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We previously demonstrated efficacy of the COVID-19 vaccine candidate, SCB-2019, in adults in the SPECTRA phase 2/3 efficacy study. We extended the study to include 1278 healthy 12–17-year-old adolescents in Belgium, Colombia and the Philippines who received either two doses of SCB-2019 or placebo 21 days apart, to assess immunogenicity as neutralizing antibodies against prototype SARS-CoV-2 and variants of concern, and safety and reactogenicity as solicited and unsolicited adverse events with a comparator group of young adults (18–25 years). In participants with no evidence of prior SARS-CoV-2 infection SCB-2019 immunogenicity in adolescents was non-inferior to that in young adults; respective geometric mean neutralizing titers (GMT) against prototype SARS-CoV-2 14 days after the second vaccination were 271 IU/mL (95% CI: 211–348) and 144 IU/mL (116–178). Most adolescents (1077, 84.3%) had serologic evidence of prior SAR-CoV-2 exposure at baseline; in these seropositive adolescents neutralizing GMTs increased from 173 IU/mL (135–122) to 982 IU/mL (881–1094) after the second dose. Neutralizing titers against Delta and Omicron BA SARS-CoV-2 variants were also increased, most notably in those with prior exposure.SCB-2019 vaccine was well tolerated with generally mild or moderate, transient solicited and unsolicited adverse events that were comparable in adolescent vaccine and placebo groups except for injection site pain – reported after 20% of SCB-2019 and 7.3% of placebo injections. SCB-2019 vaccine was highly immunogenic against SARS-CoV-2 prototype and variants in adolescents, especially in those with evidence of prior exposure, with comparable immunogenicity to young adults.Clinical trial registrationEudraCT 2020-004272-17;ClinicalTrials.govNCT04672395.

Complex living agents consist of cells, which are themselves competent sub-agents navigating physiological and metabolic spaces. Behaviour science, evolutionary developmental biology and the field of machine intelligence all seek to understand the scaling of biological cognition: what enables individual cells to integrate their activities to result in the emergence of a novel, higher-level intelligence with large-scale goals and competencies that belong to it and not to its parts? Here, we report the results of simulations based on the TAME framework, which proposes that evolution pivoted the collective intelligence of cells during morphogenesis of the body into traditional behavioural intelligence by scaling up homeostatic competencies of cells in metabolic space. In this article, we created a minimal in silico system (two-dimensional neural cellular automata) and tested the hypothesis that evolutionary dynamics are sufficient for low-level setpoints of metabolic homeostasis in individual cells to scale up to tissue-level emergent behaviour. Our system showed the evolution of the much more complex setpoints of cell collectives (tissues) that solve a problem in morphospace: the organization of a body-wide positional information axis (the classic French flag problem in developmental biology). We found that these emergent morphogenetic agents exhibit a number of predicted features, including the use of stress propagation dynamics to achieve the target morphology as well as the ability to recover from perturbation (robustness) and long-term stability (even though neither of these was directly selected for). Moreover, we observed an unexpected behaviour of sudden remodelling long after the system stabilizes. We tested this prediction in a biological system—regenerating planaria—and observed a very similar phenomenon. We propose that this system is a first step towards a quantitative understanding of how evolution scales minimal goal-directed behaviour (homeostatic loops) into higher-level problem-solving agents in morphogenetic and other spaces.

Complex living agents consist of cells, which are themselves competent sub-agents navigating physiological and metabolic spaces. Behaviour science, evolutionary developmental biology and the field of machine intelligence all seek to understand the scaling of biological cognition: what enables individual cells to integrate their activities to result in the emergence of a novel, higher-level intelligence with large-scale goals and competencies that belong to it and not to its parts? Here, we report the results of simulations based on the TAME framework, which proposes that evolution pivoted the collective intelligence of cells during morphogenesis of the body into traditional behavioural intelligence by scaling up homeostatic competencies of cells in metabolic space. In this article, we created a minimal in silico system (two-dimensional neural cellular automata) and tested the hypothesis that evolutionary dynamics are sufficient for low-level setpoints of metabolic homeostasis in individual cells to scale up to tissue-level emergent behaviour. Our system showed the evolution of the much more complex setpoints of cell collectives (tissues) that solve a problem in morphospace: the organization of a body-wide positional information axis (the classic French Flag problem in developmental biology). We found that these emergent morphogenetic agents exhibit a number of predicted features, including the use of stress propagation dynamics to achieve its target morphology as well as the ability to recover from perturbation (robustness) and long-term stability (even though neither of these was directly selected for). Moreover, we observed an unexpected behaviour of sudden remodelling long after the system stabilizes. We tested this prediction in a biological system—regenerating planaria—and observed a very similar phenomenon. We propose that this system is a first step towards a quantitative understanding of how evolution scales minimal goal-directed behaviour (homeostatic loops) into higher-level problem-solving agents in morphogenetic and other spaces.

If the development of machine learning and artificial intelligence plays a role in many fields of research and technology today, it has a special relationship with neurosciences. Indeed, historically inspired by our knowledge of the brain, deep learning shares some vocabularies with neurosciences and can sometimes be considered a brain’s model. Taking the particular example of epileptic seizure, which can develop in any biological neural tissue, we raise the question if and how the models used for deep learning can capture or model these pathological events. This particular example is a starting point to discuss the nature, limits, and functions of these models, and what we expect from a model of the brain. Finally, we argue that a pluralistic approach leading to the integrated coexistence of different models is necessary to study the brain in all its complexity.

Morphoceuticals are a new class of interventions that target the setpoints of anatomical homeostasis for efficient, modular control of growth and form. Here, we focus on a subclass of these: electroceuticals, which specifically target the cellular bioelectrical interface - voltage-based mechanisms that coordinate cell groups toward specific morphological outcomes. Cellular collectives form bioelectrical networks via ion channels and gap junctions. The endogenous cellular ion flows are present across all tissues and are key to processing morphogenetic information, controlling gene expression and allowing cell networks to adaptively and dynamically control growth and pattern formation. Recent progress in understanding this physiological control system, including predictive computational models, suggests that targeting the bioelectrical interface can control embryogenesis and maintain shape against injury, senescence, and tumorigenesis. We propose a roadmap of efforts in drug discovery focused on manipulating endogenous bioelectric signaling for regenerative medicine, cancer suppression, and anti-aging therapeutics.

Coronavirus Disease 2019 (COVID‐19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2), has rapidly spread throughout Latin America, a region swept by multiple previous and ongoing epidemics. There are significant concerns that the arrival of COVID‐19 is currently overlapping with other viruses, particularly dengue, in various endo‐epidemic regions across South America. In this report, we analyzed trends for both viral infections in Colombia during the first 20 epidemiological weeks of 2020. From January 1st to May 16th, 2020 (epidemiological weeks, EW, 1‐20), a total of 52,679 cases of dengue and 14,943 cases of COVID‐19 have been confirmed in Colombia. As both conditions may potentially lead to fatal outcomes, especially in patients with chronic co‐morbidities, overlapping infections and co‐occurrence may increase the number of patients requiring intensive care and mechanical ventilation. In regions such as Valle del Cauca, intensified preparation for such scenarios should be pondered, and further studies should be performed to address this critical issue in a timely matter. This article is protected by copyright. All rights reserved.

A substantial unmet need remains for safe and effective vaccines against dengue virus disease, particularly for individuals who are dengue-naive and those younger than 9 years. We aimed to assess the efficacy, safety, and immunogenicity of a live attenuated tetravalent dengue vaccine (TAK-003) in healthy children aged 4-16 years.We present data up to 18 months post-vaccination from an ongoing phase 3, randomised, double-blind trial of TAK-003 in endemic regions of Asia and Latin America (26 medical and research centres across Brazil, Colombia, Dominican Republic, Nicaragua, Panama, Philippines, Sri Lanka, and Thailand). Healthy children aged 4-16 years were randomly assigned 2:1 (stratified by age and region) to receive two doses of TAK-003 or two doses of placebo, 3 months apart. Investigators, participants and their parents or guardians, and sponsor representatives advising on trial conduct were masked to trial group assignments. Participants presenting with febrile illness were tested for virologically confirmed dengue (VCD) by serotype-specific RT-PCR. In timeframes beginning 30 days post-second dose, the primary endpoint (overall vaccine efficacy) was assessed in the first 11 months, and the secondary endpoints (efficacy by baseline serostatus, serotype, hospitalised dengue, and severe dengue) in the first 17 months. This study is registered with ClinicalTrials.gov, NCT02747927.20 099 participants were randomly assigned and vaccinated between Sept 7, 2016, and Aug 18, 2017; 19 021 (94·6%) were included in the per protocol analysis, and 20 071 (99·9%) in the safety set. The primary endpoint was achieved with an overall vaccine efficacy of 80·2% (95% CI 73·3 to 85·3; 61 cases of VCD in the TAK-003 group vs 149 cases of VCD in the placebo group). In the secondary endpoint assessment timeframe, an overall vaccine efficacy of 73·3% (95% CI 66·5 to 78·8) was observed. Analysis of secondary endpoints showed efficacies of 76·1% (95% CI 68·5 to 81·9) in individuals who were seropositive at baseline, 66·2% (49·1 to 77·5) in individuals who were seronegative at baseline, 90·4% (82·6 to 94·7) against hospitalised dengue, and 85·9% (31·9 to 97·1) against dengue haemorrhagic fever. Efficacy varied by individual serotypes (DENV 1, 69·8% [95% CI 54·8 to 79·9]; DENV 2, 95·1% [89·9 to 97·6]; DENV 3, 48·9% [27·2 to 64·1]; DENV 4, 51·0% [-69·4 to 85·8]). Cumulative rates of serious adverse events were similar in TAK-003 (4·0%) and placebo (4·8%) recipients, and were consistent with expected medical disorders in the study population. Infection was the most frequent reason leading to serious adverse events. 20 participants (0·1% of the safety set) were withdrawn from the trial due to 21 adverse events by the end of part two; 14 of these participants received TAK-003 and six received placebo.TAK-003 was well tolerated and efficacious against symptomatic dengue in children regardless of serostatus before immunisation. Vaccine efficacy varied by serotype, warranting continued follow-up to assess longer-term vaccine performance.Takeda Vaccines.

Background: Young children can suffer severe consequences of norovirus gastroenteritis. We performed a dose-finding study of a bivalent virus-like particle (VLP) vaccine candidate (TAK-214) in healthy 1–8-year-old children. Methods: In this phase 2 study two age cohorts (1–3 and 4–8 years of age inclusive, N = 120 per cohort) of children enrolled from Finland, Panama and Colombia were initially randomized 1:1:1:1 to four groups which were further split into two equal subgroups, to receive one or two intramuscular doses of four TAK-214 formulations containing 15/15, 15/50, 50/50 or 50/150 μg of GI.1/GII.4c genotype VLPs and 0.5 mg Al(OH)3 at 28 days interval. ELISA Pan-Ig and histoblood group antigen-blocking (HBGA) antibodies against each VLP were measured on days 1, 29, 57 and 210. Parents/guardians recorded solicited local and systemic adverse events (AE) and any unsolicited or serious AEs (SAE). Results: All formulations were well-tolerated across both age cohorts and dosage groups with no vaccine-related SAEs reported. Solicited AEs were mostly mild-to-moderate, resolved quickly, and did not increase after the second dose. Pan-Ig and HBGA responses induced after one dose were only slightly increased by the second dose. Across dose groups at Day 29 after one dose GI.1 Pan Ig seroresponse rates (SRR) were 82–97% and 81–96% and GII.4c SRR were 79–97% and 80–91% in 1–3 and 4–8 year-olds, respectively. Respective rates were to 92–93% and 73–92% for GI.1, and 77–100% and 62–83% for GII.4c at Day 57 following two doses. HBGA responses had similar profiles. Both Pan Ig and HBGA geometric mean titers persisted above baseline up to Day 210. Conclusions: All dosages of TAK-214 displayed acceptable reactogenicity in 1–8-year-old children and induced robust, durable immune responses after one dose which are further increased after two doses. publishedVersion

All cognitive agents are composite beings. Specifically, complex living agents consist of cells, which are themselves competent sub-agents navigating physiological and metabolic spaces. Behavior science, evolutionary developmental biology, and the field of machine intelligence all seek an answer to the scaling of biological cognition: what evolutionary dynamics enable individual cells to integrate their activities to result in the emergence of a novel, higher-level intelligence that has goals and competencies that belong to it and not to its parts? Here, we report the results of simulations based on the TAME framework, which proposes that evolution pivoted the collective intelligence of cells during morphogenesis of the body into traditional behavioral intelligence by scaling up the goal states at the center of homeostatic processes. We tested the hypothesis that a minimal evolutionary framework is sufficient for small, low-level setpoints of metabolic homeostasis in cells to scale up into collectives (tissues) which solve a problem in morphospace: the organization of a body-wide positional information axis (the classic French Flag problem). We found that these emergent morphogenetic agents exhibit a number of predicted features, including the use of stress propagation dynamics to achieve its target morphology as well as the ability to recover from perturbation (robustness) and long-term stability (even though neither of these was directly selected for). Moreover we observed unexpected behavior of sudden remodeling long after the system stabilizes. We tested this prediction in a biological system - regenerating planaria - and observed a very similar phenomenon. We propose that this system is a first step toward a quantitative understanding of how evolution scales minimal goal-directed behavior (homeostatic loops) into higher-level problem-solving agents in morphogenetic and other spaces., Comment: 27 pages, 11 Figures, 2 Algorithms

A range of safe and effective vaccines against SARS CoV 2 are needed to address the COVID 19 pandemic. We aimed to assess the safety and efficacy of the COVID-19 vaccine SCB-2019.This ongoing phase 2 and 3 double-blind, placebo-controlled trial was done in adults aged 18 years and older who were in good health or with a stable chronic health condition, at 31 sites in five countries (Belgium, Brazil, Colombia, Philippines, and South Africa). The participants were randomly assigned 1:1 using a centralised internet randomisation system to receive two 0·5 mL intramuscular doses of SCB-2019 (30 μg, adjuvanted with 1·50 mg CpG-1018 and 0·75 mg alum) or placebo (0·9% sodium chloride for injection supplied in 10 mL ampoules) 21 days apart. All study staff and participants were masked, but vaccine administrators were not. Primary endpoints were vaccine efficacy, measured by RT-PCR-confirmed COVID-19 of any severity with onset from 14 days after the second dose in baseline SARS-CoV-2 seronegative participants (the per-protocol population), and the safety and solicited local and systemic adverse events in the phase 2 subset. This study is registered on EudraCT (2020-004272-17) and ClinicalTrials.gov (NCT04672395).30 174 participants were enrolled from March 24, 2021, until the cutoff date of Aug 10, 2021, of whom 30 128 received their first assigned vaccine (n=15 064) or a placebo injection (n=15 064). The per-protocol population consisted of 12 355 baseline SARS-CoV-2-naive participants (6251 vaccinees and 6104 placebo recipients). Most exclusions (13 389 [44·4%]) were because of seropositivity at baseline. There were 207 confirmed per-protocol cases of COVID-19 at 14 days after the second dose, 52 vaccinees versus 155 placebo recipients, and an overall vaccine efficacy against any severity COVID-19 of 67·2% (95·72% CI 54·3-76·8), 83·7% (97·86% CI 55·9-95·4) against moderate-to-severe COVID-19, and 100% (97·86% CI 25·3-100·0) against severe COVID-19. All COVID-19 cases were due to virus variants; vaccine efficacy against any severity COVID-19 due to the three predominant variants was 78·7% (95% CI 57·3-90·4) for delta, 91·8% (44·9-99·8) for gamma, and 58·6% (13·3-81·5) for mu. No safety issues emerged in the follow-up period for the efficacy analysis (median of 82 days [IQR 63-103]). The vaccine elicited higher rates of mainly mild-to-moderate injection site pain than the placebo after the first (35·7% [287 of 803] vs 10·3% [81 of 786]) and second (26·9% [189 of 702] vs 7·4% [52 of 699]) doses, but the rates of other solicited local and systemic adverse events were similar between the groups.Two doses of SCB-2019 vaccine plus CpG and alum provides notable protection against the entire severity spectrum of COVID-19 caused by circulating SAR-CoV-2 viruses, including the predominating delta variant.Clover Biopharmaceuticals and the Coalition for Epidemic Preparedness Innovations.

BACKGROUND Children frequently develop fever after hematopoietic stem cell transplant (HSCT). Although the etiology of many febrile episodes (FEs) is not an infection, patients often receive broad-spectrum antibiotics in response. METHODS To improve the judicious use of antibiotics in pediatric HSCT patients, we performed a prospective cohort study of children receiving an HSCT in Clinica Imbanaco (Cali, Colombia) between September 2016 and December 2019. We assessed all FEs occurring during 3 periods (infusion, neutropenic and engraftment). We measured procalcitonin and C-reactive protein (CRP) sequentially during each FE and compared levels among patients with fever due to significant infection (FSI) versus fever not attributable to infection (FNI) in each transplant period. RESULTS There were 166 FEs in 95 patients. FSI accounted for 12%, 42% and 42% of FE during infusion, neutropenic and engraftment periods, respectively. CRP had better discriminatory capacity for FSI versus FNI in the infusion period [area under the curve (AUC) 0.80 (95% confidence interval [CI], 0.62-0.96) for a CRP level of 50 mg/L]. Neither biomarker performed well in the neutropenic period. During the engraftment period, a CRP of 65 mg/L had an AUC of 0.81 (95% CI, 0.65-0.96), while a procalcitonin level of 0.25 ng/mL had an AUC of 0.83 (95% CI, 0.63-1.0). In contrast to procalcitonin, the CRP's pattern of change throughout the first 3 days of fever in each transplant period was different in FSI compared with FNI. CONCLUSION Sequential measurement of biomarkers, especially CRP, may allow clinicians to more appropriately manage antibiotic use in pediatric HSCT units.

Dengue, a mosquito-borne viral disease, was designated a World Health Organization top 10 threat to global health in 2019.We present primary efficacy data from part 1 of an ongoing phase 3 randomized trial of a tetravalent dengue vaccine candidate (TAK-003) in regions of Asia and Latin America in which the disease is endemic. Healthy children and adolescents 4 to 16 years of age were randomly assigned in a 2:1 ratio (stratified according to age category and region) to receive two doses of vaccine or placebo 3 months apart. Participants presenting with febrile illness were tested for virologically confirmed dengue by serotype-specific reverse-transcriptase polymerase chain reaction. The primary end point was overall vaccine efficacy in preventing virologically confirmed dengue caused by any dengue virus serotype.Of the 20,071 participants who were given at least one dose of vaccine or placebo (safety population), 19,021 (94.8%) received both injections and were included in the per-protocol analysis. The overall vaccine efficacy in the safety population was 80.9% (95% confidence interval [CI], 75.2 to 85.3; 78 cases per 13,380 [0.5 per 100 person-years] in the vaccine group vs. 199 cases per 6687 [2.5 per 100 person-years] in the placebo group). In the per-protocol analyses, vaccine efficacy was 80.2% (95% CI, 73.3 to 85.3; 61 cases of virologically confirmed dengue in the vaccine group vs. 149 cases in the placebo group), with 95.4% efficacy against dengue leading to hospitalization (95% CI, 88.4 to 98.2; 5 hospitalizations in the vaccine group vs. 53 hospitalizations in the placebo group). Planned exploratory analyses involving the 27.7% of the per-protocol population that was seronegative at baseline showed vaccine efficacy of 74.9% (95% CI, 57.0 to 85.4; 20 cases of virologically confirmed dengue in the vaccine group vs. 39 cases in the placebo group). Efficacy trends varied according to serotype. The incidence of serious adverse events was similar in the vaccine group and placebo group (3.1% and 3.8%, respectively).TAK-003 was efficacious against symptomatic dengue in countries in which the disease is endemic. (Funded by Takeda Vaccines; TIDES ClinicalTrials.gov number, NCT02747927.).

Objective: Antibody persistence evaluation for all antigens of a fully liquid DTaP-IPV-HB-PRP~T vaccine at 3.5 and 4.5 y of age following different primary series and booster schedules in South Africa and Latin America. Methods: Participants had completed one of two previous studies (Study 1-South Africa; Study 2-Latin America). In Study 1, participants who had not received HB vaccine at birth received a 6–10-14 week primary series of DTaP-IPV-HB-PRP~T or DTwP/PRP~T-Hib+HB+OPV and a third group who had received HB vaccine at birth received a 6–10-14 week primary series of DTaP-IPV-HB-PRP~T; all received a booster (15–18 months) of the primary series vaccine(s) except for HB in the DTwP/PRP~T-Hib group. In Study 2, participants received HB vaccine at birth, a 2–4-6 month primary series of DTaP-IPV-HB-PRP~T or DTaP-HB-IPV//PRP~T, and a DTaP-IPV-HB-PRP~T or DTaP-HB-IPV//PRP~T booster (12–24 months). Participants were followed up at 3.5 and 4.5 y of age for antibody persistence. Results: Approximately 80% of eligible participants were assessed. In Study 1, a birth dose of HB increased anti-HBs persistence (≥10 mIU/mL) following DTaP-IPV-HB-PRP~T primary and booster vaccination from 76.3% to 96.1% at 3.5 y of age and from 73.3% to 96.1% at 4.5 y of age; in Study 2, anti-HBs persistence was high and similar in each group. For the other antigens, there were no differences between groups or studies at 3.5 or 4.5 y. Conclusion: Good persistence of antibodies to each antigen in the DTaP-IPV-HB-PRP~T vaccine up to pre-school age, irrespective of the vaccination schedule during the first 2 y of life.

Drug repositioning (also called drug repurposing) is a strategy for identifying new therapeutic targets for existing drugs. This approach is of great importance in pharmacology as it is a faster and cheaper way to develop new medical treatments. In this paper, we present, to our knowledge, the first application of multiplex-heterogeneous network embedding to drug repositioning. Network embedding learns the vector representations of nodes, opening the whole machine learning toolbox for a wide variety of applications including link prediction, node labelling or clustering. So far, the application of network embedding for drug repositioning focused on heterogeneous networks. Our approach for drug repositioning is based on multiplex-heterogeneous network embedding. Such method allows the richness and complexity of multiplex and heterogeneous networks to be projected in the same vector space. In other words, multiplex-heterogeneous networks aggregate different multi-omics data in the same network representation. We validate the approach on a task of link prediction and on a case study for SARS-CoV2 drug repositioning. Experimental results show that our approach is highly robust and effective for finding new drug-target associations.

Synthetic biology and gene editing opens new possibilities for human enhancement requiring ethical, societal and biopolitical considerations to evaluate its implications on the biopower and the human species. In this article, from a critical and exploratory analysis, we advocate that recent biotechnological developments allowed by synthetic biology (including gene editing) are transforming the line of forces of biopower and biopolitics. After having described the paradigm of life as an engineering discipline conveyed by synthetic biology, we first analyze using the concept of somatechnology that this technoscience is transforming the figure of the cyborg towards the biocyborg blurring the distinctions natural/artificial and man/machine. In second, we investigate the bioeconomy of enhancement and its effect on how the individuals developed new modes of subjectivation and how they consider their own bodies. We end the article by analysing the transformations of biopower with gene editing and the use of technologies of genetic self-modification by self-experimenters.

Network embedding approaches are gaining momentum to analyse a large variety of networks. Indeed, these approaches have demonstrated their efficiency for tasks such as community detection, node classification, and link prediction. However, very few network embedding methods have been specifically designed to handle multiplex networks, i.e. networks composed of different layers sharing the same set of nodes but having different types of edges. Moreover, to our knowledge, existing approaches cannot embed multiple nodes from multiplex-heterogeneous networks, i.e. networks composed of several layers containing both different types of nodes and edges. In this study, we propose MultiVERSE, an extension of the VERSE method with Random Walks with Restart on Multiplex (RWR-M) and Multiplex-Heterogeneous (RWR-MH) networks. MultiVERSE is a fast and scalable method to learn node embeddings from multiplex and multiplex-heterogeneous networks. We evaluate MultiVERSE on several biological and social networks and demonstrate its efficiency. MultiVERSE indeed outperforms most of the other methods in the tasks of link prediction and network reconstruction for multiplex network embedding, and is also efficient in the task of link prediction for multiplex-heterogeneous network embedding. Finally, we apply MultiVERSE to study rare disease-gene associations using link prediction and clustering. MultiVERSE is freely available on github at https://github.com/Lpiol/MultiVERSE., 29 pages, 6 figures

OBJECTIVE There is a relative lack of information about infections occurring in children following allogeneic hematopoietic stem cell transplants (allo-HSCT) in developing countries. Herein, we describe the incidence rates of different infections according to the transplant period and baseline condition in Colombia. METHODS In a retrospective cohort study of all children who underwent allo-HSCTs from 2012 to 2017 in a hospital in Cali, Colombia, we reviewed medical records from the first post-transplant day until day + 365 to describe microbiologically confirmed incidence rates of infections and deaths during three post-transplant periods and according to baseline condition. RESULTS Most allo-HSCT (n = 144, 96%) were followed by infections over the following year, mostly due to bacteria and cytomegalovirus (4.3 and 3.3 per 1000 patient-days, respectively). Children were at the highest risk for infection in the first 30 days post-HSTC, but mortality was highest after 100 days. Overall, high mortality (n = 44, 31.7%) was associated with infections, especially from extensively drug-resistant bacteria, adenovirus, and aspergillosis. Infection rates were similar independent of the baseline condition. CONCLUSION Almost all children in this cohort developed infections post allo-HSCT. Describing the distribution of infections throughout the first post allo-HSCT year allows clinicians to narrow the differential diagnosis of infections according to the post-transplant period. This is especially useful when prioritizing interventions in children receiving HSCT in stringent healthcare systems in developing countries.

Late gestational exposure to Zika increases the odds of delay in the Bayley-II mental developmental index (MDI) in children with normal baseline neurologic assessments; 9-fold when comparing third and first trimester exposure. Risk of MDI developmental delay increases by 8% for each week of gestational age at time of exposure.

Las aleaciones Ti-β se han vuelto altamente demandadas en la industria, por sus buenas características físicas y químicas. En el presente trabajo, se sintetizó una aleación Ti-13Ta-3Sn (%at) por aleado mecánico con tiempos entre 2 y 100h. Las aleaciones se caracterizaron por difracción de rayos X (DRX) y los patrones se analizaron por el método Rietveld con el software MAUD. Se caracterizaron los cambios microestructurales y la evolución de las fases Ti-α y Ti-β. Se identificó la presencia una nueva fase metaestable fcc y la síntesis de una aleación con un 79,80% en peso de fase Ti-β, ambas con tamaño de cristalita nanométrico. The Ti-β alloys have become highly demanded in industry, due to their good physical and chemical characteristics. In the present work, a Ti-13Ta-3Sn (%at) alloy was synthesized using mechanical alloying (MA) between the times of 2 and 100h. The alloys were characterized by X-ray diffraction (XRD) and analyzed by the Rietveld method with the MAUD software. The microstructural changes and the evolution of the Ti-α and Ti-β phases were characterized. Identifying the presence of a new metastable fcc phase and the synthesis of an alloy with 79.80%wt of Ti-β phase, both alloys with nanometric crystallite size. Los autores agradecen al apoyo de FONDECYT 1161444, FONDECYT 1190797, FONDEQUIP EQM 140095 y al Programa de Incentivos a la Iniciación Científica (PIIC) de la USM.

Supplemental Digital Content is available in the text., Background: Acute otitis media (AOM) is an important cause of childhood morbidity and antibiotic prescriptions. However, the relative importance of the well-known otopathogens, Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hflu), remains unclear because of a limited number of tympanocentesis-based studies that vary significantly in populations sampled, case definitions and heptavalent pneumococcal conjugate vaccine use. Methods: We conducted a pooled analysis of results from 10 AOM etiology studies of similar design, the protocols of which were derived from a common protocol and conducted in children 3 months to 5 years of age in different countries. Generalized estimating equations were used to account for within-study correlations. Results: The majority, 55.5% (95% confidence interval: 47.0%–65.7%) of 1124 AOM episodes, were bacterial pathogen positive: 29.1% (24.8%–34.1%) yielded Hflu and 23.6% (19.0%–29.2%) Spn. Proportions of Hflu and Spn were higher and lower, respectively, in heptavalent pneumococcal conjugate vaccine–vaccinated children. Hflu and Spn were each isolated from 20% to 35% of children in every 1-year age range. Hflu was less likely to be isolated from first (vs. subsequent) episodes [relative risk (RR): 0.71 (0.60–0.84)]. Spn was more often isolated from sporadic (vs. recurrent) cases [RR: 0.76 (0.61–0.97)]; the opposite was true for Hflu [RR: 1.4 (1.00–1.96)]. Spn cases were more likely to present with severe (vs. mild) symptoms [RR: 1.42 (1.01–2.01)] and Hflu cases with severe tympanic membrane inflammation [RR: 1.35 (1.06–1.71)]. Conclusions: Spn and Hflu remain the leading otopathogens in all populations examined. While associated with overlapping symptoms and severity, they exhibit some differences in their likelihood to cause disease in specific subpopulations.

Summary Background Better population data on respiratory viruses in children in tropical and southern hemisphere countries is needed. Methods The epidemiology of respiratory viruses among healthy children (6 months to

Importance Ivermectin is widely prescribed as a potential treatment for COVID-19 despite uncertainty about its clinical benefit. Objective To determine whether ivermectin is an efficacious treatment for mild COVID-19. Design, Setting, and Participants Double-blind, randomized trial conducted at a single site in Cali, Colombia. Potential study participants were identified by simple random sampling from the state’s health department electronic database of patients with symptomatic, laboratory-confirmed COVID-19 during the study period. A total of 476 adult patients with mild disease and symptoms for 7 days or fewer (at home or hospitalized) were enrolled between July 15 and November 30, 2020, and followed up through December 21, 2020. Intervention Patients were randomized to receive ivermectin, 300 μg/kg of body weight per day for 5 days (n = 200) or placebo (n = 200). Main Outcomes and Measures Primary outcome was time to resolution of symptoms within a 21-day follow-up period. Solicited adverse events and serious adverse events were also collected. Results Among 400 patients who were randomized in the primary analysis population (median age, 37 years [interquartile range {IQR}, 29-48]; 231 women [58%]), 398 (99.5%) completed the trial. The median time to resolution of symptoms was 10 days (IQR, 9-13) in the ivermectin group compared with 12 days (IQR, 9-13) in the placebo group (hazard ratio for resolution of symptoms, 1.07 [95% CI, 0.87 to 1.32];P = .53 by log-rank test). By day 21, 82% in the ivermectin group and 79% in the placebo group had resolved symptoms. The most common solicited adverse event was headache, reported by 104 patients (52%) given ivermectin and 111 (56%) who received placebo. The most common serious adverse event was multiorgan failure, occurring in 4 patients (2 in each group). Conclusion and Relevance Among adults with mild COVID-19, a 5-day course of ivermectin, compared with placebo, did not significantly improve the time to resolution of symptoms. The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand the effects of ivermectin on other clinically relevant outcomes. Trial Registration ClinicalTrials.gov Identifier:NCT04405843

Geographical information systems (GIS) use for development of epidemiological maps in tropical diseases is increasingly frequently utilized. Here, we apply this technique to map the current Zika virus (ZIKV) outbreak in Colombia. Surveillance cases data of the ongoing epidemic of ZIKV in Valle del Cauca department and its capital, Cali (2015-2016), were used to estimate cumulated incidence rates (cases/100,000 population) to develop the first maps in the department and it municipalities. The GIS software used was Kosmo Desktop 3.0RC1(A (R)). Three thematic incidence rate maps were developed. Up to April 2, 2016, 9,825 cases of ZIKV were reported (15.15 % of the country cases). The burden of ZIKV infection has been concentrated in the North of the department. Valle del Cauca borders with other departments with incidence of ZIKV infection, such as Quindio (173 cases) and Risaralda (687 cases). Eleven municipalities of Valle del Cauca had cases in the range between 250 and 499 cases/100,000, all in the North and East of the department. Cali, the capital concentrates more than a third of the reported cases of ZIKV in Valle del Cauca. Use of GIS-based epidemiological maps allows to guide decision-making for prevention and control of diseases that constitute significant public health problems in the region and the country, such as exemplified by the emergence of ZIKV infection, particularly in departments such as Valle del Cauca with a high disease incidence

Epidemiological data from Latin America on acute gastroenteritis (AGE) in the post rotavirus vaccine era obtained using highly sensitive molecular techniques are scarce.This prospective surveillance study was performed between March 15, 2015 and March 19, 2016 in two municipal health networks (MHNs) in Cali, Colombia to detect AGE in children5 years of age. Consecutive sampling was performed simultaneously in all health facilities belonging to both MHNs until completion of the required sample size. Stool samples from AGE patients were tested with a nucleic acid assay for 16 pathogens. Detection frequency and incidence rates were obtained for specific pathogens according to age-group in children with AGE leading to hospitalization or outpatient care.Overall incidence rates of AGE-related hospitalization and outpatient care were 20 and 237 per 1000 children5 years of age, respectively. Despite almost complete rotavirus vaccine uptake, rotavirus was the most common etiology overall, including hospitalization and outpatient treatment of 0-23-month-olds, with incidence rates of 12 and 108 per 1000 children, respectively. Norovirus incidence rates were similar to rotavirus rates in this age group and associated with high Vesikari scores. Shigella predominated in 24-59-month-olds.AGE remains an important cause of morbidity in children under 5 years of age, especially in those under 2 years. Rotavirus remains the leading AGE-associated pathogen, followed closely by norovirus in younger children. Preventive measures, including novel vaccination strategies, are necessary in this population to further reduce AGE-related morbidity.

International audience; Recent research suggests that conceptual or emotional factors could influence the perceptual processing of stimuli. In this article, we aimed to evaluate the effect of social information (positive, negative, or no information related to the character of the target) on subjective (perceived and felt valence and arousal), physiological (facial mimicry) as well as on neural (P100 and N170) responses to dynamic emotional facial expressions (EFE) that varied from neutral to one of the six basic emotions. Across three studies, the results showed reduced ratings of valence and arousal of EFE associated with incongruent social information (Study 1), increased electromyographical responses (Study 2), and significant modulation of P100 and N170 components (Study 3) when EFE were associated with social (positive and negative) information (vs. no information). These studies revealed that positive or negative social information reduces subjective responses to incongruent EFE and produces a similar neural and physiological boost of the early perceptual processing of EFE irrespective of their congruency. In conclusion, the article suggests that the presence of positive or negative social context modulates early physiological and neural activity preceding subsequent behavior.

Introduccion: entre las patologias bucales que aquejan a los ninos con VIH/sida se encuentra la caries dental, entidad prevenible si se detecta y controla en sus etapas iniciales para evitar mayores complicaciones. El objetivo del presente estudio consistio en determinar la prevalencia de caries en ninos y jovenes con VIH/sida de transmision vertical de la Clinica Pediatrica de VIH, de Cali, Colombia, 2013, y explorar relaciones con factores biologicos. Metodologia: estudio descriptivo de prevalencia en 101 historias clinicas de ninos y jovenes de 1 a 17 anos con VIH/sida por transmision vertical de la Clinica Pediatrica de VIH, de Cali. Se usaron los sistemas de clasificacion ICDAS y COP/ceo. Se incluyo analisis multivariado y ajuste por variables confusoras para explorar relaciones con factores sociodemograficos, paraclinicos, nutricionales y odontologicos. Se conto con el aval de los comites de etica institucionales. Resultados: la prevalencia de vida de caries cavitada en ninos con VIH fue de 34,65% COP/ceo_d (5-6) 3,29 ± 3,06. Esta prevalencia aumenta 83,17% con el sistema ICDAS 2-6 . La prevalencia puntual de caries activa fue de 74,26% COP-d 5,68 ± 5,48. No se encontro asociacion estadisticamente significativa con ninguna variable socioeconomica ni inmunologica. Los pacientes con inmunodepresion moderada y severa presentaron un OR 1,13 IC95% (0,33-3,81) p = 0,84. Se encontro una probable asociacion con el indice de placa OR 4,58 IC95% (1,44-14,55) p = 0,006 y con la historia de caries OR 4,21 IC95% (1,09-16,13) Conclusion : los pacientes con VIH de la Clinica Pediatrica presentan alta prevalencia de caries cuando se valoran lesiones precavitacionales. No se encontro una probable asociacion de caries con el estadio inmunologico ni con el clinico, por lo que este aspecto no es un factor de riesgo adicional. DOI: http://dx.doi.org/10.17533/udea.rfo.v29n2a2

Summary Objectives This phase III study assessed the safety and immunogenicity of MenACWY-CRM, a quadrivalent meningococcal conjugate vaccine, administered with routine vaccines starting at 2 months of age. Methods Healthy infants received MenACWY-CRM in a two- or three-dose primary infant series plus a single toddler dose. In addition, a two-dose toddler catch-up series was evaluated. Immune responses to MenACWY-CRM were assessed for serum bactericidal activity with human complement (hSBA). Reactogenicity and safety results were collected systematically. Results After a full infant/toddler series or two-dose toddler catch-up series, MenACWY-CRM elicited immune responses against the four serogroups in 94–100% of subjects. Noninferiority of the two- versus three-dose MenACWY-CRM infant dosing regimen was established for geometric mean titers for all serogroups. Following the three-dose infant primary series, 89–98% of subjects achieved an hSBA ≥8 across all serogroups. Immune responses to concomitant routine vaccines given with MenACWY-CRM were noninferior to responses to routine vaccines alone, except for pertactin after the two-dose infant series. Noninferiority criteria were met for all concomitant antigens after the three-dose infant series. Conclusions MenACWY-CRM vaccination regimens in infants and toddlers were immunogenic and well tolerated. No clinically meaningful effects of concomitant administration with routine infant and toddler vaccines were observed.

GlaxoSmithKline Biologicals Background. the vaccine efficacy (VE) of 1 or 2 doses of AS03-adjuvanted influenza A(H1N1) vaccine relative to that of 2 doses of nonadjuvanted influenza A(H1N1) vaccine in children 6 months to

ResumenAntecedentesPoco se sabe sobre la neumonitis intersticial linfoidea (NIL) en niños con infección por el virus de inmunodeficiencia humana-1 (VIH-1).ObjetivoDescribir las características clínicas y patológicas de NIL en niños infectados por VIH-1 en un centro de referencia para VIH pediátrico en Cali (Colombia).MétodosSe llevó a cabo una descripción de serie de casos de NIL basados en revisión retrospectiva de historias clínicas de todos los casos de niños con enfermedad pulmonar crónica y LIP confirmada por biopsia entre los años 2001 y 2012.Resultados y conclusionesDiez de 12 casos con NIL fueron confirmados por biopsia pulmonar. Se observó una respuesta clínica y de función respiratoria luego del tratamiento con prednisona, excepto en un caso que presentó tos persistente. No se encontraron casos de tuberculosis pulmonar (TP) en nuestra serie y el papel de la biopsia pulmonar fue crítico para alcanzar un diagnóstico preciso.AbstractBackgroundLittle is known about Lymphoid Interstitial Pneumonitis (LIP) in children with HIV infection.AimsTo describe the clinical and pathological characteristics of LIP in infected children in a referral center for pediatric HIV in Cali (Colombia).MethodsCase series based on retrospective analysis of clinical charts among HIV-infected children with chronic lung disease and lung-biopsy proven LIP between the years 2001 and 2012.Results and conclusions10 of 12 cases of LIP were confirmed by lung biopsy. Significant clinical and respiratory functional improvement was obtained in all cases after prednisone therapy, excepting one child who presented persistent cough. No case of pulmonary TB was detected in our cohort. Lung biopsy was critical to obtain an accurate diagnosis.

This was a safety follow-up study conducted in 382 toddlers in Colombia who had last received dengue vaccine (CYD-TDV) 2 years before. A review of local municipal epidemiologic reports for dengue cases was also conducted for ~28 months postimmunization. One case of clinical dengue was reported; it was neither considered as severe nor related to the study vaccine.

Having previously demonstrated the feasibility of administering A/H5N1 and seasonal influenza vaccine antigens in an MF59-adjuvanted tetravalent formulation, we now report on long-term antibody persistence and responses to a booster dose of a combined seasonal-pandemic, tetravalent influenza vaccine in adults. The primary objective was the evaluation of responses to a booster dose of tetravalent influenza vaccine containing seasonal (A/H1N1, A/H3N2, and B) and avian (A/H5N1, clade 2) influenza virus strains administered to 265 healthy 18- to 40-year-old volunteers 1 year after priming with one or two clade 1 A/H5N1 doses. Secondary objectives were assessment of reactogenicity, safety, and antibody persistence 1 year after priming with a combined seasonal-pandemic, tetravalent vaccine. Responses to seasonal strains met all European licensure criteria; seroprotection rates were 94 to 100%, 100%, and 61 to 90% for A/H1N1, A/H3N2, and B strains, respectively. Anamnestic responses were observed against homologous and heterologous A/H5N1 strains whether priming with one or two A/H5N1 doses, with a monovalent A/H5N1 vaccine, or with a tetravalent vaccine. A single dose of MF59-adjuvanted A/H5N1 vaccine given alone or as part of a fixed combination with a seasonal influenza vaccine was sufficient to prime adult subjects, resulting in robust antigen-specific and cross-reactive antibody responses to heterologous booster immunization 1 year later. These data support the feasibility of incorporating prepandemic priming into seasonal influenza vaccination programs. (This study has been registered at clinicaltrials.gov under registration no. NCT00481065.)

La paracoccidioidomicosis, enfermedad sistémica fungémica, es causada por Paracoccidioides brasiliensis. Se produce por la inhalación de conidias, conduciendo a una infección pulmonar transitoria que por lo general, se autoresuelve. En jovenes puede progresar a una forma aguda o subaguda. Generalmente quienes la padecen son agricultores, ya que los principales lugares donde se localiza el gérmen es en los cultivos de café, cacao y algodón. Las manifestaciones clinicas pueden ser en piel, mucosas, sistema reticuloendotelial, pulmones, y glandula suprarrenal, entre otros. Su manejo es con antimicóticos por tiempo prolongado y por lo general se requieren combinaciones de los mismos. Sepresenta el caso de una adolescente con paracoccidioidomicosis subaguda.

Balancing habitual and deliberate forms of choice entails a comparison of their respective merits—the former being faster but inflexible, and the latter slower but more versatile. Here, we show that arbitration between these two forms of control can be derived from first principles within an Active Inference scheme. We illustrate our arguments with simulations that reproduce rodent spatial decisions in T-mazes. In this context, deliberation has been associated with vicarious trial and error (VTE) behavior (i.e., the fact that rodents sometimes stop at decision points as if deliberating between choice alternatives), whose neurophysiological correlates are “forward sweeps” of hippocampal place cells in the arms of the maze under consideration. Crucially, forward sweeps arise early in learning and disappear shortly after, marking a transition from deliberative to habitual choice. Our simulations show that this transition emerges as the optimal solution to the trade-off between policies that maximize reward or extrinsic value (habitual policies) and those that also consider the epistemic value of exploratory behavior (deliberative or epistemic policies)—the latter requiring VTE and the retrieval of episodic information via forward sweeps. We thus offer a novel perspective on the optimality principles that engender forward sweeps and VTE, and on their role on deliberate choice.

Balancing habitual and deliberate forms of choice entails a comparison of their respective merits—the former being faster but inflexible, and the latter slower but more versatile. Here, we show that arbitration between these two forms of control can be derived from first principles within an Active Inference scheme. We illustrate our arguments with simulations that reproduce rodent spatial decisions in T-mazes. In this context, deliberation has been associated with vicarious trial and error (VTE) behavior (i.e., the fact that rodents sometimes stop at decision points as if deliberating between choice alternatives), whose neurophysiological correlates are “forward sweeps” of hippocampal place cells in the arms of the maze under consideration. Crucially, forward sweeps arise early in learning and disappear shortly after, marking a transition from deliberative to habitual choice. Our simulations show that this transition emerges as the optimal solution to the trade-off between policies that maximize reward or extrinsic value (habitual policies) and those that also consider the epistemic value of exploratory behavior (deliberative or epistemic policies)—the latter requiring VTE and the retrieval of episodic information via forward sweeps. We thus offer a novel perspective on the optimality principles that engender forward sweeps and VTE, and on their role on deliberate choice.

Active inference is a general framework for perception and action that is gaining prominence in computational and systems neuroscience but is less known outside these fields. Here, we discuss a proof-of-principle implementation of the active inference scheme for the control or the 7-DoF arm of a (simulated) PR2 robot. By manipulating visual and proprioceptive noise levels, we show under which conditions robot control under the active inference scheme is accurate. Besides accurate control, our analysis of the internal system dynamics (e.g. the dynamics of the hidden states that are inferred during the inference) sheds light on key aspects of the framework such as the quintessentially multimodal nature of control and the differential roles of proprioception and vision. In the discussion, we consider the potential importance of being able to implement active inference in robots. In particular, we briefly review the opportunities for modelling psychophysiological phenomena such as sensory attenuation and related failures of gain control, of the sort seen in Parkinson's disease. We also consider the fundamental difference between active inference and optimal control formulations, showing that in the former the heavy lifting shifts from solving a dynamical inverse problem to creating deep forward or generative models with dynamics, whose attracting sets prescribe desired behaviours.

Introduccion. La hepatitis A es una enfermedad infectocontagiosa causada por un virus ARN no encapsulado de la familia Picornaviridae y del genero Hepatovirus, que se trasmite por via fecal-oral, bien sea de persona a persona o en epidemias originadas por una fuente comun. Objetivo. Se estimo la seroprevalencia de anticuerpos de tipo IgG contra el virus de la hepatitis A en ninos de 1 a 15 anos, atendidos en un hospital universitario como parte de un estudio cooperativo nacional. Metodos. Se realizo un estudio descriptivo y prospectivo, entre junio y noviembre de 2007. Los niveles de anticuerpos se detectaron mediante un inmunoensayo enzimatico de microparticulas. A cada participante del estudio se le hizo una encuesta de riesgo con las variables objeto del estudio. Resultados. Se estudiaron 422 ninos. La prevalencia global de anticuerpos contra el virus de la hepatitis A fue de 29,1%: 37,1% en el grupo de 5 a 9 anos, 36,1%, en el de 10 a 15 y 13,8%, en el de 1 a 4 anos. La mayor proporcion de prevalencia de anticuerpos se encontro en los ninos de estrato socioeconomico mas bajo: 44,2% para el estrato 1 y 27,9% para el estrato 2. Discusion. En este estudio se encontro una seroprevalencia de anticuerpos para hepatitis A mas baja en menores de 5 anos, lo que puede indicar una transicion del patron epidemiologico hacia un nivel intermedio. La prevalencia fue mayor en los ninos de estratos socioeconomicos bajos, lo que puede estar en relacion con el hacinamiento y las malas practicas de higiene Introduccion. La hepatitis A es una enfermedad infectocontagiosa causada por un virus ARN no encapsulado de la familia Picornaviridae y del genero Hepatovirus, que se trasmite por via fecal-oral, bien sea de persona a persona o en epidemias originadas por una fuente comun. Objetivo. Se estimo la seroprevalencia de anticuerpos de tipo IgG contra el virus de la hepatitis A en ninos de 1 a 15 anos, atendidos en un hospital universitario como parte de un estudio cooperativo nacional. Metodos. Se realizo un estudio descriptivo y prospectivo, entre junio y noviembre de 2007. Los niveles de anticuerpos se detectaron mediante un inmunoensayo enzimatico de microparticulas. A cada participante del estudio se le hizo una encuesta de riesgo con las variables objeto del estudio. Resultados. Se estudiaron 422 ninos. La prevalencia global de anticuerpos contra el virus de la hepatitis A fue de 29,1%: 37,1% en el grupo de 5 a 9 anos, 36,1%, en el de 10 a 15 y 13,8%, en el de 1 a 4 anos. La mayor proporcion de prevalencia de anticuerpos se encontro en los ninos de estrato socioeconomico mas bajo: 44,2% para el estrato 1 y 27,9% para el estrato 2. Discusion. En este estudio se encontro una seroprevalencia de anticuerpos para hepatitis A mas baja en menores de 5 anos, lo que puede indicar una transicion del patron epidemiologico hacia un nivel intermedio. La prevalencia fue mayor en los ninos de estratos socioeconomicos bajos, lo que puede estar en relacion con el hacinamiento y las malas practicas de higiene

ResumenObjetivosdescribir las alteraciones metabólicas en niños con diagnóstico de VIH y en tratamiento con terapia antirretroviral altamente efectiva (Highly Active Antiretroviral Therapy, HAART).Métodosse realizó una primera fase descriptiva de los valores de lípidos y glucemia en una cohorte de niños positivos para VIH. De una clínica pediátrica se reclutaron, entre junio de 2003 y junio de 2005, niños mayores de un mes y menores de 16 años en terapia HAART. Estos resultados se compararon con valores de la población. En una segunda fase, se estudió la densidad ósea en estos niños, utilizando DEXA (dual energy X-ray absorptiometry) y antropometría, y se comparó la de controles sanos.Resultadosse incluyeron 38 niños positivos para VIH. En 59,5% de los niños se clasificaron con displidemia. Al compararlo con la población de referencia, el grupo positivo para VIH presentó una prevalencia mayor de hipertrigliceridemia y HDLc (highdensity lipoprotein) anormalmente bajo. Tomando en cuenta la variación por edad, los valores de colesterol total y LDLc (lowdensity lipoprotein), mostraron un aumento en el grupo que recibía inhibidores de proteasa (IP) contra el que no. La diferencia del puntaje Z de BMD (bone mineral density) entre los grupos fue de 0,56 (IC95%: 0,1- 1,0), teniendo un menor puntaje Z el grupo positivo para VIH. El puntaje Z de la densidad de masa ósea mostró un declive con el tiempo de exposición, que no fue evidente en el grupo control.Conclusionesencontramos alteraciones en los lípidos similares a las descritas en el adulto seropositivo. En el grupo con IP se encontraron alteraciones del colesterol que cambiaban según la edad. Se encontró una pérdida de la densidad ósea, progresiva con el tiempo de exposición e independiente de la edad. Consideramos que esta relación podría ser de origen multifactorial, incluyendo los efectos de la infección y del tratamiento.SummaryObjectivesour goal is to describe metabolic alterations in children with HIV and under highly effective anti-retroviral treatment (HAART).Methodologya first descriptive phase of lipid levels and glucemia was carried out in a cohort of HIV positive children. In a paediatric hospital, children >1 month and