Lindegibson1378

Given SARS-CoV-2 infection occurs primarily through respiratory transmission, preventing HCP acquisition requires fidelity to consistent PPE usage. Infection prevention strategies and implementation of transmission-based precautions have reduced spread and outbreaks. Epidemiologic studies of acute care outbreaks often include reports of PPE nonadherence and community exposure contributing to SARS-CoV-2 transmission within this setting.

Given SARS-CoV-2 infection occurs primarily through respiratory transmission, preventing HCP acquisition requires fidelity to consistent PPE usage. Infection prevention strategies and implementation of transmission-based precautions have reduced spread and outbreaks. Epidemiologic studies of acute care outbreaks often include reports of PPE nonadherence and community exposure contributing to SARS-CoV-2 transmission within this setting.

Development of immunogens that elicit an anti-HIV-1 broadly neutralizing antibody (bnAb) response will be a key step in the development of an effective HIV-1 vaccine. Although HIV-1 bnAb epitopes have been identified and mechanisms of action studied, current HIV-1 Envelope based immunogens do not elicit HIV-1 bnAbs in humans or animal models. A better understanding of how HIV-1 bnAbs arise during infection and the clinical factors associated with bnAb development may be critical for HIV-1 immunogen design efforts.

Longitudinal plasma samples from the treatment naïve control arm of the Short Pulse Anti-Retroviral Therapy at Seroconversion (SPARTAC) primary HIV-1 infection cohort were used in an HIV-1 pseudo-type neutralization assay to measure the neutralization breadth, potency and specificity of bnAb responses over time.

In the SPARTAC cohort, development of plasma neutralization breadth and potency correlates with duration of HIV infection and high viral loads, and typically takes 3 - 4 years to arise. bnAb activity was mostly directed to one or two bnAb epitopes per donor and > 60% of donors with the highest plasma neutralization having bnAbs targeted towards glycan-dependent epitopes.

This study highlights the SPARTAC cohort as an important resource for more in-depth analysis of bnAb developmental pathways.

This study highlights the SPARTAC cohort as an important resource for more in-depth analysis of bnAb developmental pathways.

Emtricitabine triphosphate (FTC-TP) in dried blood spots (DBS), a measure of short-term ART adherence, is associated with viral suppression in persons with HIV (PWH). However, its ability to predict future viremia remains unknown.

Prospective, observational cohort (up to 3 visits in 48 weeks).

PWH receiving TDF/FTC-based ART had DBS and HIV viral load (VL) obtained at routine clinical visits. FTC-TP in DBS was dichotomized into quantifiable vs. below the limit of quantification (BLQ). The adjusted odds ratio (aOR) of future viremia (≥20 copies/mL at next study visit) was estimated according to FTC-TP at the current visit. To assess for possible interactions, additional models adjusted for tenofovir diphosphate (TFV-DP) in DBS and 3-day self-reported adherence.

Data from 433 PWH (677 paired DBS/HIV VL samples) were analyzed. The aOR (95% CI) for future viremia for BLQ vs. quantifiable FTC-TP was 3.4 (1.8, 6.5; p = 0.0002). https://www.selleckchem.com/products/AZ-960.html This diminished after adjusting for TFV-DP (aOR 1.9 [0.9, 4.1]; p = 0.090). Among PWH reporting 100% 3-day adherence, the odds of future viremia were 6.0 times higher ([1.8, 20.3]; p = 0.001) when FTC-TP was BLQ vs. quantifiable. Among participants (n = 75) reporting < 100% adherence, BLQ FTC-TP in DBS was not predictive of future viremia (aOR 1.3 [0.4, 4.6]; p = 0.96).

Non-quantifiable FTC-TP in DBS predicts future viremia and is particularly informative in PWH reporting perfect adherence. As point-of-care adherence measures become available, mismatches between objective and subjective measures, such as FTC-TP in DBS and self-report, could help clinicians identify individuals at an increased risk of future viremia.

Non-quantifiable FTC-TP in DBS predicts future viremia and is particularly informative in PWH reporting perfect adherence. As point-of-care adherence measures become available, mismatches between objective and subjective measures, such as FTC-TP in DBS and self-report, could help clinicians identify individuals at an increased risk of future viremia.Clinical trials including an analytical treatment interruption (ATI) are vital for evaluating the efficacy of novel strategies for HIV remissions. We briefly describe an interactive tool for predicting viral rebound timing in ATI trials and the impact of posttreatment controller (PTC) definitions on PTC frequency estimates. A 4-week viral load threshold of 1000 cps/ml provides both high specificity and sensitivity for PTC detection. PTC frequency varies greatly based on the definition of a PTC.

To characterise the clinical, laboratory and radiological characteristics of persons with HIV (PWH) presenting with cerebrospinal fluid (CSF) HIV RNA escape.

Retrospective case review of PWH presenting with symptomatic CSF HIV RNA escape at seven tertiary HIV clinical sites in UK and Italy.

PWH with symptomatic CSF HIV RNA escape episodes were identified and data obtained from medical records. CSF HIV RNA escape was defined as quantifiable CSF HIV RNA in unquantifiable plasma HIV RNA or CSF HIV RNA greater than plasma HIV RNA in cases where plasma HIV RNA was quantifiable. The onset of clinical symptoms was classified as acute (<2 weeks-6 months), or chronic (>6 months) and differences in presentation in those with CSF HIV RNA below and above 1000 copies/mL determined.

We identified 106 PWH with CSF HIV RNA escape (65 male); 68 (64%) PWH had acute presentations and 38 (36%) had chronic presentations. Cognitive decline (n = 54, 50.9%), confusion (n = 20, 18.9%) and headache (n = 28, 26.4%) were the most common presentations, with cognitive decline being more common in PWH who presented chronically compared with PWH who presented acutely (73.7% vs 35.3%, p = 0.0002). Sixty PWH had CSF HIV RNA ≥1000 copies/mL and presented more frequently with confusion (n = 15/60, 25.0%) compared to PWH with CSF HIV RNA <1000 copies/mL at presentation (n = 5/46, 10.9%; p = 0.03).

Cognitive decline, confusion and headache are the most frequent presenting symptoms of CSF HIV RNA escape and their relative frequency varied according to symptom onset and CSF HIV RNA concentration.

Cognitive decline, confusion and headache are the most frequent presenting symptoms of CSF HIV RNA escape and their relative frequency varied according to symptom onset and CSF HIV RNA concentration.