David Boulware, MD, MPH

Lois & Richard King Distinguished Associate Professor, Division of Infectious Diseases and International Medicine

David Boulware

Contact Info

boulw001@umn.edu

Mailing Address:
4-103 MRF
689 23rd Ave SE
Minneapolis, MN 55455

Administrative Assistant Name
IDIM Division

Administrative Phone
612-624-1966

Administrative Email
IDIMDivision@umn.edu

Administrative Fax Number
612-625-4410

Lois & Richard King Distinguished Associate Professor, Division of Infectious Diseases and International Medicine


Infectious Disease Physician


Medical School, Indiana University School of Medicine, Indianapolis, IN

Internal Medicine and Pediatrics Residency, University of Minnesota, Minneapolis, MN

Infectious Disease Fellowship, University of Minnesota, Minneapolis, MN

Summary

Dr. Boulware is an infectious disease physician-scientist with formal training in clinical trials, public health, and tropical medicine. Dr. Boulware combines his clinical research with nested basic science investigations into disease pathogenesis to conduct translational research. His primary research interests are in meningitis in resource-limited areas including diagnosis, prevention, treatment, and quality improvement initiatives incorporating cost-effectiveness analyses in order to translate knowledge into improved care. Dr. Boulware’s current research is focused on improving the clinical outcomes of HIV-infected persons with cryptococcal meningitis, the second most common AIDS-defining opportunistic infection in Sub-Saharan Africa and the most common cause of adult meningitis. Additionally, Dr. Boulware has been motivated to improve the diagnostics for TB meningitis, and now that TB meningitis can be promptly diagnosed, to also improve the treatment of tuberculous meningitis. Dr. Boulware leads a multidisciplinary, international research team with active research collaborations with partners in Uganda, South Africa, Ethiopia, Brazil, Botswana, the Netherlands, and the United Kingdom.

Awards & Recognition

  • Educational Excellence Award for the Department of Medicine, Univ. of Minnesota, 2011
  • Lois & Richard King Distinguished Assistant Professor, 2013

Professional Associations

  • DHHS-IDSA Working Group on Guidelines for the Prevention and Treatment of Opportunistic Infections among HIV-Exposed and HIV-Infected Children, 2007
  • American Society of Tropical Medicine & Hygiene, CTropMed Examination committee
  • American Society of Tropical Medicine & Hygiene, Scientific Program Committee
  • World Health Organization (WHO) Guidelines for Management of Advanced HIV Disease, 2017
  • World Health Organization (WHO) Cryptococcal Guidelines Peer Review Committee, 2018

Research

Research Summary/Interests

  • Reducing HIV-related mortality in people living with AIDS
  • Improving Diagnostics for Meningitis
  • Improving treatments for Cryptococcal meningitis and TB meningitis
  • Preventing avoidable deaths due to subclinical cryptococcosis
  • Clinical Trials for novel meningitis therapeutics and strategies
  • Quality improvement initiatives to improve survival in resource-limited settings
  • Antimicrobial resistance in low and middle income countries

Research Projects:

  • Improving Diagnostics and Neurocognitive Outcomes in HIV/AIDS-related Meningitis (R01 NS086312)
  • Adjunctive Sertraline for the Treatment of HIV-Associated Cryptococcal Meningitis (UK MRC/DfID/Wellcome Trust Global Health Trials)
  • Phased Implementation of a Public Health Programme: Cryptococcal Screening and Treatment in South Africa. (R01AI118511)
  • Operational Research for Cryptococcal Antigen Screening (ORCAS) of HIV Patients (U01AI125003)
  • Doris Duke International Clinical Research Fellowship program for Medical Students (PI)
  • Infectious Disease Training in Clinical Investigation (T32AI055433)
  • NIH Partnership for Research on Ebola Virus in Liberia (Prevail) Team Member, Prevail II (ZMapp) Trial Protocol writer, Prevail I/II/IV Medical Monitor.

Publications

Out of more than 109 peer-reviewed publications; see full listing on PubMed.

  • Bahr NC, Nuwagira E, Evans EE, Cresswell FV, Bystrom PV, Byamukama A, Bridge SC, Bangdiwala AS, Meya DB, Denkinger CM, Muzoora C, Boulware DR; ASTRO-CM Trial Team. Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis in HIV-infected adults: a prospective cohort study. Lancet Infect Dis. 2018; 18: 68-75. doi: 10.1016/S1473-3099(17)30474-7.
  • Rajasingham R, Smith RM, Park BJ, Jarvis JN, Govender NP, Chiller TM, Denning DW, Loyse A, Boulware DR. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017 Aug; 17: 873-881.
  • Rhein J, Morawski BM, Hullsiek KH, Nabeta HW, Kiggundu R, Tugume L, Musubire AK, Akampurira A, Smith KD, Alhadab A, Williams DA, Abassi M, Bahr NC, Velamakanni SS, Fisher J, Nielsen K, Meya DB, Boulware DR, on behalf of ASTRO-CM Study Team. Efficacy of adjunctive sertraline for the treatment of HIV-associated cryptococcal meningitis: An open-label dose-ranging study. Lancet Infect Dis. 2016; 16: 809-18. doi: 10.1016/S1473-3099(16)00074-8.
  • Bahr NC, Tugume L, Rajasingham R, Kiggundu R, Williams DA, Morawski B, Alland D, Meya DB, Rhein J, Boulware DR. Improved diagnostic sensitivity for TB meningitis with Xpert MTB/Rif testing of centrifuged CSF: a prospective study. Int J Tuberc Lung Dis. 2015; 19: 1209-15.doi:10.5588/ijtld.15.0253.
  • Boulware DR, Meya DB, Muzoora C, Rolfes MA, Huppler Hullsiek K, Musubire A, Taseera K, Nabeta HW, Schutz C, Williams DA, Rajasingham R, Rhein J, Thienemann F, Lo MW, Nielsen K, Bergemann KL, Kambugu A, Manabe YC, Janoff EN, Bohjanen PR, Meintjes G, COAT Team. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med. 2014; 370; 2487-98. PMC4127879 doi: 10.1056/NEJMoa1312884
  • Rolfes MA, Huppler Hullsiek K, Rhein J, Nabeta HW, Taseera K, Schutz C, Musubire A, Rajasingham R, Williams DA, Thienemann F, Muzoora C, Meintjes G, Meya DB, Boulware DR. The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis. Clin Infect Dis. 2014; 59: 1607-14. doi: 10.1093/cid/ciu596
  • Rajasingham R, Rhein J, Klammer K, Musubire A, Nabeta H, Akampurira A, Mossel EC, Williams DA, Boxrud DJ, Crabtree MB, Miller BR, Rolfes MA, Tengsupakul S, Andama AO, Meya DB, Boulware DR. Epidemiology of Meningitis in an HIV-infected Ugandan Cohort. Am J Trop Med Hyg. 2014; 92(2):274-9. PMC4347329
  • Bahr NC, Rolfes MA, Musubire A, Nabeta H, Williams DA, Rhein J, Kambugu A, Meya DB, Boulware DR. Standardized electrolyte supplementation and fluid management improves survival during amphotericin therapy for cryptococcal meningitis in resource-limited settings. Open Forum Infect Dis 2014: 1: ofu070. doi: 10.1093/ofid/ofu070
  • Boulware DR, Rolfes MA, Rajasingham R, von Hohenberg M, Qin Z, Taseera K, Schutz C, Kwizera R, Butler EK, Meintjes G, Muzoora C, Bischof JC, Meya DB. Multisite validation of cryptococcal antigen lateral flow assay and quantification by laser thermal contrast. Emerg Infect Dis. 2014; 20: 45-53. PMC3884728 doi: 10.3201/eid2001.130906
  • Carlson RD, Rolfes MA, Birkenkamp KE, Nakasujja N, Rajasingham R, Meya DB, Boulware DR. Predictors of neurocognitive outcomes on antiretroviral therapy after cryptococcal meningitis: A prospective cohort study. Metabol Brain Dis.2014; 29: 269-279. PMC4033836 doi: 10.1007/s11011-013-9476-1
  • Durski KN, Kuntz KM, Yasukawa K, Virnig BA, Meya DB, Boulware DR. Cost-effective diagnostic checklists for meningitis in resource limited settings. J Acquir Immune Defic Syndr.2013; 63:e101-108. Doi: 10.1097/QAI.0b013e31828e1e56
  • Rajasingham R, Meya DB, Boulware DR. Integrating cryptococcal antigen screening and preemptive treatment into routine HIV care. JAIDS 2012; 59:85-91. PMC3311156
  • Rajasingham R, Rolfes MA, Birkenkamp K, Meya DB, Boulware DR. Cryptococcal meningitis treatment strategies in resource-limited settings: a cost-effectiveness analysis. PLoS Med. 2012; 9: e1001316. doi: 10.1371/journal.pmed.1001316
  • Meya DB, Manabe YC, Castelnuovo C, Cook BA, Elbireer AM, Kambugu A, Kamya MR, Bohjanen PR, Boulware DR. Cost-effectiveness of serum cryptococcal antigen screening to prevent deaths among HIV-infected persons with a CD4+ <100 cells/mcL who start HIV therapy in resource-limited settings. Clin Infect Dis. 2010; 51:448-55. PMC2946373

Clinical

Clinics

Delaware Street Clinic (Infectious Disease/HIV Clinic)

Board Certifications

  • Internal Medicine
  • Infectious Diseases
  • International Society of Travel Medicine, Certificate of Knowledge
  • American Society of Tropical Medicine & Hygiene, Certification in Tropical Medicine & Travelers’ Health

Clinical Interests

Central nervous system infections; AIDS-related opportunistic infections; Tropical medicine; Travel medicine; Cost Effectiveness

Hospital Privileges

University of Minnesota Medical Center, Fairview