Kamya MR, Tappero JW, Dorsey G. Artemisinin-based combination therapies are efficacious and safe for treatment of uncomplicated malaria in HIV-infected Ugandan children. Clin Infect Dis. 2014 Aug 1; 59(3):446-53. PMID: 24759826; PMCID: PMC4155440.
    18. Ruel T, Kakuru A, Ikilezi G, Mwangwa F, Dorsey G, Rosenthal PJ, Charlebois E, Havlir D, Kamya M, Achan J. Virologic and immunologic outcomes of HIV-infected Ugandan children randomized to lopinavir/ritonavir or nonnucleoside reverse transcriptase inhibitor therapy. J Acquir Immune Defic Syndr. 2014 Apr 15; 65(5):535-41. PMID: 24326597; PMCID: PMC3999287.
    19. Jenster M, Bonifacio SL, Ruel T, Rogers EE, Tam EW, Partridge JC, Barkovich AJ, Ferriero DM, Glass HC. Maternal or neonatal infection: association with neonatal encephalopathy outcomes. Pediatr Res. 2014 Jul; 76(1):93-9. PMID: 24713817; PMCID: PMC4062582.
    20. Gandhi M, Mwesigwa J, Aweeka F, Plenty A, Charlebois E, Ruel T, Huang Y, Clark T, Ades V, Natureeba P, Luwedde FA, Achan J, Kamya MR, Havlir DV, Cohan D. Hair and plasma data show that lopinavir, ritonavir, and efavirenz all transfer from mother to infant in utero, but only efavirenz transfers via breastfeeding. J Acquir Immune Defic Syndr. 2013 Aug 15; 63(5):578-84. PMID: 24135775; PMCID: PMC3800282.
    21. Ades V, Mwesigwa J, Natureeba P, Clark TD, Plenty A, Charlebois E, Achan J, Kamya MR, Havlir DV, Cohan D, Ruel T. Neonatal mortality in HIV-exposed infants born to women receiving combination antiretroviral therapy in Rural Uganda. J Trop Pediatr. 2013 Dec; 59(6):441-6. PMID: 23764539; PMCID: PMC3842848.
    22. Ikilezi G, Achan J, Kakuru A, Ruel T, Charlebois E, Clark TD, Rosenthal PJ, Havlir D, Kamya MR, Dorsey G. Prevalence of asymptomatic parasitemia and gametocytemia among HIV-infected Ugandan children randomized to receive different antiretroviral therapies. Am J Trop Med Hyg. 2013 Apr; 88(4):744-6. PMID: 23358639; PMCID: PMC3617863.
    23. Achan J, Kakuru A, Ikilezi G, Ruel T, Clark TD, Nsanzabana C, Charlebois E, Aweeka F, Dorsey G, Rosenthal PJ, Havlir D, Kamya MR. Antiretroviral agents and prevention of malaria in HIV-infected Ugandan children. N Engl J Med. 2012 Nov 29; 367(22):2110-8. PMID: 23190222; PMCID: PMC3664297.
    24. Young S, Murray K, Mwesigwa J, Natureeba P, Osterbauer B, Achan J, Arinaitwe E, Clark T, Ades V, Plenty A, Charlebois E, Ruel T, Kamya M, Havlir D, Cohan D. Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy. PLoS One. 2012; 7(8):e41934. PMID: 22879899; PMCID: PMC3413694.
    25. Ruel T, Boivin MJ, Boal HE, Bangirana P, Charlebois E, Havlir DV, Rosenthal PJ, Dorsey G, Achan J, Akello C, Kamya MR, Wong JK. Neurocognitive and motor deficits in HIV-infected Ugandan children with high CD4 cell counts. Clin Infect Dis. 2012 Apr; 54(7):1001-9. PMID: 22308272; PMCID: PMC3297647.
    26. Kay J, Wanzira H, Sandison T, Kakuru A, Bigira V, Kamya M, Homsy J, Tappero JW, Havlir D, Dorsey G, Ruel T. Virologic suppression in nevirapine-exposed HIV-infected infants initiating antiretroviral therapy in rural Uganda. J Trop Pediatr. 2012 Jun; 58(3):194-9. PMID: 21930666; PMCID: PMC3530275.
    27. Ruel T, Zanoni BC, Ssewanyana I, Cao H, Havlir DV, Kamya M, Achan J, Charlebois ED, Feeney ME. Sex differences in HIV RNA level and CD4 cell percentage during childhood. Clin Infect Dis. 2011 Sep; 53(6):592-9. PMID: 21840929; PMCID: PMC3160805.
    28. Ruel T, Kamya MR, Li P, Pasutti W, Charlebois ED, Liegler T, Dorsey G, Rosenthal PJ, Havlir DV, Wong JK, Achan J. Early virologic failure and the development of antiretroviral drug resistance mutations in HIV-infected Ugandan children. J Acquir Immune Defic Syndr. 2011 Jan 1; 56(1):44-50. PMID: 21099693; PMCID: PMC3078046.
    29. Charlebois ED, Ruel T, Gasasira AF, Achan J, Kateera F, Akello C, Cao H, Dorsey G, Rosenthal PJ, Ssewanyana I, Kamya MR, Havlir DV. Short-term risk of HIV disease progression and death in Ugandan children not eligible for antiretroviral therapy. J Acquir Immune Defic Syndr. 2010 Nov; 55(3):330-5. PMID: 20592617; PMCID: PMC3025136.
    30. Li P, Ruel T, Fujimoto K, Hatano H, Yukl S, Eller LA, Liegler T, Kamya M, Gassasira A, Dorsey G, Rosenthal PJ, Havlir DV, Wong JK. Novel application of Locked Nucleic Acid chemistry for a Taqman assay for measuring diverse human immunodeficiency virus type 1 subtypes. J Virol Methods. 2010 Dec; 170(1-2):115-20. PMID: 20863855; PMCID: PMC3280821.
    31. Gasasira AF, Kamya MR, Ochong EO, Vora N, Achan J, Charlebois E, Ruel T, Kateera F, Meya DN, Havlir D, Rosenthal PJ, Dorsey G. Effect of trimethoprim-sulphamethoxazole on the risk of malaria in HIV-infected Ugandan children living in an area of widespread antifolate resistance. Malar J. 2010; 9:177. PMID: 20573194; PMCID: PMC2903607.
    32. Boivin MJ, Ruel T, Boal HE, Bangirana P, Cao H, Eller LA, Charlebois E, Havlir DV, Kamya MR, Achan J, Akello C, Wong JK. HIV-subtype A is associated with poorer neuropsychological performance compared with subtype D in antiretroviral therapy-naive Ugandan children. AIDS. 2010 May 15; 24(8):1163-70. PMID: 20425886; PMCID: PMC2880483.
    33. Ruel T, Ssewanyana I, Achan J, Gasasira A, Kamya MR, Kekitiinwa A, Wong JK, Cao H, Havlir D, Charlebois ED. Dynamics of T cell activation accompanying CD4 recovery in antiretroviral treated HIV-infected Ugandan children. Clin Immunol. 2009 Jun; 131(3):410-4. PMID: 19303366; PMCID: PMC3032795.
    34. Ssewanyana I, Baker CA, Ruel T, Bousheri S, Kamya M, Dorsey G, Rosenthal PJ, Charlebois E, Havlir D, Cao H. The Distribution and Immune Profile of T Cell Subsets in HIV-Infected Children from Uganda. AIDS Res Hum Retroviruses. 2009 Jan; 25(1):65-71. PMID: 19182922; PMCID: PMC2858297.
    35. Ruel T, Achan J, Gasasira AF, Charlebois ED, Mehbratu T, Rosenthal PJ, Dorsey G, Kamya MR, Kekitiinwa A, Wong J, Havlir DV. HIV RNA suppression among HIV-infected Ugandan children with measles. J Acquir Immune Defic Syndr. 2008 Jun 1; 48(2):225-7. PMID: 18520684; PMCID: PMC3040680.
    36. Gasasira AF, Kamya MR, Achan J, Mebrahtu T, Kalyango JN, Ruel T, Charlebois E, Staedke SG, Kekitiinwa A, Rosenthal PJ, Havlir D, Dorsey G. High risk of neutropenia in HIV-infected children following treatment with artesunate plus amodiaquine for uncomplicated malaria in Uganda. Clin Infect Dis. 2008 Apr 1; 46(7):985-91. PMID: 18444813.
      View in: PubMed
    37. Ssewanyana I, Elrefaei M, Dorsey G, Ruel T, Jones NG, Gasasira A, Kamya M, Nakiwala J, Achan J, Charlebois E, Havlir D, Cao H. Profile of T cell immune responses in HIV-infected children from Uganda. J Infect Dis. 2007 Dec 1; 196(11):1667-70. PMID: 18008251.
      View in: PubMed
    38. Kamya MR, Gasasira AF, Achan J, Mebrahtu T, Ruel T, Kekitiinwa A, Charlebois ED, Rosenthal PJ, Havlir D, Dorsey G. Effects of trimethoprim-sulfamethoxazole and insecticide-treated bednets on malaria among HIV-infected Ugandan children. AIDS. 2007 Oct 1; 21(15):2059-66. PMID: 17885296.
      View in: PubMed
    39. Gora D, Yaya T, Jocelyn T, Didier F, Maoulouth D, Amadou S, Ruel T, Gonzalez JP. The potential role of rodents in the enzootic cycle of Rift Valley fever virus in Senegal. Microbes Infect. 2000 Apr; 2(4):343-6. PMID: 10817634.
      View in: PubMed
    40. Cheng Q, Ruel T, Zhou W, Moloo SK, Majiwa P, O'Neill SL, Aksoy S. Tissue distribution and prevalence of Wolbachia infections in tsetse flies, Glossina spp. Med Vet Entomol. 2000 Mar; 14(1):44-50. PMID: 10759311.
      View in: PubMed
    41. Ruel T, Kelley DB, Tobias ML. Facilitation at the sexually differentiated laryngeal synapse of Xenopus laevis. J Comp Physiol A. 1998 Jan; 182(1):35-42. PMID: 9447712; PMCID: PMC3493214.
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