John Robert Koethe, M.D.

Associate Professor
Faculty Appointments
Associate Professor of Medicine
M.S.C.I., Clinical Investigation , Vanderbilt University, Nashville, TennesseeM.D., Yale University, New Haven, ConnecticutB.A., Oberlin College, Oberlin, Ohio
Office Address
1161 21st Avenue South
Nashville, TN 37232-2582
Research Description
Dr. Koethe is a board certified infectious diseases physician and researcher. His focus is how the interaction of HIV infection and nutritional host factors, such as obesity, affects the risk of metabolic disease among patients on long-term HIV treatment. He received formal training in clinical and translational research design and methods, and biostatistics from the Vanderbilt Masters of Science in Clinical Investigation Program (2010-2012). He is currently supported by a career development grant from NIAID (K23AI100700) to study 1) how total adiposity and adipose tissue distribution affect innate and adaptive immune function in HIV-infected individuals, and 2) how obesity alters the phenotype of HIV-associated cardiometabolic disease in a well-characterized 100 participant clinical cohort of HIV-infected persons and HIV-negative controls. Recent analyses from this cohort have highlighted novel relationships between circulating T cell subsets, metabolic and cardiovascular health parameters, metabolomic profiles, and plasma biomarkers. Additionally, a sub-cohort has undergone adipose tissue biopsies to study the distribution of circulating versus adipose-resident T cell subsets, and characterize T cell receptor clonality (via TCR sequencing) in the two tissue compartments. Dr. Koethe is also the PI of a NIDDK-supported study (R56DK108352) to assess the relationships between circulating T cell profiles and the risk of incident diabetes among the 2300 HIV-infected and HIV-negative participants in the Veterans Aging Cohort Study (VACS).
Research Keywords
HIV; obesity; metabolism; immunology; nutrition
Grome HN, Barnett L, Hagar CC, Harrison DG, Kalams S, Koethe JR. Association of T Cell and Macrophage Activation with Arterial Vascular Health in HIV. AIDS Res. Hum. Retroviruses [print-electronic]. 2016 Aug 8/15/2016; PMID: 27527002, DOI: 10.1089/AID.2016.0113, ISSN: 1931-8405.

Koethe JR, von Reyn CF. Protein-calorie malnutrition, macronutrient supplements, and tuberculosis. Int. J. Tuberc. Lung Dis. 2016 Jul; 20(7): 857-63. PMID: 27287634, DOI: 10.5588/ijtld.15.0936, ISSN: 1815-7920.

Koethe JR, Jenkins CA, Petucci C, Culver J, Shepherd BE, Sterling TR. Superior Glucose Tolerance and Metabolomic Profiles, Independent of Adiposity, in HIV-Infected Women Compared With Men on Antiretroviral Therapy. Medicine (Baltimore). 2016 May; 95(19): e3634. PMID: 27175676, PMCID: PMC4902518, PII: 00005792-201605100-00055, DOI: 10.1097/MD.0000000000003634, ISSN: 1536-5964.

Koethe JR, Jenkins CA, Lau B, Shepherd BE, Wester W, Rebeiro PF, Silverberg MJ, Thorne JE, Gill J, Mayor AM, Willig A, Bosch R, Horberg MA, Justice AC, Sterling TR, Moore RD. Higher Time-updated Body Mass Index: Association with Improved CD4+ Cell Recovery on HIV Treatment. J. Acquir. Immune Defic. Syndr [print-electronic]. 2016 Apr 4/21/2016; PMID: 27116044, DOI: 10.1097/QAI.0000000000001035, ISSN: 1944-7884.

PrayGod G, Blevins M, Woodd S, Rehman AM, Jeremiah K, Friis H, Kelly P, Changalucha J, Heimburger DC, Filteau S, Koethe JR. A longitudinal study of systemic inflammation and recovery of lean body mass among malnourished HIV-infected adults starting antiretroviral therapy in Tanzania and Zambia. Eur J Clin Nutr [print-electronic]. 2016 Apr; 70(4): 499-504. PMID: 26785764, PII: ejcn2015221, DOI: 10.1038/ejcn.2015.221, ISSN: 1476-5640.

Tirivayi N, Koethe JR. The economic benefits of high CD4 counts among people living with HIV/AIDS in Zambia. J Public Health (Oxf) [print-electronic]. 2016 Jan 1/19/2016; PMID: 26791910, PII: fdv199, DOI: 10.1093/pubmed/fdv199, ISSN: 1741-3850.

Koethe JR, Grome H, Jenkins CA, Kalams SA, Sterling TR. The metabolic and cardiovascular consequences of obesity in persons with HIV on long-term antiretroviral therapy. AIDS. 2016 Jan 1/2/2016; 30(1): 83-91. PMID: 26418084, PMCID: PMC4703444, DOI: 10.1097/QAD.0000000000000893, ISSN: 1473-5571.

Koethe JR, Jenkins CA, Lau B, Shepherd BE, Justice AC, Tate JP, Buchacz K, Napravnik S, Mayor AM, Horberg MA, Blashill AJ, Willig A, Wester CW, Silverberg MJ, Gill J, Thorne JE, Klein M, Eron JJ, Kitahata MM, Sterling TR, Moore RD, . Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada. AIDS Res. Hum. Retroviruses [print-electronic]. 2016 Jan; 32(1): 50-8. PMID: 26352511, PMCID: PMC4692122, DOI: 10.1089/aid.2015.0147, ISSN: 1931-8405.

Koethe JR, Jenkins CA, Lau B, Shepherd BE, Silverberg MJ, Brown TT, Blashill AJ, Anema A, Willig A, Stinnette S, Napravnik S, Gill J, Crane HM, Sterling TR, . Body mass index and early CD4 T-cell recovery among adults initiating antiretroviral therapy in North America, 1998-2010. HIV Med [print-electronic]. 2015 Oct; 16(9): 572-7. PMID: 25960080, PMCID: PMC4558259, DOI: 10.1111/hiv.12259, ISSN: 1468-1293.

Bestawros M, Chidumayo T, Blevins M, Canipe A, Bala J, Kelly P, Filteau S, Shepherd BE, Heimburger DC, Koethe JR. Increased systemic inflammation is associated with cardiac and vascular dysfunction over the first 12 weeks of antiretroviral therapy among undernourished, HIV-infected adults in Southern Africa. J AIDS Clin Res. 2015 Mar; 6(3): PMID: 26038711, PMCID: PMC4450092, DOI: 10.4172/2155-6113.1000431, ISSN: 2155-6113.

Koethe JR, Jenkins CA, Turner M, Bebawy S, Shepherd BE, Wester CW, Sterling TR. Body mass index and the risk of incident noncommunicable diseases after starting antiretroviral therapy. HIV Med [print-electronic]. 2015 Jan; 16(1): 67-72. PMID: 25230709, PMCID: PMC4268383, DOI: 10.1111/hiv.12178, ISSN: 1468-1293.

Canipe A, Chidumayo T, Blevins M, Bestawros M, Bala J, Kelly P, Filteau S, Shepherd BE, Heimburger DC, Koethe JR. A 12 week longitudinal study of microbial translocation and systemic inflammation in undernourished HIV-infected Zambians initiating antiretroviral therapy. BMC Infect. Dis. 2014; 14: 521. PMID: 25266928, PMCID: PMC4261887, PII: 1471-2334-14-521, DOI: 10.1186/1471-2334-14-521, ISSN: 1471-2334.

Koethe JR, Marseille E, Giganti MJ, Chi BH, Heimburger D, Stringer JS. Estimating the cost-effectiveness of nutrition supplementation for malnourished, HIV-infected adults starting antiretroviral therapy in a resource-constrained setting. Cost Eff Resour Alloc. 2014; 12: 10. PMID: 24839400, PMCID: PMC4024113, PII: 1478-7547-12-10, DOI: 10.1186/1478-7547-12-10, ISSN: 1478-7547.

Koethe JR, Hulgan T, Niswender K. Adipose tissue and immune function: a review of evidence relevant to HIV infection. J. Infect. Dis [print-electronic]. 2013 Oct 10/15/2013; 208(8): 1194-201. PMID: 23878320, PMCID: PMC3778969, PII: jit324, DOI: 10.1093/infdis/jit324, ISSN: 1537-6613.

Koethe JR, Dee K, Bian A, Shintani A, Turner M, Bebawy S, Sterling TR, Hulgan T. Circulating interleukin-6, soluble CD14, and other inflammation biomarker levels differ between obese and nonobese HIV-infected adults on antiretroviral therapy. AIDS Res. Hum. Retroviruses [print-electronic]. 2013 Jul; 29(7): 1019-25. PMID: 23469772, PMCID: PMC3685684, DOI: 10.1089/aid.2013.0016, ISSN: 1931-8405.

Koethe JR, Blevins M, Bosire C, Nyirenda C, Kabagambe EK, Mwango A, Kasongo W, Zulu I, Shepherd BE, Heimburger DC. Self-reported dietary intake and appetite predict early treatment outcome among low-BMI adults initiating HIV treatment in sub-Saharan Africa. Public Health Nutr [print-electronic]. 2013 Mar; 16(3): 549-58. PMID: 22691872, PMCID: PMC3772135, PII: S1368980012002960, DOI: 10.1017/S1368980012002960, ISSN: 1475-2727.

Koethe JR, Bian A, Shintani AK, Wester CW, Erdem H, Hulgan T. An association between adiposity and serum levels of macrophage inflammatory protein-1a and soluble CD14 in HIV-infected adults: results from a cross-sectional study. Antivir. Ther. (Lond.) [print-electronic]. 2013; 18(5): 729-33. PMID: 23748193, PMCID: PMC3923367, DOI: 10.3851/IMP2645, ISSN: 2040-2058.

Koethe JR, Blevins M, Nyirenda CK, Kabagambe EK, Chiasera JM, Shepherd BE, Zulu I, Heimburger DC. Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia: A Novel Context for Refeeding Syndrome?. J Nutr Metab [print-electronic]. 2013; 2013: 545439. PMID: 23691292, PMCID: PMC3652146, DOI: 10.1155/2013/545439, ISSN: 2090-0724.

Koethe JR, Bian A, Shintani AK, Boger MS, Mitchell VJ, Erdem H, Hulgan T. Serum leptin level mediates the association of body composition and serum C-reactive protein in HIV-infected persons on antiretroviral therapy. AIDS Res. Hum. Retroviruses [print-electronic]. 2012 Jun; 28(6): 552-7. PMID: 22145933, PMCID: PMC3358098, DOI: 10.1089/aid.2011.0232, ISSN: 1931-8405.

Koethe JR, Jenkins CA, Shepherd BE, Stinnette SE, Sterling TR. An optimal body mass index range associated with improved immune reconstitution among HIV-infected adults initiating antiretroviral therapy. Clin. Infect. Dis [print-electronic]. 2011 Nov; 53(9): 952-60. PMID: 21946189, PMCID: PMC3189168, PII: cir606, DOI: 10.1093/cid/cir606, ISSN: 1537-6591.

Koethe JR, Blevins M, Nyirenda C, Kabagambe EK, Shepherd BE, Wester CW, Zulu I, Chiasera JM, Mulenga LB, Mwango A, Heimburger DC. Nutrition and inflammation serum biomarkers are associated with 12-week mortality among malnourished adults initiating antiretroviral therapy in Zambia. J Int AIDS Soc. 2011; 14: 19. PMID: 21477359, PMCID: PMC3094357, PII: 1758-2652-14-19, DOI: 10.1186/1758-2652-14-19, ISSN: 1758-2652.

Koethe JR, Limbada MI, Giganti MJ, Nyirenda CK, Mulenga L, Wester CW, Chi BH, Stringer JS. Early immunologic response and subsequent survival among malnourished adults receiving antiretroviral therapy in Urban Zambia. AIDS. 2010 Aug 8/24/2010; 24(13): 2117-21. PMID: 20543657, PMCID: PMC2919155, DOI: 10.1097/QAD.0b013e32833b784a, ISSN: 1473-5571.

Koethe JR, Lukusa A, Giganti MJ, Chi BH, Nyirenda CK, Limbada MI, Banda Y, Stringer JS. Association between weight gain and clinical outcomes among malnourished adults initiating antiretroviral therapy in Lusaka, Zambia. J. Acquir. Immune Defic. Syndr. 2010 Apr 4/1/2010; 53(4): 507-13. PMID: 19730111, PMCID: PMC3749827, DOI: 10.1097/QAI.0b013e3181b32baf, ISSN: 1944-7884.

Koethe JR, Heimburger DC. Nutritional aspects of HIV-associated wasting in sub-Saharan Africa. Am. J. Clin. Nutr [print-electronic]. 2010 Apr; 91(4): 1138S-1142S. PMID: 20147470, PMCID: PMC2844686, PII: ajcn.2010.28608D, DOI: 10.3945/ajcn.2010.28608D, ISSN: 1938-3207.

Koethe JR, Westfall AO, Luhanga DK, Clark GM, Goldman JD, Mulenga PL, Cantrell RA, Chi BH, Zulu I, Saag MS, Stringer JS. A cluster randomized trial of routine HIV-1 viral load monitoring in Zambia: study design, implementation, and baseline cohort characteristics. PLoS ONE. 2010; 5(3): e9680. PMID: 20300631, PMCID: PMC2837376, DOI: 10.1371/journal.pone.0009680, ISSN: 1932-6203.

Koethe JR, Chi BH, Megazzini KM, Heimburger DC, Stringer JS. Macronutrient supplementation for malnourished HIV-infected adults: a review of the evidence in resource-adequate and resource-constrained settings. Clin. Infect. Dis. 2009 Sep 9/1/2009; 49(5): 787-98. PMID: 19624276, PMCID: PMC3092426, DOI: 10.1086/605285, ISSN: 1537-6591.