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Ingen søgeord valgt.
43 emner vises.
Marwa El Baldi, Amina Laghrissi, Zakia Marso, Fatima Zahra Chellat, Mohamed Berraho, Nabil Tachfouti, Samira El Fakir, Soufiane Mellas, Amar Mohamed Fahd, Jamal kohen, Fouad Boulaguige, Jamal Naamane, Khalid Lahmadi, Karima El Rhazi
PLoS One Infectious Diseases, 2.11.2022
Tilføjet 2.11.2022
by Marwa El Baldi, Amina Laghrissi, Zakia Marso, Fatima Zahra Chellat, Mohamed Berraho, Nabil Tachfouti, Samira El Fakir, Soufiane Mellas, Amar Mohamed Fahd, Jamal kohen, Fouad Boulaguige, Jamal Naamane, Khalid Lahmadi, Karima El Rhazi
Background Coronavirus disease (COVID-19) has emerged and spread rapidly worldwide and established a global public health crisis in early 2020. The first Moroccan case was reported on March 2, 2020. Since then, healthcare workers (HCWs) played a major role in saving human lives threatened by COVID-19. This study aimed to assess the prevalence of COVID-19 infection among Moroccan physicians and to report associated risk factors prior vaccination campaign. Methods A cross-sectional study was carried out in the Fez-Meknes region of Morocco, 545 physicians’ data was collected using a self-reported online questionnaire. The data collection was done between December 1, 2020, and February 1, 2021. Results The prevalence of COVID-19 among physicians was 27.3%. The mean age of the confirmed COVID-19 group was 38.4±12.9 years old. There was no association between COVID-19 infection and preventive measures compliance by physicians and healthcare authorities in the workplace. However, multivariate analysis strengthened the following factors such as increased risk of COVID-19 infection within men ☯aOR:1.896; 95% IC 1.272–2.828; p = 0.002]; the presence of at least one comorbidity ☯aOR:2.268; 95%IC 1.414–3.637; p = 0.001]; and working at a university or military hospitals ☯aOR:2.578; 95%IC 1.667–3.989; p = 0.001]. Conclusion This study allows comparing COVID-19 prevalence among healthcare workers before and after vaccination programs. This should support better preparation strategy for any future pandemics with appropriate and increased awareness for men, carrying comorbidity, and working environment with high COVID-19 disease management.
Læs mere Tjek på PubMedDuriya Charypkhan, Simon R. Rüegg
PLoS One Infectious Diseases, 2.11.2022
Tilføjet 2.11.2022
by Duriya Charypkhan, Simon R. Rüegg
Brucellosis is one of the main livestock disease risks in Kazakhstan. It’s been endemic there since 1930, accounting for over 1300 human cases per annum. The economic loss was 45 million USD in 2015 alone. Since 1952, Kazakhstan has implemented various control strategies with little success. One Health approaches have been suggested to tackle brucellosis, however, there is a lack of evidence for best practices to operationalise One Health in the literature, and methods for implementation are not established. The intention of this study was to introduce the One Health approach during the evaluation phase of the policy cycle. A two-day workshop was organized by the authors to familiarize participants with the evaluation methodology. Twenty-one specialists representing veterinary and public health sector, together with researchers, took part in this study. For two weeks following the workshop, first author conducted individual interviews with workshop participants to obtain individual scorings to assess knowledge integration capacity (One Health-ness). The evaluation results show that there is a lack of knowledge about the perceived damage caused by brucellosis to animal owners and other stakeholders. There is insufficient data available about farmers’ practices, interests and motivations, and also data is missing for important transmission processes such as the amount of unsafe dairy consumption. The absence of such data illustrates the extent of the uncertainty to which decision-makers are exposed despite well-elaborated transmission models and supports the importance of co-producing solutions with participatory methods. The results suggest the need for broader involvement of stakeholders. Outputs of this study could help navigate the initial stages of One Health operationalization.
Læs mere Tjek på PubMedVaitiare Mulderij-Jansen, Prachi Pundir, Maria E. Grillet, Theophilus Lakiang, Izzy Gerstenbluth, Ashley Duits, Adriana Tami, Ajay Bailey
PLoS One Infectious Diseases, 2.11.2022
Tilføjet 2.11.2022
by Vaitiare Mulderij-Jansen, Prachi Pundir, Maria E. Grillet, Theophilus Lakiang, Izzy Gerstenbluth, Ashley Duits, Adriana Tami, Ajay Bailey
Background Aedes aegypti and Aedes albopictus are primary vectors of emerging or re-emerging arboviruses that threaten public health worldwide. Many efforts have been made to develop interventions to control these Aedes species populations. Still, countries in the Latin America and the Caribbean (LAC) region struggle to create/design/develop sustainable and effective control strategies. This scoping review synthesises evidence concerning the effectiveness of Ae. aegypti and Ae. albopictus prevention and control interventions performed in LAC (2000–2021). The findings can be used to evaluate, compare and develop more effective control strategies. Methodology The review is based on the methodology by Joanna Briggs Institute for conducting a scoping review. The MEDLINE (via PubMed and Web of Science), Cochrane Library, Scopus, EMBASE and ScienceDirect databases were used to search for articles. Grey literature was searched from governmental and non-governmental organisation websites. Four reviewers independently screened all titles and abstracts and full-text of the articles using the Rayyan web application, based on pre-defined eligibility criteria. Results A total of 122 publications were included in the review. Most studies focused on dengue virus infection and data on Ae. aegypti. Entomological data were mainly used to determine the intervention’s effectiveness. An integrated control intervention was the most commonly employed strategy in both regions. Biological control measures, environmental management, and health education campaigns on community participation achieved more sustainable results than an intervention where only a chemical control measure was used. Challenges to implementing interventions were insufficient financial support, resources, workforce, intersectoral collaboration and legislation. Conclusions Based on the synthesised data, an integrated vector (Aedes) management focused on community participation seems to be the most effective approach to mitigate Aedes-borne infectious diseases. Maintaining the approach’s effect remains challenging as it requires multisectoral and multi-disciplinary team engagement and active community participation. Future research needs to address the barriers to program implementation and maintenance as data on this topic is lacking.
Læs mere Tjek på PubMedSanne Raghoebar, Joyce Delnoij, Bart A. Kamphorst, Henk Broekhuizen
PLoS One Infectious Diseases, 2.11.2022
Tilføjet 2.11.2022
by Sanne Raghoebar, Joyce Delnoij, Bart A. Kamphorst, Henk Broekhuizen
Introduction Adherence to behavioral measures such as physical distancing are key to mitigating the effects of viral pandemics such as the COVID-19 pandemic. Adherence depends in part on people’s perception of what others do (descriptive norms) or approve of (injunctive norms). This study examines the effects that exposure to images depicting people following or breaking physical distancing rules have on perceptions of descriptive and injunctive norms and subsequent adherence behavior. Methods An online between-subjects experiment (n = 315) was conducted, in which participants were exposed to a set of five photographs of different public spaces in which people either did or did not adhere to physical distancing rules (pre-registration: https://www.osf.io/uek2p). Participants’ adherence behavior was measured using a triangulation of measures (incentivized online behavioral task, vignettes, intention measure). Perceptions of relevant social norms were also measured. Results Mann-Whitney tests showed no effects of condition on perceptions of descriptive and injunctive norms or on adherence behavior. Linear regressions showed that both component paths of the indirect effect (condition on norm perceptions, and norm perceptions on adherence behavior) were non-significant, hence mediation analyses were not conducted. Conclusions Exposure to images of people following (compared to breaking) physical distancing rules did not affect adherence to such rules or perceived norms. We surmise that a single exposure to such images, especially in the context of COVID-19, is insufficient to affect behavior. We therefore recommend performing a comparable experiment in which participants are exposed repeatedly to images showing people (non)adhering to a specific behavior in a particular context for a longer period.
Læs mere Tjek på PubMedMelissa N. Webby, Abraham O. Oluwole, Conrado Pedebos, Patrick G. Inns, Anna Olerinyova, Dheeraj Prakaash, Nicholas G. Housden, Georgina Benn, Dawei Sun, Bart W. Hoogenboom, Philipp Kukura, Shabaz Mohammed, Carol V. Robinson, Syma Khalid, Colin Kleanthous
Science Advances, 2.11.2022
Tilføjet 2.11.2022
Matthew N. Hayek
Science Advances, 2.11.2022
Tilføjet 2.11.2022
Peter J. Hotez
Nat Rev Microbiol, 2.11.2022
Tilføjet 2.11.2022
Nature Reviews Microbiology, Published online: 02 November 2022; doi:10.1038/s41579-022-00824-8Global COVID-19 vaccine equity remains aspirational for much of the world. But the emergence of rapidly evolving SARS-CoV-2 variants provides new opportunities to correct past public policies, support local vaccine production and combat rising anti-vaccine aggression.
Læs mere Tjek på PubMedDinkorma T. Ouologuem, Laurent Dembele, Antoine Dara, Aminatou K. Kone, Nouhoum Diallo, Cheick P. O. Sangare, Fatoumata I. Ballo, François Dao, Siaka Goita, Aboubecrin S. Haidara, Aliou Traore, Amadou B. Niangaly, Souleymane Dama, Sekou Sissoko, Fanta Sogore, Jacob N. Dara, Yacouba N. Barre, Amadou Daou, Fatoumata Cisse, Ousmaila Diakite, Diagassan Doumbia, Sekou Koumare, Bakary Fofana, Fatalmoudou Tandina, Daman Sylla, Adama Sacko, Mamadou Coulibaly, Mamadou M. Tekete, Amed Ouattara, Abdoulaye A. Djimde aMalaria Research and Training Center, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali bCenter for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
Antimicrobial Agents And Chemotherapy, 2.11.2022
Tilføjet 2.11.2022
Thanh Quang Nguyen, Bui Thi Bich Hanh, Seunghyeon Jeon, Bo Eun Heo, Yujin Park, Arunima Choudhary, Cheol Moon, Jichan Jang aDivision of Life Science, Department of Bio & Medical Big Data (BK21 Four Program), Research Institute of Life Science, Gyeongsang National Universitygrid.256681.e, Jinju, South Korea bDivision of Applied Life Science (BK21 Four Program), Research Institute of Life Science, Gyeongsang National Universitygrid.256681.e, Jinju, South Korea cDepartment of Clinical Laboratory Science, Semyung University, Jecheon, South Korea
Antimicrobial Agents And Chemotherapy, 2.11.2022
Tilføjet 2.11.2022
Ashley Nicole Greenawalt, Julie Stoudenmire, Karl Lundquist, Nicholas Noinaj, James C. Gumbart, Cynthia Nau Cornelissen aCenter for Translational Immunology, Institute for Biomedical Sciences, Georgia State Universitygrid.256304.6, Atlanta, Georgia, USA bMarkey Center for Structural Biology, Department of Biological Science, Purdue University, West Lafayette, Indiana, USA cPurdue Institute of Inflammation, Immunology and Infectious Disease, Purdue University, West Lafayette, Indiana, USA dDepartment of Biological Sciences, Purdue University, West Lafayette, Indiana, USA eSchool of Physics, Georgia Institute of Technologygrid.213917.f, Atlanta, Georgia, USA, Andreas J. Bäumler
Infection and Immunity, 2.11.2022
Tilføjet 2.11.2022
Erion Lipo, Seblewongel Asrat, Wenwen Huo, Asaf Sol, Christopher S. Fraser, Ralph R. Isberg aProgram in Genetics, Tufts University School of Medicine, Boston, Massachusetts, USA bProgram in Molecular Microbiology, Tufts University School of Medicine, Boston, Massachusetts, USA cDepartment of Molecular and Cellular Biology, University of California, Davis, California, USA dDepartment of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, Massachusetts, USA, Craig R. Roy
Infection and Immunity, 2.11.2022
Tilføjet 2.11.2022
Caitlin M. McManus, Tiffany Bouchery, Mona Suleiman, Anna O. Kildemoes, Annabel Ferguson, Tao Wang, Conor M. Finlay, Ryan Chan, Tess Renahan, Ananya Mukundan, Gyaviira Nkurunungi, Sarah D. Bobardt
Trends in Parasitology, 2.11.2022
Tilføjet 2.11.2022
The Hydra helminth conference series, formally titled ‘Parasitic Helminths: New Perspectives in Biology and Infection’, has been serving the community of helminth research as a platform for interactive discussions and collaboration opportunities since its original launch in 1997. After a break in 2020 and 2021 due to the pandemic, this long-awaited conference returned at the Bratsera Hotel in Hydra, Greece, from August 28 to 2 September this year, with 100 delegates from 19 countries across the globe.
Læs mere Tjek på PubMedGatti, C. A., Parker-Conway, K., Okorie, M.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Objectives
The interim Foundation Year 1 (FiY1) post was created in response to the COVID-19 pandemic to help bolster the workforce and manage increased clinical pressures. This study aimed to assess the impact of the FiY1 post on medical graduates’ self-reported confidence in common tasks, core skills, competencies and procedures prior to starting FY1, as a measure of increasing preparedness for practice.
Setting
A longitudinal survey was performed at a tertiary teaching hospital in the South East of England. FiY1 posts ran from June to July 2020.
Participants
Questionnaires were sent to 122 medical graduates from a single medical school (recipients included FiY1s and non-FiY1s) and to 69 FiY1s at a single Teaching Hospital NHS Trust, irrespective of medical school attended. Initial and follow-up questionnaires had 86 and 62 respondents, respectively. Of these, 39 graduates were matched; 26 were FiY1s and 13 non-FiY1s. The 39 matched results were analysed.
Primary outcome measures
Confidence levels in common FY1 tasks, core procedures and competencies were gathered before and after the FiY1 post through online questionnaires. Change in confidence comparing FiY1s and non-FiY1s was measured and analysed using linear regression.
Results
On a 5-point scale, the FiY1 post increased overall confidence in starting FY1 by 0.62 (95% CI 0.072 to 1.167, p=0.028). The FiY1 post increased confidence in performing venepuncture by 0.32 (95% CI 0.011 to 0.920, p=0.045), performing intravenous cannulation by 0.48 (95% CI 0.030 to 1.294, p=0.041) and recognising, assessing and initiating the management of the acutely ill patient by 0.32 (95% CI 0.030 to 1.301, p=0.041).
Conclusions
The COVID-19 pandemic FiY1 post improved confidence in core skills and competencies. These findings may help guide future educational interventions in conjunction with further larger scale studies, ultimately aiding to bridge the transition gap between being a medical student and a doctor.
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Chiu, C.-H., Wei, C.-J., Sheu, M.-L., Liu, Y.-P., Chang, C.-C., Chen, C.-Y.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Objectives
During the COVID-19 outbreak, medical educators’ main concern has been how to prepare new physicians and medical students to meet their obligations as healthcare providers under novel circumstances. This study aims at exploring how trainees perceive their commitments as physicians under the threat of a pandemic.
Design
A qualitative method was employed. Researchers interviewed medical students under clerkship training (fifth and sixth-year medical students) and new physicians undergoing postgraduate year (PGY) and specialty training.
Setting
A university hospital in Taipei, Taiwan.
Participants
The team conducted three focus groups for participants in three separate training stages: clerks, PGY students (PGYs), and residents. Researchers collected data from 31 March to 2 April 2020 and analysed the thematic analysis results.
Results
Seventeen medical students and new physicians took part in the focus groups, five of whom (31.25%) were female. Participants consisted of four residents, six PGYs, and seven medical students. Through their responses, the authors determined four major dimensions with corresponding subdimensions that significantly affected their sense of medical professionalism, including medical knowledge and clinical skills, sense of duty towards public health, teamwork and protection of patient rights.
Conclusions
We therefore concluded that participants grew to accept their roles after acquiring the knowledge and skills needed to care for patients with COVID-19. Alternative teaching arrangements and their impact on trainees’ clinical performance require further discussion.
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Tsuno, K., Tabuchi, T.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Objectives
To investigate the risk factors for workplace bullying and mental health outcomes among workers during the COVID-19 pandemic.
Design
A cross-sectional study.
Setting
A nationwide online survey was conducted from August to September 2020 in Japan.
Participants
16 384 workers (men: n=9565; women: n=6789).
Main outcome variables
Workplace bullying was measured by one item from the Brief Job Stress Questionnaire; severe psychological distress according to the Kessler Psychological Distress Scale (≥13) and suicidal ideation by one item. Prevalence ratios were calculated by modified Poisson regression analyses adjusting for potential confounders such as gender, age, occupational characteristics and a prior history of depression.
Results
Overall, 15% of workers experienced workplace bullying, 9% had severe psychological distress and 12% had suicidal ideation during the second and third wave of the COVID-19 pandemic in Japan. The results of this study showed men, executives, managers and permanent employees had a higher risk of bullying than women or part-time workers. Increased physical and psychological demands were common risk factors for bullying, severe psychological distress and suicidal ideation. Starting to work from home was a significant predictor for adverse mental health outcomes but a preventive factor against workplace bullying.
Conclusions
The results of this study showed different high-risk groups for bullying or mental health during the pandemic. Any intervention to decrease workplace bullying or mental health problems should focus not only on previously reported vulnerable workers but also workers who have experienced a change in work style or job demands.
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Hoogendijk, E. O., Schuster, N. A., van Tilburg, T. G., Schaap, L. A., Suanet, B., De Breij, S., Kok, A. A., Van Schoor, N. M., Timmermans, E. J., de Jongh, R. T., Visser, M., Huisman, M.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Objectives
The aim of this study was to develop an index to measure older adults’ exposure to the COVID-19 pandemic and to study its association with various domains of functioning.
Design
Cross-sectional study.
Setting
The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands.
Participants
Community-dwelling older adults aged 62–102 years (n=1089) who participated in the LASA COVID-19 study (June–September 2020), just after the first wave of the pandemic.
Primary outcome measures
A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness).
Results
The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018–2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile.
Conclusions
Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.
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Kjellberg, A., Abdel-Halim, L., Hassler, A., El Gharbi, S., Al-Ezerjawi, S., Boström, E., Sundberg, C. J., Pernow, J., Medson, K., Kowalski, J. H., Rodriguez-Wallberg, K. A., Zheng, X., Catrina, S., Runold, M., Stahlberg, M., Bruchfeld, J., Nygren-Bonnier, M., Lindholm, P.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Introduction
Long COVID-19, where symptoms persist 12 weeks after the initial SARS-CoV-2-infection, is a substantial problem for individuals and society in the surge of the pandemic. Common symptoms are fatigue, postexertional malaise and cognitive dysfunction. There is currently no effective treatment and the underlying mechanisms are unknown, although several hypotheses exist, with chronic inflammation as a common denominator. In prospective studies, hyperbaric oxygen therapy (HBOT) has been suggested to be effective for the treatment of similar syndromes such as chronic fatigue syndrome and fibromyalgia. A case series has suggested positive effects of HBOT in long COVID-19. This randomised, placebo-controlled clinical trial will explore HBOT as a potential treatment for long COVID-19. The primary objective is to evaluate if HBOT improves health-related quality of life (HRQoL) for patients with long COVID-19 compared with placebo/sham. The main secondary objective is to evaluate whether HBOT improves endothelial function, objective physical performance and short-term HRQoL.
Methods and analysis
A randomised, placebo-controlled, double-blind, phase II clinical trial in 80 previously healthy subjects debilitated due to long COVID-19, with low HRQoL. Clinical data, HRQoL questionnaires, blood samples, objective tests and activity metre data will be collected at baseline. Subjects will be randomised to a maximum of 10 treatments with hyperbaric oxygen or sham treatment over 6 weeks. Assessments for safety and efficacy will be performed at 6, 13, 26 and 52 weeks, with the primary endpoint (physical domains in RAND 36-Item Health Survey) and main secondary endpoints defined at 13 weeks after baseline. Data will be reviewed by an independent data safety monitoring board.
Ethics and dissemination
The trial is approved by the Swedish National Institutional Review Board (2021–02634) and the Swedish Medical Products Agency (5.1-2020-36673). Positive, negative and inconclusive results will be published in peer-reviewed scientific journals with open access.
Trial registration number
NCT04842448.
Læs mere Tjek på PubMed
Anschau, F., Aredes, N. D. A., Reveiz, L., Padilla, M., Gomes, R. d. M., Carvalho, W. M., Leles, F. A. G., Reese, F. B., Hubert, A. H., Kemper, E. S., de Souza, R. R., Salviano, C. F., e Silva, H. S., Coelho, E. B., Gatto, G. C., de Morais, R. F., Alegre, L. N., Padilha dos Reis, R. C., dos Santos Neto, J. F., Garbini, A. F., Purper, C. P., dos Santos, V. B., Charao de Almeida, R. d. S., Donida, B., Bitencourt, R. F., Kopittke, L., dos Santos, F. C., Lutkmeier, R., Carazai, D. d. R., Reis, V. A. S., Deulefeu, F. C., Severino, F. G., da Costa Neto, J. G., Carvalho, N. d. V., de Andrade, A. J. R., Teixeira, A. M., Braga Neto, O., Muller, G. C., Kuchenbecker, R. d. S.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Introduction
With the COVID-19 pandemic, hospitals in low-income countries were faced with a triple challenge. First, a large number of patients required hospitalisation because of the infection’s more severe symptoms. Second, there was a lack of systematic and broad testing policies for early identification of cases. Third, there were weaknesses in the integration of information systems, which led to the need to search for available information from the hospital information systems. Accordingly, it is also important to state that relevant aspects of COVID-19’s natural history had not yet been fully clarified. The aim of this research protocol is to present the strategies of a Brazilian network of hospitals to perform systematised data collection on COVID-19 through the WHO platform.
Methods and analysis
This is a multicentre project among Brazilian hospitals to provide data on COVID-19 through the WHO global platform, which integrates patient care information from different countries. From October 2020 to March 2021, a committee worked on defining a flowchart for this platform, specifying the variables of interest, data extraction standardisation and analysis.
Ethics and dissemination
This protocol was approved by the Research Ethics Committee (CEP) of the Research Coordinating Center of Brazil (CEP of the Hospital Nossa Senhora da Conceicao), on 29 January 2021, under approval No. 4.515.519 and by the National Research Ethics Commission (CONEP), on 5 February 2021, under approval No. 4.526.456. The project results will be explained in WHO reports and published in international peer-reviewed journals, and summaries will be provided to the funders of the study.
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Wiertz, C. M. H., Hemmen, B., Sep, S. J. S., van Santen, S., van Horn, Y. Y., van Kuijk, S. M. J., Verbunt, J. A.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Objectives
The aim of the study was to evaluate recovery of participation in post-COVID-19 patients during the first year after intensive care unit (ICU) discharge. The secondary aim was to identify the early determinants associated with recovery of participation.
Design
Prospective cohort study.
Setting
COVID-19 post-ICU inpatient rehabilitation in the Netherlands, during the first epidemic wave between April and July 2020, with 1-year follow-up.
Participants
COVID-19 ICU survivors ≥18 years of age needing inpatient rehabilitation.
Main outcome measures
Participation in society was assessed by the ‘Utrecht Scale for Evaluation of Rehabilitation-Participation’ (USER-P) restrictions scale. Secondary measures of body function impairments (muscle force, pulmonary function, fatigue (Multidimensional Fatigue Inventory), breathlessness (Medical Research Council (MRC) breathlessness scale), pain (Numerical Rating Scale)), activity limitations (6-minute walking test, Patient reported outcomes measurement information system (PROMIS) 8b), personal factors (coping (Utrecht Proactive Coping Scale), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Global Psychotrauma Screen—Post Traumatic Stress Disorder), cognitive functioning (Checklist for Cognitive Consequences after an ICU-admission)) and social factors were used. Statistical analyses: linear mixed-effects model, with recovery of participation levels as dependent variable. Patient characteristics in domains of body function, activity limitations, personal and social factors were added as independent variables.
Results
This study included 67 COVID-19 ICU survivors (mean age 62 years, 78% male). Mean USER-P restrictions scores increased over time; mean participation levels increasing from 62.0, 76.5 to 86.1 at 1, 3 and 12 months, respectively. After 1 year, 50% had not fully resumed work and restrictions were reported in physical exercise (51%), household duties (46%) and leisure activities (29%). Self-reported complaints of breathlessness and fatigue, more perceived limitations in daily life, as well as personal factors (less proactive coping style and anxiety/depression complaints) were associated with delayed recovery of participation (all p value <0.05).
Conclusions
This study supports the view that an integral vision of health is important when looking at the long-term consequence of post-ICU COVID-19. Personal factors such as having a less proactive coping style or mental impairments early on contribute to delayed recovery.
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Book, J., Broichhaus, L., Grüne, B., Niessen, J., Wiesmüller, G. A., Joisten, C., Kossow, A.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Objectives
To estimate the awareness, implementation and difficulty of behavioural recommendations and their correlates in officially ordered domestic isolation and quarantine during the COVID-19 pandemic.
Design
Online retrospective cohort survey conducted from 12 December 2020 to 6 January 2021 as part of the Cologne–Corona Counselling and Support for Index and Contact Persons During the Quarantine Period study.
Setting
Administrative area of the city of Cologne, Germany.
Participants
3011 infected persons (IPs) and 5822 contacts over 16 years of age who were in officially ordered domestic isolation or quarantine between 28 February 2020 and 9 December 2020. Of these, 60.4% were women.
Outcome measures
Self-developed scores were calculated based on responses about awareness and implementation of 19 behavioural recommendations to determine community-based and household-based adherence. Linear regression analyses were conducted to determine factors influencing adherence.
Results
The average adherence to all recommendations, including staying in a single room, keeping distance and wearing a mask, was 13.8±2.4 out of 15 points for community-based recommendations (CBRs) and 17.2±6.8 out of 25 points for household-based recommendations (HBRs). IPs were significantly more adherent to CBRs (14.3±2.0 points vs 13.7±2.6 points, p<0.001) and HBRs (18.2±6.7 points vs 16.5±6.8 points, p<0.001) than were contact persons. Among other factors, both status as an IP and being informed about the measures positively influenced participants’ adherence. The linear regression analysis explained 6.6% and 14.4% (corr. R²) of the adherence to CBRs and HBRs.
Conclusions
Not all persons under official quarantine were aware of the relevant behavioural recommendations. This was especially true in cases where instructions were given for measures to be taken in one’s own household. Due to the high transmission rates within households, HBRs should be communicated with particular emphasis.
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Warda, A. K., Dempsey, E. M., Forssten, S. D., Ryan, C. A., Cryan, J. F., Patterson, E., O'Riordan, M. N., OShea, C.-A., Keohane, F., Meehan, G., OConnor, O., Ross, R. P., Stanton, C.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Introduction
The intestinal microbiome in early life plays a major role in infant health and development. Factors like antibiotic exposure, breast/formula feeding and mode of delivery are known to affect the microbiome. The increasing occurrence of caesarean section (C-section) deliveries and antibiotic exposure warrants further insight into the potential missing microbes in those infants. The study objective is to study the effect of maternal antibiotic administration during pregnancy and/or C-section mode of delivery on the development of the infant’s intestinal microbiome until the age of 2 years.
Methods and analysis
A single site, cross-sectional observational study of C-section and vaginally delivered infants being either exposed to maternal antibiotic treatment or not during the third trimester of pregnancy. Throughout the nine visits, stool, urine, saliva, hair, breast milk and vaginal swabs will be collected from either mother and/or infant for microbiome and metabolomic analysis.
Ethics and dissemination
The protocol was approved by the Clinical Research Ethics Committee of the Cork Teaching Hospitals. The trial has been registered at ClinicalTrials.gov.
The findings from this study will be disseminated in peer-reviewed journals, during scientific conferences, and directly to the study participants. Sequencing data will be deposited in public databases.
Trial registration number
NCT04134819.
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Schovsbo, S. U., Mollehave, L. T., Petersen, M. W., Ahrendt Bjerregaard, A., Eliasen, M., Pedersen, S. B., Eplov, L. F., Karhus, L. L., Fink, P., Linneberg, A., Dantoft, T. M., Jorgensen, T., Benros, M. E.
BMJ Open, 2.11.2022
Tilføjet 2.11.2022
Objectives
It has been suggested that infections can trigger functional somatic disorders (FSD). However, current evidence is limited by inconsistent findings in smaller studies conducted in clinical settings within selected populations and short follow-up times. We aimed to test the hypothesis that former infections are associated with FSD using data from nationwide registries and a large population-based cohort study, the Danish Study of Functional Disorders study.
Design
FSD cases were identified in a cross-sectional population-based cohort and linked retrospectively to former hospital contacts with infections identified in the Danish National Patient Registry. The associations between FSD and former infections within 17 years were analysed using logistic regressions to calculate ORs and 95% CIs adjusted for age, sex and subjective social status.
Setting
A population-based cohort in Denmark examined between 2011 and 2015.
Participants
A total of 9656 men and women aged 18–76 years.
Main outcome measures
FSD measured by various delimitations, including bodily distress syndrome (BDS), irritable bowel (IB), chronic fatigue (CF), chronic widespread pain (CWP), and multiple chemical sensitivity (MCS).
Results
Overall, infections were associated with increased risk of all delimitations of FSD. The associations were more pronounced for multisystemic FSD. The number of prior infections increased the risk in a dose-response manner (p<0.0001). Bacterial but not viral infections were significantly associated with BDS (OR 1.69 (95% CI 1.46 to 1.96)), IB (OR 1.41 (95% CI 1.06 to 1.88)), CWP (OR 1.47 (95% CI 1.13 to 1.90)) and CF (OR 1.62 (95% CI 1.34 to 1.96)), but not MCS.
Conclusion
Former infections leading to hospital contacts were associated with a higher risk of having FSD. These associations were more pronounced for bacterial than viral infections, and more infections increased the risk in a dose-response manner. These results tend to support the idea that severe infections could play a role in FSD.
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Immunity, 26.10.2022
Tilføjet 2.11.2022
Publication date: Available online 1 November 2022Source: ImmunityAuthor(s): Julie Rebejac, Elisa Eme-Scolan, Laurie Arnaud Paroutaud, Sarah Kharbouche, Matei Teleman, Lionel Spinelli, Emeline Gallo, Annie Roussel-Queval, Ana Zarubica, Amandine Sansoni, Quentin Bardin, Philippe Hoest, Marie-Cécile Michallet, Carine Brousse, Karine Crozat, Monica Manglani, Zhaoyuan Liu, Florent Ginhoux, Dorian B. McGavern, Marc Dalod
Læs mere Tjek på PubMedJunyu He, Yanding Wang, Xianyu Wei, Hailong Sun, Yuanyong Xu, Wenwu Yin, Yong Wang, Wenyi Zhang
Journal of Medical Virology, 2.11.2022
Tilføjet 2.11.2022
Francesco Branda, Massimo Pierini, Sandra Mazzoli
Journal of Medical Virology, 2.11.2022
Tilføjet 2.11.2022
Joanna Luczkowiak, Gonzalo Rivas, Nuria Labiod, Fátima Lasala, Marta Rolo, Jaime Lora‐Tamayo, Mikel Mancheno‐Losa, David Rial‐Crestelo, Alfredo Pérez‐Rivilla, María Dolores Folgueira, Rafael Delgado
Journal of Medical Virology, 2.11.2022
Tilføjet 2.11.2022
Fan Deng, Yu Chen, Qi‐Shun Sun, Ze‐Bin Lin, Yue Min, Bing‐Cheng Zhao, Zhi‐Bin Huang, Wei‐Feng Liu, Cai Li, Jing‐Juan Hu, Ke‐Xuan Liu
Journal of Medical Virology, 2.11.2022
Tilføjet 2.11.2022
Zhuanzhuan Wei, Yiyi Jiang, Gaomei Zhao, Chenwenya Li, Songling Han, Yin Chen, Tao Wang, Tianmin Cheng, Junping Wang, Cheng Wang
Journal of Medical Virology, 2.11.2022
Tilføjet 2.11.2022
Ismail Cem Yilmaz
Frontiers in Immunology, 26.10.2022
Tilføjet 2.11.2022
Leishmania parasites harbor a unique network of circular DNA known as kinetoplast DNA (kDNA). The role of kDNA in leishmania infections is poorly understood. Herein, we show that kDNA delivery to the cytosol of Leishmania major infected THP-1 macrophages provoked increased parasite loads when compared to untreated cells, hinting at the involvement of cytosolic DNA sensors in facilitating parasite evasion from the immune system. Parasite proliferation was significantly hindered in cGAS- STING- and TBK-1 knockout THP-1 macrophages when compared to wild type cells. Nanostring nCounter gene expression analysis on L. major infected wild type versus knockout cells revealed that some of the most upregulated genes including, Granulysin (GNLY), Chitotriosidase-1 (CHIT1), Sialomucin core protein 24 (CD164), SLAM Family Member 7 (SLAMF7), insulin-like growth factor receptor 2 (IGF2R) and apolipoprotein E (APOE) were identical in infected cGAS and TBK1 knockout cells, implying their involvement in parasite control. Amlexanox treatment (a TBK1 inhibitor) of L. major infected wild type cells inhibited both the percentage and the parasite load of infected THP-1 cells and delayed footpad swelling in parasite infected mice. Collectively, these results suggest that leishmania parasites might hijack the cGAS-STING-TBK1 signaling pathway to their own advantage and the TBK1 inhibitor amlexanox could be of interest as a candidate drug in treatment of cutaneous leishmaniasis.
Læs mere Tjek på PubMedA.G. Leroy, V. Crenn, P. Le Turnier, S. Pineau, O. Grossi, P. Bémer, the Nantes Bone and Joint Infections Study Group
Clinical Microbiology and Infection, 1.11.2022
Tilføjet 2.11.2022
Cefazolin remains the standard of care for antimicrobial prophylaxis in joint replacement surgery [1]. However, prosthetic joint infections (PJIs) involving Gram-negative bacilli (GNB) - possibly poorly susceptible to cefazolin - are increasing [2]. The main objective of this study was to describe cefazolin resistance among GNB isolated from post-operative PJIs.
Læs mere Tjek på PubMedMocroft, Amanda; Geressu, Adam; Beguelin, Charles; Llibre, Josep M.; Lazarus, Jeffrey V.; Tomazic, Janez; Smidt, Jelena; Parczewski, Milosz; Brännström, Johanna; Sedlacek, Dalibor; Degen, Olaf; van der Valk, Marc; Paduta, Dzmitry; Flamholc, Leo; Schmid, Patrick; Orkin, Chloe; Nielsen, Lars N.; Hoffmann, Christian; Beniowski, Marek; Oprea, Cristiana; Begovac, Josip; Peters, Lars
AIDS, 26.10.2022
Tilføjet 2.11.2022
Background:
There are limited data on end-stage liver disease (ESLD) and mortality in people living with HIV (PLWH) coinfected with both hepatitis B and C virus.
Methods:
All PLWH aged >18 under follow-up in EuroSIDA positive for HBsAg (HBV), and/or HCVRNA+, were followed from baseline (latest of 1/1/2001, EuroSIDA recruitment, known HBV/HCV status) to ESLD, death, last visit, or 31/12/2020. Follow-up while HCVRNA- was excluded. In 2 separate models, Poisson regression compared 3 groups updated over time; HIV/HBV, HIV/HCV, and HIV/HBV/HCV.
Results:
Among 5733 included individuals, 4476 (78.1%) had HIV/HCV, 953 (16.6%) had HIV/HBV and 304 (5.3%) had HIV/HBV/HCV. In total, 289 (5.0%) developed ESLD during 34178 person-years of follow-up (PYFU), incidence 8.5/1000 PYFU (95% confidence interval [CI] 7.5–9.4) and 707 deaths occurred during 34671 PYFU (incidence 20.4/1000 PYFU; 95% CI 18.9–21.9). After adjustment, compared to those with HIV/HCV, persons with HIV/HBV had significantly lower rates of ESLD (adjusted incidence rate ratio [aIRR] 0.53; 95% CI 0.34–0.81). Those with HIV/HBV/HCV had marginally significantly higher rates of ESLD (aIRR 1.49; 95% CI 0.98–2.26). Those under follow-up ≥2014 had significantly lower rates of ESLD compared to 2007–2013 (aIRR 0.65; 95% CI 0.47–0.89). Differences in ESLD between the 3 groups were most pronounced in those aged ≥40. After adjustment, there were no significant differences in all-cause mortality across the 3 groups.
Conclusions:
HIV/HBV coinfected individuals had lower rates of ESLD and HIV/HBV/HCV had higher rates of ESLD compared to those with HIV/HCV, especially in those aged >40. ESLD decreased over time across all groups.
ClinicalTrials.gov Identifier:
NCT02699736
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedZhou, Chao-Ying; Wang, Rui-Ning; He, Wen-Ting; Luo, Dong-Rong; Yuan, Si-Rui; Wen, Qian; Hu, Sheng-Feng; Zhou, Xin-Ying; Ma, Li
AIDS, 26.10.2022
Tilføjet 2.11.2022
Objective:
Mycobacterium tuberculosis/human immunodeficiency virus (MTB/HIV) coinfection has become an urgent problem in the field of prevention and control of infectious diseases in recent years. Adoptive cellular immunotherapy using antigen-specific T cell receptor (TCR) engineered T cells which recognize the specific antigen artificially may have tremendous potential in anti-MTB/HIV coinfection. We have previously successfully identified a MTB Ag85B199–207 and HIV-1 Env120–128 peptide-bispecific TCR screened out from peripheral blood mononuclear cells of a HLA-A∗0201+ healthy individual and have further studied that how residues on the predicted complementarity determining region (CDR) 3 of the β chain contribute to the bispecific TCR contact with the peptide-MHC. However, it is not clear which amino acids in the predicted CDR3α of the bispecific TCR play a crucial role in ligand recognition.
Methods:
The variants in the CDR3α of the bispecific TCR were generated using alanine substitution. We then evaluated the immune effects of the five variants on T cell recognition upon encounter with the MTB or HIV-1 antigen.
Results:
Mutation of two amino acids (E112A, Y115A) in CDR3α of the bispecific TCR caused a markedly diminished T cell response to antigen, whereas mutation of the other three amino acids (S113A, P114A, S116A) resulted in completely eliminated response.
Conclusion:
This study demonstrates that Ser113, Pro114 and Ser116 in CDR3α of the bispecific TCR are especially important for antigen recognition. These results will pave the way for the future development of an improved high-affinity bispecific TCR for use in adoptive cellular immunotherapy for MTB/HIV coinfected patients.
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedCummings, Matthew J.; Bakamutumaho, Barnabas; Price, Adam; Owor, Nicholas; Kayiwa, John; Namulondo, Joyce; Byaruhanga, Timothy; Jain, Komal; Postler, Thomas S.; Muwanga, Moses; Nsereko, Christopher; Nayiga, Irene; Kyebambe, Stephen; Che, Xiaoyu; Sameroff, Stephen; Tokarz, Rafal; Shah, Shivang S.; Larsen, Michelle H.; Lipkin, W. Ian; Lutwama, Julius J.; O’Donnell, Max R.
AIDS, 26.10.2022
Tilføjet 2.11.2022
Background:
The global burden of sepsis is concentrated in high HIV-burden settings in sub-Saharan Africa (SSA). Despite this, little is known about the immunopathology of sepsis in persons with HIV (PWH) in the region. We sought to determine the influence of HIV on host immune responses and organ dysfunction among adults hospitalized with suspected sepsis in Uganda.
Design:
Prospective cohort study.
Methods:
We compared organ dysfunction and 30-day outcome profiles of PWH and those without HIV. We quantified 14 soluble immune mediators, reflective of key domains of sepsis immunopathology, and performed whole-blood RNA-sequencing on samples from a subset of patients. We used propensity score methods to match PWH and those without HIV by demographics, illness duration, and clinical severity, and compared immune mediator concentrations and gene expression profiles across propensity score-matched groups.
Results:
Among 299 patients, 157 (52.5%) were PWH (clinical stage 3 or 4 in 80.3%, 67.7% with known HIV on antiretroviral therapy). PWH presented with more severe physiologic derangement and shock, and had higher 30-day mortality (34.5% vs. 10.2%; P
Læs mere Tjek på PubMedAliyu, Gambo G.; Lawton, Jonathan G.; Mitchell, Andrew B.; Abimiku, Alash’le G.; Jelpe, Tapdiyel; Bassey, Orji; Riedel, David J.; Swaminathan, Mahesh; Chang, Joy Chih-Wei; DeVos, Joshua R.; Patel, Hetal; Charurat, Man E.; Stafford, Kristen A.
AIDS, 26.10.2022
Tilføjet 2.11.2022
Background:
HIV drug resistance (HIVDR) surveillance is an important tool to monitor threats to progress towards epidemic control. The characterization of HIVDR in Nigeria at the national level is needed to inform both clinical decisions and population-level HIV policy strategies. This study uses data obtained from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) to describe the prevalence and distribution of HIVDR in Nigeria.
Methods:
NAIIS was a cross-sectional, population-based survey of households throughout Nigeria in 2018. NAIIS was designed to provide estimates of HIV prevalence and related health indicators from a nationally representative sample. The study population included participants aged 15–64 years who tested positive for HIV, had a viral load at least 1000 copies/ml, and had available HIV drug resistance genotypes. HIV isolates were genotyped to detect drug resistance mutations. Individual characteristics of study participants associated with HIVDR were identified using a weighted multivariable logistic regression model.
Results:
Of 1355 respondents with available HIV genotypes, 293 (19%) had evidence of drug-resistant mutations (DRMs) that conferred resistance to at least one antiretroviral drug. The majority of DRMs observed conferred resistance to NNRTIs (17.6%) and NRTIs (11.2%). HIVDR was associated with being ART-experienced, longer duration on ART, and lower CD4+ count but not sociodemographic characteristics.
Conclusion:
The population level DRM prevalence in Nigeria was consistent with what would be expected in a mature HIV treatment landscape. The continued roll out of dolutegravir-anchored regimens should mitigate the impact of NNRTI resistance on population viral load suppression and progress towards epidemic control.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRemien, Robert H.; Dācus, Jagadīśa-devaśrī; Farley, Jason E.; Hughes, James P.; Gamble, Theresa; Wang, Zhe (Zoe); Batey, D. Scott; Mayer, Kenneth H.; Del Rio, Carlos; Balán, Iván C.; Irvin, Risha; Mitchell, Kate M.; Cummings, Vanessa; Eshleman, Susan H.; Conserve, Donaldson; Knox, Justin; Yu, Kaiyue; Beyrer, Chris
AIDS, 26.10.2022
Tilføjet 2.11.2022
Objective(s):
After identifying and recruiting men who have sex with men living with HIV and virally unsuppressed, this study attempted to enhance treatment and care via case management to increase the proportion who achieved viral suppression.
Design:
Participants were randomized into one of two study arms: standard of care (SOC) or enhanced case management (CM) intervention. Participants were followed for 12 months with quarterly study assessments, with blood collected for CD4+ cell count testing, HIV viral load testing (primary prespecified outcome), and plasma storage.
Methods:
Participants identified via respondent-driven sampling and direct recruitment and were invited to participate in the randomized controlled trial. The CM intervention provided a wide range of support services including, health education, clinical care coordination, medication adherence support, and social service assistance. The month-12 assessment included questions about healthcare utilization, stigma, substance use, and mental health.
Results:
Among the 144 participants virally unsuppressed at baseline, most had had a previous positive HIV test result; were Black, non-Hispanic, gay and bisexual men, aged 22–50. Among the 128 participants at the last study visit, 68 were virally suppressed, with no statistically significant difference between the CM and SOC arms (viral suppression 42% and 53%, respectively; adjusted odds ratio = 0.62 [P = 0.15; 95% confidence interval: 0.32, 1.2]).
Conclusions:
Reaching targets of at least 90% sustained viral suppression among all people with HIV will likely require more than an individual-level CM approach that addresses barriers to optimal care and treatment at multiple levels.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMcmahon, William C.; Kwatra, Gaurav; Izu, Alane; Koen, Anthonet L.; Greffrath, Johann; Fairlie, Lee; Patel, Faeezah; Mukendi, Christian K.; Mbele, Nkululeko J.; Lala, Rushil; Burgers, Wendy A.; Nunes, Marta C.; Cutland, Clare L.; Gilbert, Sarah C.; Lambe, Teresa; Pollard, Andrew J.; Madhi, Shabir A.
AIDS, 26.10.2022
Tilføjet 2.11.2022
Objective(s):
This study aimed to investigate SARS-CoV-2-specific T cell responses 14 days after single-dose ChAdOx1 nCoV-19 (AZD1222) vaccination in black Africans living with and without HIV in South Africa, as well as determine the effect of AZD1222 vaccination on cell-mediated immune responses in people living with HIV (PLWH) with prior SARS-CoV-2 infection.
Methods:
A total of 70 HIV-uninfected people and 104 PLWH were prospectively enrolled in the multicentre, randomised, double-blinded, placebo-controlled, phase Ib/IIa trial (COV005). Peripheral blood mononuclear cells were collected from trial participants 14 days after receipt of first dose of study treatment (placebo or AZD1222 vaccine). T cell responses against the full-length spike (FLS) glycoprotein of wild-type (‘WT’) SARS-CoV-2 and mutated S-protein regions found in the Alpha, Beta, and Delta variants were assessed using an ex vivo ELISpot assay.
Results:
Among AZD1222 recipients without preceding SARS-CoV-2 infection, T cell responses to FLS of WT SARS-CoV-2 were similarly common in PLWH and HIV-uninfected people (30/33, 90.9% vs. 16/21, 76.2%; p=0.138); and magnitude of response was similar among responders (78 vs. 56 SFCs/106 PBMCs; p = 0.255). Among PLWH, AZD1222 vaccinees with prior SARS-CoV-2 infection, displayed a heightened T cell response magnitude compared to those without prior infection (186 vs. 78 SFCs/106 PBMCs; p = 0.001); and similar response rate (14/14, 100% vs. 30/33, 90.9%; p = 0.244).
Conclusions:
Our results indicate comparable T cell responses following AZD1222 vaccination in HIV-uninfected people and PLWH on stable anti-retroviral therapy. Our results additionally show that hybrid immunity acquired through SARS-CoV-2 infection and AZD1222 vaccination, induce a heightened T cell response.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedPrins, Henrieke A.B.; Rokx, Casper; Verbon, Annelies; van Sighem, Ard; De Bree, Godelieve J.; Dijkstra, Maartje; Prins, Jan M.; Reiss, Peter; van Kampen, Jeroen J.A.; Van De Vijver, David A.M.C.
AIDS, 26.10.2022
Tilføjet 2.11.2022
Objective:
Timely identification of acute or early HIV infection (AEHI) is important to help prevent onward transmission, and understanding the number of secondary infections resulting from individuals with AEHI is key to planning HIV prevention services and case finding.
Design:
We performed a phylogenetic investigation of a dense sample of individuals with AEHI who took part in the Netherlands Cohort Study on Acute HIV infection (NOVA) in the Netherlands during 2015-2021.
Methods:
Transmission clusters were identified using phylogenetic analyses based on HIV pol sequences. The Tamura-Nei model was used to estimate genetic distance. A number of 1,000 bootstraps was used to check the reliability of clustering using maximum likelihood. A cluster was defined as having a bootstrap value of at least 95% and a genetic distance of at most 1.5%. Sensitivity analyses using different values for the bootstrap and genetic distance were performed to study the reproducibility of the clustering.
Results:
Of the 156 participants included in NOVA between July 2015 and April 2021, 134 individuals for whom baseline characteristics and genotypic resistance data at baseline were available could be included. We identified 10 clusters, but the majority of persons (111/134) were not part of a cluster, suggesting mainly independent transmission events.
Conclusions:
Mainly independent transmission events among a study population consisting predominantly of MSM in a low-incidence high-resource setting is likely the result of active AEHI case finding and direct start of treatment, and the roll-out over recent years of preventive measures such as preexposure prophylaxis.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedColeman, Jenell S.; Diniz, Clarissa P.; Fuchs, Edward J.; Marzinke, Mark A.; Aung, Wutyi; Bakshi, Rahul P.; Farzadegan, Homayoon; Bream, Jay H.; Nilles, Tricia L.; Hudson, Sherry; Bumpus, Namandjé N.; Schwartz, George J.; Rosenblum, Michael A.; Rooney, James F.; Hendrix, Craig W.
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 2.11.2022
Background:
Depot medroxyprogesterone acetate (DMPA) is a widely-used contraceptive method. HIV pre-exposure prophylaxis with emtricitabine and tenofovir disoproxil fumarate (F/TDF) is highly effective in reducing HIV acquisition in women. We sought to determine the impact of DMPA on F/TDF pharmacokinetics and pharmacodynamics.
Methods:
Twelve healthy pre-menopausal cisgender women were enrolled and each completed four sequential conditions: (1) baseline, (2) steady-state F/TDF alone, (3) steady-state F/TDF+DMPA, and (4) DMPA alone. Assessments included clinical, pharmacokinetic, viral infectivity (ex vivo challenge of peripheral blood mononuclear cells by X4- and R5-tropic green fluorescent protein pseudoviruses and cervical tissue by HIVBaL), endocrine, immune cell phenotyping, and renal function.
Results:
Compared to baseline, F/TDF (+/- DMPA) significantly decreased both %R5- and X4-infected CD4 T cells and F/TDF+DMPA decreased cervical explant p24 (all p<0.05). During DMPA alone, %R5- and X4-infected CD4 T cells were higher than during F/TDF periods and lower than baseline, (not statistically significant). Cervical explant p24 fell between baseline and F/TDF values (not statistically significant). There were neither statistically significant differences in F/TDF pharmacokinetics, including total or renal clearance of either antiviral drug, nor changes in glomerular filtration rate with the addition of DMPA. There were few immune cell phenotypic differences across conditions.
Conclusions:
F/TDF decreased HIV infection in both challenge assays while DMPA alone did not enhance HIV infection in either challenge assay. DMPA did not alter F/TDF pharmacokinetics or renal function.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMorar, Neetha S; Mansoor, Leila E; Naidoo, Kalendri; Katz, Ariana WK; Garcia, Morgan; Duma, Cebo; Precious Myeni, Nqobile Bonakele; Tshbalala, Themba; Naidoo, Sarita; Montgomery, Elizabeth T
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 2.11.2022
Background:
The dapivirine vaginal ring (“the ring”) reduced HIV acquisition by about 35% in phase III trials, with modeling from open-label extension trials estimating 50% HIV protection with consistent use. The ring may be used without male partner knowledge. The Assessment of ASPIRE and HOPE Adherence (AHA) sub-study aimed to understand the impact of socio-contextual issues on ring adherence. This sub-analysis provides insight on disclosure and male partner influence on ring acceptability.
Methods:
Data was collected using four focus group discussions with 18 male partners of phase III trial participants at two sites in KwaZulu-Natal, South Africa. Qualitative data were coded, summarized by urban vs. rural location and analysed thematically.
Results:
Male partners aged 23 – 49 years wanted to be informed about ring use to maintain the trust in their relationships. Their initial response to the ring was characterized by fear due to perceived impact of the ring on their female partner’s reproductive system, their penile safety and, that the ring would encourage women to engage in unprotected sex and infidelity. Over time and with information and experience with having a partner who had used the vaginal ring, this fear transformed to support for women to have their own HIV prevention option.
Conclusion:
Male partners supported the ring as an HIV prevention method for women but wanted to be informed about its use. Engaging male partners on female-initiated HIV prevention methods and increased education among rural men may contribute to improved partner support and facilitate women’s consistent use.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedGonzález, Raquel; Nhampossa, Tacilta; Figueroa-Romero, Antía; Mendes, Anete; Mazuze, Maura; García-Otero, Laura; Sevene, Esperança; Piqueras, Mireia; Egri, Natalia; Bedini, Josep Lluis; Saúte, Francisco; Menendez, Clara
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 2.11.2022
Introduction:
Prevalence estimates of SARS-CoV-2 infection in Africa are limited, particularly among pregnant women and in those living with HIV. This study assessed the seroprevalence of SARS-CoV-2 antibodies among Mozambican HIV-infected pregnant women during the first year of the pandemic, before COVID-19 vaccines were deployed in the country.
Setting:
The study was conducted in Manhiça district, a semi-rural area in southern Mozambique.
Methods:
A prospective cohort study including pregnant women living with HIV was carried out from November 2019 to June 2021. Women were enrolled at the first antenatal care (ANC) clinic visit and followed until post-partum. HIV viral load (HIV-VL) and IgM/IgG antibodies against SARS-CoV-2 were determined in blood samples at first ANC clinic visit and at delivery. Associations between SARS-CoV-2 serostatus and maternal characteristics at enrolment were analysed.
Results:
A total of 397 women were enrolled. SARS-CoV-2 IgG/IgM antibodies were detected in 7.1% of women at enrolment and in 8.5% of women at delivery. Overall, SARS-CoV-2 antibodies were detected in 45 (11.3%; 95%CI 8.4-14.9%) women during the study period; the first seropositive sample was identified in September 2020. Having undetectable HIV-VL was associated with seropositivity of SARS-CoV-2 IgG/IgM (OR 3.35 [1.10-11.29]; p=0.039).
Conclusion:
Seroprevalence of SARS-CoV-2 antibodies in this cohort of Mozambican unvaccinated pregnant women was similar to reported global estimates of approximately 10% in pregnancy for 2021. Findings also suggest that pregnant women with high HIV- viral load may have an impaired immune response against SARS-CoV-2 and might need to be carefully managed in case of COVID-19.
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