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Article

HIVR4P 2016, Partnering for Prevention: Conference Summary and Highlights

by Barbara L. Shacklett; Cynthia Derdeyn; Morenike Oluwatoyin Folayan; Raphael J. Landovitz; Colin Anthony; Anna-Janina Behrens; Thomas J. Hope; Elise Landais; Lorna Leal; Jeanne M. Marrazzo; Lynn Morris; Nelly Mugo; Kenneth Ngure; Veronica Noseda; Srinika Ranasinghe; Damien C. Tully; Yegor Voronin; Mitchell Warren; Constantinos Kurt Wibmer; Irene Y. Xie; Gabriella Scarlatti; Bargavi Thyagarajan

2017

Subjects
  • Health Sciences, Immunology
  • Health Sciences, Public Health
  • File Download
  • View Abstract

Abstract:Close

HIV Research for Prevention: AIDS Vaccine, Microbicide, and ARV-based Prevention Science (HIVR4P) was built on a growing consensus that effective HIV prevention requires a combination of approaches and that understanding, analyzing, and debating the cross-cutting issues that impact prevention research are all essential to combat the global HIV/AIDS epidemic. To that end, the biennial HIVR4P conference is dedicated to all biomedical HIV prevention research approaches, including HIV vaccines, microbicides, pre-exposure prophylaxis, and treatment as prevention. The HIVR4P 2016 conference was held in Chicago, Illinois (USA), on October 17-21, and included more than 700 scientific presentations and 21 satellite sessions covering the latest and most promising advances across the HIV prevention research field. The theme "Partnering for Prevention" represented the conference's commitment to breaking down silos between research disciplines as well as between researchers, program developers, care providers, advocates, communities, and funders. Delegates spanning 42 countries attended the conference. One-third of those in attendance were early career investigators, which reflects a firm commitment to emerging researchers and ultimately to the goal of developing a sustainable scientific enterprise well into the future. This article presents a concise summary of highlights from the conference. For a more detailed account, one may find full abstracts, daily summaries, and webcasts on the conference website at hivr4p.org.

Article

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia

by Lisa Haddad; Kristin Wall; Bellington Vwalika; Naw Htee Khu; Ilene Brill; William Kilembe; Robert Stephenson; Elwyn Chomba; Cheswa Vwalika; Amanda Tichacek; Susan Allen

2013

Subjects
  • Health Sciences, Epidemiology
  • Health Sciences, Obstetrics and Gynecology
  • Health Sciences, Public Health
  • File Download
  • View Abstract

Abstract:Close

OBJECTIVE:: To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. DESIGN:: Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. METHODS:: We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. RESULTS:: Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the womenÊs younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. CONCLUSION:: We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.

Article

Anti-HIV IgA isotypes: differential virion capture and inhibition of transcytosis are linked to prevention of mucosal R5 SHIV transmission

by Jennifer D. Watkins; Anton M. Sholukh; Muhammad M. Mukhtar; Nagadenahalli B. Siddappa; Samir K. Lakhashe; Mikyung Kim; Ellis L. Reinherz; Sandeep Gupta; Donald N. Forthal; Quentin Sattentau; Francois Villinger; Davide Corti; Ruth M. Ruprecht

2013

Subjects
  • Health Sciences, Immunology
  • Biology, Virology
  • File Download
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Abstract:Close

Objective: Although passive immunization with anti-HIV-1 Env IgG1 neutralizing monoclonal antibodies (nmAbs) prevented simian-human immunodeficiency virus (SHIV) infection in rhesus monkeys, IgA nmAbs have not been tested. Here, we sought to determine whether human anti-HIV-1 dimeric (d)IgA1, dIgA2, and IgG1 differ in their ability to prevent mucosal R5 SHIV acquisition in rhesus monkeys. Design: DIgA1, dIgA2, and IgG1 versions of nmAb HGN194 were applied intrarectally in three rhesus monkey groups 30min before intrarectal SHIV challenge. Methods: After a control pharmacokinetic study confirmed that nmAb concentrations in rectal fluids over time were similar for all HGN194 isotypes, control and nmAb-treated animals were challenged intrarectally with an R5 SHIV, and viral loads were monitored. Results: Unexpectedly, dIgA1 provided the best protection in vivo - although all nmAbs showed similar neutralizing activity in vitro. Five out of the six dIgA1-treated rhesus monkeys remained virus-free compared to only one out of six animals given dIgA2 (P= 0.045 by log-rank test) and two out of six rhesus monkeys treated with IgG1 forms of the nmAb (P= 0.12). Protection correlated significantly with virion capture activity by a given nmAb form, as well as inhibition of transcytosis of cell-free virus across an epithelial cell layer in vitro. Conclusions: Our data imply that dIgA1-mediated capturing of virions in mucosal secretions and inhibition of transcytosis can provide significant prevention of lentiviral acquisition - over and above direct virus neutralization. Vaccine strategies that induce mucosal IgA, especially IgA1, should be developed as a first line of defense against HIV-1, a virus predominantly transmitted mucosally.

Article

Mycobacterium abscessus subspecies massiliense infection after skin graft and cholecystectomy in a burn patient

by Nathan A. Summers; Russell Ryan Kempker; Federico Palacio Bedoya

2018

Subjects
  • Health Sciences, Epidemiology
  • Health Sciences, Immunology
  • File Download
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Diagnosing skin and soft tissue infections due to rapidly growing mycobacteria (RGM) can often prove difficult, leading to delays in treatment. Postoperative infections caused by RGM are increasingly recognized both within and outside the USA, but are rarely encountered in burn units. We report a case of postoperative skin and soft tissue infection along a cholecystectomy incision in a burn patient caused by Mycobacterium abscessus subsp. massiliense. Postoperative infections caused by RGM require a high index of suspicion, often necessitating biopsy for definitive diagnosis. Physicians should consider this diagnosis when postoperative infections arise later than typically seen for routine bacterial infections and fail to respond to first-line therapy.

Article

Priority actions to fight antibiotic resistance: results of an international meeting

by Vincent Jarlier; jean Carlet; John McGowan Jr.; Herman Goossens; Andreas Voss; Stephan Harbarth; Didier Pittet

2012

Subjects
  • Health Sciences, Public Health
  • Health Sciences, Immunology
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Article

Severe Neurologic Disorders in 2 Fetuses with Zika Virus Infection, Colombia

by Jorge Acosta-Reyes; Edgar Navarro; Maria Jose Herrera; Eloina Goenaga; Martha L. Ospina; Edgar Parra; Marcela Mercado; Pablo Chaparro; Mauricio Beltran; Maria Luz Gunturiz; Lissethe Pardo; Catalina Valencia; Sandra Huertas; Jorge Rodriguez; Germán Ruiz; Diana Valencia; Lisa Haddad; Sarah C. Tinker; Cynthia A. Moore; Hernando Baquero

2017

Subjects
  • Health Sciences, Immunology
  • Health Sciences, Epidemiology
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We report the results of pathologic examinations of 2 fetuses from women in Colombia with Zika virus infection during pregnancy that revealed severe central nervous system defects and potential associated abnormalities of the eye, spleen, and placenta. Amniotic fluid and tissues from multiple fetal organs tested positive for Zika virus.

Article

Preventing HIV Among Young People: Research Priorities for the Future

by Audrey Pettifor; Linda-Gail Bekker; Sybil Hosek; Ralph Diclemente; Molly Rosenberg; Sheana Bull; Susannah Allison; Sinead Delany-Moretlwe; Bill G. Kapogiannis; Frances Cowan

2013

Subjects
  • Health Sciences, Public Health
  • Health Sciences, Immunology
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Objective: To review the current state of knowledge on the prevention of sexual transmission of HIV in adolescents and to highlight the existing gaps and priority areas for future research. Background: A disproportionate burden of HIV infections falls on adolescents, a developmental stage marked by unique neural, biological, and social transition. Successful interventions are critical to prevent the spread of HIV in this vulnerable population. Methods: We summarized the current state of research on HIV prevention in adolescents by providing examples of successful interventions and best practices, and highlighting current research gaps. Results: Adolescent interventions fall into 3 main categories: biomedical, behavioral, and structural. The majority of current research has focused on individual behavior change, whereas promising biomedical and structural interventions have been largely understudied in adolescents. Combination prevention interventions may be particularly valuable to this group. Conclusions: Adolescents have unique needs with respect to HIV prevention, and, thus, interventions should be designed to most effectively reach out to this population with information and services that will be relevant to them.

Article

Correctional Facilities as Partners in Reducing HIV Disparities

by Josiah D. Rich; Ralph Diclemente; Judith Levy; Karen Lyda; Monica Ruiz; David L. Rosen; Dora Dumont

2013

Subjects
  • Health Sciences, Public Health
  • Sociology, Social Structure and Development
  • Health Sciences, Medicine and Surgery
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The United States now has the highest incarceration rate in the world. The majority of prison and jail inmates come from predominantly nonwhite and medically underserved communities. Although incarceration has adverse effects on both individual and community health, prisons and jails have also been used successfully as venues to provide health services to people with HIV who frequently lack stable health care. We review demographic trends shaping the difficulties in providing care to incarcerated people with HIV and recommend the Centers for AIDS Research Collaboration on HIV in Corrections as a model of interdisciplinary collaboration in addressing those difficulties.

Article

Natural History of Cryptosporidiosis in a Longitudinal Study of Slum-Dwelling Bangladeshi Children: Association with Severe Malnutrition

by Poonum S. Korpe; Rashidul Haque; Carol Gilchrist; Cristian Valencia; Feiyang Niu; Miao Lu; Jennie Z. Ma; Sarah E. Petri; Daniel Reichman; Mamun Kabir; Priya Duggal; William A. Petri

2016

Subjects
  • Health Sciences, Epidemiology
  • Biology, Microbiology
  • Sociology, Ethnic and Racial Studies
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Background: Cryptosporidiosis is a common cause of infectious diarrhea in young children worldwide, and is a significant contributor to under-five mortality. Current treatment options are limited in young children. In this study, we describe the natural history of Cryptosporidium spp. infection in a birth cohort of children in Bangladesh and evaluate for association with malnutrition. Methodology/Principal Findings: This is a longitudinal birth cohort study of 392 slum-dwelling Bangladeshi children followed over the first two years of life from 2008 to 2014. Children were monitored for diarrheal disease, and stool was tested for intestinal protozoa. Anthropometric measurements were taken at 3-month intervals. A subset of Cryptosporidium positive stools were genotyped for species and revealed that C. hominis was isolated from over 90% of samples. In the first two years of life, 77% of children experienced at least one infection with Cryptosporidium spp. Non-diarrheal infection (67%) was more common than diarrheal infection (6.3%) although 27% of children had both types of infection. Extreme poverty was associated with higher rates of infection (chi-square, 49.7% vs 33.3%, p = 0.006). Malnutrition was common in this cohort, 56% of children had stunted growth by age two. Children with Cryptosporidium spp. infection had a greater than 2-fold increased risk of severe stunting at age two compared to uninfected children (odds ratio 2.69, 95% CI 1.17, 6.15, p = 0.019) independent of sex, income, maternal body-mass index, maternal education and weight for age adjusted z (WAZ) score at birth. Conclusions/Significance: Cryptosporidium infection is common (77%) in this cohort of slum-dwelling Bangladeshi children, and both non-diarrheal and diarrheal infections are significantly associated with a child’s growth at 2 years of age.

Article

Combatting Sepsis: A Public Health Perspective

by Raymund B. Dantes; Lauren Epstein

2018

Subjects
  • Health Sciences, Medicine and Surgery
  • Health Sciences, Public Health
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Public health professionals and organizations have an opportunity to create a more comprehensive sepsis prevention strategy that spans the continuum of care and merges existing infection prevention strategies with chronic disease management and improved education on the signs and symptoms of worsening infection and sepsis. Recent public health efforts have improved our understanding of US national sepsis epidemiology and focused on increasing sepsis awareness. Additional opportunities and challenges include creating more integrated sepsis and infection prevention programs that encompass outpatient and inpatient care.
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