Awewura Kwara

Awewura Kwara, MD, MB, ChB, MPH, TM

Professor Of Medicine, VA Section Chief

Department: MD-INFECTIOUS DISEASES
Business Phone: (352) 294-5481

About Awewura Kwara

Dr. Kwara is a professor of medicine within the Division of Infectious Diseases & Global Medicine. He is an Infectious Diseases Specialist with broad expertise in general infectious diseases, HIV/AIDS and travel medicine. He received his medical degree from the University of Ghana Medical School and master’s in public health and tropical medicine degree from Tulane University. Dr. Kwara completed Internal Medicine Residency at Cook County Hospital in Chicago and an Infectious Disease Fellowship at Tulane University Health Sciences Center in New Orleans. He is board certified in internal medicine and infectious diseases. He is also certified in Clinical Tropical Medicine and Travelers’ Health.

Board Certifications

  • Infectious Disease
    American Board of Internal Medicine
  • Internal Medicine
    American Board of Internal Medicine

Clinical Profile

Specialties
  • Infectious Disease
Areas of Interest
  • HIV/AIDS
  • Infectious diseases
  • Traveler’s guide to avoiding infectious diseases

Research Profile

Dr. Kwara’s research is focused on clinical pharmacology of antiretroviral and antituberculosis therapy in persons living with human immunodeficiency virus (HIV) with tuberculosis (TB) or hepatitis B virus (HBV) coinfection. He is the PI of NIH that seeks to investigate the pharmacokinetics, drug-drug interactions and pharmacogenetic determinants of HIV, HBV and TB treatment outcomes. His work with collaborators in the US and Ghana seeks to unravel the molecular basis for the inter-individual variability in TB, HBV and HIV drugs pharmacokinetics, and drug-drug interactions in individuals with HIV and TB coinfection. Dr. Kwara collaborates with colleagues at the Center for Pharmacogenenomics in the Department of Pharmacotherapy and Translation Research at UF College of Pharmacy. Beyond the field of HIV therapeutics, our research could inform how pharmacogenomics and/or applied pharmacokinetics can be used to optimize the treatment outcome of common infectious diseases at the individual and population levels.

Areas of Interest
  • HIV
  • HIV/HBV coinfection
  • Pharmacogenomics
  • TB/HIV coinfection
  • Translational and clinical pharmacology
  • Tuberculosis
Open Researcher and Contributor ID (ORCID)

0000-0002-1118-8331

Publications

2024
A Randomized Clinical Trial of Bayesian-Guided Beta-Lactam Infusion Strategy and Associated Bacterial Resistance and Clinical Outcomes in Patients With Severe Pneumonia.
Therapeutic drug monitoring. 46(1):95-101 [DOI] 10.1097/FTD.0000000000001144. [PMID] 38018847.
2024
Association of tenofovir diphosphate and lamivudine triphosphate concentrations with HIV and hepatitis B virus viral suppression.
AIDS (London, England). 38(3):351-362 [DOI] 10.1097/QAD.0000000000003764. [PMID] 37861682.
2024
Clinical considerations and pharmacokinetic interactions between HIV and tuberculosis therapeutics.
Expert review of clinical pharmacology. [DOI] 10.1080/17512433.2024.2317954. [PMID] 38339997.
2024
Depression and Anxiety Symptoms and Treatment Utilization, and Associated HIV Outcomes among Adults with HIV in Rural Florida.
AIDS and behavior. 28(1):164-173 [DOI] 10.1007/s10461-023-04147-4. [PMID] 37566153.
2024
HIV symptom severity and associated factors among young people with HIV in Ghana.
AIDS care. 1-9 [DOI] 10.1080/09540121.2023.2299332. [PMID] 38184890.
2023
Adequacy of WHO weight-band dosing and fixed-dose combinations for the treatment of TB in children.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 27(5):401-407 [DOI] 10.5588/ijtld.22.0591. [PMID] 37143230.
2023
Effect of HIV infection on plasma exposure to first-line TB drugs and target attainment in children.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 27(12):931-937 [DOI] 10.5588/ijtld.23.0184. [PMID] 38042977.
2023
Global estimates and determinants of antituberculosis drug pharmacokinetics in children and adolescents: a systematic review and individual patient data meta-analysis.
The European respiratory journal. 61(3) [DOI] 10.1183/13993003.01596-2022. [PMID] 36328357.
2023
Pharmacokinetics and pharmacodynamics of adult dolutegravir tablets in treatment-experienced children with HIV weighing at least 20 kg.
AIDS (London, England). 37(9):1409-1417 [DOI] 10.1097/QAD.0000000000003576. [PMID] 37070558.
2022
Assessing risk factors for latent and active tuberculosis among persons living with HIV in Florida: A comparison of self-reports and medical records
PLOS ONE. 17(8) [DOI] 10.1371/journal.pone.0271917. [PMID] 35925972.
2022
Childhood tuberculosis and factors associated with mortality and loss to follow-up at a major paediatric treatment centre in Southern Ghana.
The Pan African medical journal. 43 [DOI] 10.11604/pamj.2022.43.90.35440. [PMID] 36605983.
2022
Preferences for a Game-Based SMS Adherence Intervention Among Young People Living with HIV in Ghana: A Qualitative Study.
AIDS and behavior. 26(7):2169-2181 [DOI] 10.1007/s10461-021-03562-9. [PMID] 35066732.
2021
Could pharmacogenetics aid the prediction of nevirapine pharmacokinetics and allow individualized treatment?
Pharmacogenomics. 22(14):881-884 [DOI] 10.2217/pgs-2021-0106.
2021
Effect of malnutrition on the pharmacokinetics of anti-TB drugs in Ghanaian children.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 25(1):36-42 [DOI] 10.5588/ijtld.20.0301. [PMID] 33384043.
2021
HIV virological non-suppression and its associated factors in children on antiretroviral therapy at a major treatment centre in Southern Ghana: a cross-sectional study.
BMC infectious diseases. 21(1) [DOI] 10.1186/s12879-021-06459-z. [PMID] 34340689.
2021
Pharmacogenetic predictors of nevirapine pharmacokinetics in Ghanaian children living with HIV with or without TB coinfection.
Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases. 92 [DOI] 10.1016/j.meegid.2021.104856. [PMID] 33839311.
2021
Reply to: Observations on malnutrition and anti-TB drugs in Ghana.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 25(9):779-780 [DOI] 10.5588/ijtld.21.0357. [PMID] 34802507.
2020
Pharmacokinetics of Efavirenz 600 mg Once Daily During Pregnancy and Post Partum in Ghanaian Women Living With HIV
Clinical Therapeutics. 42(9):1818-1825 [DOI] 10.1016/j.clinthera.2020.07.008. [PMID] 32811669.
2019
A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs.
Clinical pharmacokinetics. 58(6):747-766 [DOI] 10.1007/s40262-018-0716-8. [PMID] 30406475.
2019
Brief Report: Relationship Between ABCC4 SNPs and Hepatitis B Virus Suppression During Tenofovir-Containing Antiretroviral Therapy in Patients With HIV/HBV Coinfection.
Journal of acquired immune deficiency syndromes (1999). 82(4):421-425 [DOI] 10.1097/QAI.0000000000002136. [PMID] 31335591.
2019
Effect of First-Line Antituberculosis Therapy on Nevirapine Pharmacokinetics in Children Younger than Three Years Old
Antimicrobial Agents and Chemotherapy. 63(10) [DOI] 10.1128/aac.00839-19.
2019
Effect of HIV infection on TB treatment outcomes and time to mortality in two urban hospitals in Ghana-a retrospective cohort study.
The Pan African medical journal. 32 [DOI] 10.11604/pamj.2019.32.206.18673. [PMID] 31312318.
2019
Effect of Rifampin-Isoniazid-Containing Antituberculosis Therapy on Efavirenz Pharmacokinetics in HIV-Infected Children 3 to 14 Years Old
Antimicrobial Agents and Chemotherapy. 63(1) [DOI] 10.1128/aac.01657-18.
2019
High mortality during tuberculosis retreatment at a Ghanaian tertiary center: a retrospective cohort study.
The Pan African medical journal. 33 [DOI] 10.11604/pamj.2019.33.111.18574. [PMID] 31489089.
2019
Identification of hepatitis B virus genotype A/E recombinants in Ghana.
Virus genes. 55(5):707-712 [DOI] 10.1007/s11262-019-01690-y. [PMID] 31346975.
2019
In response to identification of a quadruple mutation that confers tenofovir resistance in chronic hepatitis B patients.
Journal of hepatology. 71(6):1259-1260 [DOI] 10.1016/j.jhep.2019.07.010. [PMID] 31564447.
2019
In-Clinic Adolescent Peer Group Support for Engagement in Sub-Saharan Africa: A Feasibility and Acceptability Trial.
Journal of the International Association of Providers of AIDS Care. 18 [DOI] 10.1177/2325958219835786. [PMID] 30907257.
2019
Low Birthweight, Retention in HIV Care, and Adherence to ART Among Postpartum Women Living with HIV in Ghana.
AIDS and behavior. 23(2):433-444 [DOI] 10.1007/s10461-018-2194-2. [PMID] 29968140.
2019
Population pharmacokinetics of efavirenz in HIV and TB/HIV coinfected children: the significance of genotype-guided dosing.
The Journal of antimicrobial chemotherapy. 74(9):2698-2706 [DOI] 10.1093/jac/dkz238. [PMID] 31243456.
2018
A cross-sectional study of tuberculosis drug resistance among previously treated patients in a tertiary hospital in Accra, Ghana: public health implications of standardized regimens.
BMC infectious diseases. 18(1) [DOI] 10.1186/s12879-018-3053-5. [PMID] 29606091.
2018
Effect of Genetic Variation of NAT2 on Isoniazid and SLCO1B1 and CES2 on Rifampin Pharmacokinetics in Ghanaian Children with Tuberculosis.
Antimicrobial agents and chemotherapy. 62(3) [DOI] 10.1128/AAC.02099-17. [PMID] 29263072.
2018
Evaluation of the Adequacy of the 2010 Revised World Health Organization Recommended Dosages of the First-line Antituberculosis Drugs for Children: Adequacy of Revised Dosages of TB Drugs for Children.
The Pediatric infectious disease journal. 37(1):43-51 [DOI] 10.1097/INF.0000000000001687. [PMID] 28719501.
2018
Evaluation of the Adequacy of WHO Revised Dosages of the First-Line Antituberculosis Drugs in Children with Tuberculosis Using Population Pharmacokinetic Modeling and Simulations.
Antimicrobial agents and chemotherapy. 62(9) [DOI] 10.1128/AAC.00008-18. [PMID] 29914960.
2018
Human pegivirus (HPgV) infection in Ghanaians co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV).
Virus genes. 54(3):361-367 [DOI] 10.1007/s11262-018-1555-2. [PMID] 29551002.
2018
Zika Virus Exposure in an HIV-Infected Cohort in Ghana.
Journal of acquired immune deficiency syndromes (1999). 78(5):e35-e38 [DOI] 10.1097/QAI.0000000000001718. [PMID] 29771784.
2017
Causes of death and factors associated with early mortality of HIV-infected adults admitted to Korle-Bu Teaching Hospital.
The Pan African medical journal. 27 [DOI] 10.11604/pamj.2017.27.48.8917. [PMID] 28819470.
2017
Identification and comparative analysis of hepatitis B virus genotype D/E recombinants in Africa.
Virus genes. 53(4):538-547 [DOI] 10.1007/s11262-017-1469-4. [PMID] 28567562.
2017
Metabolic interactions between acetaminophen (paracetamol) and two flavonoids, luteolin and quercetin, through in-vitro inhibition studies.
The Journal of pharmacy and pharmacology. 69(12):1762-1772 [DOI] 10.1111/jphp.12812. [PMID] 28872689.
2017
Pharmacokinetics of the First-Line Antituberculosis Drugs in Ghanaian Children with Tuberculosis with or without HIV Coinfection.
Antimicrobial agents and chemotherapy. 61(2) [DOI] 10.1128/AAC.01701-16. [PMID] 27855070.
2016
ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study.
BMC infectious diseases. 16(1) [PMID] 27927183.
2016
Building Sustainable Local Capacity for Global Health Research in West Africa.
Annals of global health. 82(6):1010-1025 [DOI] 10.1016/j.aogh.2016.10.011. [PMID] 28314488.
2016
Pharmacokinetics of First-Line Antituberculosis Drugs Using WHO Revised Dosage in Children With Tuberculosis With and Without HIV Coinfection.
Journal of the Pediatric Infectious Diseases Society. 5(4):356-365 [PMID] 26407268.
2016
Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients.
BMC infectious diseases. 16 [DOI] 10.1186/s12879-016-1342-4. [PMID] 26759172.
2016
Quality of life among Ghanaian adolescents living with perinatally acquired HIV: a mixed methods study.
AIDS care. 28(4):460-4 [DOI] 10.1080/09540121.2015.1114997. [PMID] 26643735.
2016
Retention in Care of HIV-Positive Postpartum Females in Kumasi, Ghana.
Journal of the International Association of Providers of AIDS Care. 15(5):406-11 [DOI] 10.1177/2325957415603507. [PMID] 26319433.
2016
The emerging threat of pre-extensively drug-resistant tuberculosis in West Africa: preparing for large-scale tuberculosis research and drug resistance surveillance.
BMC medicine. 14(1) [PMID] 27806714.
2015
Delayed entry to care by men with HIV infection in Kumasi, Ghana.
The Pan African medical journal. 22 [DOI] 10.11604/pamj.2015.22.107.7010. [PMID] 26848354.
2015
Preclinical Evaluations To Identify Optimal Linezolid Regimens for Tuberculosis Therapy.
mBio. 6(6):e01741-15 [DOI] 10.1128/mBio.01741-15. [PMID] 26530386.
2015
The Role of Nutritional Status on Follow-up among HIV-infected Children at a Teaching Hospital Clinic in Ghana.
West African journal of medicine. 34(1):20-6 [PMID] 26902812.
2014
Factors associated with variability in rifampin plasma pharmacokinetics and the relationship between rifampin concentrations and induction of efavirenz clearance.
Pharmacotherapy. 34(3):265-71 [DOI] 10.1002/phar.1388. [PMID] 24420746.
2014
Isoniazid mediates the CYP2B6*6 genotype-dependent interaction between efavirenz and antituberculosis drug therapy through mechanism-based inactivation of CYP2A6.
Antimicrobial agents and chemotherapy. 58(7):4145-52 [DOI] 10.1128/AAC.02532-14. [PMID] 24820076.
2014
Secondary metabolism pathway polymorphisms and plasma efavirenz concentrations in HIV-infected adults with CYP2B6 slow metabolizer genotypes.
The Journal of antimicrobial chemotherapy. 69(8):2175-82 [DOI] 10.1093/jac/dku110. [PMID] 24729586.
2014
Sex differences in perceived risk and testing experience of HIV in an urban fishing setting in Ghana.
International journal for equity in health. 13 [DOI] 10.1186/s12939-014-0109-z. [PMID] 25398271.
2014
Tuberculosis control in RI: maintaining control efforts in the context of declining incidence and funding for tuberculosis programs.
Rhode Island medical journal (2013). 98(1):18-21 [PMID] 25562055.
2012
Pharmacokinetic interactions between the hormonal emergency contraception, levonorgestrel (Plan B), and Efavirenz.
Infectious diseases in obstetrics and gynecology. 2012 [DOI] 10.1155/2012/137192. [PMID] 22536010.
2012
Treatment default among patients initiating HAART at the Korle-Bu Teaching Hospital in Accra, Ghana.
West African journal of medicine. 31(4):264-9 [PMID] 23468030.
2011
Factors associated with mortality and default among patients with tuberculosis attending a teaching hospital clinic in Accra, Ghana.
Transactions of the Royal Society of Tropical Medicine and Hygiene. 105(12):675-82 [DOI] 10.1016/j.trstmh.2011.07.017. [PMID] 21920570.
2011
Factors associated with recently transmitted Mycobacterium tuberculosis strain MS0006 in Hinds County, Mississippi.
Southern medical journal. 104(12):819-26 [DOI] 10.1097/SMJ.0b013e3182383166. [PMID] 22089361.
2011
Impact of immigration on the molecular epidemiology of tuberculosis in Rhode Island.
Journal of clinical microbiology. 49(3):834-44 [DOI] 10.1128/JCM.01952-10. [PMID] 21159930.
2011
Modest but variable effect of rifampin on steady-state plasma pharmacokinetics of efavirenz in healthy African-American and Caucasian volunteers.
Antimicrobial agents and chemotherapy. 55(7):3527-33 [DOI] 10.1128/AAC.00980-10. [PMID] 21518840.
2011
Paradoxically elevated efavirenz concentrations in HIV/tuberculosis-coinfected patients with CYP2B6 516TT genotype on rifampin-containing antituberculous therapy.
AIDS (London, England). 25(3):388-90 [DOI] 10.1097/QAD.0b013e3283427e05. [PMID] 21150552.
2011
Viral decay rates are similar in HIV-infected patients with and without TB coinfection during treatment with an Efavirenz-based regimen.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 52(4):547-50 [DOI] 10.1093/cid/ciq196. [PMID] 21252140.
2010
Dose adjustment of the non-nucleoside reverse transcriptase inhibitors during concurrent rifampicin-containing tuberculosis therapy: one size does not fit all.
Expert opinion on drug metabolism & toxicology. 6(1):55-68 [DOI] 10.1517/17425250903393752. [PMID] 19968575.
2010
High Frequency of First-Line Anti-Tuberculosis Drug Resistance among Persons with Chronic Pulmonary Tuberculosis at a Teaching Hospital Chest Clinic.
Ghana medical journal. 44(2):42-6 [PMID] 21327002.
2010
Highly active antiretroviral therapy and employment status in accra, ghana.
Ghana medical journal. 44(4):144-9 [PMID] 21416048.
2010
Outcome of hospital admissions in HIV-infected children at the Korle Bu Teaching Hospital, Accra, Ghana.
West African journal of medicine. 29(6):379-83 [PMID] 21465444.
2009
CYP2B6 (c.516G–>T) and CYP2A6 (*9B and/or *17) polymorphisms are independent predictors of efavirenz plasma concentrations in HIV-infected patients.
British journal of clinical pharmacology. 67(4):427-36 [DOI] 10.1111/j.1365-2125.2009.03368.x. [PMID] 19371316.
2009
CYP2B6, CYP2A6 and UGT2B7 genetic polymorphisms are predictors of efavirenz mid-dose concentration in HIV-infected patients.
AIDS (London, England). 23(16):2101-6 [DOI] 10.1097/QAD.0b013e3283319908. [PMID] 19779319.
2009
Interindividual variability in pharmacokinetics of generic nucleoside reverse transcriptase inhibitors in TB/HIV-coinfected Ghanaian patients: UGT2B7*1c is associated with faster zidovudine clearance and glucuronidation.
Journal of clinical pharmacology. 49(9):1079-90 [DOI] 10.1177/0091270009338482. [PMID] 19628728.
2008
Antiretroviral drug concentrations and HIV RNA in the genital tract of HIV-infected women receiving long-term highly active antiretroviral therapy.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 46(5):719-25 [DOI] 10.1086/527387. [PMID] 18220480.
2008
Factors associated with failure to complete isoniazid treatment for latent tuberculosis infection in Rhode Island.
Chest. 133(4):862-8 [PMID] 18071014.
2008
Pharmacokinetics of efavirenz when co-administered with rifampin in TB/HIV co-infected patients: pharmacogenetic effect of CYP2B6 variation.
Journal of clinical pharmacology. 48(9):1032-40 [DOI] 10.1177/0091270008321790. [PMID] 18728241.
2008
Status epilepticus resulting from severe efavirenz toxicity in an HIV-infected patient.
The AIDS reader. 18(7):386-8, C3 [PMID] 18655316.
2005
Highly active antiretroviral therapy (HAART) in adults with tuberculosis: current status.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 9(3):248-57 [PMID] 15786886.
2005
Manifestations and outcome of extra-pulmonary tuberculosis: impact of human immunodeficiency virus co-infection.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 9(5):485-93 [PMID] 15875918.
2004
Development of opportunistic infections after diagnosis of active tuberculosis in HIV-infected patients.
AIDS patient care and STDs. 18(6):341-7 [PMID] 15294084.
2003
Evaluation of the epidemiologic utility of secondary typing methods for differentiation of Mycobacterium tuberculosis isolates.
Journal of clinical microbiology. 41(6):2683-5 [PMID] 12791904.
1999
Respiratory illness after severe respiratory syncytial virus disease in infancy in The Gambia.
The Journal of pediatrics. 135(6):683-8 [PMID] 10586169.
1998
Meningitis caused by a serogroup W135 clone of the ET-37 complex of Neisseria meningitidis in West Africa.
Tropical medicine & international health : TM & IH. 3(9):742-6 [PMID] 9754670.

Grants

Jul 2021 ACTIVE
Linking within- and between-host dynamics in tracking recent Mycobacterium tuberculosis transmission
Role: Other
Funding: NATL INST OF HLTH NIAID
Dec 2020 ACTIVE
Pharmacokinetics and Pharmacodynamics of Dolutegravir in Children Weighing =20 Kg Living with HIV with and without TB Coinfection
Role: Principal Investigator
Funding: NATL INST OF HLTH NIAID
Apr 2020 ACTIVE
Adherence and Intracellular Pharmacology of Tenofovir and HBV Suppression in People with HBV/HIV Coinfection
Role: Principal Investigator
Funding: NATL INST OF HLTH NIAID
Sep 2018 ACTIVE
Pharmacokinetics of Anti-tuberculosis and Antiretroviral Drugs in Children
Role: Principal Investigator
Funding: NATL INST OF HLTH NICHD
Jun 2016 – May 2023
Training Program in Tuberculosis and HIV Research in Ghana D43
Role: Principal Investigator
Funding: FOGARTY INTERNATIONAL CENTER
Jun 2016 – Aug 2018
Pharmacokinetics of Anti-tuberculosis and Antiretroviral Drugs in Children
Role: Principal Investigator
Funding: NATL INST OF HLTH NICHD

Education

Fellowship – Infectious Disease
2001 · Tulane University
Residency – Internal Medicine
1999 · Cook County Hospital
Internship – Internal Medicine
1997 · Cook County Hospital
Bachelor of Medicine and Bachelor of Surgery
1992 · University of Ghana

Contact Details

Phones:
Business:
(352) 294-5481
Emails:
Addresses:
Business Mailing:
PO Box 100289
GAINESVILLE FL 32610
Business Street:
2055 MOWRY RD STE 250
GAINESVILLE FL 32611