1
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Gergen M, Hewitt A, Sanger CB, Striker R. Monitoring immune recovery on HIV therapy: critical, helpful, or waste of money in the current era? AIDS 2024; 38:937-943. [PMID: 38310348 PMCID: PMC11064897 DOI: 10.1097/qad.0000000000003850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Affiliation(s)
| | | | - Cristina B. Sanger
- Department of Surgery
- Department of Surgery, W. S. Middleton Memorial Veterans’ Hospital, Madison, WI, USA
| | - Rob Striker
- Division of Infectious Diseases, Department of Medicine, University of Wisconsin School of Medicine and Public Health
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2
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Morando N, Rosenzvit MC, Pando MA, Allmer J. The Role of MicroRNAs in HIV Infection. Genes (Basel) 2024; 15:574. [PMID: 38790203 PMCID: PMC11120859 DOI: 10.3390/genes15050574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
MicroRNAs (miRNAs), a class of small, non-coding RNAs, play a pivotal role in regulating gene expression at the post-transcriptional level. These regulatory molecules are integral to many biological processes and have been implicated in the pathogenesis of various diseases, including Human Immunodeficiency Virus (HIV) infection. This review aims to cover the current understanding of the multifaceted roles miRNAs assume in the context of HIV infection and pathogenesis. The discourse is structured around three primary focal points: (i) elucidation of the mechanisms through which miRNAs regulate HIV replication, encompassing both direct targeting of viral transcripts and indirect modulation of host factors critical for viral replication; (ii) examination of the modulation of miRNA expression by HIV, mediated through either viral proteins or the activation of cellular pathways consequent to viral infection; and (iii) assessment of the impact of miRNAs on the immune response and the progression of disease in HIV-infected individuals. Further, this review delves into the potential utility of miRNAs as biomarkers and therapeutic agents in HIV infection, underscoring the challenges and prospects inherent to this line of inquiry. The synthesis of current evidence positions miRNAs as significant modulators of the host-virus interplay, offering promising avenues for enhancing the diagnosis, treatment, and prevention of HIV infection.
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Affiliation(s)
- Nicolas Morando
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Universidad de Buenos Aires, Buenos Aires 1121, Argentina; (N.M.); (M.A.P.)
| | - Mara Cecilia Rosenzvit
- Departamento de Microbiología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires 1121, Argentina;
- Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM, UBA-CONICET), Universidad de Buenos Aires, Buenos Aires 1121, Argentina
| | - Maria A. Pando
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Universidad de Buenos Aires, Buenos Aires 1121, Argentina; (N.M.); (M.A.P.)
| | - Jens Allmer
- Medical Informatics and Bioinformatics, Institute for Measurement Engineering and Sensor Technology, Hochschule Ruhr West, University of Applied Sciences, 45479 Mülheim an der Ruhr, Germany
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3
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Cotugno N, Neri A, Sanna M, Santilli V, Manno EC, Pascucci GR, Morrocchi E, Amodio D, Ruggiero A, Ciofi degl Atti ML, Barneschi I, Grappi S, Cocchi I, Giacomet V, Trabattoni D, Olivieri G, Bernardi S, O’Connor D, Montomoli E, Pollard AJ, Palma P. Children with perinatally acquired HIV exhibit distinct immune responses to 4CMenB vaccine. JCI Insight 2024; 9:e177182. [PMID: 38775152 PMCID: PMC11141905 DOI: 10.1172/jci.insight.177182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/05/2024] [Indexed: 06/02/2024] Open
Abstract
Children with perinatally acquired HIV (PHIV) have special vaccination needs, as they make suboptimal immune responses. Here, we evaluated safety and immunogenicity of 2 doses of 4-component group B meningococcal vaccine in antiretroviral therapy-treated children with PHIV and healthy controls (HCs). Assessments included the standard human serum bactericidal antibody (hSBA) assay and measurement of IgG titers against capsular group B Neisseria meningitidis antigens (fHbp, NHBA, NadA). The B cell compartment and vaccine-induced antigen-specific (fHbp+) B cells were investigated by flow cytometry, and gene expression was investigated by multiplexed real-time PCR. A good safety and immunogenicity profile was shown in both groups; however, PHIV demonstrated a reduced immunogenicity compared with HCs. Additionally, PHIV showed a reduced frequency of fHbp+ and an altered B cell subset distribution, with higher fHbp+ frequency in activated memory and tissue-like memory B cells. Gene expression analyses on these cells revealed distinct mechanisms between PHIV and HC seroconverters. Overall, these data suggest that PHIV presents a diverse immune signature following vaccination. The impact of such perturbation on long-term maintenance of vaccine-induced immunity should be further evaluated in vulnerable populations, such as people with PHIV.
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Affiliation(s)
- Nicola Cotugno
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine and
| | - Alessia Neri
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome “Tor Vergata,” Rome, Italy
| | - Marco Sanna
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Veronica Santilli
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Emma Concetta Manno
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giuseppe Rubens Pascucci
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome “Tor Vergata,” Rome, Italy
| | - Elena Morrocchi
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Donato Amodio
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine and
| | - Alessandra Ruggiero
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Marta Luisa Ciofi degl Atti
- Unit of Epidemiology, Clinical Pathways and Clinical Risk, Medical Direction, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | | | - Ilaria Cocchi
- Paediatric Infectious Disease Unit, “Luigi Sacco” Hospital, and
| | - Vania Giacomet
- Paediatric Infectious Disease Unit, “Luigi Sacco” Hospital, and
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Giulio Olivieri
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome “Tor Vergata,” Rome, Italy
| | - Stefania Bernardi
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Daniel O’Connor
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Emanuele Montomoli
- VisMederi Life Sciences Srl, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Paolo Palma
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine and
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4
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Airola C, Andaloro S, Gasbarrini A, Ponziani FR. Vaccine Responses in Patients with Liver Cirrhosis: From the Immune System to the Gut Microbiota. Vaccines (Basel) 2024; 12:349. [PMID: 38675732 PMCID: PMC11054513 DOI: 10.3390/vaccines12040349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/11/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Vaccines prevent a significant number of deaths annually. However, certain populations do not respond adequately to vaccination due to impaired immune systems. Cirrhosis, a condition marked by a profound disruption of immunity, impairs the normal immunization process. Critical vaccines for cirrhotic patients, such as the hepatitis A virus (HAV), hepatitis B virus (HBV), influenza, pneumococcal, and coronavirus disease 19 (COVID-19), often elicit suboptimal responses in these individuals. The humoral response, essential for immunization, is less effective in cirrhosis due to a decline in B memory cells and an increase in plasma blasts, which interfere with the creation of a long-lasting response to antigen vaccination. Additionally, some T cell subtypes exhibit reduced activation in cirrhosis. Nonetheless, the persistence of memory T cell activity, while not preventing infections, may help to attenuate the severity of diseases in these patients. Alongside that, the impairment of innate immunity, particularly in dendritic cells (DCs), prevents the normal priming of adaptive immunity, interrupting the immunization process at its onset. Furthermore, cirrhosis disrupts the gut-liver axis balance, causing dysbiosis, reduced production of short-chain fatty acids (SCFAs), increased intestinal permeability, and bacterial translocation. Undermining the physiological activity of the immune system, these alterations could impact the vaccine response. Enhancing the understanding of the molecular and cellular factors contributing to impaired vaccination responses in cirrhotic patients is crucial for improving vaccine efficacy in this population and developing better prevention strategies.
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Affiliation(s)
- Carlo Airola
- Liver Unit, CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (C.A.); (S.A.); (A.G.)
| | - Silvia Andaloro
- Liver Unit, CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (C.A.); (S.A.); (A.G.)
| | - Antonio Gasbarrini
- Liver Unit, CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (C.A.); (S.A.); (A.G.)
- Department of Translational Medicine and Surgery, Catholic University, 00168 Rome, Italy
| | - Francesca Romana Ponziani
- Liver Unit, CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (C.A.); (S.A.); (A.G.)
- Department of Translational Medicine and Surgery, Catholic University, 00168 Rome, Italy
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5
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Höft MA, Burgers WA, Riou C. The immune response to SARS-CoV-2 in people with HIV. Cell Mol Immunol 2024; 21:184-196. [PMID: 37821620 PMCID: PMC10806256 DOI: 10.1038/s41423-023-01087-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
This review examines the intersection of the HIV and SARS-CoV-2 pandemics. People with HIV (PWH) are a heterogeneous group that differ in their degree of immune suppression, immune reconstitution, and viral control. While COVID-19 in those with well-controlled HIV infection poses no greater risk than that for HIV-uninfected individuals, people with advanced HIV disease are more vulnerable to poor COVID-19 outcomes. COVID-19 vaccines are effective and well tolerated in the majority of PWH, though reduced vaccine efficacy, breakthrough infections and faster waning of vaccine effectiveness have been demonstrated in PWH. This is likely a result of suboptimal humoral and cellular immune responses after vaccination. People with advanced HIV may also experience prolonged infection that may give rise to new epidemiologically significant variants, but initiation or resumption of antiretroviral therapy (ART) can effectively clear persistent infection. COVID-19 vaccine guidelines reflect these increased risks and recommend prioritization for vaccination and additional booster doses for PWH who are moderately to severely immunocompromised. We recommend continued research and monitoring of PWH with SARS-CoV-2 infection, especially in areas with a high HIV burden.
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Affiliation(s)
- Maxine A Höft
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Wendy A Burgers
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa.
| | - Catherine Riou
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa.
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6
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Engels D, Havla J, Förderreuther S, Kümpfel T. Therapy challenges for NMOSD in a patient with HIV. Mult Scler 2023; 29:1872-1875. [PMID: 37712413 PMCID: PMC10687800 DOI: 10.1177/13524585231199022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023]
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) in people living with HIV (PLWH) is rare and its management can be difficult. Here we report a case of an HIV patient with bilateral vision loss, who was diagnosed with AQP4-IgG-positive NMOSD in 2020 during the COVID-19 pandemic. Rituximab treatment was initiated after attack therapy with corticosteroids and plasma exchange. NMOSD and HIV disease remained stable, but SARS-CoV-2 immune response after repeated vaccinations was insufficient. After switching immunotherapy due to the lack of vaccination response to satralizumab, peripheral B cells reoccurred and a humoral immune response was observed after reapplication of SARS-CoV-2 vaccination. This case illustrates the challenges associated with the treatment of NMOSD in PLWH.
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Affiliation(s)
- Daniel Engels
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany
| | | | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany
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7
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Nunes MC, Tamblyn A, Jose L, Ntsimane M, Lerotholi N, Machimana C, Taylor A, Laher F, Madhi SA. Immunogenicity of tetanus, diphtheria and acellular pertussis vaccination among pregnant women living with and without HIV. AIDS 2023; 37:2305-2310. [PMID: 37773052 PMCID: PMC10653295 DOI: 10.1097/qad.0000000000003731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/11/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE Vaccination during pregnancy with tetanus-diphtheria-acellular pertussis (Tdap) vaccine is recommended to protect the young infants against pertussis. There is a paucity of data on immune responses to Tdap in pregnant women with HIV (PWWH), and its impact on the protection of their infants has not been described. METHODS In an open label phase IV clinical trial in South Africa, we evaluated the immunogenicity and safety of Tdap in PWWH compared with HIV-uninfected women. Antigen-specific immunoglobulin G (IgG) to pertussis toxoid, filamentous haemagglutinin, pertactin, fimbriae, diphtheria and tetanus were measured by electrochemiluminescence-based multiplex assay. RESULTS Overall, 91 PWWH and 136 HIV-uninfected pregnant women were enrolled. All PWWH were on antiretroviral treatment and 94.5% had HIV viral loads <40 copies per millilitre. Antibody levels prevaccination were lower among PWWH compared with HIV-uninfected women for all antigens. At 1 month postvaccination PWWH compared with HIV-uninfected women had lower fold-increase and antibody concentrations for all epitopes. Also, a lower proportion of PWWH achieved ≥4-fold increase from pre to postvaccination for pertussis toxoid and pertactin, or diphtheria IgG levels ≥0.1 IU/ml and ≥1 IU/ml postvaccination. Adverse events postvaccination were similar in PWWH and HIV-uninfected. CONCLUSION Tdap vaccination was safe and immunogenic. PWHW had, however, attenuated humoral immune responses, which could affect the effectiveness of protecting their infants against pertussis compared with those born to women without HIV.ClinicalTrials.gov identifier: NCT05264662.
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Affiliation(s)
- Marta C. Nunes
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon and Centre International de Recherche en Infectiologie (CIRI), Équipe Santé publique, épidémiologie et écologie évolutive des maladies infectieuses (PHE3ID), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Amy Tamblyn
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Lisa Jose
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Mathapelo Ntsimane
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Ntoetse Lerotholi
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Charmaine Machimana
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Ashleigh Taylor
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Farzanah Laher
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
| | - Shabir A. Madhi
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences
- Wits Infectious Diseases and Oncology Research Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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8
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Vanetti C, Milazzo L, Ardizzone F, Oreni L, Cappelletti G, Trabattoni D, Biasin M. Humoral and Cellular Immune Response Elicited by Two Doses of mRNA BNT162b2 Vaccine Against SARS-CoV-2 in People Living with HIV. AIDS Res Hum Retroviruses 2023; 39:495-499. [PMID: 37031355 DOI: 10.1089/aid.2022.0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023] Open
Abstract
At present, whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines can elicit robust humoral and cellular immune responses in people living with HIV (PLWH) is still controversial. We assessed humoral and cellular immune response after the administration of the BNT162b2-mRNA-vaccine in seven antiretroviral therapy-treated PLWH patients and in nine HIV-negative health care workers (PWOH) over a 3-month span of time from the first vaccine dose. The neutralizing activity against both the European and the Delta variants declined after 3 months equally in both PLWH and PWOH. The gene expression analysis of factors involved in the antiviral immune response did not show any significant difference between PLWH and PWOH; among circulating cytokines/chemokines, a progressive decline was observed in the mean values of IL-1β, IL-5, IL-6, IL-13, and IL-15 in both PLWH and PWOH. Conversely, the ratio between naive and terminally differentiated T-CD4+ effector memory showed a reduction trend over time in PLWH. Our findings showed no significant differences in the ability to mount an immune response after the administration of two SARS-CoV-2 mRNA BNT162b2 doses in PLWH and PWOH. However, as BNT162b2 vaccinated PLWH display an early waning immunity in the T cell compartment, the administration of a booster dose may be necessary to maintain a SARS-CoV-2-specific immune response.
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Affiliation(s)
- Claudia Vanetti
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Laura Milazzo
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Infectious Diseases, L. Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Francesco Ardizzone
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Letizia Oreni
- Department of Infectious Diseases, L. Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Gioia Cappelletti
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
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9
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Vaid A, Rastogi N, Doherty TM, San Martin P, Chugh Y. Review of the unmet medical need for vaccination in adults with immunocompromising conditions: An Indian perspective. Hum Vaccin Immunother 2023; 19:2224186. [PMID: 37402477 DOI: 10.1080/21645515.2023.2224186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 07/06/2023] Open
Abstract
Immunocompromised (IC) populations are at increased risk of vaccine-preventable diseases (VPDs). In India, the concern of VPDs in IC populations is particularly acute due to the prevalence of crowded living situations, poor sanitation and variable access to healthcare services. We present a narrative review of IC-related disease and economic burden, risk of VPDs and vaccination guidelines, based on global and India-specific literature (2000-2022). IC conditions considered were cancer, diabetes mellitus, chronic kidney disease, respiratory disorders, disorders treated with immunosuppressive therapy, and human immune deficiency virus (HIV). The burden of IC populations in India is comparable to the global population, except for cancer and HIV, which have lower prevalence compared with the global average. Regional and socioeconomic inequalities exist in IC prevalence; VPDs add to the burden of IC conditions, especially in lower income strata. Adult vaccination programs could improve health and reduce the economic impact of VPDs in IC populations.
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Affiliation(s)
- Ashok Vaid
- Medical Oncology and Hematology, Medanta Cancer Institute, Gurugram, India
| | - Neha Rastogi
- Pediatric Hematology, Oncology and BMT, Medanta Cancer Institute, Gurugram, India
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10
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Teles MS, Lushniak S, Chiang TPY, Bailey JR, Gebo KA, Karaba AH, Durand CM, Segev DL, Connolly CM, Werbel WA. Immunogenicity and Reactogenicity Following 2- and 3-Dose SARS-CoV-2 Vaccination in Persons With HIV. J Acquir Immune Defic Syndr 2023; 92:e3-e6. [PMID: 36476571 PMCID: PMC9743179 DOI: 10.1097/qai.0000000000003112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Mayan S. Teles
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stephanie Lushniak
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Teresa Po-Yu Chiang
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Justin R. Bailey
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kelly A. Gebo
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Andrew H. Karaba
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christine M. Durand
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
- Department of Surgery, NYU Grossman School of Medicine, New York, NY
| | - Caoilfhionn M. Connolly
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - William A. Werbel
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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11
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Abstract
Invasive fungal infections are emerging diseases that kill over 1.5 million people per year worldwide. With the increase of immunocompromised populations, the incidence of invasive fungal infections is expected to continue to rise. Vaccines for viral and bacterial infectious diseases have had a transformative impact on human health worldwide. However, no fungal vaccines are currently in clinical use. Recently, interest in fungal vaccines has grown significantly. One Candida vaccine has completed phase 2 clinical trials, and research on vaccines against coccidioidomycosis continues to advance. Additionally, multiple groups have discovered various Cryptococcus mutant strains that promote protective responses to subsequent challenge in mouse models. There has also been progress in antibody-mediated fungal vaccines. In this review, we highlight recent fungal vaccine research progress, outline the wealth of data generated, and summarize current research for both fungal biology and immunology studies relevant to fungal vaccine development. We also review technological advancements in vaccine development and highlight the future prospects of a human vaccine against invasive fungal infections.
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Affiliation(s)
- Amariliz Rivera
- Department of Pediatrics and Center for Immunity and Inflammation, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA;
| | - Jennifer Lodge
- Department of Molecular Microbiology, Washington University in St. Louis, St. Louis, Missouri, USA
- Current affiliation: Department of Molecular Genetics and Microbiology, Duke University, Durham, North Carolina, USA;
| | - Chaoyang Xue
- Public Health Research Institute and Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA;
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12
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Kusejko K, Chammartin F, Smith D, Odermatt M, Schuhmacher J, Koller M, Günthard HF, Briel M, Bucher HC, Speich B. Developing and testing a Corona VaccinE tRiAL pLatform (COVERALL) to study Covid-19 vaccine response in immunocompromised patients. BMC Infect Dis 2022; 22:654. [PMID: 35902817 PMCID: PMC9330973 DOI: 10.1186/s12879-022-07621-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rapid course of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic calls for fast implementation of clinical trials to assess the effects of new treatment and prophylactic interventions. Building trial platforms embedded in existing data infrastructures is an ideal way to address such questions within well-defined subpopulations. METHODS We developed a trial platform building on the infrastructure of two established national cohort studies: the Swiss human immunodeficiency virus (HIV) Cohort Study (SHCS) and Swiss Transplant Cohort Study (STCS). In a pilot trial, termed Corona VaccinE tRiAL pLatform (COVERALL), we assessed the vaccine efficacy of the first two licensed SARS-CoV-2 vaccines in Switzerland and the functionality of the trial platform. RESULTS Using Research Electronic Data Capture (REDCap), we developed a trial platform integrating the infrastructure of the SHCS and STCS. An algorithm identifying eligible patients, as well as baseline data transfer ensured a fast inclusion procedure for eligible patients. We implemented convenient re-directions between the different data entry systems to ensure intuitive data entry for the participating study personnel. The trial platform, including a randomization algorithm ensuring balance among different subgroups, was continuously adapted to changing guidelines concerning vaccination policies. We were able to randomize and vaccinate the first trial participant the same day we received ethics approval. Time to enroll and randomize our target sample size of 380 patients was 22 days. CONCLUSION Taking the best of each system, we were able to flag eligible patients, transfer patient information automatically, randomize and enroll the patients in an easy workflow, decreasing the administrative burden usually associated with a trial of this size.
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Affiliation(s)
- Katharina Kusejko
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland. .,Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
| | - Frédérique Chammartin
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Daniel Smith
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Marc Odermatt
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Julian Schuhmacher
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Michael Koller
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Huldrych F Günthard
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland.,Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Matthias Briel
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Heiner C Bucher
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Benjamin Speich
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.,Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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13
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Pandey D, Mehta G, Sachdeva M, Tripathi R. Adverse Event Following Immunization (AEFI) in Children: An Analysis of Reporting in VigiAccess. Drug Res (Stuttg) 2022; 72:435-440. [PMID: 35724674 DOI: 10.1055/a-1852-5335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION It is an indubitable fact that vaccination has been instrumental in the eradication and prevention of the deadliest diseases worldwide. Continuous vaccine safety surveillance is helpful to counter the negative perception and thus allay the fear of Adverse Events Following Immunization (AEFI) in the general public. VigiAccess, the WHO global database of reported side effects of medicinal products, can be accessed by the public at large. The objective of this study is to assess the characteristics of AEFIs of the commonly used vaccines in children in VigiAccess. MATERIALS AND METHODS VigiAccess was thoroughly explored for the categories, number, and types of AEFIs of commonly used vaccines among children that are reported in five continents between 2011 and 2021. RESULTS After a comprehensive analysis in VigiAccess, 27 kinds of AEFIs were discovered. For the nine vaccines, a total of 1,412,339 AEFIs were found. The most prevalent AEFIs were general disorder and administration site condition (436,199 or 30%). The majority of AEFIs are found in America, with Europe, Oceania, Asia, and Africa following closely behind. Girls of age from 27 days to 23 months had the highest number of AEFIs. The highest number of AEFIs was recorded in the year 2018. CONCLUSION America has the maximum, whilst Africa has the least AEFI. Few AEFIs were caused by the measles vaccination, while the majority were related to the general disorder and administration site condition. Data synchronization in VigiAccess needs to be enhanced to improve its dependability.
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Affiliation(s)
- Diksha Pandey
- Department of Pharmacology, Raj Kumar Goel Institute of Technology (Pharmacy), Ghaziabad, Uttar Pradesh, India
| | - Geetika Mehta
- Department of Pharmacology, Raj Kumar Goel Institute of Technology (Pharmacy), Ghaziabad, Uttar Pradesh, India
| | - Monika Sachdeva
- Department of Pharmacology, Raj Kumar Goel Institute of Technology (Pharmacy), Ghaziabad, Uttar Pradesh, India
| | - Rashmi Tripathi
- Department of Pharmacology, Raj Kumar Goel Institute of Technology (Pharmacy), Ghaziabad, Uttar Pradesh, India
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14
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González de Aledo M, Cañizares A, Vázquez-Rodríguez P, Castro Á, Moldes L, López S, Míguez E, Bou G, Mena Á. Safety and Immunogenicity of SARS-CoV-2 vaccines in people with HIV. AIDS 2022; 36:691-695. [PMID: 34999608 DOI: 10.1097/qad.0000000000003161] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the safety and the serological response after two doses of mRNA-based SARS-CoV-2 vaccination in people with HIV (PWH). METHODS Participants were evaluated 4 weeks after the second dose of mRNA-1273 or BNT162b2 vaccine. Tolerability was evaluated with a specific adverse event questionnaire. Patient's sera were analysed using LIAISON SARS-CoV-2 TrimericS IgG (DiaSorin). RESULTS One-hundred PWH were included, 75% of them men, with a mean age of 44 ± 11 years old, all receiving antiretroviral treatment and mostly with controlled viral loads (98% with HIV RNA <50 copies/ml) and 96% had >200 CD4+/μl. All patients seroconverted after vaccination (antibody concentration ≥33.8 binding antibody units [BAU]/ml). Only 3% of the patients had a low antibody concentration (<520 BAU/ml), whereas 67% of them had concentrations above the assay's detection range (>2080 BAU/ml). Fifty-six patients had local or systemic symptoms, with mild arthromyalgia being the most common systemic symptom. No severe adverse events were reported. CONCLUSIONS Vaccination with two doses of mRNA-1273 or BNT162b2 is well tolerated in PWH under effective antiretroviral treatment and it leads to a successful antibody response.
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Affiliation(s)
| | - Angelina Cañizares
- Servicio de Microbiología, Complejo Hospitalario Universitario de A Coruña (CHUAC)
| | - Pilar Vázquez-Rodríguez
- Grupo de Virología Clínica, Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidad de A Coruña (UDC)
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna
| | - Ángeles Castro
- Grupo de Virología Clínica, Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidad de A Coruña (UDC)
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna
| | - Luz Moldes
- Servicio de Microbiología, Complejo Hospitalario Universitario de A Coruña (CHUAC)
| | - Soledad López
- Grupo de Virología Clínica, Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidad de A Coruña (UDC)
- Servicio de Medicina Interna
| | - Enrique Míguez
- Grupo de Virología Clínica, Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidad de A Coruña (UDC)
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna
| | - Germán Bou
- Servicio de Microbiología, Complejo Hospitalario Universitario de A Coruña (CHUAC)
| | - Álvaro Mena
- Grupo de Virología Clínica, Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidad de A Coruña (UDC)
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna
- Biobanco de A Coruña, Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Spain
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15
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Feng Y, Zhang Y, He Z, Huang H, Tian X, Wang G, Chen D, Ren Y, Jia L, Wang W, Wu J, Shao L, Zhang W, Tang H, Wan Y. Immunogenicity of an inactivated SARS-CoV-2 vaccine in people living with HIV-1: a non-randomized cohort study. EClinicalMedicine 2022; 43:101226. [PMID: 34901799 PMCID: PMC8642727 DOI: 10.1016/j.eclinm.2021.101226] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/14/2021] [Accepted: 11/19/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Inactivated COVID-19 vaccines are safe and effective in the general population with intact immunity. However, their safety and immunogenicity have not been demonstrated in people living with HIV (PLWH). METHODS 42 HIV-1 infected individuals who were stable on combination antiretroviral therapy (cART) and 28 healthy individuals were enrolled in this open-label two-arm non-randomized study at Hubei Provincial Center for Disease Control and Prevention, China. Two doses of an inactivated COVID-19 vaccine (BBIBP-CorV) were given on April 22, 2021 and May 25, 2021, respectively. The reactogenicity of the vaccine were evaluated by observing clinical adverse events and solicited local and systemic reactions. Humoral responses were measured by anti-spike IgG ELISA and surrogate neutralization assays. Cell-mediated immune responses and vaccine induced T cell activation were measured by flow cytometry. FINDINGS All the HIV-1 infected participants had a CD4+ T cell count >200 cells/μL both at baseline (659·0 ± 221·9 cells/μL) and 4 weeks after vaccination (476·9 ± 150·8 cells/μL). No solicited adverse reaction was observed among all participants. Similar binding antibody, neutralizing antibody and S protein specific T cell responses were elicited in PLWH and healthy individuals. PLWH with low baseline CD4+/CD8+ T cell ratios (<0·6) generated lower antibody responses after vaccination than PLWH with medium (0·6∼1·0) or high (≥1·0) baseline CD4+/CD8+ T cell ratios (P<0·01). The CD3+, CD4+ and CD8+ T cell counts of PLWH decreased significantly after vaccination (P<0·0001), but it did not lead to any adverse clinical manifestation. Moreover, we found that the general HIV-1 viral load among the PLWH cohort decreased significantly after vaccination (P=0·0192). The alteration of HIV-1 viral load was not significantly associated with the vaccine induced CD4+ T cell activation (P>0·2). INTERPRETATION Our data demonstrated that the inactivated SARS-CoV-2 vaccine was safe, immunogenic in PLWH who are stable on cART with suppressed viral load and CD4+ T cell count > 200 cells/μL. However, the persistence of the vaccine-induced immunities in PLWH need to be further investigated.
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Affiliation(s)
- Yanmeng Feng
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430065, China
| | - Yifan Zhang
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou 450052, China
- Department of laboratory medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Zhangyufan He
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
- Department of laboratory medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Haojie Huang
- Wuhan Pioneer Social Work Service Center, Wuhan 430071, China
| | - Xiangxiang Tian
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou 450052, China
- Department of laboratory medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Gang Wang
- Department of laboratory medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Daihong Chen
- Department of laboratory medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Yanqin Ren
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
| | - Liqiu Jia
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
| | - Wanhai Wang
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou 450052, China
| | - Jing Wu
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
| | - Lingyun Shao
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
| | - Wenhong Zhang
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
- Key Laboratory of Medical Molecular Virology (MOE/MOH) and Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai 200438, China
- National Clinical Research Centre for Aging & Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Heng Tang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430065, China
- Correspondence should be addressed to: Heng Tang, Yanmin Wan
| | - Yanmin Wan
- Department of Infectious Disease of Huashan Hospital, National Medical Center for Infectious Diseases and Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Fudan University, Shanghai 200040, China
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai 200438, China
- Department of radiology, Shanghai Public Health Clinical Center, Shanghai 201508, China
- Correspondence should be addressed to: Heng Tang, Yanmin Wan
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16
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Costiniuk CT, Singer J, Langlois MA, Kulic I, Needham J, Burchell A, Jenabian MA, Walmsley S, Ostrowski M, Kovacs C, Tan D, Harris M, Hull M, Brumme Z, Brockman M, Margolese S, Mandarino E, Angel JB, Routy JP, Anis AH, Cooper C. CTN 328: immunogenicity outcomes in people living with HIV in Canada following vaccination for COVID-19 (HIV-COV): protocol for an observational cohort study. BMJ Open 2021; 11:e054208. [PMID: 34916326 PMCID: PMC8678543 DOI: 10.1136/bmjopen-2021-054208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 11/25/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Most existing vaccines require higher or additional doses or adjuvants to provide similar protection for people living with HIV (PLWH) compared with HIV-uninfected individuals. Additional research is necessary to inform COVID-19 vaccine use in PLWH. METHODS AND ANALYSIS This multicentred observational Canadian cohort study will enrol 400 PLWH aged >16 years from Montreal, Ottawa, Toronto and Vancouver. Subpopulations of PLWH of interest will include individuals: (1) >55 years of age; (2) with CD4 counts <350 cells/mm3; (3) with multimorbidity (>2 comorbidities) and (4) 'stable' or 'reference' PLWH (CD4 T cells >350 cells/mm3, suppressed viral load for >6 months and <1 comorbidity). Data for 1000 HIV-negative controls will be obtained via a parallel cohort study (Stop the Spread Ottawa), using similar time points and methods. Participants receiving >1 COVID-19 vaccine will attend five visits: prevaccination; 1 month following the first vaccine dose; and at 3, 6 and 12 months following the second vaccine dose. The primary end point will be the percentage of PLWH with COVID-19-specific antibodies at 6 months following the second vaccine dose. Humoral and cell-mediated immune responses, and the interplay between T cell phenotypes and inflammatory markers, will be described. Regression techniques will be used to compare COVID-19-specific immune responses to determine whether there are differences between the 'unstable' PLWH group (CD4 <350 cells/mm3), the stable PLWH cohort and the HIV-negative controls, adjusting for factors believed to be associated with immune response. Unadjusted analyses will reveal whether there are differences in driving factors associated with group membership. ETHICS AND DISSEMINATION Research ethics boards at all participating institutions have granted ethics approval for this study. Written informed consent will be obtained from all study participants prior to enrolment. The findings will inform the design of future COVID-19 clinical trials, dosing strategies aimed to improve immune responses and guideline development for PLWH. TRIAL REGISTRATION NUMBER NCT04894448.
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Affiliation(s)
- Cecilia T Costiniuk
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre; Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada
| | - Joel Singer
- Canadian Institutes of Health Research (CIHR)--Canadian HIV Trials Network and Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marc-André Langlois
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Iva Kulic
- Canadian Institutes of Health Research (CIHR)--Canadian HIV Trials Network and Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Judy Needham
- Canadian Institutes of Health Research (CIHR)--Canadian HIV Trials Network and Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Ann Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Ontario, Canada
| | - Mohammad-Ali Jenabian
- Department of Biological Sciences and CERMO-FC Research Centre, Université du Québec à Montréal (UQAM), Montreal, Quebec, Canada
| | - Sharon Walmsley
- Department of Medicine, Division of Infectious Diseases, Toronto General Hospital, Toronto, Ontario, Canada
| | - Mario Ostrowski
- Clinical Sciences Division and Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Colin Kovacs
- Maple Leaf Medical Clinic, Toronto, Ontario, Canada
| | - Darrell Tan
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Montreal, Ontario, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Marianne Harris
- Brisith Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Mark Hull
- Brisith Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Zabrina Brumme
- Brisith Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Mark Brockman
- Brisith Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Shari Margolese
- Community Advisory Committee, CIHR Canadian HIV Trials Network, Vancouver, British Columbia, Canada
| | - Enrico Mandarino
- Community Advisory Committee, CIHR Canadian HIV Trials Network, Vancouver, British Columbia, Canada
| | - Jonathan B Angel
- Department of Medicine, Division of Infectious Diseases, The Ottawa Hospital, The Ottawa Hospital Research Institute and Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jean-Pierre Routy
- Department of Medicine, Division of Hematology and Chronic Viral Illness Service, McGill University Health Centre, Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Aslam H Anis
- Canadian Institutes of Health Research (CIHR)--Canadian HIV Trials Network and Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Curtis Cooper
- Department of Medicine, Division of Infectious Diseases, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Ruddy JA, Boyarsky BJ, Bailey JR, Karaba AH, Garonzik-Wang JM, Segev DL, Durand CM, Werbel WA. Safety and antibody response to two-dose SARS-CoV-2 messenger RNA vaccination in persons with HIV. AIDS 2021; 35:2399-2401. [PMID: 34261097 PMCID: PMC10323870 DOI: 10.1097/qad.0000000000003017] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study of SARS-CoV-2 mRNA vaccination in 14 persons with HIV (PWH) demonstrated uniformly high anti-SARS-CoV-2 receptor binding domain (RBD) antibody titres after two doses, despite varied titres after a single dose. The majority of vaccine reactions were mild and no adverse events occurred.
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Affiliation(s)
- Jake A. Ruddy
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brian J. Boyarsky
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Justin R. Bailey
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrew H. Karaba
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Christine M. Durand
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - William A. Werbel
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Andreoni M, Sticchi L, Nozza S, Sarmati L, Gori A, Tavio M. Recommendations of the Italian society for infectious and tropical diseases (SIMIT) for adult vaccinations. Hum Vaccin Immunother 2021; 17:4265-4282. [PMID: 34524945 PMCID: PMC8828129 DOI: 10.1080/21645515.2021.1971473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 12/14/2022] Open
Abstract
Vaccination prevents 2-3 million deaths worldwide every year. Nevertheless, vaccine-preventable diseases (VPDs) still cause a considerable number of deaths especially in subjects belonging to "risk groups." These are represented by older adults, immunocompromised individuals and all subjects with underlying chronic medical conditions (cardiovascular, pulmonary, renal and liver chronic diseases, diabetes, immunodeficiency disorders). They have a weaker immune system and, if infected, are more likely to develop severe complications of their condition or of the preventable-infectious disease. This document summarizes the recommendations for vaccination of the main Global Institutional Organizations and analyses the risks of comorbidities associated with infectious disease and the benefits of vaccination for each specific group. The document provides a clear, practical and authoritative guide to adult vaccination.
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Affiliation(s)
- Massimo Andreoni
- UOC Infectious diseases Tor Vergata Polyclinic, University Hospital Viale, Rome, Italy
| | - Laura Sticchi
- Hygiene Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Nozza
- Medical Director, San Raffaele Hospital, Milan, Italy
| | - Loredana Sarmati
- UOC Infectious diseases Tor Vergata Polyclinic, University Hospital Viale, Rome, Italy
| | - Andrea Gori
- UOC Infectious Diseases, Irccs Ca’Granda Foundation, Maggiore Policlinico Hospital, Milan, Italy
| | - Marcello Tavio
- UOC Division of Emerging Infectious Diseases and Immunosuppressed, AOU Ospedali Riuniti of Ancona, Ancona, Italy
| | - Society for Infectious and Tropical Diseases (SIMIT)
- UOC Infectious diseases Tor Vergata Polyclinic, University Hospital Viale, Rome, Italy
- Hygiene Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Medical Director, San Raffaele Hospital, Milan, Italy
- UOC Infectious Diseases, Irccs Ca’Granda Foundation, Maggiore Policlinico Hospital, Milan, Italy
- UOC Division of Emerging Infectious Diseases and Immunosuppressed, AOU Ospedali Riuniti of Ancona, Ancona, Italy
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19
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D'Amato S, Pellicanò GF, Nunnari G, Fedele F, Squeri R, Mazzitelli F, D'Andrea F, Maisano D, Squeri R, Genovese C. Management care improvement of people living with HIV: definition of a targeted clinical pathway in a University Hospital of South Italy. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021244. [PMID: 34487078 PMCID: PMC8477122 DOI: 10.23750/abm.v92i4.11425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/20/2021] [Indexed: 12/03/2022]
Abstract
Background and aim: In the world 37,9 billions live with Human Immunodeficiency Virus and, despite the availability of retroviral therapy, they have an higher risk to acquire other infectious diseases and to develop severe complications. According to several guidelines their immunization is crucial but only some center have developed a specific scheduled pathway and vaccination coverage is very low. Aim of this study is: a) incentivize the active and free of charge offer of vaccines and increase of immunization coverage; b) application and implementation of a shared clinical pathway avoiding reluctance, embarrassment or shame by patients for their condition; d) instauration of an empathic relationship between doctor and patient; e) evaluation of side effects. Methods: A prospective study was conducted from October 2019 to February 2020 at the University Hospital G. Martino of Messina. Inclusion criteria were: age over 18; absence of other diseases; absence of immunization against HBV or HAV; CD4 count for live attenuated viral vaccines of 350/uL and for other vaccine 200/uL. A specific scheduled pathway was adopted for every patient. Statistical analysis was performed with Excel software. Results: 86 patients were enrolled (74.4% were males, 79.1% were Italian; mean age=40±13.3 SD). An increase in administration was observed between 2018 and 2019 (+164.3% for flu and for other vaccines +370%). The higher increase was observed for HPV one. No-one received DTpa, MMRV or Zoster vaccine. Conclusions: The undertook clinical pathway showed the relevance of specific management of these patients and the need to increase the vaccination offer. (www.actabiomedica.it)
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Affiliation(s)
- Smeralda D'Amato
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy.
| | | | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - Franco Fedele
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
| | | | - Francesco Mazzitelli
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy.
| | - Flavia D'Andrea
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - Daniele Maisano
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
| | - Raffaele Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
| | - Cristina Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
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Fang F, Zhao J, Ahmed SE, Qu A. A weak‐signal‐assisted procedure for variable selection and statistical inference with an informative subsample. Biometrics 2021. [DOI: 10.1111/biom.13346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Fang Fang
- Key Laboratory of Advanced Theory and Application in Statistics and Data Science ‐ MOE School of Statistics East China Normal University Shanghai China
| | - Jiwei Zhao
- Department of Biostatistics and Medical Informatics University of Wisconsin Madison Wisconsin
| | - S. Ejaz Ahmed
- Faculty of Mathematics and Science Brock University St. Catharines Ontario Canada
| | - Annie Qu
- Department of Statistics University of California Irvine California
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Righi E, Gallo T, Azzini AM, Mazzaferri F, Cordioli M, Merighi M, Tacconelli E. A Review of Vaccinations in Adult Patients with Secondary Immunodeficiency. Infect Dis Ther 2021; 10:637-661. [PMID: 33687662 PMCID: PMC7941364 DOI: 10.1007/s40121-021-00404-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 01/20/2021] [Indexed: 12/29/2022] Open
Abstract
Vaccine-preventable diseases and their related complications are associated with increased morbidity and mortality in patients with altered immunocompetence. Optimised immunisation in this patient population is challenging because of limited data from vaccine trials, suboptimal vaccine efficacy and safety concerns. Reliable efficacy data are lacking among patients with altered immunocompetence, and existing recommendations are mainly based on expert consensus and may vary geographically. Inactivated vaccines can be generally used without risks in this group, but their efficacy may be reduced, and immunisation schedules vary according to local guidelines, age, and type and stage of the underlying disease. Live vaccines, if indicated, should be administered with care because of the risk of vaccine-associated disease. We have reviewed the current evidence on vaccination principles and recommendations in adult patients with secondary immunodeficiencies, including asplenia, HIV infection, stem cell and solid organ transplant, haematological malignancies, inflammatory bowel disease and other chronic disorders.
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Affiliation(s)
- Elda Righi
- Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
- Infectious Diseases, Verona University Hospital, Verona, Italy.
| | - Tolinda Gallo
- Public Health Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Anna Maria Azzini
- Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Infectious Diseases, Verona University Hospital, Verona, Italy
| | | | - Maddalena Cordioli
- Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Infectious Diseases, Verona University Hospital, Verona, Italy
| | - Mara Merighi
- Infectious Diseases, Verona University Hospital, Verona, Italy
| | - Evelina Tacconelli
- Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Infectious Diseases, Verona University Hospital, Verona, Italy
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22
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Drewes J, Langer PC, Ebert J, Kleiber D, Gusy B. Sociodemographic, HIV-Related Characteristics, and Health Care Factors as Predictors of Self-Reported Vaccination Coverage in a Nationwide Sample of People Aging with HIV in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094901. [PMID: 34064514 PMCID: PMC8125659 DOI: 10.3390/ijerph18094901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/16/2022]
Abstract
Preventing infectious diseases through vaccination becomes more significant among the growing population of people aging with HIV. Coverage rates for vaccinations and factors associated with vaccination utilization among this population in Germany are unknown. We assessed the coverage of eight recommended vaccinations in a certain time frame in our convenience sample of 903 people living with HIV aged 50 years and older. We analysed coverage rates and used bivariate and multiple linear regression analyses to identify factors associated with number of reported vaccinations. Coverage rates in our sample ranged between 51.0% for meningococcus disease and 84.6% for the triple vaccination against tetanus, diphtheria, and pertussis. All rates were higher compared to the German general population. Seven factors were related to the number of vaccinations in multiple regression analysis: sexual orientation, education, relationship status, CD4 count, time since last visit to HIV specialist, type of HIV specialist, and distance to HIV specialist. Vaccination coverage among people aging with HIV in Germany is high, but not optimal. To improve vaccination uptake, strengthened efforts need to be focused on female and heterosexual male patients, socioeconomically disadvantaged patients, and patients with barriers to access regular HIV care.
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Affiliation(s)
- Jochen Drewes
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
- Correspondence:
| | - Phil C. Langer
- Department of Social Psychology, International Psychoanalytic University, 10555 Berlin, Germany;
| | - Jennifer Ebert
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
| | - Dieter Kleiber
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
| | - Burkhard Gusy
- Public Health: Prevention and Psychosocial Health Research, Freie Universität Berlin, 14195 Berlin, Germany; (J.E.); (D.K.); (B.G.)
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23
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Efficacy and safety of human papillomavirus vaccination in HIV-infected patients: a systematic review and meta-analysis. Sci Rep 2021; 11:4954. [PMID: 33654181 PMCID: PMC7925667 DOI: 10.1038/s41598-021-83727-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 02/03/2021] [Indexed: 11/09/2022] Open
Abstract
The prophylactic vaccines available to protect against infections by HPV are well tolerated and highly immunogenic. People with HIV have a higher risk of developing HPV infection and HPV-associated cancers due to a lower immune response, and due to viral interactions. We performed a systematic review of RCTs to assess HPV vaccines efficacy and safety on HIV-infected people compared to placebo or no intervention in terms of seroconversion, infections, neoplasms, adverse events, CD4+ T-cell count and HIV viral load. The vaccine-group showed a seroconversion rate close to 100% for each vaccine and a significantly higher level of antibodies against HPV vaccine types, as compared to the placebo group (MD = 4333.3, 95% CI 2701.4; 5965.1 GMT EL.U./ml for HPV type 16 and MD = 1408.8, 95% CI 414.8; 2394.7 GMT EL.U./ml for HPV type 18). There were also no differences in terms of severe adverse events (RR = 0.6, 95% CI 0.2; 1.6) and no severe adverse events (RR = 0.6, 95% CI 0.9; 1.2) between vaccine and placebo groups. Secondary outcomes, such as CD4 + T-cell count and HIV viral load, did not differ between groups (MD = 14.8, 95% CI − 35.1; 64.6 cells/µl and MD = 0.0, 95% CI − 0.3; 0.3 log10 RNA copies/ml, respectively). Information on the remaining outcomes was scarce and that did not allow us to combine the data. The results support the use of the HPV vaccine in HIV-infected patients and highlight the need of further RCTs assessing the effectiveness of the HPV vaccine on infections and neoplasms.
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Thindwa D, Pinsent A, Ojal J, Gallagher KE, French N, Flasche S. Vaccine strategies to reduce the burden of pneumococcal disease in HIV-infected adults in Africa. Expert Rev Vaccines 2020; 19:1085-1092. [PMID: 33269987 PMCID: PMC8315211 DOI: 10.1080/14760584.2020.1843435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Streptococcus pneumoniae is the leading cause of invasive bacterial disease, globally. Despite antiretroviral therapy, adults infected with human immunodeficiency virus (HIV) are also at high risk of pneumococcal carriage and disease. Pneumococcal conjugate vaccines (PCVs) provide effective protection against vaccine serotype (VT) carriage and disease in children, and have been introduced worldwide, including most HIV-affected low- and middle-income countries. Unlike high-income countries, the circulation of VT persists in the PCV era in some low-income countries and results in a continued high burden of pneumococcal disease in HIV-infected adults. Moreover, no routine vaccination that directly protects HIV-infected adults in such settings has been implemented. AREAS COVERED Nonsystematic review on the pneumococcal burden in HIV-infected adults and vaccine strategies to reduce this burden. EXPERT OPINION We propose and discuss the relative merit of changing the infant PCV program to use (1a) a two prime plus booster dose schedule, (1b) a two prime plus booster dose schedule with an additional booster dose at school entry, to directly vaccinate (2a) HIV-infected adults or vaccinating (2b) HIV-infected pregnant women for direct protection, with added indirect protection to the high-risk neonates. We identify key knowledge gaps for such an evaluation and propose strategies to overcome them.
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Affiliation(s)
- Deus Thindwa
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK,Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi,CONTACT Deus Thindwa Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, United Kingdom
| | - Amy Pinsent
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK,Aquarius Population Health, London, UK
| | - John Ojal
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK,Epidemiology and Demography Department, KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine, Coast, Kilifi, Kenya
| | - Katherine E Gallagher
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Neil French
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi,Institute of Infection and Global Health, Department of Clinical Infection, Microbiology, and Immunology, University of Liverpool, Liverpool, UK
| | - Stefan Flasche
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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25
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Harris RC, Sumner T, Knight GM, Zhang H, White RG. Potential impact of tuberculosis vaccines in China, South Africa, and India. Sci Transl Med 2020; 12:eaax4607. [PMID: 33028708 DOI: 10.1126/scitranslmed.aax4607] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 11/12/2019] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
Abstract
More effective tuberculosis vaccines are needed to help reach World Health Organization tuberculosis elimination goals. Insufficient evidence exists on the potential impact of future tuberculosis vaccines with varying characteristics and in different epidemiological settings. To inform vaccine development decision making, we modeled the impact of hypothetical tuberculosis vaccines in three high-burden countries. We calibrated Mycobacterium tuberculosis (M.tb) transmission models to age-stratified demographic and epidemiological data from China, South Africa, and India. We varied vaccine efficacy to prevent infection or disease, effective in persons M.tb uninfected or infected, and duration of protection. We modeled routine early-adolescent vaccination and 10-yearly mass campaigns from 2025. We estimated median percentage population-level tuberculosis incidence rate reduction (IRR) in 2050 compared to a no new vaccine scenario. In all settings, results suggested vaccines preventing disease in M.tb-infected populations would have greatest impact by 2050 (10-year, 70% efficacy against disease, IRR 51%, 52%, and 54% in China, South Africa, and India, respectively). Vaccines preventing reinfection delivered lower potential impact (IRR 1, 12, and 17%). Intermediate impact was predicted for vaccines effective only in uninfected populations, if preventing infection (IRR 21, 37, and 50%) or disease (IRR 19, 36, and 51%), with greater impact in higher-transmission settings. Tuberculosis vaccines have the potential to deliver substantial population-level impact. For prioritizing impact by 2050, vaccine development should focus on preventing disease in M.tb-infected populations. Preventing infection or disease in uninfected populations may be useful in higher transmission settings. As vaccine impact depended on epidemiology, different development strategies may be required.
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Affiliation(s)
- Rebecca C Harris
- TB Modelling Group, TB Centre and Centre for the Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
| | - Tom Sumner
- TB Modelling Group, TB Centre and Centre for the Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Gwenan M Knight
- TB Modelling Group, TB Centre and Centre for the Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Hui Zhang
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Richard G White
- TB Modelling Group, TB Centre and Centre for the Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a global pandemic, prompting unprecedented efforts to contain the virus. Many developed countries have implemented widespread testing and have rapidly mobilized research programmes to develop vaccines and therapeutics. However, these approaches may be impractical in Africa, where the infrastructure for testing is poorly developed and owing to the limited manufacturing capacity to produce pharmaceuticals. Furthermore, a large burden of HIV-1 and tuberculosis in Africa could exacerbate the severity of infection and may affect vaccine immunogenicity. This Review discusses global efforts to develop diagnostics, therapeutics and vaccines, with these considerations in mind. We also highlight vaccine and diagnostic production platforms that are being developed in Africa and that could be translated into clinical development through appropriate partnerships for manufacture. The COVID-19 pandemic has prompted unparalleled progress in the development of vaccines and therapeutics in many countries, but it has also highlighted the vulnerability of resource-limited countries in Africa. Margolin and colleagues review global efforts to develop SARS-CoV-2 diagnostics, therapeutics and vaccines, with a focus on the opportunities and challenges in Africa.
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27
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Johnson TM, Klepser DG, Bares SH, Scarsi KK. Predictors of vaccination rates in people living with HIV followed at a specialty care clinic. Hum Vaccin Immunother 2020; 17:791-796. [PMID: 32881642 DOI: 10.1080/21645515.2020.1802163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
People Living with HIV (PLWH) remain disproportionately susceptible to vaccine-preventable illnesses due to increased morbidity and mortality from common pathogens, increased transmission related to epidemiologic factors, and decreased vaccination rates. We aimed to describe patient-specific predictive factors that may impact adherence to the CDC's recommended vaccination schedules in PLWH. We retrospectively evaluated adult PLWH in care at the University of Nebraska Medical Center's HIV clinic and collected information related to demographics, clinic visits, vaccination status, and measures of HIV disease control. Patients were categorized as "Adherent" if they had received all vaccinations for which they were eligible and were categorized as "Non-Adherent" if they were deficient or delayed in receiving one or more vaccinations. Participant characteristics were compared between groups by multivariable logistic regression to identify predictors associated with vaccine schedule non-adherence. We evaluated 502 PLWH who met our inclusion criteria; 206 of these (41%) had received all eligible vaccinations, while 296 (59%) were missing one or more vaccinations. The mean age of participants was 48 years old, 76% were male, and 53% were white. Our participants had a median of 2.83 clinic visits per year and missed 8.3% of scheduled clinic visits. Factors associated with non-adherence to vaccination schedules included a high frequency of missed clinic appointments (>10%), men who have sex with men, and a CD4 count <200 cells/mm3. Knowledge of variables associated with vaccination rates may be beneficial in identifying patients at-risk for under-vaccination and designing targeted education programs for providers and patients.
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Affiliation(s)
- Tanner M Johnson
- College of Pharmacy, Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE, USA.,Department of Pharmacy, UCHealth University of Colorado Hospital, Aurora, CO, USA.,Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA
| | - Donald G Klepser
- College of Pharmacy, Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sara H Bares
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kimberly K Scarsi
- College of Pharmacy, Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE, USA.,Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Xu Z, Chokkalingam N, Tello-Ruiz E, Walker S, Kulp DW, Weiner DB. Incorporation of a Novel CD4+ Helper Epitope Identified from Aquifex aeolicus Enhances Humoral Responses Induced by DNA and Protein Vaccinations. iScience 2020; 23:101399. [PMID: 32763137 PMCID: PMC7409978 DOI: 10.1016/j.isci.2020.101399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/25/2020] [Accepted: 07/20/2020] [Indexed: 01/12/2023] Open
Abstract
CD4+ T cells play an important role in the maturation of the antibody responses. Conjugation of identified CD4+ T cell helper epitope to the target antigen has been developed as a strategy to enhance vaccine-induced humoral immunity. In this work, we reported the identification of a novel HLA-IAb helper epitope LS-3 from Aquifex aeolicus. In silico analysis predicted this epitope to have high binding affinity to common human HLA alleles and have complementary binding coverage to the established PADRE epitope. Introduction of HLA-IAb knockout mutations to the LS-3 epitope significantly attenuated humoral responses induced by a vaccine containing this epitope. Finally, engineered fusion of the epitope to a model antigen, influenza hemagglutinin, significantly improved both binding and hemagglutination inhibition antibody responses in mice receiving DNA or protein vaccines. In summary, LS-3 and additional identified CD4+ helper epitopes may be further explored to improve vaccine responses in translational studies. Identification of a novel CD4+ helper epitope, LS-3, from Aquifex aeolicus In silico analysis predicts high binding affinity of LS-3 to human HLA-DR alleles Fusing LS-3 to antigen enhances humoral response by vaccinations
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Affiliation(s)
- Ziyang Xu
- The Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104, USA; Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Neethu Chokkalingam
- The Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104, USA
| | - Edgar Tello-Ruiz
- The Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104, USA
| | - Susanne Walker
- The Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104, USA
| | - Daniel W Kulp
- The Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104, USA.
| | - David B Weiner
- The Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104, USA.
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29
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Rech-Medeiros AF, Marcon PDS, Tovo CDV, de Mattos AA. Evaluation of response to hepatitis B virus vaccine in adults with human immunodeficiency virus. Ann Hepatol 2020; 18:725-729. [PMID: 31176604 DOI: 10.1016/j.aohep.2019.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/26/2019] [Accepted: 02/10/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND AIM Viral hepatitis is a serious public health problem. The risk of progression to chronic hepatitis in hepatitis B virus (HBV) infection occurs in 5-10% of adults and is a leading cause of cirrhosis and hepatocellular carcinoma worldwide. Individuals infected with human immunodeficiency virus (HIV) may have coinfection with HBV. The existence of unvaccinated groups represents a significant risk not only individually but also at the community level. The aim of this study was to evaluate HBV vaccine response in adults with HIV infection. MATERIALS AND METHODS A retrospective, descriptive study of the cross-sectional type was carried out in an outpatient HIV referral center in southern Brazil. All medical records of adult HIV patients seen during January 2006 to December 2015 were selected. In statistical analysis, a significance level of 5% was used. RESULTS Of the 201 patients evaluated with a complete vaccination scheme, 55.72% were males, with a mean age of 43.86±12.68 years. Vaccine response occurred in 80.10% (161/201) of the patients, and it did not correlate with age, CD4+ cell count or viral load. CONCLUSION HBV vaccine response in a HIV population was satisfactory, highlighting the importance of vaccination for prevention, cost reduction and better prognosis in preventing HBV/HIV coinfection.
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Affiliation(s)
- Arlete F Rech-Medeiros
- Hepatology Post-Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Patrícia Dos S Marcon
- Hepatology Post-Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Department of Gastroenterology, Hospital Mãe de Deus, Porto Alegre, RS, Brazil.
| | - Cristiane do V Tovo
- Hepatology Post-Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Angelo A de Mattos
- Hepatology Post-Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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Nelson NP, Weng MK, Hofmeister MG, Moore KL, Doshani M, Kamili S, Koneru A, Haber P, Hagan L, Romero JR, Schillie S, Harris AM. Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recomm Rep 2020; 69:1-38. [PMID: 32614811 PMCID: PMC8631741 DOI: 10.15585/mmwr.rr6905a1] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
HEPATITIS A IS A VACCINE-PREVENTABLE, COMMUNICABLE DISEASE OF THE LIVER CAUSED BY THE HEPATITIS A VIRUS (HAV). THE INFECTION IS TRANSMITTED VIA THE FECAL-ORAL ROUTE, USUALLY FROM DIRECT PERSON-TO-PERSON CONTACT OR CONSUMPTION OF CONTAMINATED FOOD OR WATER. HEPATITIS A IS AN ACUTE, SELF-LIMITED DISEASE THAT DOES NOT RESULT IN CHRONIC INFECTION. HAV ANTIBODIES (IMMUNOGLOBULIN G [IGG] ANTI-HAV) PRODUCED IN RESPONSE TO HAV INFECTION PERSIST FOR LIFE AND PROTECT AGAINST REINFECTION; IGG ANTI-HAV PRODUCED AFTER VACCINATION CONFER LONG-TERM IMMUNITY. THIS REPORT SUPPLANTS AND SUMMARIZES PREVIOUSLY PUBLISHED RECOMMENDATIONS FROM THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP) REGARDING THE PREVENTION OF HAV INFECTION IN THE UNITED STATES. ACIP RECOMMENDS ROUTINE VACCINATION OF CHILDREN AGED 12-23 MONTHS AND CATCH-UP VACCINATION FOR CHILDREN AND ADOLESCENTS AGED 2-18 YEARS WHO HAVE NOT PREVIOUSLY RECEIVED HEPATITIS A (HEPA) VACCINE AT ANY AGE. ACIP RECOMMENDS HEPA VACCINATION FOR ADULTS AT RISK FOR HAV INFECTION OR SEVERE DISEASE FROM HAV INFECTION AND FOR ADULTS REQUESTING PROTECTION AGAINST HAV WITHOUT ACKNOWLEDGMENT OF A RISK FACTOR. THESE RECOMMENDATIONS ALSO PROVIDE GUIDANCE FOR VACCINATION BEFORE TRAVEL, FOR POSTEXPOSURE PROPHYLAXIS, IN SETTINGS PROVIDING SERVICES TO ADULTS, AND DURING OUTBREAKS.
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Jilich D, Malý M, Fleischhans L, Kulířová V, Machala L. Cross-sectional study on vaccination coverage in newly diagnosed HIV-infected persons in the Czech Republic. Cent Eur J Public Health 2019; 27:217-222. [PMID: 31580557 DOI: 10.21101/cejph.a5830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/20/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Individuals with HIV infection are at an increased risk for a number of infectious diseases, some of which are preventable by vaccination. Unfortunately, little is known about the attitudes of this population group to vaccination, therefore, we decided to find out vaccination coverage against 5 infections among newly diagnosed HIV-infected patients in the Czech Republic. METHODS This cross-sectional study was conducted on newly diagnosed patients who started their follow-up care at the HIV Clinic of Na Bulovce Hospital during the two following years. Vaccination history data and results of serological tests were collected from all participants. RESULTS Enrolled were 269 HIV-positive subjects (94.1% males) with a mean age of 34.4 years, 64 subjects (23.8%) had tertiary education, 229 (85.1%) were men having sex with men, 32 (11.9%) were heterosexual, and 8 (3.0%) were injection drug users. The mean CD4+ T-lymphocyte count was 556.2/µL, with 149 persons (55.4%) who had a CD4+ T-lymphocyte count > 500/µL, and 68 (25.3%) individuals were late presenters with CD4+ T-lymphocyte count < 350/µL. A vaccination against tetanus was reported by 262 subjects (97.4%), against influenza by 18 subjects (6.7%), against tick-borne encephalitis by 18 subjects (6.7%), against viral hepatitis A by 78 persons (29.0%), and against hepatitis B by 104 subjects (38.7%). For influenza, tick-borne encephalitis and hepatitis A, a significant positive impact of tertiary education was found (p-values < 0.001-0.044). Vaccination coverage against both types of hepatitis was significantly lower in late presenters (p = 0.044 and p = 0.004, respectively). CONCLUSIONS Vaccination rates found in our cohort were except tetanus and hepatitis B in young people low, especially for influenza and tick-borne encephalitis. Higher level of education and less advanced HIV infection were associated with higher vaccination rates. To improve this unsatisfactory situation, more attention should be paid to vaccination.
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Affiliation(s)
- David Jilich
- Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic
| | - Marek Malý
- Department of Biostatistics, National Institute of Public Health, Prague, Czech Republic
| | - Lukáš Fleischhans
- Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic
| | | | - Ladislav Machala
- Department of Infectious Diseases, Third Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic
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Hawkins KL, Gordon KS, Levin MJ, Weinberg A, Battaglia C, Rodriguez-Barradas MC, Brown ST, Rimland D, Justice A, Tate J, Erlandson KM. Herpes Zoster and Herpes Zoster Vaccine Rates Among Adults Living With and Without HIV in the Veterans Aging Cohort Study. J Acquir Immune Defic Syndr 2018; 79:527-533. [PMID: 30179984 PMCID: PMC6203599 DOI: 10.1097/qai.0000000000001846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Despite historically high rates of herpes zoster among people living with HIV (PLWH), comparative studies of herpes zoster by HIV serostatus are lacking since the advent of combination antiretroviral therapy and availability of zoster vaccine. METHODS Annual rates (2002-2015) of first-episode herpes zoster and zoster vaccination were calculated for PLWH and uninfected adults in the Veterans Aging Cohort Study and stratified by HIV serostatus and age. Herpes zoster was captured using ICD9 codes and vaccine receipt with procedural codes and pharmacy data. RESULTS Of 45,177 PLWH and 103,040 uninfected veterans, rates of herpes zoster decreased among PLWH (17.6-8.1/1000) over the study period but remained higher than uninfected adults (4.1/1000) at the end of study period. Rates were higher in PLWH with lower CD4 (<200 vs >500 cells/µL: 18.0 vs 6.8/1000) and unsuppressed vs suppressed HIV-1 RNA (21.8 vs 7.1/1000). Restricted to virologically suppressed participants with CD4 >350 cells per microliter, herpes zoster rates were similar among PLWH aged younger than 60 years and aged 60 years and older in 2015 (6.6 vs 6.7/1000) but higher than all uninfected age groups. At study end, cumulative receipt of zoster vaccine for PLWH aged 60 years and older was less than half that of uninfected veterans: 98.7 vs 215.2/1000. CONCLUSIONS Herpes zoster rates among PLWH have markedly decreased, but, even in cART-treated individuals, remain 50% higher than uninfected adults. Lower rates of zoster vaccine receipt combined with high rates of herpes zoster support the need for a safe and effective vaccine against herpes zoster for PLWH, formal zoster vaccine guidelines for PLWH, and consideration for expanded use at younger ages.
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Affiliation(s)
- Kellie L Hawkins
- Denver Public Health, Denver, CO
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Kirsha S Gordon
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
| | - Myron J Levin
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Adriana Weinberg
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Catherine Battaglia
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Maria C Rodriguez-Barradas
- Department of Medicine, Infectious Diseases Section, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX
| | - Sheldon T Brown
- Department of Medicine, James J. Peters Veterans Affairs Medical Center, Mount Sinai School of Medicine, New York, NY
| | - David Rimland
- Division of Infectious Diseases, Atlanta Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, GA
| | - Amy Justice
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
| | - Janet Tate
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
| | - Kristine M Erlandson
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
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Tsachouridou O, Georgiou A, Naoum S, Vasdeki D, Papagianni M, Kotoreni G, Forozidou E, Tsoukra P, Gogou C, Chatzidimitriou D, Skoura L, Zebekakis P, Metallidis S. Factors associated with poor adherence to vaccination against hepatitis viruses, streptococcus pneumoniae and seasonal influenza in HIV-infected adults. Hum Vaccin Immunother 2018; 15:295-304. [PMID: 30111224 DOI: 10.1080/21645515.2018.1509644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Vaccination against various pathogens is recommended for HIV positive adults. There are not sufficient data either on vaccination coverage of HIV positive adults or the risk factors associated with poor adherence to routine vaccination. PATIENTS-METHODS During the period 2004-2014 vaccination coverage of a group of HIV infected adults against hepatitis A virus (HAV), hepatitis B virus (HBV), seasonal influenza virus and pneumococcal disease was recorded. Vaccination coverage was separated into two chronological periods, before and after 2010, as 2010 marks the start of the economic crisis in Greece. RESULTS 1210 patients were included in our study. Vaccine coverage throughout the study for hepatitis B, hepatitis A, seasonal influenza and pneumococcal infection was 73.6%, 70.4%, 39% and 79%, respectively. The complete lack of insurance coverage was an independent factor of non-compliance in all proposed vaccines (vaccination against pneumococcal disease: OR: 0.82 95%CI: 0.49-1.35, vaccination against HBV: OR: 0.82, 95% CI: 0.45-1.49, vaccination against HAV OR: 0.54, 95%CI: 0.34-0.87, vaccination against influenza: OR: 1.27, 95% CI: 0.76-2.10). In addition, low educational level was associated with poor compliance to vaccination against pneumococcal disease, hepatitis A, hepatitis B, and influenza. Finally, the recommendation for vaccination after the onset of the economic crisis (2010) led to poor compliance to vaccination against HBV, HAV and pneumococcal disease, but not against influenza. CONCLUSIONS In our study, vaccination coverage for vaccine-preventable diseases was found to be insufficient for HIV positive adults in Northern Greece. Also, low educational level, lack of insurance coverage and economic distress have contributed to poor vaccine compliance, leading to poor protection of the HIV positive population and decreased immune coverage in the community.
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Affiliation(s)
- Olga Tsachouridou
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Adamantini Georgiou
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Symeon Naoum
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Dimitra Vasdeki
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Maria Papagianni
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Georgia Kotoreni
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Evropi Forozidou
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Paraskevi Tsoukra
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Christiana Gogou
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Dimitrios Chatzidimitriou
- b National AIDS Reference Centre of Northern Greece , Aristotle University Medical School , Thessaloniki , Greece
| | - Lemonia Skoura
- b National AIDS Reference Centre of Northern Greece , Aristotle University Medical School , Thessaloniki , Greece
| | - Pantelis Zebekakis
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
| | - Symeon Metallidis
- a 1st Department of Internal Medicine , AHEPA University Hospital, Aristotle University Medical School , Thessaloniki , Greece
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Gagneux-Brunon A, Fresard A, Lucht F, Botelho-Nevers E. Vaccine coverage in PLWH: disparities and potential impact of vaccine hesitancy. Hum Vaccin Immunother 2018; 15:305-306. [PMID: 30303429 DOI: 10.1080/21645515.2018.1534517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Amandine Gagneux-Brunon
- a Department of Infectious and Tropical Diseases , University Hospital of Saint-Etienne , Saint-Etienne , France.,b Clinical Investigation Center-1408 , INSERM, Vaccinology , Saint-Etienne , France.,c I-REIVAC Innovative clinical research network in vaccinology , France.,d Groupe Immunité des Muqueuses et Agents Pathogènes , Jean Monnet University, University of Lyon , Saint-Etienne , France
| | - Anne Fresard
- a Department of Infectious and Tropical Diseases , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Frédéric Lucht
- a Department of Infectious and Tropical Diseases , University Hospital of Saint-Etienne , Saint-Etienne , France.,b Clinical Investigation Center-1408 , INSERM, Vaccinology , Saint-Etienne , France.,c I-REIVAC Innovative clinical research network in vaccinology , France.,d Groupe Immunité des Muqueuses et Agents Pathogènes , Jean Monnet University, University of Lyon , Saint-Etienne , France
| | - Elisabeth Botelho-Nevers
- a Department of Infectious and Tropical Diseases , University Hospital of Saint-Etienne , Saint-Etienne , France.,b Clinical Investigation Center-1408 , INSERM, Vaccinology , Saint-Etienne , France.,c I-REIVAC Innovative clinical research network in vaccinology , France.,d Groupe Immunité des Muqueuses et Agents Pathogènes , Jean Monnet University, University of Lyon , Saint-Etienne , France
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Moysi E, Pallikkuth S, De Armas LR, Gonzalez LE, Ambrozak D, George V, Huddleston D, Pahwa R, Koup RA, Petrovas C, Pahwa S. Altered immune cell follicular dynamics in HIV infection following influenza vaccination. J Clin Invest 2018; 128:3171-3185. [PMID: 29911996 DOI: 10.1172/jci99884] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/25/2018] [Indexed: 12/29/2022] Open
Abstract
HIV infection changes the lymph node (LN) tissue architecture, potentially impairing the immunologic response to antigenic challenge. The tissue-resident immune cell dynamics in virologically suppressed HIV+ patients on combination antiretroviral therapy (cART) are not clear. We obtained LN biopsies before and 10 to 14 days after trivalent seasonal influenza immunization from healthy controls (HCs) and HIV+ volunteers on cART to investigate CD4+ T follicular helper (Tfh) and B cell dynamics by flow cytometry and quantitative imaging analysis. Prior to vaccination, compared with those in HCs, HIV+ LNs exhibited an altered follicular architecture, but harbored higher numbers of Tfh cells and increased IgG+ follicular memory B cells. Moreover, Tfh cell numbers were dependent upon preservation of the follicular dendritic cell (FDC) network and were predictive of the magnitude of the vaccine-induced IgG responses. Interestingly, postvaccination LN samples in HIV+ participants had significantly (P = 0.0179) reduced Tfh cell numbers compared with prevaccination samples, without evidence for peripheral Tfh (pTfh) cell reduction. We conclude that influenza vaccination alters the cellularity of draining LNs of HIV+ persons in conjunction with development of antigen-specific humoral responses. The underlying mechanism of Tfh cell decline warrants further investigation, as it could bear implications for the rational design of HIV vaccines.
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Affiliation(s)
- Eirini Moysi
- Tissue Analysis Core, Immunology Laboratory, Vaccine Research Center (VRC), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA.,Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Suresh Pallikkuth
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lesley R De Armas
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Louis E Gonzalez
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David Ambrozak
- Immunology Laboratory, VRC, NIAID, NIH, Bethesda, Maryland, USA
| | - Varghese George
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David Huddleston
- Department of Trauma Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rajendra Pahwa
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Richard A Koup
- Immunology Laboratory, VRC, NIAID, NIH, Bethesda, Maryland, USA
| | - Constantinos Petrovas
- Tissue Analysis Core, Immunology Laboratory, Vaccine Research Center (VRC), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Savita Pahwa
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, USA
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Dlamini SK, Madhi SA, Muloiwa R, Von Gottberg A, Moosa MYS, Meiring ST, Wiysonge CS, Hefer E, Mulaudzi MB, Nuttall J, Moorhouse M, Kagina BM. Guidelines for the vaccination of HIV-infected adolescents and adults in South Africa. South Afr J HIV Med 2018. [DOI: 10.4102/sajhivmed.v19i1.839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
No abstract available.
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Teresa Aguado M, Barratt J, Beard JR, Blomberg BB, Chen WH, Hickling J, Hyde TB, Jit M, Jones R, Poland GA, Friede M, Ortiz JR. Report on WHO meeting on immunization in older adults: Geneva, Switzerland, 22-23 March 2017. Vaccine 2018; 36:921-931. [PMID: 29336923 PMCID: PMC5865389 DOI: 10.1016/j.vaccine.2017.12.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/11/2017] [Indexed: 12/30/2022]
Abstract
Many industrialized countries have implemented routine immunization policies for older adults, but similar strategies have not been widely implemented in low- and middle-income countries (LMICs). In March 2017, the World Health Organization (WHO) convened a meeting to identify policies and activities to promote access to vaccination of older adults, specifically in LMICs. Participants included academic and industry researchers, funders, civil society organizations, implementers of global health interventions, and stakeholders from developing countries with adult immunization needs. These experts reviewed vaccine performance in older adults, the anticipated impact of adult vaccination programs, and the challenges and opportunities of building or strengthening an adult and older adult immunization platforms. Key conclusions of the meeting were that there is a need for discussion of new opportunities for vaccination of all adults as well as for vaccination of older adults, as reflected in the recent shift by WHO to a life-course approach to immunization; that immunization in adults should be viewed in the context of a much broader model based on an individual's abilities rather than chronological age; and that immunization beyond infancy is a global priority that can be successfully integrated with other interventions to promote healthy ageing. As WHO is looking ahead to a global Decade of Healthy Ageing starting in 2020, it will seek to define a roadmap for interdisciplinary collaborations to integrate immunization with improving access to preventive and other healthcare interventions for adults worldwide.
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Affiliation(s)
| | - Jane Barratt
- International Federation on Ageing, Toronto, Canada.
| | - John R Beard
- Ageing and Life Course, World Health Organization, Geneva, Switzerland.
| | - Bonnie B Blomberg
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Wilbur H Chen
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA.
| | | | - Terri B Hyde
- Vaccine Introduction Team, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, United Kingdom; Modelling and Economics Unit, Public Health England, London, United Kingdom.
| | | | - Gregory A Poland
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, Rochester, MN, USA.
| | - Martin Friede
- Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland.
| | - Justin R Ortiz
- Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland.
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Adriaensen W, Dorlo TPC, Vanham G, Kestens L, Kaye PM, van Griensven J. Immunomodulatory Therapy of Visceral Leishmaniasis in Human Immunodeficiency Virus-Coinfected Patients. Front Immunol 2018; 8:1943. [PMID: 29375567 PMCID: PMC5770372 DOI: 10.3389/fimmu.2017.01943] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/18/2017] [Indexed: 12/23/2022] Open
Abstract
Patients with visceral leishmaniasis (VL)–human immunodeficiency virus (HIV) coinfection experience increased drug toxicity and treatment failure rates compared to VL patients, with more frequent VL relapse and death. In the era of VL elimination strategies, HIV coinfection is progressively becoming a key challenge, because HIV-coinfected patients respond poorly to conventional VL treatment and play an important role in parasite transmission. With limited chemotherapeutic options and a paucity of novel anti-parasitic drugs, new interventions that target host immunity may offer an effective alternative. In this review, we first summarize current views on how VL immunopathology is significantly affected by HIV coinfection. We then review current clinical and promising preclinical immunomodulatory interventions in the field of VL and discuss how these may operate in the context of a concurrent HIV infection. Caveats are formulated as these interventions may unpredictably impact the delicate balance between boosting of beneficial VL-specific responses and deleterious immune activation/hyperinflammation, activation of latent provirus or increased HIV-susceptibility of target cells. Evidence is lacking to prioritize a target molecule and a more detailed account of the immunological status induced by the coinfection as well as surrogate markers of cure and protection are still required. We do, however, argue that virologically suppressed VL patients with a recovered immune system, in whom effective antiretroviral therapy alone is not able to restore protective immunity, can be considered a relevant target group for an immunomodulatory intervention. Finally, we provide perspectives on the translation of novel theories on synergistic immune cell cross-talk into an effective treatment strategy for VL–HIV-coinfected patients.
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Affiliation(s)
- Wim Adriaensen
- Unit of HIV and Neglected Tropical Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thomas P C Dorlo
- Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Guido Vanham
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Luc Kestens
- Unit of Immunology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Paul M Kaye
- Centre for Immunology and Infection, Department of Biology, Hull York Medical School, University of York, Heslington, York, United Kingdom
| | - Johan van Griensven
- Unit of HIV and Neglected Tropical Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Marcus JL, Baxter R, Leyden WA, Muthulingam D, Yee A, Horberg MA, Klein DB, Towner WJ, Chao CR, Quesenberry CP, Silverberg MJ. Invasive Pneumococcal Disease Among HIV-Infected and HIV-Uninfected Adults in a Large Integrated Healthcare System. AIDS Patient Care STDS 2016; 30:463-470. [PMID: 27749111 DOI: 10.1089/apc.2016.0165] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It is unclear whether HIV-infected individuals remain at higher risk of invasive pneumococcal disease (IPD) compared with HIV-uninfected individuals. We conducted a cohort study of HIV-infected and demographically matched HIV-uninfected adults within Kaiser Permanente Northern California during the period 1996-2011. We used Poisson models to obtain rate ratios (RRs) for incident IPD associated with HIV infection and other risk factors. Among 13,079 HIV-infected and 137,643 HIV-uninfected adults, the IPD rate per 100,000 person-years was 160 (n = 109 events) for HIV-infected and 8 (n = 75 events) for HIV-uninfected subjects, with an adjusted RR of 13.0 [95% confidence interval (CI): 9.1-18.7]. For HIV-infected individuals, IPD incidence per 100,000 person-years decreased by 71% during study follow-up, from 305 in 1996-1999 to 88 in 2010-2011 (p < 0.001), with an adjusted RR of 6.6 (95% CI: 2.7-16.1) compared with HIV-uninfected subjects in 2010-2011. Risk factors for IPD among HIV-infected individuals included black compared with white race/ethnicity, smoking, cancer, and higher HIV RNA levels. The 23-valent pneumococcal polysaccharide vaccination was not associated with a reduced risk of IPD in HIV-infected or HIV-uninfected individuals. Among HIV-infected IPD cases, the most common serotype was 19A (33%), and 59% of serotypes were covered by the 13-valent pneumococcal conjugate vaccine (PCV13). Despite a dramatic decline in IPD incidence for HIV-infected adults since 1996, IPD rates were nearly sevenfold higher compared with HIV-uninfected adults in recent years, even after adjustment for risk factors. Timely antiretroviral therapy initiation, risk reduction strategies, and recent guidelines recommending PCV13 use may further reduce IPD incidence among HIV patients.
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Affiliation(s)
- Julia L. Marcus
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Roger Baxter
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Wendy A. Leyden
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | | | - Arnold Yee
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Michael A. Horberg
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Daniel B. Klein
- Kaiser Permanente Northern California, San Leandro Medical Center, San Leandro, California
| | - William J. Towner
- Kaiser Permanente Southern California, Los Angeles Medical Center, Los Angeles, California
| | - Chun R. Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
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Abstract
OBJECTIVES Curative strategies using agents to perturb the HIV reservoir have demonstrated only modest activity, whereas increases in viremia after standard vaccination have been described. We investigated whether vaccination against non-HIV pathogens can induce HIV transcription and thereby play a role in future eradication strategies. DESIGN A randomized controlled trial (NCT00329251) was performed to compare the effects of clinical vaccines with placebo on HIV transcription and immune activation. METHODS Twenty-six HIV-infected individuals on suppressive antiretroviral therapy were randomized to receive a vaccination schedule (n = 13) or placebo (n = 13). Cell-associated RNA and DNA were extracted from peripheral blood mononuclear cells, and HIV was quantified by droplet digital PCR using primers for gag and 2-LTR (for HIV DNA), unspliced gag RNA (gag usRNA), multispliced tat-rev RNA (tat-rev msRNA) and polyA mRNA. RESULTS Significant increases in gag usRNA after influenza/hepatitis B vaccination (P = 0.02) and in gag usRNA (P = 0.04) and polyA mRNA (P = 0.04) after pneumococcus/hepatitis B vaccination were seen in vaccinees but not controls. HIV DNA and plasma HIV RNA did not change in either group. Increases in CD4 and CD8 T-cell activation markers (P = 0.08 and P < 0.001, respectively) and HIV-specific CD8 responses (P = 0.04 for p24 gag, P = 0.01 for p17 gag and P = 0.04 for total gag) were seen in vaccinees but not controls. CONCLUSION In this study, vaccination was associated with increases in HIV cell-associated RNA and HIV-specific responses during antiretroviral therapy. Using standard vaccines to stimulate HIV transcription may therefore be a useful component of future eradication strategies.
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Cunha GHD, Galvão MTG, Medeiros CMD, Rocha RP, Lima MAC, Fechine FV. Vaccination status of people living with HIV/AIDS in outpatient care in Fortaleza, Ceará, Brazil. Braz J Infect Dis 2016; 20:487-93. [PMID: 27542868 PMCID: PMC9425449 DOI: 10.1016/j.bjid.2016.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 07/17/2016] [Accepted: 07/24/2016] [Indexed: 11/27/2022] Open
Abstract
Antiretroviral therapy has increased the survival of patients with HIV/AIDS, thus necessitating health promotion practice with immunization. Vaccines are critical components for protecting people living with HIV/AIDS (PLWHA). The purpose of study was to analyze the vaccination status of PLWHA in outpatient care in Fortaleza, Ceará, Brazil. Cross-sectional study performed from June 2014 to June 2015. The screening was done with patients in antiretroviral therapy, 420 patients underwent screening, but only 99 met the inclusion criteria. Data were collected for interviews using forms to characterize sociodemographic, clinical and vaccination situations. Only 14 patients had complete vaccination schedules. The most used vaccines were hepatitis B, influenza vaccine and 23-valent pneumococcal. There was no difference between men and women regarding the proportion of PLWHA with full vaccination schedule or between sex, skin color, marital status, sexual orientation, religion or occupational status. There was no difference between having or not having a complete vaccination schedule and age, years of education, family income or number of hospitalizations. CD4+ T-cells count of patients with incomplete immunization was lower than patients with complete immunization. Health education strategies can be done individually or in groups to explain the importance of vaccination and to remind about doses to be administered. Most patients did not have proper adherence to vaccination schedules, especially due to lack of guidance. Results implied that education in health is important for vaccination adhesion, knowledge of adverse events and continuation of schemes.
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Affiliation(s)
| | | | | | - Ryvanne Paulino Rocha
- Universidade Federal do Ceará (UFC), Departamento de Enfernagem, Fortaleza, CE, Brazil
| | | | - Francisco Vagnaldo Fechine
- Universidade Federal do Ceará (UFC), Centro de Pesquisa e Desenvolvimento de Medicamentos, Fortaleza, CE, Brazil
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Hellenbrand W, Koch J, Harder T, Bogdan C, Heininger U, Tenenbaum T, Terhardt M, Vogel U, Wichmann O, von Kries R. Background Paper for the update of meningococcal vaccination recommendations in Germany: use of the serogroup B vaccine in persons at increased risk for meningococcal disease. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:1314-43. [PMID: 26487381 DOI: 10.1007/s00103-015-2253-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In December 2013 Bexsero® became available in Germany for vaccination against serogroup B meningococci (MenB). In August 2015 the German Standing Committee on Vaccination (STIKO) endorsed a recommendation for use of this vaccine in persons at increased risk of invasive meningococcal disease (IMD). This background paper summarizes the evidence underlying the recommendation. Bexsero® is based on surface protein antigens expressed by about 80% of circulating serogroup B meningococci in Germany. The paper reviews available data on immunogenicity and safety of Bexsero® in healthy children and adolescents; data in persons with underlying illness and on the effectiveness in preventing clinical outcomes are thus far unavailable.STIKO recommends MenB vaccination for the following persons based on an individual risk assessment: (1) Persons with congenital or acquired immune deficiency or suppression. Among these, persons with terminal complement defects and properdin deficiency, including those under eculizumab therapy, are at highest risk with reported invasive meningococcal disease (IMD) incidences up 10,000-fold higher than in the general population. Persons with asplenia were estimated to have a ~ 20-30-fold increased risk of IMD, while the risk in individuals with other immune defects such as HIV infection or hypogammaglobulinaemia was estimated at no more than 5-10-fold higher than the background risk. (2) Laboratory staff with a risk of exposure to N. meningitidis aerosols, for whom an up to 271-fold increased risk for IMD has been reported. (3) Unvaccinated household (-like) contacts of a MenB IMD index case, who have a roughly 100-200-fold increased IMD risk in the year after the contact despite chemoprophylaxis. Because the risk is highest in the first 3 months and full protective immunity requires more than one dose (particularly in infants and toddlers), MenB vaccine should be administered as soon as possible following identification of the serogroup of the index case.
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Affiliation(s)
| | - Judith Koch
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Thomas Harder
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Tobias Tenenbaum
- Pediatric Infectious Diseases and Pulmonology, University Children's Hospital, Mannheim-Heidelberg University, Mannheim, Germany
| | | | - Ulrich Vogel
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Rüdiger von Kries
- Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians University, Munich, Germany
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An immunization update for HIV-infected adults in the United States: review of the literature. J Assoc Nurses AIDS Care 2015; 26:201-7. [PMID: 25665888 DOI: 10.1016/j.jana.2014.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 11/17/2014] [Indexed: 01/22/2023]
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Singh HK, Chiu YL, Wilkin T. Measles, Mumps, and Rubella Serostatus and Response to MMR Vaccination Among HIV-Infected Adults. AIDS Patient Care STDS 2015; 29:461-4. [PMID: 26153909 DOI: 10.1089/apc.2015.0050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Harjot Kaur Singh
- Division of Infectious Diseases, Weill Cornell Medical College, New York City, New York
| | - Ya-Lin Chiu
- Everest Clinical Research Service, Inc., Little Falls, New Jersey
| | - Timothy Wilkin
- Department of Medicine, Weill Cornell Medical College, New York City, New York
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