Relevant Degree Programs
Great Supervisor Week Mentions
It's #GreatSupervisor week @UBC and I’m so lucky to be supervised by @money2_dmoney. She's a kind and supportive boss lady! Major kudos for reining in my scattered and wild ideas.
Graduate Student Supervision
Doctoral Student Supervision (Jan 2008 - May 2021)
Background: Human papillomavirus (HPV) is the causal agent of virtually all cervical cancer and genital warts. Women living with HIV (WLWH) experience higher rates of HPV-associated infection and disease than women without HIV. HPV vaccination has proven safe and efficacious in young women without HIV, however, little was known about the vaccine in WLWH. The work represented in this thesis was designed to answer key questions around HPV infection and the impact of HPV vaccination in WLWH. Methods: WLWH across Canada were invited to participate in a CIHR-funded, multi-centre study of quadrivalent HPV vaccination starting in 2009. Participants were administered three doses of vaccine at 0/2/6 months. Demographic and clinical data, serology (cLIA), liquid-based cervical cytology, and HPV DNA genotyping (Linear array assay) were collected at baseline and post-vaccine series every 6-12 months up to 8 years. Participants were referred for clinical colposcopies as per the standard at their institutions. Results: Pre-vaccination rates of prevalent and persistent oncogenic HPV infection among participants were high. Extending the spacing of the three vaccine doses out to two years did not significantly impact the peak anti-HPV antibody titer achieved in this cohort. Two years post-vaccination, efficacy of the vaccine was good, demonstrating lower rates of clinical endpoints than in unvaccinated Canadian WLWH, but higher rates than those seen in vaccinated women without HIV. Post-vaccination rates of persistent non-vaccine oncogenic HPV types were relatively high with a higher proportion of non-vaccine HPV types than of HPV types contained in the nonavalent vaccine. Conclusions: These findings support the value of HPV vaccination and the need for ongoing cervical cancer screening post-vaccination in WLWH. They also do not indicate concern with extending the spacing interval between the first and third doses up to two years. Collectively, these findings have provided great value to the clinical care of WLWH by informing best vaccination and screening practices for this particularly vulnerable population.
Master's Student Supervision (2010 - 2020)
Background: The vaginal microbiome is a dynamic environment colonized by a wide array of microorganisms. Although bacterial vaginosis (BV) is characterized by a disruption in the normal bacterial microbiome of the vagina, the factors contributing to recurrent BV remain unknown. In addition, very little is known about the role of viruses in the vaginal microbiome and associated dysbioses. Objectives: 1) characterize the vaginal bacteriome of women with recurrent BV using cpn60 sequencing, compare bacterial profiles to healthy-asymptomatic cohort, and correlate profiles to descriptive characteristics; and 2) characterize the vaginal virome of healthy-asymptomatic, HIV-positive women and women with recurrent BV, and correlate profiles to descriptive characteristics. Methods: Twenty-six women were recruited into the recurrent BV bacteriome study. Vaginal swabs were obtained for cpn60 sequencing and Gram stain Nugent scoring. Additionally, samples from 54 women were analyzed in the virome study: 21 healthy-asymptomatic, 25 HIV-positive and eight recurrent BV. The vaginal swabs were processed to enrich for viruses and then subjected to metagenomics shotgun sequencing. Demographic, behavioural and clinical information was collected for all participants, in both bacteriome and virome studies.Results: Bacteriome analyses detected 122 cpn60 operational taxonomic units (OTUs). Bacterial profiles clustered into six community state types (CSTs). Trends suggested a relationship between BV-associated CSTs and number of sexual partners (past year), oral sex, use of (hormonal) contraception, abnormal discharge (past 48 hours), lifetime history of trichomoniasis, and number of BV episodes (past two months and year). Virome analyses detected a total of 477 species. Viral profiles clustered into seven groups. Viral patterns were identified within bacteriome CSTs, Nugent scores, viral loads, between Lactobacillus-dominant, Lactobacillus iners-dominant, and heterogeneous profiles, and were associated with a number of descriptive characteristics.Conclusions: The vaginal microbiome is highly diverse and potentially associated with many clinical factors. Our ability to use the microbiome data to subdivide women into clusters, and detect trends between clusters and characteristics will expand our knowledge on the vaginal microbiome as a whole.
Disruptions or imbalances of the vaginal microbiome can lead to negative reproductive health consequences for women, including an increased risk of sexually transmitted infections, pelvic inflammatory disease, and preterm birth. HIV-positive women may be particularly vulnerable to microbiome disruptions due to the immune dysfunction intrinsic to this disease. The objective of this study was to explore the vaginal microbiome in HIV-positive reproductive-aged women utilizing cpn60 metagenomic profiling and to correlate vaginal bacterial profiles with demographic/clinical variables. 54 HIV-positive women were recruited from the Oak Tree Clinic in Vancouver, BC. Demographic/clinical information was collected and vaginal gram-stains were assessed by Nugent’s scoring. Total DNA was extracted from vaginal swabs and PCR amplified using cpn60-specific universal primers. Cpn60-sequence libraries were generated with 454-GS-FLX Titanium pyrosequencing. 64 unique bacterial phylotypes were classified based on sequence similarity to known bacterial organisms and 10 common vaginal community clusters were generated. Fisher’s exact test and Wilcoxon signed-rank tests were utilized to conduct statistical analyses. The mean age of enrolled women was 36.6 years (range=22.3–48.8). The mean CD4 count for these women was 484 cells/mm³ (range=90-930 cells/mm³) while the mean viral load was 13,144 copies/mL (range=40 copies/mL correlated with Atopobium vaginae, Gardnerella vaginalis D, Prevotella amnii, and 4 other potentially novel bacterial species (P