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Perti T, Baeten J, Johnston C, Diem K, Ochbamichael N, Huang ML, Selke S, Magaret A, Corey L, Wald A. O3-S5.03 High-dose valacyclovir decreases plasma HIV-1 levels more than standard dose acyclovir in HIV-1, HSV-2 positive persons: a randomised, crossover trial. Sex Transm Infect 2011. [DOI: 10.1136/sextrans-2011-050109.129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Johnston C, Saracino M, Kuntz S, Magaret A, Schiffer JT, Selke S, Huang ML, Corey L, Wald A. O3-S5.02 Frequent breakthrough genital HSV-2 shedding on standard and high dose valacyclovir. Sex Transm Infect 2011. [DOI: 10.1136/sextrans-2011-050109.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Schiffer J, Swan D, Magaret A, Johnston C, Selke S, Wald A, Corey L. O4-S1.04 Rapid spread of herpes simplex virus-2 in the human genital tract. Sex Transm Infect 2011. [DOI: 10.1136/sextrans-2011-050109.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Wald A, Stoelben S, Tyring S, Warren T, Johnston C, Huang ML, Timmler B, Ruebsamen-Schaeff H, Corey L, Birkmann A. O3-S5.01 Impact of AIC316, a novel antiviral helicase-primase inhibitor, on genital HSV shedding: randomised, double-blind, placebo-controlled trial. Sex Transm Infect 2011. [DOI: 10.1136/sextrans-2011-050109.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Mujugira A, Margaret A, Celum C, Lingappa J, Baeten J, Fife K, De Bruyn G, Bukusi E, Corey L, Wald A. P1-S5.25 Acyclovir and transmission of HSV-2 from HSV-2/HIV-1 dually infected persons. Sex Transm Infect 2011. [DOI: 10.1136/sextrans-2011-050108.203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Hires L, Van Der Pol B, Williams J, Corey L, Hook EW, Nye M, Taylor S, Martens M, Mena L, Warren T. P3-S2.04 Clinical evaluation of the BD HSV2 Qx assay for the direct qualitative testing of HSV2 as compared to viral culture and a laboratory-based PCR assay using male and female external anogenital lesions. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lu Y, Hendrix C, Celum C, Baeten J, Cowan F, Delany-Moretlwe S, Reid S, Hughes J, Wald A, Corey L. LBO-1.1 Acyclovir achieves lower concentration in African HIV-, HSV-2+ women compared to non-African populations, possibly explaining lower herpes suppression. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050119.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pantone A, Van Der Pol B, Williams J, Corey L, Hook E, Body B, Taylor S, Fine P, Ginde S, Lebed J. P3-S2.03 Clinical evaluation of the BD HSV1 Qx assay for the direct qualitative testing of HSV1 as compared to viral culture and a laboratory-based PCR assay using male and female external anogenital lesions. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pollack M, Leisenring W, Pergam S, Corey L, Boeckh M. Evaluation of a Novel Viral Load Based Surveillance Strategy for Prevention of Cytomegalovirus (CMV) Disease in Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Renaud C, Pergam SA, Polyak C, Jain R, Kuypers J, Englund JA, Corey L, Boeckh MJ. Early emergence of an H275Y mutation in a hematopoietic cell transplant recipient treated with intravenous peramivir. Transpl Infect Dis 2010; 12:513-7. [PMID: 21062390 PMCID: PMC3024056 DOI: 10.1111/j.1399-3062.2010.00582.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Oseltamivir resistance in pandemic 2009 influenza A/H1N1 is caused by the neuraminidase mutation H275Y. This mutation has also been associated with in vitro resistance to peramivir, but few clinical cases have been described to date. Using allele-specific real-time reverse transcriptase polymerase chain reaction assay for the H275Y mutation, we were able to identify resistant H1N1 in a hematopoietic cell transplant recipient receiving intravenous peramivir therapy, and through serial testing we determined the molecular evolution of resistance. This case demonstrates that an H275Y mutant population can emerge early and replicate in vivo under peramivir antiviral pressure to become the major viral population.
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Celum C, Wald A, Lingappa JR, Magaret AS, Wang RS, Mugo N, Mujugira A, Baeten JM, Mullins JI, Hughes JP, Bukusi EA, Cohen CR, Katabira E, Ronald A, Kiarie J, Farquhar C, Stewart GJ, Makhema J, Essex M, Were E, Fife KH, de Bruyn G, Gray GE, McIntyre JA, Manongi R, Kapiga S, Coetzee D, Allen S, Inambao M, Kayitenkore K, Karita E, Kanweka W, Delany S, Rees H, Vwalika B, Stevens W, Campbell MS, Thomas KK, Coombs RW, Morrow R, Whittington WLH, McElrath MJ, Barnes L, Ridzon R, Corey L. Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2. N Engl J Med 2010; 362:427-39. [PMID: 20089951 PMCID: PMC2838503 DOI: 10.1056/nejmoa0904849] [Citation(s) in RCA: 391] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated with increased plasma and genital levels of HIV-1. Therapy to suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels, suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV-1. METHODS We conducted a randomized, placebo-controlled trial of suppressive therapy for HSV-2 (acyclovir at a dose of 400 mg orally twice daily) in couples in which only one of the partners was seropositive for HIV-1 (CD4 count, > or = 250 cells per cubic millimeter) and that partner was also infected with HSV-2 and was not taking antiretroviral therapy at the time of enrollment. The primary end point was transmission of HIV-1 to the partner who was not initially infected with HIV-1; linkage of transmissions was assessed by means of genetic sequencing of viruses. RESULTS A total of 3408 couples were enrolled at 14 sites in Africa. Of the partners who were infected with HIV-1, 68% were women, and the baseline median CD4 count was 462 cells per cubic millimeter. Of 132 HIV-1 seroconversions that occurred after randomization (an incidence of 2.7 per 100 person-years), 84 were linked within couples by viral sequencing: 41 in the acyclovir group and 43 in the placebo group (hazard ratio with acyclovir, 0.92, 95% confidence interval [CI], 0.60 to 1.41; P=0.69). Suppression with acyclovir reduced the mean plasma concentration of HIV-1 by 0.25 log(10) copies per milliliter (95% CI, 0.22 to 0.29; P<0.001) and the occurrence of HSV-2-positive genital ulcers by 73% (risk ratio, 0.27; 95% CI, 0.20 to 0.36; P<0.001). A total of 92% of the partners infected with HIV-1 and 84% of the partners not infected with HIV-1 remained in the study for 24 months. The level of adherence to the dispensed study drug was 96%. No serious adverse events related to acyclovir were observed. CONCLUSIONS Daily acyclovir therapy did not reduce the risk of transmission of HIV-1, despite a reduction in plasma HIV-1 RNA of 0.25 log(10) copies per milliliter and a 73% reduction in the occurrence of genital ulcers due to HSV-2. (ClinicalTrials.gov number, NCT00194519.)
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Rolland M, Tovanabutra S, Gilbert PB, Sanders-Buell E, Heath L, deCamp AC, Magaret CC, Bose M, Bradfield A, O'Sullivan A, Crossler J, Deng W, Zhao H, Wong K, Raugi DN, Hural J, Dubey S, Frahm N, Michael NL, Shiver J, Corey L, Li F, Self SG, Kim J, Buchbinder S, Casimiro DR, Robertson MN, McElrath MJ, McCutchan FE, Mullins JI. OA06-06 LB. Evidence of vaccine-induced changes in breakthrough HIV-1 strains from the Step trial. Retrovirology 2009. [PMCID: PMC2767565 DOI: 10.1186/1742-4690-6-s3-o42] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Self S, Li F, Corey L, McElrath J. P17-25. A model for coverage of T-cell HIV vaccines: where are we and where do we need to be? Retrovirology 2009. [PMCID: PMC2767812 DOI: 10.1186/1742-4690-6-s3-p307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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de Bruyn G, Mlisana K, Metch B, Churchyard G, Nchabeleng M, Bekker L, Roux S, Naicker N, Latka M, Corey L, Kublin J, Gray G. P14-07. Offering new prevention modalities in HIV vaccine trials: experience with male circumcision in the Phambili trial. Retrovirology 2009. [PMCID: PMC2767687 DOI: 10.1186/1742-4690-6-s3-p195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Curlin M, Celum C, Sanchez J, Selke S, Baeten J, Huang M, Zuckerman R, Lu X, Erdman D, Corey L. P11-17. Intermittent rectal shedding of multiple human adenovirus serotypes among HIV-positive MSM. Retrovirology 2009. [PMCID: PMC2767651 DOI: 10.1186/1742-4690-6-s3-p162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lingappa JR, Hughes JP, Donnel D, Baeten JM, Mullins JI, Campbell MS, Gray GE, Essex M, Farquhar C, Rees H, Wald A, Corey L, Celum C. OA01-06 LB. HIV-1 plasma RNA and risk of HIV-1 transmission. Retrovirology 2009. [PMCID: PMC2767532 DOI: 10.1186/1742-4690-6-s3-o12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Malhotra U, Nolin J, Horton H, Li F, Corey L, Mullins JI, McElrath MJ. Functional properties and epitope characteristics of T-cells recognizing natural HIV-1 variants. Vaccine 2009; 27:6678-87. [PMID: 19747576 DOI: 10.1016/j.vaccine.2009.08.093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 08/17/2009] [Accepted: 08/26/2009] [Indexed: 11/18/2022]
Abstract
To understand how broad recognition of HIV-1 variants may be achieved we examined T-cell reactivity in newly infected persons as well as vaccine recipients to a broad spectrum of potential T-cell epitope (PTE) variants containing conservative, semi-conservative and non-conservative amino acid substitutions. Among early infected persons T-cells recognized epitope variants with one substitution at a significantly higher frequency versus those with two (P=0.0098) and three (P=0.0125) substitutions. Furthermore T-cells recognized variants containing conservative substitutions at a higher frequency versus those containing semi-conservative (P=0.0029) and non-conservative (P<0.0001) substitutions. Similar effects were observed on recognition of variants by vaccine-induced T-cells. Moreover even when variants were recognized, the IFN-gamma and granzyme B responses as well as T-cell proliferation were of lower magnitude. Finally, we show that epitope distribution is strongly influenced by both processing preferences and amino acid entropy. We conclude that induction of broad immunity is likely to require immunogen sequences that encompass multiple variants. However, cost-effective design of peptide and sequence based vaccine immunogens that provide maximal coverage of circulating sequences may be achieved through emphasis on virus domains likely to be T-cell targets.
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Nguyen HQ, Okuku F, Ssewankambo F, Magaret AS, Johnston C, Wald A, Kambugu A, Corey L, Orem J, Casper C. AIDS-associated Kaposi sarcoma in Uganda: response to treatment with highly active antiretroviral therapy and chemotherapy. Infect Agent Cancer 2009. [PMCID: PMC4261744 DOI: 10.1186/1750-9378-4-s2-o5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kuypers J, Campbell AP, Cent A, Corey L, Boeckh M. Comparison of conventional and molecular detection of respiratory viruses in hematopoietic cell transplant recipients. Transpl Infect Dis 2009; 11:298-303. [PMID: 19453994 DOI: 10.1111/j.1399-3062.2009.00400.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Sensitive detection of respiratory viruses is important for early diagnosis of infection in patients following hematopoietic cell transplantation (HCT). To evaluate the relative sensitivity of respiratory virus detection in specimens from HCT recipients, we compared the results of conventional and quantitative molecular methods. METHODS We tested 688 nasal wash samples collected prospectively from 131 patients during the first 100 days after HCT by viral culture, fluorescent antibody staining (FA), and real-time quantitative reverse transcription-polymerase chain reaction (PCR) assay for detection of respiratory syncytial virus (RSV), influenza virus types A (FluA) and B (FluB), and parainfluenza virus types 1 (PIV1) and 3 (PIV3). Testing for human metapneumovirus (MPV) was performed only by PCR. Data regarding 10 respiratory symptoms were collected with each sample. RESULTS By any method 37 specimens were positive for a respiratory virus; 34 were positive by PCR, 15 by culture, and 6 by FA. Four specimens were positive by all 3 methods (3 RSV, 1 FluA). One specimen was positive for PIV1, and 2 were positive for rhinovirus by culture alone. Specimens positive by PCR alone included 2 RSV, 2 PIV1, 8 PIV3, and 8 MPV. In 10 specimens positive for RSV, PIV, or influenza virus collected from patients reporting no respiratory symptoms, 9, 4, and 1 specimen were positive by PCR, culture, and FA, respectively. Overall, specimens positive only by PCR had significantly fewer viral copies/mL (mean log(10)=4.32) than specimens positive by both PCR and culture (mean log(10)=5.75; P=0.002) or PCR and FA (mean log(10)=6.83; P<0.001). CONCLUSIONS FA testing alone did not detect a significant proportion of respiratory virus-positive samples in HCT recipients, especially in patients with no respiratory symptoms and patients with PIV detection. PCR increased the yield of positive specimens 2 times relative to culture and more than 4 times relative to FA. Detection of respiratory viruses by PCR alone was associated with lower virus quantities and with fewer reported respiratory symptoms compared with concomitant detection by both PCR and conventional methods, indicating that PCR may be important to detect asymptomatic or mildly symptomatic stages of respiratory viral infections.
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Gurunathan S, Habib RE, Baglyos L, Meric C, Plotkin S, Dodet B, Corey L, Tartaglia J. Use of predictive markers of HIV disease progression in vaccine trials. Vaccine 2009; 27:1997-2015. [DOI: 10.1016/j.vaccine.2009.01.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 12/19/2008] [Accepted: 01/08/2009] [Indexed: 10/21/2022]
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Milano F, Campbell A, Kuypers J, Englund J, Callais C, Corey L, Boeckh M. Human Coronavirus (HCOV) and Rhinovirus (HRHV) Infection among Hematopoietic Stem Cell Transplantation (HCT) Recipients. Biol Blood Marrow Transplant 2009. [PMCID: PMC7129590 DOI: 10.1016/j.bbmt.2008.12.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Boeckh M, Nichols G, Chemaly R, Papanicolaou G, Wingard J, Kirby K, Dahlgren C, Corey L, Leisenring W. 75: Prevention of Late CMV Disease After HCT: A Randomized Double-Blind Multicenter Trial of Valganciclovir (VGCV) Prophylaxis Versus PCR-guided GCV/VGCV Preemptive Therapy. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sandhu R, Smith J, Kirby K, Heimfeld S, Corey L, Boeckh M. 80: Primary CMV Infection in CMV Seronegative Recipients of a Stem Cell Product from a Seropositive Donor (D+/R-): Frequency of and Risk Factors for Transmission. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hakki M, Limaye AP, Kim HW, Kirby KA, Corey L, Boeckh M. Invasive Pseudomonas aeruginosa infections: high rate of recurrence and mortality after hematopoietic cell transplantation. Bone Marrow Transplant 2007; 39:687-93. [PMID: 17401395 DOI: 10.1038/sj.bmt.1705653] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Limited data exist regarding the incidence and factors associated with outcome of invasive Pseudomonal infections in hematopoietic cell transplant (HCT). A retrospective analysis of cases of invasive Pseudomonas aeruginosa infection and factors associated with outcome was performed. P. aeruginosa invasive infection occurred in 95 of 5772 patients (1.65%) a median of 63 days after HCT (range 5-1435). Only 28% of infections occurred during periods of neutropenia (absolute neutrophil count<500 cells/mm(3)). Infection-attributable mortality during the initial episode of infection was 35.8%. Factors associated with initial mortality included the presence of a copathogen and high-dose steroid use. Ten (16.4%) of those who survived the initial infection experienced a recurrence of P. aeruginosa infection at a median of 9 days (range 3-17) after stopping antibiotics and 60% of those died as a result of recurrent infection a median of 1 day (range 1-7) after onset of recurrence. Grade 3-4 graft-versus-host disease was associated with a higher risk of recurrent infection. The risk of recurrence was not influenced by the presence of copathogens. Thus, invasive P. aeruginosa infections are associated with high recurrence rates and mortality in this immunocompromised population. Aggressive attempts to reduce immunosuppression and to treat copathogens may help during the initial infection.
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Vu D, Peck A, Nichols G, Varley C, Englund J, Corey L, Boeckh M. OSELTAMIVIR PROPHYLAXIIS IN HEMATOPOIETIC STEM CELL TRANSPLANTATION RECIPIENTS: A CASE-CONTROL STUDY. J Investig Med 2007. [DOI: 10.1097/00042871-200701010-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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