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Aims and Objectives: Mouth acts as a mirror for most of the underlying systemic diseases. Very few studies were done in south Indian population to observe the oral manifestations of human immunodeficiency virus (HIV) in relation to the cluster of differentiation 4 (CD4) count, and this study mainly highlights the presenting complaint of HIV patients during their dental visit. The study was aimed to determine the chief complaints of patients along with oral manifestations of HIV and correlate them to CD4 count. Materials and Methods: One hundred consecutive HIV-positive patients were considered for the study. All the oral manifestations and the chief complaints along with the calculated CD4 counts were noted and the results were correlated. Spearman correlation was used for CD4 count and other oral manifestations. Results: The mean CD4 counts were 421 cells/mm3 with a standard deviation (SD) of 404.34 for the most common oral manifestation of burning mouth and 176.5 cells/mm3 for the least common manifestation of malignancies. The CD4 count ranged from 120 to 1100 cells/mm3. The mean age and CD4 count were 38 years and 398.86, respectively. There was a statistically significant correlation with candidiasis and gingivitis, and the rest of the conditions were insignificant. Conclusion: The study results suggest that the chief complaint of presentation of an HIV-positive patient is pain due to carious teeth/abscess followed by burning mouth, with candidiasis being the most common disease. [ABSTRACT FROM AUTHOR]

Background and Objective: Stigmatization and discrimination are phenomena familiar to all human immunodeficiency virus (HIV)-positive patients, which create a significant amount of stress; little is known about the role of family support in alleviation of this stressful condition. The current study aims to investigate the relationship between the perceptions of family support, stigmatization, and symptoms of posttraumatic stress in HIV-positive patients in Pakistan. Methods: A total of 100 seropositive patients, aged between 18 and 50 years, were approached through professional organizations in Lahore, Pakistan, based on purposive and snowball sampling strategies. The magnitude of stigma experienced by the patients was assessed by administering the Berger HIV stigma scale. The multidimensional scale of perceived social support and post-traumatic stress disorder checklist were used to assess post-traumatic stress symptoms (PTSS) and perceived family support (PFS). Results: The study identified a positive relationship between experiencing stigma and the development of PTSS. Also, a significant inverse relationship between PFS and PTSS was observed, whereas a consequential negative association between experiencing stigma and PFS was evident in patients who disclosed their illness to their families. Conclusion: The current study documents that HIV seropositive patients in Pakistan experience high levels of stigma, especially in relation to the disease disclosure to their families and other social contacts. An already immune compromised status and stigmatization leads to significant stress symptoms which ultimately decrease the perception about accessibility of social support in the times of crisis. [ABSTRACT FROM AUTHOR]

Simple Summary: Toxoplasmosis is a zoonotic disease caused by T. gondii infection. The main aims of this study were to assess the seropositivity to toxoplasmosis of an exotic breed of cattle (n = 400) from different farms using the Latex Agglutination Test, validate the Cattle Toxo IgG ELISA kit with the help of the commercially available ELISA kit and compare the efficacy of the LAT and Cattle Toxo IgG ELISA kit for assessing seropositivity of cattle to toxoplasmosis. Four hundred cattle sera were collected from an exotic breed of cattle in Pakistan. These sera were evaluated through an LAT and Cattle Toxo IgG ELISA kit. Of 400 samples, 90 were elected and screened through a commercially available ELISA kit. The sensitivity and specificity of the Cattle Toxo IgG ELISA kit came out to be 100% and 96.15%, and in LAT, it was found as 26.31% and 61.53%, respectively. The Cattle Toxo IgG ELISA kit revealed 29.75% (119/400) seropositivity, 6% less than that found through LAT. The results of this study show that Cattle Toxo IgG ELISA kit is a highly accurate and reliable serodiagnostic tool to diagnose bovine toxoplasmosis. Toxoplasma gondii is a protozoan parasite that causes toxoplasmosis in warm-blooded vertebrates, globally. The main aims of this study were to assess the seropositivity to toxoplasmosis of an exotic breed of cattle (n = 400) from different farms using the Latex Agglutination Test and validate Cattle Toxo IgG ELISA kit. Of a total of 400 cattle sera that were evaluated by LAT, 143 (35.75%) were found positive. Based on these data, 90 samples (n = 60 seronegative by LAT; n = 30 seropositive by LAT) were elected for screening through a commercially available ELISA kit. The same 90 samples were screened through a Cattle Toxo IgG ELISA kit for validation purposes. Of 90 samples, 40 were seropositive in the Cattle Toxo IgG ELISA kit (100% sensitivity), and 38 were seropositive in a commercially available ELISA kit. All 50 samples in the Cattle Toxo IgG ELISA kit (96.15% specificity) were also seronegative in the commercially available ELISA kit. Hence, the sensitivity and specificity of the Cattle Toxo IgG ELISA kit came out to be 100% and 96.15%, and in LAT, it was found as 26.31% and 61.53%, respectively. Therefore, the Cattle Toxo IgG ELISA kit is a highly reliable serodiagnostic tool to diagnose bovine toxoplasmosis. [ABSTRACT FROM AUTHOR]

Background & objectives: Serosurvey of COVID-19 provides a better estimation of people who have developed antibodies against the infection. Undertaking such a serosurvey in certain districts of India which are densely populated with prominent tribes can provide valuable information regarding seropravelance of SARS-CoV-2 antibodies among such indigenous populations. In this context, two rounds of population-based, cross-sectional serosurveys for SARS-CoV-2 IgG antibody were carried out in Jharkhand, a tribal-dominated State of India, to compare the seroprevalence of SARS-CoV-2 infection and to determine the associated demographic risk factors. Methods: The surveys were carried out in June 2020 and February 2021 in ten districts of the State of Jharkhand. Blood samples were collected from the residents of the selected districts by random sampling and tested for anti-SARS-CoV-2 antibodies using an automated chemiluminescence immunoassay platform. A total of 4761 and 3855 eligible participants were included in round 1 and round 2, respectively. Results: The age- and gender-standardized seroprevalence for COVID-19 during round 1 was 0.54 per cent (0.36-0.80) that increased to 41.69 per cent (40.16-43.22) during round 2 with a gap of eight months in between. The seropositivity among male and female participants was 0.73 and 0.45 per cent, respectively, during the first round and 51.35 and 33.70 per cent, respectively, during the second round. During the first round, 17.37 per cent of the participants were tribal with seropositivity of 0.24 per cent (0.02-0.87), and during the second round, 21.14 per cent were tribal with seropositivity of 39.14 per cent (35.77-42.59). Compared to tribal group, non-tribal participants had an adjusted odds of 1.24 (95% confidence interval=1.04-1.48) for SARS-CoV-2 seropositivity. Interpretation & conclusions: COVID-19 seroprevalence was found to be low during the first round (0.54%) of the survey, possibly due to the travel restrictions during lockdown better adherence to social distancing and wearing of face masks among the people. Understanding the dynamics of SARS-CoV-2 transmission and the susceptibility to infection at the individual as well as community level will inform decision and help policy makers to design and implement effective public health strategies to mitigate the pandemic in this State. [ABSTRACT FROM AUTHOR]

Introduction: Blood transfusion is one of the most important and integral intervention of the modern medicine but, simultaneously it carries the solemn risk of transmitting various life-threatening Transfusion-Transmissible Infectious (TTI) agents. Aim: To study the serological profile of voluntary blood donors in a blood bank of tertiary healthcare centre in Kumaon region, Uttarakhand, India. Materials and Methods: A hospital based prospective study was conducted from September 2018-September 2020. All the potential blood donors coming to the Department of Pathology and Blood Bank were included and after obtaining informed consent from the donor, venous blood was collected. Samples were tested for Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), syphilis, and malarial parasite. The data was collected and tabulated in Microsoft Excel sheet and was analysed by calculating frequency and percentages. Results: A total of 8874 donors were screened during the study period; of these 5.66% (503/8874) were found to be seropositive. Seroprevalence of HBV, HCV, HIV, syphilis and malaria was 1.87% (166/8874), 3.23% (287/8874), 0.15% (14/8874), 0.40% (35/8874) and 0.01% (01/8874) respectively. Highest prevalence of TTI (55.06%; 277/503) was within the age group of 18-28 years. Maximum seroreactivity was seen in blood group- B positive (32.60%; 164/503) followed by A positive (25.84%; 130/503). Conclusion: Although, there has been a down-swing in the prevalence of TTI’s but, there is still need for improvement in the quality of transfusion medicine services and implementation of strict donor criteria to further minimise the risk of TTI’s.

Respiratory syncytial virus (RSV) remains the most common cause of lower respiratory tract infections in children worldwide. Development of a vaccine has been hindered due the risk of enhanced respiratory disease (ERD) following natural RSV exposure and the young age (

Introduction: Hepatitis infections are endemic in many countries. The serological hallmark for these infections is the presence of antibodies and antigens in the blood of the infected persons. These serological markers give an idea on the seropositivity of specific hepatitis. Objectives: This research was designed to investigate the seroprevalence of hepatitis A (HAV), B (HBV) and C (HCV) infections among patients attending health care facilities in two riverine communities in Akwa Ibom State, Nigeria. Methods: A cross sectional-descriptive study was conducted in two riverine communities, namely: Ikot Abasi and Oron, as well as one upland community, Uyo, as a control. Ethical approval and consents were obtained from the State Ministry of Health and volunteers. Three hundred (300) blood samples, 100 samples from each study area were collected and tested for the presence of HAV, HBV, and HCV antibodies and antigens using hepatitis rapid immunoassay and antibodies kits (Acon Diagnostics, USA), respectively. Structured questionnaires were used to obtain socio-demographic information from participants. Results: The prevalence rates of HAV, HBV, and HCV infections were: 14%, 10% and 6% in Ikot Abasi; 20%, 14% and 8% in Oron; while Uyo recorded 2%, 12% and 6%, respectively. The prevalence of HAV infection at the riverine communities was significantly higher than in the control (p=0.016). Children ≤ 10 years showed a higher prevalence of HAV. The prevalence of HBV and HCV infections in the riverine communities did not differ from the control (p=0.011). Prevalence based on socio- demographic parameters differed (p<0.05) in some study areas. Conclusion: Predisposing factors for the transmission of hepatitis A infection, such as indiscriminate sewage disposal, lack of awareness and sensitization campaign abound in riverine communities. These factors are not responsible for transmission of HBV and HCV infections in both the riverine and non-riverine communities. Therefore, proper hygiene, good sexual conduct, awareness and vaccination campaign are encouraged in the study areas. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the serologic response to the BNT162b2 messenger ribonucleic acid vaccine in patients with urothelial carcinoma and renal cell carcinoma. Methods: Between June 2021 and November 2021, we retrospectively evaluated blood samples from 60 healthy controls (control group), 57 patients with urothelial carcinoma, and 28 patients with renal cell carcinoma who had received two doses of the BNT162b2 vaccine at Hirosaki University Hospital. We determined the immunoglobulin G antibody titers against the severe acute respiratory syndrome coronavirus 2 spike receptor‐binding domain. Seropositivity was defined as ≥15 U/mL. We investigate factors associated with antibody titers and seropositivity in the patients with urothelial carcinoma and renal cell carcinoma. Results: Antibody titers in the control, urothelial carcinoma, and renal cell carcinoma groups were 813, 431, and 500 U/mL, respectively. Seropositivity was 100%, 90%, and 96% in the control, urothelial carcinoma, and renal cell carcinoma groups, respectively. Of the 85 patients, 37 of 57 (65%) and 21 of 28 (75%) were actively undergoing anticancer treatment for urothelial carcinoma and renal cell carcinoma, respectively. Anti‐severe acute respiratory syndrome coronavirus 2 spike immunoglobulin G antibody titers and seropositivity was not significantly different between the patients with urothelial carcinoma and renal cell carcinoma. Anti‐severe acute respiratory syndrome coronavirus 2 spike immunoglobulin G antibody titers were not significantly associated with active anticancer therapy or steroid treatment for immune‐related adverse events. Univariable logistic regression analysis revealed that older age and metastatic disease were significantly and negatively associated with seropositivity. Conclusions: Patients with urothelial carcinoma or renal cell carcinoma exhibited an adequate antibody response to the BNT162b2 vaccine. Active anticancer therapy was not significantly associated with seropositivity following vaccination with severe acute respiratory syndrome coronavirus 2 BNT162b2 in patients with urothelial carcinoma and renal cell carcinoma. [ABSTRACT FROM AUTHOR]

Background and objectives: The immunogenicity of vaccines is known to be attenuated in patients with end‐stage kidney disease due to uremia. Patients on dialysis were excluded from coronavirus disease 2019 (COVID‐19) vaccine trials; thus, the effectiveness of vaccines for this population is unclear. The aim of this study was to explore whether Asian dialysis patients can effectively produce an immune response after being vaccinated with the first dose of the ChAdOx1 nCoV‐19 vaccine. Design setting, participants, and measurements: In this prospective cohort study, we included Asian hemodialysis patients who received the ChAdOx1 nCoV‐19 vaccine. At 3 weeks after the first dose of vaccination, we assessed the humoral immune response by measuring anti‐SARS‐CoV‐2 S antibody titers. The primary outcome was the seropositive rate following vaccination, defined as an antibody titer greater than or equal to 0.8 U/ml. Factors associated with seropositivity were explored in multivariate logistic regression analyses. Results: In total, 434 participants were included. The mean age was 64 years, the mean dialysis vintage was 6 years, and 61% of the participants were men. At a mean time of 22 days from vaccination, 56% of the participants were seropositive. The vast majority (88%) had low antibody titers (< 15 U/ml). The multivariate logistic regression analyses showed that older age (every increase of 10 years, odds ratio [OR] 0.80, 95% CI 0.65–0.98, p = 0.03) was negatively associated with seropositivity and that higher Kt/V (every increase of 0.1, OR 1.14, 95% CI 1.01–1.28, p = 0.03) and higher serum albumin level (every increase of 0.1 g/dl, OR 1.09, 95% CI 1.02–1.18, p = 0.02) were positively associated with seropositivity. Conclusions: In Asian hemodialysis patients, the seropositive rate was low, and most had low antibody titers after the first dose of the ChAdOx1 nCoV‐19 vaccine. Younger age, better dialysis adequacy, and higher albumin levels were associated with seropositivity. [ABSTRACT FROM AUTHOR]

Background There are few data on the full spectrum of disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across the lifespan from community-based or nonclinical settings. Methods We followed 2338 people in Managua, Nicaragua, aged <94 years from March 2020 through March 2021. SARS-CoV-2 infection was identified through real-time reverse transcription polymerase chain reaction (RT-PCR) or through enzyme-linked immunosorbent assay. Disease presentation was assessed at the time of infection or retrospectively by survey at the time of blood collection. Results There was a large epidemic that peaked between March and August 2020. In total, 129 RT-PCR–positive infections were detected, for an overall incidence rate of 5.3 infections per 100 person-years (95% confidence interval [CI], 4.4–6.3). Seroprevalence was 56.7% (95% CI, 53.5%–60.1%) and was consistent from age 11 through adulthood but was lower in children aged ≤10 years. Overall, 31.0% of the infections were symptomatic, with 54.7% mild, 41.6% moderate, and 3.7% severe. There were 2 deaths that were likely due to SARS-CoV-2 infection, yielding an infection fatality rate of 0.2%. Antibody titers exhibited a J-shaped curve with respect to age, with the lowest titers observed among older children and young adults and the highest among older adults. When compared to SARS-CoV-2–seronegative individuals, SARS-CoV-2 seropositivity at the midyear sample was associated with 93.6% protection from symptomatic reinfection (95% CI, 51.1%–99.2%). Conclusions This population exhibited a very high SARS-CoV-2 seropositivity with lower-than-expected severity, and immunity from natural infection was protective against symptomatic reinfection. [ABSTRACT FROM AUTHOR]

There have been occasional reports on varicella infection among healthcare workers (HCWs) despite varicella-zoster virus (VZV) seropositivity. We compared the levels of humoral and cellular immunity to VZV in seropositive HCWs who had acquired immunity by natural infection or vaccination. Seropositive healthy HCWs with an apparent history of varicella or VZV vaccination once or twice were recruited. Their samples were assessed for anti-VZV IgG levels, the relative avidity index (RAI), and the frequencies of VZV-specific cytokine-producing or polyfunctional CD4+ or CD8+ T cells. A total of 75 seropositive HCWs (29 with a history of varicella, 25 vaccinated once, and 21 vaccinated twice) were assessed for humoral immunity. Cellular responses could be analyzed in 59 (28, 21, and 10 in the respective groups). The anti-VZV IgG level, RAI, and memory CD4+ T cell responses were significantly higher in the past infection group than in the vaccinated once group. The RAI levels were significantly higher in the past infection group than in the vaccinated twice group. Seropositive HCWs without a varicella history, especially those who received the vaccine only once, had significantly lower levels of immune responses to VZV. Such HCWs might need to comply with airborne precautions. [ABSTRACT FROM AUTHOR]

Simple Summary: African swine fever (ASF) has been present in Poland since 2014. The article describes and explains the changes in the ASF epidemic in the wild boar population in the period 2014–2020. In that relatively short time, the disease has spread to about half of the territory of Poland, affecting eastern and western provinces. Most ASF-positive animals were molecular/virus-positive, however, the observation of the increase of serologically positive animals (potential survivors) in successive years of the epidemic, especially in areas where the virus has been present for a longer time, may indicate the potential beginning of ASF endemicity in Poland. African swine fever (ASF) is a lethal hemorrhagic disease of Suidae, i.e., domestic pigs and wild boars. The disease was introduced to Poland in 2014 and is now present in the wild boar population. Appropriate ASF prevention requires further research for answers to fundamental questions about the importance of vectors in virus transmission, the impact of environmental factors on the presence of ASFV in wild boar habitats, and the role of survivors as potential virus carriers and their part in the potential endemicity of ASF. In order to analyze the changes in the molecular and serological prevalence of ASFV in wild boar population in Poland, real-time PCR and ELISA/IPT tests were conducted. In the analyzed period (2014–2020), most of the ASF-positive wild boars were molecular/virus-positive, however, over the years the percentage and the number of seropositive animals has increased. At the beginning of the epidemic, the disease was limited to a small area of the country. Since then, it has spread to new provinces of Poland. From the beginning and until today, most notifications of ASF-positive wild boars were for carcasses (passive surveillance), however, the number of serologically positive animals is still increasing. Despite the fact that notifications of ASF outbreaks are still being received near the eastern border of Poland, the old ASF area seems to be limited mainly to ASF serologically positive animals, which may indicate the beginning of ASF endemicity in Poland. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate the clinico-epidemiologic characteristics of optic neuritis based on the status of serum aquaporin-4 antibody (AQP4-Ab) in patients with optic neuritis (ON).Methods: Medical records of 106 patients with ON and a follow-up of 3 years were reviewed. For each patient, the following data were extracted: medical history, findings of the ocular examination, brain, orbital or spinal MRI, and serological tests for AQP4. The ON was classified as typical or atypical based on disc examination and improvement in vision after intravenous methylprednisolone (IVMP). The clinical findings (typical or atypical), disease course, and outcomes were analyzed according to the serostatus of the ON.Results: 10 patients ((9.4%) were seropositive for AQP4-Ab; all had atypical ON. 96 patients (91%) were seronegative for AQP4-Ab: 36 atypical ON and 60 typical ON. Profound visual impairment at presentation was seen in all patients. However, at the end of the study period, seropositive and seronegative atypical ON had poor visual outcomes as compared to seronegative typical ON (P = 0.002). Five seropositive and four seronegative patients with atypical ON developed transverse myelitis. Bilateral disease with relapse was more in seropositive patients (80%); however, seronegative with atypical ON also had bilateral presentation and relapse in 42% and 41%, respectively.Conclusion: AQP4-Ab seropositive patients mostly present with atypical features such as bilateral recurrent ON, poor visual outcome, and increased incidence of transverse myelitis. However, atypical clinical features can also be seen in seronegative ON with a poor visual outcome and a recalcitrant course. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a new pathogen which has become an uncontrollable pandemic. On the other hand, the humoral immune system, as a defensive line, protects the body by producing antibodies. Immunoglobulin M (IgM) and G (IgG) are considered as the most important antibodies that are produced by the immune system of the host. Previous evaluations on the production of IgM and IgG antibodies by patients suffering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection specifies that IgM is an acute phase antibody and increases on the first days of infection. Then, as the chronic phase begins, the level of the IgM decreases and switches to the production of IgG. In addition, the durability of the IgG antibody shows the duration of the immunity against COVID-19. Thus, the present review article focused on the antibody production mechanism in studies conducted on COVID-19 patients, the protection role of antibodies, and their stability.

Sang Hee Park,1 Xue Han,2 Francis Lobo,2 Sakina Nanji,1 Dipen Patel1 1Modeling and Meta-Analysis, Pharmerit International, Bethesda, MD, USA; 2WW HEOR Markets-US, Bristol-Myers Squibb Company, Lawrenceville, NJ, USACorrespondence: Xue HanBristol-Myers Squibb Company, 3401 Princeton Pike, Lawrenceville, NJ 08648, USATel +1 213-309-9719Fax +1 609 302 5808Email Xue.Han1@bms.comPurpose: The primary objective of this study was to compare the cost per responder (CPR) between abatacept and adalimumab among seropositive rheumatoid arthritis (RA) patients.Patients and Methods: CPR analysis was conducted from a US payer perspective over 24 weeks for early moderate-to-severe seropositive RA patients. Efficacy data (American College of Rheumatology [ACR] improvement criteria [ACR20/50/70] and DAS28-C reactive protein < 2.6) for abatacept and adalimumab were sourced from the post hoc analysis of the Early AMPLE trial (NCT02557100). Medication costs were considered assuming complete adherence. A 30% rebate was applied for adalimumab in the base case.Results: At week 24, the total per patient pharmacy cost was $26,273.34 and $21,731.18, whereas the CPR (using ACR70 as the responder definition) was $46,337.46 and $74,935.10 (difference of -$28,597.64) for abatacept and adalimumab, respectively. The CPR was consistently lower for abatacept compared to adalimumab across all clinical measures, with differences ranging from -$7099.32 to -$43,608.97.Conclusion: While the pharmacy cost was higher for abatacept compared to adalimumab, due to its higher clinical efficacy, the CPR was consistently lower for seropositive RA patients treated with abatacept. The results may be useful for healthcare decision-makers in understanding how to optimize treatment for seropositive RA patients while minimizing costs in today’s budget-constrained health environment.Keywords: positive shared epitope, anti-citrullinated protein antibodies, anti-cyclic citrullinated peptide, rheumatoid factor, biomarker, seropositive

Peter Stephen Shija,1,2 Joshua Alexander Karaba,1,2 Rune Nathaniel Philemon,1,3 Bernard Lucas Minja,1 Philbert Patrick Mtenga,1,2 Denis Robert Katundu1,2 1Kilimanjaro Christian Medical Center Moshi (KCMC), Moshi, Tanzania; 2Department of Ear Nose and Throat (ENT) Head and Neck Surgery, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; 3Kilimanjaro Christian Medical University College, Institute of Public Health Moshi, Moshi, TanzaniaCorrespondence: Peter Stephen ShijaDepartment of ENT Head and Neck Surgery, Kilimanjaro Christian Medical University College, P.O Box 2240, Moshi, TanzaniaTel +255754392916Email shijapsn@yahoo.comBackground: To date, HIV/AIDS remains a threat of the 21st century. The overall rate of new HIV infection continues to decline in several countries, but there is still a remarkable burden of disease seen in sub-Saharan Africa. Several studies observed that 70% to 90% of HIV-infected patients present with ear, nose and throat symptoms. The aim of this study was to identify the magnitude of ENT manifestations among HIV-infected patients attended HIV clinics at KCMC based on age, sex, and CD4 count.Methods: This was a descriptive cross-sectional study conducted at KCMC hospital involving HIV-infected patients who attended HIV clinics from February to July 2018. Convenient sampling was employed to get study participants, and 200 patients were recruited in the study. Data were collected through a questionnaire from patients, and results were analyzed using SPSS version 20.Results: Sixty-eight (34%) of 200 HIV-infected patients had ENT manifestations. The most affected age group was 0– 9 years. ENT manifestations were more prevalent in females (23.5%) than in males (10.5%). Those with CD4 count less than 200cells/μL also it was a high prevalence (56.3%).Conclusion: This study observed that one-third of the studied population had ENT manifestations. All medical practitioners should be aware of ENT manifestations in HIV-infected patients in order to assure early and appropriate intervention.Keywords: ENT manifestations, HIV, magnitude, seropositive, Tanzania

Background: Dietary intake of HIV-seropositive persons remains a major concern across various settings around the globe. Inadequate dietary intake, infections and stage of disease progression elicit malnutrition among HIV-seropositive individuals, which hastens progression of HIV to full-blown AIDS. Aim: The study sought to determine the dietary intake of HIV-seropositive clients attending Longisa County Hospital Comprehensive Care Clinic, Bomet County, Kenya. Methods: A cross-sectional analytical study design was administered on a comprehensive sample of 210 patients. A 24-hour dietary recall questionnaire and Food Frequency Questionnaire (FFQ) were used by the researcher to collect data on the dietary intake of the respondents. The 24-hour dietary recall data were analysed using NutriSurvey whereas data obtained from the FFQ were analysed manually. Results: Study respondents comprised more females (61.6%) than males (38.6%). Adequacy in energy intake amongst the respondents was average as males attained 47.4% of recommended energy intake, whereas females attained 50.0%. Intakes for selected nutrients, vitamin A, B1, B2, C, were adequate for males and females. Iron intake was significantly low among female respondents as 89.3% did not meet the RDA. Similarly, zinc intake among male respondents was low as only 28.9% met the RDA. The mean number of meals consumed by the respondents was 3.8 ± 0.1. Consumption frequency of legumes, fruits, other vegetables, meats, eggs and fish was irregular. Conclusion: The dietary intake of the respondents was not satisfactory as evidenced by inadequacies in intake of certain nutrients and low number of meals consumed on a daily basis. Inadequate dietary intake is detrimental to HIV and AIDS management and treatment modalities, hence resulting in poor treatment outcomes. Care and treatment modalities at HIV and AIDS clinics should encompass provision of clear and concise information on the importance of adequate dietary intake as a means of optimising positive treatment outcomes.

ABSTRACT: Human Visceral Leishmaniasis (VL) is expanding, and it is distributed in the five geographic regions of Brazil, with the Northeast being the region that presents the most significant number of registered cases. The main urban reservoir of the etiological agent of VL is the domestic dog, and it is known that canine cases precede human cases. One of the control actions of VL, recommended by the Ministry of Health, is performing the euthanasia of seropositive dogs. In 2013, in the municipality of Iguatama/MG, the first canine serological survey was carried out in the city, with a prevalence of 8.3% of seropositive dogs for Leishmania infantum. Of the seropositive animals for Canine Visceral Leishmaniasis (CVL) in this survey, 84% were euthanized, and 16% died within two years after diagnosis. No other control measures for CVL were taken in the municipality. The objectives of the present study were to determine the current prevalence of seropositive dogs for CVL in the municipality of Iguatama and to observe the impact of euthanasia of seropositive dogs to VL as the only control measure performed in this municipality, which is considered an enzootic area of the disease. For this, a new canine epidemiological survey was carried out in the municipality of Iguatama, following the guidelines of the Manual of Surveillance and Control of Visceral Leishmaniasis. Blood samples were collected from 270 dogs and tested by DPP® immunochromatographic test and by Enzyme-Linked Immunosorbent Assay (ELISA). The animals that presented inconclusive results had new blood samples collected and analyzed. The only animal that showed a positive result in DPP® and undetermined in the ELISA, in the first evaluation, became seropositive four months later, so this study reinforces the recommendation of the Ministry of Health to reassess dogs that present inconclusive results for CVL. From a total of 270 samples, 21 (7.8%) were reagents in both tests. Thus, the prevalence of seropositive dogs for CVL, in 2017, in the urban area of the municipality of Iguatama was 7.8%. The Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) molecular technique confirmed infection by L. infantum in the ten dogs sampled with CVL-positive serology. The comparison between the current prevalence (after euthanasia) with that found in 2013 (8.3%), there was no significant difference (p=0.764). The prevalence of CVL in the urban area of the municipality of Iguatama is still high, making it possible to presume that the euthanasia of seropositive dogs for CVL, and the absence of monitoring or other interventions measures, did not contribute to decrease the transmission of the parasite and was not sufficient for the control of CVL in the municipality of Iguatama, an area considered as non-endemic to CVL until 2013.

Objectives - This study aims to describe the socio-demographic characteristics and motivations of blood donors at the Blood Transfusion Center of the University Hospital Center of Oran, to analyze their immuno-hematological and microbiological data. Materials and methods - It is a cross-sectional descriptive study, conducted over a period of three months (from January 1st to March 31st, 2017) at the Blood Transfusion Center of Oran University Hospital. This study included blood donors who showed up at the fixed site and responded to a questionnaire during the donation. Biological data were collected from immuno-hematological and microbiological qualification records of donation. Results - We collected 1004 predominantly male donors (sex ratio 4/1), with an average age of 35 years with a predominance of the age group [28-37] years. The average social class is the most common (67.23%). Secondary and universitary education levels are predominant (47.73%). Approximately 63% of our sample are clearing donors, 45% of whom are new donors. Half of the volunteer donors (50.5%) are irregular donors. The main motivation for giving is family, followed by religious motivation and solidarity. Almost of the participants is motivated for a subsequent donation. 47% of donors have a blood group O, 34% of group A, 15% of group B and 4% of group AB. The prevalence of infectious transmissible agents by transfusion in this population is 1%. Conclusion - This study described the socio-demographic characteristics and motivations of the blood donors at the Blood Transfusion Center in Oran. Efforts should focus on raising awareness, quality of donor recruitment and retention, which is a step toward improving blood safety.

Background: Infection with Helicobacter pylori is typically contracted in early childhood and is associated with a variety of upper gastrointestinal disorders. There is still little local information available on infection epidemiology. This study was performed to determine the antibodies of seroprevalence of H. pylori in people, with their relation to age and gender. Methods: A retrospective epidemiologic survey was conducted in different polyclinics in Tripoli from January 2021 to December 2021 to determine the seroprevalence of H. pylori infection. A total of 707 participants (452 males and 255 females, with mean age of 39 ± 19.3 years) were included in this study. For the detection of H. pylori, enzyme-linked immunosorbent assay kits were utilized. In contrast, the absence of both antibodies (IgG and IgA) resulted in the designation of an H. pylori-negative status. Anti-H pylori immunoglobulin (Ig) G/IgA =30 enzyme immune units were classified as H. pylori positive. Chi-square test was used to analyze the obtained data. Results: The overall positive seropositive samples among the study participants were 122 (17.2%). The seropositivity was high 42 (34.4%) among the age group 30 <40 years, compared with the other age groups. There was no significant difference between male and female cases regarding the seropositive samples. Conclusion: Seroprevalence of H. pylori infection shows a drop comparing to previously local reports. Nationwide epidemiological research is necessary for determining the seroprevalence of H. pylori in Libya. [ABSTRACT FROM AUTHOR]

Background: There is preliminary evidence that individuals with previous SARS‐CoV‐2 infections exhibit a more pronounced antibody response. However, these assumptions have not yet been supported by data obtained through various CE‐marked tests. This study aimed to close this gap. Methods: Sixty‐nine seronegatives and 12 individuals post‐SARS‐CoV‐2 infection (tested by CE‐labelled Roche NC immunoassay or PCR‐confirmed assay) were included 21 ± 1 days after receiving the first dose of the Pfizer/BioNTech BNT162b2 vaccine. Antibody response to viral spike protein (S) was assessed by CE‐labelled Roche S and DiaSorin S1/S2 assays and by a surrogate virus neutralization test (sVNT). Results: After a single dose of BNT162b2, individuals after natural SARS‐CoV‐2 infection presented with markedly higher anti‐S levels than naïve individuals (Roche S: 9078.5 BAU/mL [5267.0‐24 298.5] vs 79.6 [24.7‐142.3]; and DiaSorin S1/S2: 1465.0 AU/mL [631.0‐5365.0] vs 63.7 [47.8‐87.5]) and showed all the maximum observed inhibition activity in the sVNT (98%), without overlaps between groups. There was a trend for higher responses in those with a more distant infection, although not statistically significant. The relative antibody increase after dose 2 was significantly higher among naïve individuals (25‐fold), but antibody levels remained below that of seropositives. Conclusions: Compared with naïve individuals, seropositives after natural SARS‐CoV‐2 infection presented with a substantially higher antibody response already after dose 1 of BNT162b2, as measured by two CE‐marked in vitro diagnostic tests and a sVNT. These results should stimulate discussion and research on whether individuals after previous SARS‐CoV‐2 infection would benefit from a two‐part vaccination schedule or whether these currently much‐needed second doses could be saved. [ABSTRACT FROM AUTHOR]

West Nile virus (WNV) is a mosquito‐borne virus of a re‐emergence importance with a wide range of vertebrate hosts. Granted, it causes asymptomatic infection, but fatal cases and neurologic disorders were also recorded, especially in humans, horses and some exposed birds. The virus is globally spread and birds are considered an amplifying and reservoir host of WNV, helping to spread the disease due to their close contact with main hosts. In this study, we aimed to detect the presence of antibodies against WNV in backyard hens that were reared in the western Anatolian part of Turkey. A total of 480 chicken sera were randomly collected from six provinces in the west of Turkey (Mugla, Izmir, Aydin, Afyonkarahisar, Kutahya and Manisa) with 80 samples from each province (40 in spring and 40 in fall seasons). They were tested by using a competitive ELISA method to identify the specific avian antibodies of IgG that produced against the WNV envelope proteins (pr‐E). Twelve of 480 (2.5%) sera were found seropositive, three of these positive sera were detected from the Izmir province (3.75%) collected in the spring session and the other nine positive sera were detected from the Mugla province (11.25%) collected in the fall session. Both of these provinces are located seaside and have suitable climate conditions for vectors of infection. The results indicated that WNV infection is in circulation in these provinces, and that may put the other susceptible vertebrates under risk of infection. [ABSTRACT FROM AUTHOR]

• Data from 401 healthcare workers were analyzed, including 59 with previous SARS-CoV-2 infection. • The first dose was highly immunogenic, especially in the seropositive. • The second dose boosted immunogenicity, particularly in seniors and uninfected subjects. • Post-prime immunogenicity in the seropositive exceeded post-boost antibody titers in the uninfected. This study monitored titers of neutralizing IgG against the receptor-binding domain of the SARS-CoV-2 S1 subunit 14 days post-injection of each dose of the BNT162b2 mRNA Covid-19 vaccine in 401 Greek healthcare workers aged 20–67. After the first dose, titers varied upon age and history of infection, being lower in the 50+ age group and significantly higher among the seropositive. After the second dose, immunogenicity was significantly boosted in the age 50+ and SARS-CoV-2-naïve individuals, indicating the effectuality of its timely administration, yet questioning its value among the seropositive. [ABSTRACT FROM AUTHOR]

Objectives Comorbidities contribute to the morbidity and mortality in RA, and are thus important to capture and treat early. In contrast to the well-studied comorbidity risks in established RA, less is known about the comorbidity pattern up until diagnosis of RA. We therefore compared whether the occurrence of defined conditions, and the overall comorbidity burden at RA diagnosis, is different from that in the general population, and if it differs between seropositive and seronegative RA. Methods Using Swedish national clinical and demographic registers, we identified new-onset RA patients (n  = 11 086), and matched (1:5) to general population controls (n  = 54 813). Comorbidities prior to RA diagnosis were identified in the Patient and Prescribed Drug Registers, and compared using logistic regression. Results At diagnosis of RA, respiratory (odds ratio (OR) = 1.58, 95% CI: 1.44, 1.74), endocrine (OR = 1.39, 95% CI: 1.31, 1.47) and certain neurological diseases (OR = 1.73, 95% CI: 1.59, 1.89) were more common in RA vs controls, with a similar pattern in seropositive and seronegative RA. In contrast, psychiatric disorders (OR = 0.87, 95% CI: 0.82, 0.92) and malignancies (OR = 0.88, 95% CI: 0.79, 0.97) were less commonly diagnosed in RA vs controls. The comorbidity burden was slightly higher in RA patients compared with controls (P  <0.0001). Conclusion We found several differences in comorbidity prevalence between patients with new-onset seropositive and seronegative RA compared with matched controls from the general population. These findings are important both for our understanding of the evolvement of comorbidities in established RA and for early detection of these conditions. [ABSTRACT FROM AUTHOR]

ABSTRACTIn 2016/2017, a severe epidemic of HPAIV H5N8 clade 2.3.4.4 group B (H5N8B) affected Europe. To analyse the role of mallards in the spatiotemporal dynamics of global HPAIV H5N8B dispersal, mallards (Anas platyrhynchos), naturally exposed to various AIV and therefore seropositive, were challenged with H5N8B. All experiments were controlled by infection and co-housing of seronegative juvenile Pekin ducklings. All ducks that survived the first infection were re-challenged 21 dpi with the homologous H5N8B strain. After the first H5N8B infection, seropositive mallards showed only mild clinical symptoms. Moderate to low viral shedding, occurring particularly from the oropharynx and lasting for 7 days maximum, led to severe clinical disease of all contact ducklings. All challenged seronegative Pekin ducks and contact ducklings died or had to be euthanized. H5-specific antibodies were detected in surviving birds within 2 weeks. Virus and viral RNA could be isolated from several water samples until 6 and 9 dpi, respectively. Conversely, upon re-infection with homologous H5N8B neither inoculated nor contact ducklings showed any clinical symptoms, nor was an antibody titer increase of seropositive mallards or any seroconversion of contact ducklings observed. Mallard ducks naturally pre-exposed to LPAIV can play a role as a clinically unsuspicious virus reservoir for H5N8B effective in virus transmission. Mallards with homologous immunity did not contribute to virus transmission.

Two models were developed to estimate Lyme borreliosis (LB) cases. One was based on the seroprevalence of Borrelia infections in human samples. This model used corrections for false negative and false positive results from published test sensitivity and specificity measures. A second model based on Borrelia infections in sentinel dogs was used to quantify the prevalence of Lyme disease Borrelia infections in humans; the reference baseline for this model was human and canine infections in Germany. A comparison of the two models is shown and differences discussed. The relationships between incidence, prevalence and total infection burden for LB were derived from published data and these were used in both models to calculate annual incidence, prevalence and total LB infections. The modelling was conservative and based on medical insurance records coded for erythema migrans. Linear model growth rates were used in place of the commonly adopted exponential growth. The mean of the two models was used to create estimates for various countries and continents. Examples from the analyses for LB estimated for 2018 include: incidence – USA 473,000/year, Germany 471,000/year, France 434,000/year and UK 132,000/year; prevalence – USA 2.4 million, Germany 2.4 million, France 2.2 million and UK 667,000; total infections – USA 10.1 million, Germany 10.0 million, France 9.3 million and UK 2.8 million. Estimates for the world for 2018 are: incidence 12.3 million/year; prevalence 62.1 million; and total infection burden 262.0 million. These figures are far higher than officially published data and reflect not only the underestimation of diagnosed cases, which is acknowledged by health agencies, but also undiagnosed and misdiagnosed cases.

Background and Aim: Avian reovirus (ARV) is a constraint to poultry industry in Bangladesh as a cause of several diseases in chickens, especially in broiler. However, the actual status of the viral infection is not known because the large-scale study is not conducted in this country. Therefore, this study aimed to check the presence and distribution of ARV-specific antibody in respect to area, types of chickens (broiler breeder, broiler, and layer), vaccination status, and age of chickens in Gazipur and Mymensingh districts of Bangladesh. Materials and Methods: A total of 276 chickens' blood samples were collected from two well-organized broiler breeder stock, seven broiler farms, and five layer farms located at two districts, namely Gazipur and Mymensingh of Bangladesh. Blood samples were collected from wing vein of the apparently healthy chickens using 3 ml of syringe and serum was harvested by keeping the syringe at room temperature in slanting position. The sera were transferred to the laboratory by maintaining the cool chain and further processing was performed by indirect enzyme-linked immunosorbent assay using ARV antibody test kit. Results: The results of serological test revealed that an average of 39.5% seropositive against ARV was recorded in chickens of Gazipur and Mymensingh districts. Among these, chickens of Gazipur district had the highest seropositivity of 50.5% than Mymensingh (30.7%). With respect to vaccination status, the seropositivity of vaccinated chickens in both areas was 100% and non-vaccinated chickens was 50.5% in Gazipur and 30.7% in Mymensingh district, respectively. However, regarding age groups, the seropositivity was higher in the age of 4-6 weeks (64.5%). Conclusion: The present serological findings showed a higher prevalence of ARV-specific antibodies in broiler birds. It indicates that the poultry industries of Bangladesh are contaminated with ARV which may naturally be transmitted to chickens either vertically or horizontally.

The dengue vaccine, CYD-TDV (Dengvaxia), has been licensed in 20 countries in Latin America and Southeast Asia beginning in 2015. In April 2018, the World Health Organization (WHO) advised that CYD-TDV should only be administered to individuals with a history of previous dengue virus infection. Using literature-based parameters, a mathematical model of dengue transmission and vaccination was developed to determine the optimal vaccination strategy while considering the effect of antibody-dependent enhancement (ADE). We computed the optimal vaccination rates under various vaccination costs and serological profiles. We observe that the optimal dengue vaccination rates for seropositive individuals are highest at the initial phase of a vaccination program, requiring intense effort at the early phase of an epidemic. The model shows that even in the presence of ADE, vaccination could reduce dengue incidence and provide population benefits. Specifically, optimal vaccination rates increase with a higher proportion of monotypic seropositive individuals, resulting in a higher impact of vaccination. Even in the presence of ADE and with limited vaccine efficacy, our work provides a population-level perspective on the potential merits of dengue vaccination.

Background Multisystem inflammatory syndrome in children (MIS-C) is a rare manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children that can result in increased morbidity and mortality. The inflammatory underpinnings of MIS-C have not been examined in detail. Methods We examined the plasma levels of acute phase proteins and microbial translocation markers in children with MIS-C, children with acute coronavirus disease 2019 (COVID-19) infection, SARS-CoV-2-seropositive children, and controls. Results MIS-C children exhibited significantly higher levels of C-reactive protein (CRP), alpha2 macroglobulin (α2M), serum amyloid P (SAP), lipopolysaccharide (LPS), sCD14, and LPS binding protein (LBP) and significantly lower levels of haptoglobin (Hp) in comparison with seropositive, control, and/or COVID-19 children. In addition, COVID-19 children exhibited significantly higher levels of most of the above markers in comparison with seropositive and control children. Principal component analysis using a set of these markers could clearly discriminate MIS-C and COVID-19 from seropositive and control children. MIS-C children requiring pediatric intensive care unit admission and COVID-19 children with severe disease had higher levels of CRP, SAP, and/or sCD14 at admission. Conclusions Our study describes the role of systemic inflammation and microbial translocation markers in children with MIS-C and COVID-19 and therefore helps in advancing our understanding of the pathogenesis of different presentations of SARS-CoV-2 infection in children. [ABSTRACT FROM AUTHOR]

We determined the seroprevalence of SARS-CoV-2 antibodies in NHS healthcare workers (HCWs) in a cross-sectional study from a large general hospital located in a double-sited rural and semi-rural area. The sample size of 3,119 HCWs (mean age 43±13) consisted of 75.2% women, 61.1% White individuals and predominantly (62.4%) asymptomatic individuals. Seroprevalence of SARS-CoV-2 antibodies was 19.7%. Determinants of seropositivity were preceding symptomatic infection and non-White ethnicity. Regardless of staff role or sex, multivariate regression analysis revealed that non-White HCWs were three times (odds ratio [OR] 3.12, 95% confidence interval [CI] 2.53-3.86, P<0.001) more likely to have antibodies than White staff, and seven times (OR 7.10, 95% CI 5.72-8.87, P<0.001) more likely if there was a history of preceding symptoms. We report relatively high rates of seropositivity in all NHS healthcare workers. Non-White symptomatic HCWs were significantly more likely to be seropositive than their colleagues, independent of age, sex or staff role. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has spread through the US during the last few months exposing healthcare providers to possible infection. Here we report testing of emergency department (ED) healthcare providers (HCP) for exposure to COVID-19 through lateral flow point of care (POC) and lab-based enzyme-linked immunosorbent assay (ELISA), and RTq-PCR for evidence of acute infection. 138 ED HCP were tested between May 26th (approximately one month after the peak of COVID-19 first wave of cases) and June 14th. Enrolled ED HCP represented about 70% of the total ED HCP workforce during the study period. Subjects were tested with a POC COVID-19 antibody test, and standard ELISA performed by a university-based research lab. Subjects also provided a mid-turbinate swab and a saliva specimen for RTq-PCR. All subjects provided demographic information, past medical history, information about personal protective equipment (PPE) use, COVID-19 symptoms, as well as potential COVID-19 exposures during the previous 4 weeks, both in the ED, and outside the clinical setting. None of the HCP had positive RT-PCR results; 7 HCP (5%) had positive IgG for COVID-19; there was strong agreement between the lab-based ELISA (reference test) and the POC Ab test (P ≤ 0.0001). For the POC Ab test there were no false negatives and only one false positive among the 138 participants. There was no significant difference in demographic/ethnic variables, past medical history, hours worked in the ED, PPE use, or concerning exposures between seropositive and seronegative individuals. Moreover, there was no significant difference in reported symptoms between the two groups during the previous four weeks. The rate of COVID-19 seroconversion in our ED was 5% during the month following the pandemic's first wave. Based on questionnaire responses, differences in demographics/ethnicity, medical history, COVID-19 exposures, and PPE use were not associated with ED HCP having been infected with SARS-CoV-2. In the setting of our limited cohort of subjects the COVID-19 POC Ab test performed comparably to the ELISA lab-based standard. [ABSTRACT FROM AUTHOR]

This study was designed to assess the changes in lipid profile of HIV-seropositive patients following 6week aerobic and resistance exercise training. The pretest-posttest control-group design (experimental and control groups) was adopted. Sixty female HIV-seropositive patients in stage 1 and 2 of the disease registered in University of Benin Teaching Hospital participated in the study. They were randomly assigned into control and experimental groups. The experimental group exercised for One hour, three times a week for six weeks while the control group continued with their daily routine. The baseline intensity of the exercise was 60% of maximum Heart Rate (HRmax) and 60% 1RM and it was progressed by 10% every 3 weeks. Lipid profile were recorded at baseline and on completion of 6 weeks for both groups. The hypotheses were tested with inferential statistics of Analysis of variance. The findings of this study revealed that short duration exercise training improved some of the components of the lipid profile (high density lipoprotein and triglycerides). It was therefore concluded based on the findings of this study that health professionals should recommend exercise for female HIV-infected individuals due to the health benefits. Also, human kinetics specialists should design exercise programmes suitable for this special population.

Abstract Background The value of joint ultrasonography (US) in the prediction of clinical arthritis in individuals at risk of developing rheumatoid arthritis (RA) is still a point of debate, due to varying scanning protocols and different populations. We investigated whether US abnormalities assessed with a standard joint protocol can predict development of arthritis in seropositive patients with arthralgia. Methods Anti-citrullinated protein antibodies and/or rheumatoid factor positive patients with arthralgia, but without clinical arthritis were included. US was performed at baseline in 16 joints: bilateral metacarpophalangeal 2–3, proximal interphalangeal 2–3, wrist and metatarsophalangeal (MTP) joints 2–3 and 5. Images were scored semi-quantitatively for synovial thickening and for positive signs on power Doppler (PD). Association between US abnormalities and arthritis development at the joint and at the patient level was evaluated. Also, we investigated the added value of US over clinical parameters. Results Out of 163 patients who underwent US examination, 51 (31%) developed clinical arthritis after a median follow-up time of 12 (interquartile range 5–24) months, of which 44 (86%) satisfied the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA. US revealed synovial thickening and PD in at least one joint in 49 patients (30%) and 7 patients (4%), respectively. Synovial thickening was associated with both development and timing of clinical arthritis in any joint (patient level) when MTP joints were excluded from the US assessment (odds ratio 6.6, confidence interval (CI) 1.9–22), and hazard ratio 3.4, CI 1.6–6.8, respectively, with a mean time to arthritis of 23 versus 45 months when synovial thickening was present versus not present). There was no association between US and arthritis development at the joint level. Predictive capacity was highest in the groups with an intermediate and high risk of developing arthritis based on a prediction rule with clinical parameters. Conclusions Synovial thickening on US predicted clinical arthritis development at the patient level in seropositive patients with arthralgia when MTPs were excluded from the US assessment. Positive PD signs were infrequently seen in these at-risk individuals and was not predictive. In patients at intermediate risk of RA, US may help to identify those at higher risk of developing arthritis.

Immunogenicity data from phase 1 vaccine studies can be difficult to interpret, especially in seropositive populations and when multiple assays are used. We developed 3 statistical methods (Youden index [YI] threshold, receiver-operating characteristic relative to baseline [ROC-B], and ROC of postdose levels [ROC-P]) to characterize complex immunogenicity data by assessing the proportion of a study population that achieved values above thresholds. The YI method calculates a single threshold per assay. Both ROC methods construct ROC curves for individual assays and surfaces for assay combinations to assess degree of separation of postdose values from a reference distribution; the ROC-B method uses overall predose values as the reference distribution and the ROC-P method uses pooled postdose values. All methods are applicable to a seropositive population with overlapping distributions of baseline and postdose measurements and can evaluate results of multiple assays jointly. The ROC-P method is also applicable when postdose levels are fully separated from baseline levels, as is common in a seronegative population. These methods were demonstrated using data from a phase 1a study of respiratory syncytial virus vaccines formulated with and without an adjuvant in a seropositive population of adults aged ≥60 years. All 3 methods provided a comprehensive assessment of vaccine immunogenicity effects with results presented in easily interpretable formats. In the example data, the methods demonstrated antigen dose response trend and contribution of adjuvant to response in multiple assays individually and jointly where optimal responses in assay combinations (humoral and cellular) are important.

Hepatitis B virus (HBV) infection is an infectious disease that is specific to the liver, causing both acute and chronic hepatitis. This study determined the trend of HBV infection among blood donors in the Kpandai District Hospital from January 2014 to December 2018. Retrospective analysis of donor profiles for a period of 5 years was used to assess the distribution of seropositive cases in relation to age, sex, and trend. The data was collected using pre-designed questionnaire and managed using Microsoft Excel spread sheet 2013. The overall sero-prevalence of HBV was 8.2% (230/2802). The year to year analysis depicted significant trends in reduction of HBV infection among the study population at a rate of 13 percentage points above the mean from 2014 to 2015, and 4.3 percentage points below the mean from 2016 to 2018 across the period. The prevalence in males was 8.4% (225/2687) and that of the females was 4.4% (5/115) and the highest rate of infection was among those below 30 years 9.8% (163/1666). Although the general prevalence of HBV infection was high (8.2%), there was a significant trend reduction in rate of infection across the study period. This suggests that the public health interventional strategies put in place to manage the HBV infection in Kpandai District seem to be working. [ABSTRACT FROM AUTHOR]

Background: Intradermal (ID) rabies vaccination for pre-exposure prophylaxis (PrEP) has become increasingly popular; however, there is limited evidence about the effectiveness of different ID PrEP schedules in travellers aged > 50 years or their response to ID boosters. This study aimed to compare across different ID vaccine schedules and age groups the proportion of travellers who were seropositive after (i) primary course of ID PrEP and (ii) a booster.Methods: Travellers who received ID PrEP at a travel medicine clinic in South Australia from 2000 to 2016 were included. Three schedules were examined: 1IDx3 (1 × 0.1 ml on days 0, 7, 21-28), 2IDx2 (2 × 0.1 ml on days 0, 7) and 4IDx1 (4x0.1 ml on day 0). The 4IDx1 is a non-standard schedule that has been previously explored in research settings, but not endorsed by WHO for PrEP. Antibody titres of ≥0.5 IU/ml were considered seropositive. The proportion seropositive after a primary course or post-booster was estimated for each schedule and age category. Predictors of seronegative status after a primary course were examined using multivariable logistic regression models.Results: Overall, 835 travellers (median age 37.5 years; 37.1% > 50 years) were included in the analyses of seropositivity after a primary course. Another group of 771 travellers (median age 45.9 years; 43.5% > 50 years) was included in the analyses of seropositivity post-booster. The proportion seropositive after primary course was 92.5% (95%CI: 90.5-94.1%) and highest with the 1IDx3 schedule (93.4%; 95%CI: 91.4-95.0%). After adjusting for age and timing of the serology, the odds of seronegative status were four times higher (OR 4.17; 95%CI: 1.43-12.18) with the 4IDx1 schedule compared to 1IDx3. Overall, 98.7% (95%CI: 97.6-99.3%) were seropositive post-booster. Of 46 travellers who received a booster ≥3 years after PrEP, all were seropositive post-booster.Conclusions: In older travellers, the 1IDx3 schedule was the most effective, and a high proportion were seropositive post-booster even many years after a primary course. [ABSTRACT FROM AUTHOR]

Background: Dietary intake of HIV-seropositive persons remains a major concern across various settings around the globe. Inadequate dietary intake, infections and stage of disease progression elicit malnutrition among HIV-seropositive individuals, which hastens progression of HIV to full-blown AIDS. Aim: The study sought to determine the dietary intake of HIV-seropositive clients attending Longisa County Hospital Comprehensive Care Clinic, Bomet County, Kenya. Methods: A cross-sectional analytical study design was administered on a comprehensive sample of 210 patients. A 24-hour dietary recall questionnaire and Food Frequency Questionnaire (FFQ) were used by the researcher to collect data on the dietary intake of the respondents. The 24-hour dietary recall data were analysed using NutriSurvey whereas data obtained from the FFQ were analysed manually. Results: Study respondents comprised more females (61.6%) than males (38.6%). Adequacy in energy intake amongst the respondents was average as males attained 47.4% of recommended energy intake, whereas females attained 50.0%. Intakes for selected nutrients, vitamin A, B1, B2, C, were adequate for males and females. Iron intake was significantly low among female respondents as 89.3% did not meet the RDA. Similarly, zinc intake among male respondents was low as only 28.9% met the RDA. The mean number of meals consumed by the respondents was 3.8 ± 0.1. Consumption frequency of legumes, fruits, other vegetables, meats, eggs and fish was irregular. Conclusion: The dietary intake of the respondents was not satisfactory as evidenced by inadequacies in intake of certain nutrients and low number of meals consumed on a daily basis. Inadequate dietary intake is detrimental to HIV and AIDS management and treatment modalities, hence resulting in poor treatment outcomes. Care and treatment modalities at HIV and AIDS clinics should encompass provision of clear and concise information on the importance of adequate dietary intake as a means of optimising positive treatment outcomes. [ABSTRACT FROM AUTHOR]

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Introduction: Patients receiving treatment for head-and-neck squamous cell carcinoma (HNSCC) also may have coexisting viral infections caused by HIV, HBV, and HCV (seropositive). There is scarce literature regarding the clinical presentation and treatment outcomes for these patients with coexisting viral infections (seropositive HNSCC). We conducted this study to assess the clinical presentation and treatment outcomes (overall survival [OS] and disease-specific survival [DSS]) of seropositive HNSCC patients.Methodology: This was a retrospective cohort study on seropositive HNSCC patients registered at our center from 2012 to 2014. The viral infections were identified by the presence of the antibodies to these viruses in the patient's blood samples.Results: Out of the 19,137 HNSCC patients registered, 156 patients had HBV, HCV, and/or HIV infection. Among these, HBV infection was the most common (n = 86/156, 55.1%) followed by HIV infection (n = 36/156, 23.1%) and HCV infection (n = 29/156, 18.6%). The oral cavity was the most common subsite involved. Majority of these patients presented at an advanced stage (advanced T stage - 71.8% and node positive - 62.2%). The majority of the patients received curative-intent treatment (65.4%). The OS at 3 years for these HNSCC patients with coexisting HIV, HBV, and HCV infection was 60%, 62.6%, and 57.5%, respectively, and their DSS at 3 years was 58.8%, 78.6%, and 53.8%, respectively.Conclusions: Seropositive patients with HNSCC often present in the advanced stage but have a good survival if treated appropriately. [ABSTRACT FROM AUTHOR]

Advances in microelectronic fabrication and miniaturization techniques borrowed from the semiconductor industry are now finding biotechnological applications, in the form of so called Lab-on-a-chip devices. These devices aim to exploit the physics of miniaturization to perform conventional macroscopic laboratory processes with greater resolution, specificity and quality assurance in reduced timescales and with less reagents and lower costs. [ABSTRACT FROM AUTHOR]

Abstract Background Recent advances in malaria control efforts have led to an increased number of national malaria control programmes implementing pre-elimination measures and demonstrated the need to develop new tools to track and control malaria transmission. Key to understanding transmission is monitoring the prevalence and immune response against the sexual stages of the parasite, known as gametocytes, which are responsible for transmission. Sexual-stage specific antigens, Pfs230 and Pfs48/45, have been identified and shown to be targets for transmission blocking antibodies, but they have been difficult to produce recombinantly in the absence of a fusion partner. Methods Regions of Pfs48/45 and Pfs230 known to contain transmission blocking epitopes, 6C and C0, respectively, were produced in a Lactococcus lactis expression system and used in enzyme linked immunosorbent assays to determine the seroreactivity of 95 malaria patients living in the Central Region of Ghana. Results Pfs48/45.6C and Pfs230.C0 were successfully produced in L. lactis in the absence of a fusion partner using a simplified purification scheme. Seroprevalence for L. lactis-produced Pfs48/45.6C and Pfs230.C0 in the study population was 74.7 and 72.8%, respectively. Conclusions A significant age-dependent increase in antibody titers was observed, which suggests a vaccine targeting these antigens could be boosted during a natural infection in the field.

Psoas abscess is a rare medical disease. Streptococcus intermedius is a commensal of the mouth and the upper respiratory tract but can cause various pyogenic infections especially liver and brain abscesses but rarely muscular abscess even in an immunocompromised host. We report a case of primary psoas abscess in a HIV positive patient caused by Streptococcus intermedius along with Escherichia coli. The patient responded well to antibiotic treatment along with percutaneous abscess drainage.

L'objectif de notre étude était d'étudier les caractéristiques épidémiologiques, cliniques, biologiques, radiologiques, évolutives et thérapeutiques de la population marocaine de la région Fès-Meknés atteinte de la polyarthrite rhumatoïde (PR). Matériels et méthodes : étude transversale de tous les cas de PR colligés au service de rhumatologie entre janvier 2012 et mars 2019, avec analyse descriptive. Résultats. 319 cas de PR inclus. L'âge moyen des patients était de 52,82 ans (42,39 ans au début de la maladie). Le délai moyen de diagnostic était de 5,34 ans. Le sex-ratio F/H était de 6,41 ; 4,1 % des patients avaient des antécédents familiaux de PR. Les comorbidités étaient : la dyslipidémie (18,5 %), le diabète (17,6 %), l'hypertension artérielle (16 %) et le tabagisme (5,6 %). La PR dans notre région était séropositive (90,3 %), déformante (68,7 %), érosive (77,7 %) et sévère (94 %). Les manifestations extra-articulaires étaient notées chez 48,3 % des patients. La luxation atloïdoaxoïdienne était diagnostiquée dans 4,7 % des cas et la coxite chez 8,2 %. Durant leur suivi, 8,2 % de nos patients avaient eu recours à une chirurgie orthopédique. Le méthotrexate était utilisé par 92,2 % des patients avec une dose moyenne de 14,68 ± 6,16 mg. Une corticothérapie était associée dans 85 % des cas, un anti-inflammatoire non stéroïdiens à la demande (44,8 %) et un antalgique de palier I ou II (74 %). L'association de deux traitements de fond conventionnels synthétiques était prescrite chez 8,2 % des cas. Le recours à la biothérapie a eu lieu chez 43,3 % des patients. Le rituximab et le tocilizumab étaient les plus utilisés : 32,6 et 5 %. Conclusion : dans notre population, la PR était essentiellement féminine, séropositive, déformante, érosive et sévère. Elle se compliquait dans la moitié des cas de manifestations systémiques. L'utilisation de la corticothérapie était accrue chez nos patients. Le méthotrexate était le traitement de choix et la biothérapie était prescrite chez presque la moitié de nos patients. [ABSTRACT FROM AUTHOR]

Background: The plaque reduction neutralization test (PRNT), which measures a subset of immunoglobulin antibodies (functional neutralizing antibodies), and the enzyme-linked immunosorbent assay (ELISA), which measures total immunoglobulin (neutralizing and nonneutralizing antibodies), characterize different aspects of the anti-mumps virus antibody response after vaccination.Methods: Data from a recent phase 3 clinical trial (NCT01681992) of 2 measles-mumps-rubella vaccines were used to compare anti-mumps antibody responses measured using an unenhanced PRNT (GSK; seropositivity cutoff and threshold, 2.5 and 4 times the 50% end-point dilution, respectively) with those estimated using an ELISA (thresholds, 5 and 10 ELISA units/mL, respectively).Results: Of 3990 initially seronegative samples, 3284 (82.3%) were seropositive after vaccination for anti-mumps antibodies in both assays. The Pearson correlation coefficient for double-positive samples was 0.57, indicative of a moderate correlation. Receiver operating characteristic curve analysis showed that an ELISA threshold of 51.7 ELISA units/mL best corresponded to the PRNT seroresponse threshold. There was no obvious vaccine brand effect on the correlation between assays.Conclusions: The moderate correlation between the anti-mumps antibody measurements obtained with PRNT and ELISA reflects different aspects of the serological response. In the absence of a well-defined protective serological threshold, PRNT provides complementary information on the antibody response, whereas ELISA remains a critically useful measurement of vaccine immunogenicity. [ABSTRACT FROM AUTHOR]

Background: The John Cunningham virus (JCV) is an opportunistic virus which leads to the development of progressive multifocal leukoencephalopathy (PML), which is a lytic infection of oligodendrocytes of the central nervous system in immunosuppressed patients. Infection with the JCV occurs in childhood and the virus remains quiescent in the body, activating during immunosuppression. Exposure to the virus can be detected by testing for JC virus specific antibodies in an ELISA test. Our aim was to determine the JCV seroprevalence and factors associated with its positivity among Zambian adults presenting to the University Teaching Hospital (UTH) with suspected meningoencephalitis and to assess the JCV ELISA test as a possible tool for PML risk stratification. Methodology: This was a cross sectional nested study in the TB meningitis in Zambia (TMZ) study which looked at improving ways of TB diagnosis in patients with meningoencephalitis. It included adults 18 years and older who presented with suspected meningoencephalitis and had undergone a lumbar puncture as part of their evaluation. 50 HIV positive and 50 HIV negative patients were selected from the parent study and underwent testing for JCV serology. PML cases were also recruited from the parent study based on clinical features, confirmed by JCV DNA PCR of CSF. Results: Final analysis for JCV seroprevalence was done in 96 patients and noted to be 46% (95% CI, 35.62 - 56.31). The JCV seroprevalence in the HIV positive group was 40.82% and in the HIV negative group was 51.06 % but there was no statistical difference (p-value 0.31). None of the other factors studied had any impact on the JCV seroprevalence such as age, gender, clinical presentation, CD4 count and co-morbid TB meningitis (TBM) diagnosis. There was a bimodal distribution of age associated with JCV seropositivity; with one peak occurring in the 18 to 20 years age group and the second peak occurring in the 55 to 60 years age group. 14 (3.2%) confirmed PML cases, based on clinical features and JCV DNA CSF positive, were all JCV seropositive and HIV positive with advanced immunosuppression (CD4<200/mm3). Memory impairment was associated with a 6 fold increased likelihood of having PML in advanced HIV disease with JCV seropositive patients which further, increased to over 20 fold after adjusting for age , gender and TBM diagnosis. After adjusting for other variables TBM was associated with an 87% less likelihood of having PML (p-value 0.03). Female gender was associated with increased risk of having PML (p-value 0.02) and a younger age was protective for PML (p-value 0.03). Conclusion: The prevalence of anti-JCV antibodies in patients with suspected CNS infection (meningoencephalitis) was 46%. Anti- JCV antibody prevalence did not differ significantly by age, gender, HIV status or CD4 count. Memory impairment in JCV seropositive, advanced HIV disease patients with meningoencephalitis was the most important variable associated with having PML. [ABSTRACT FROM AUTHOR]

Background: Dengue is one of the most prevalent mosquito-borne diseases in recent times, which has increased 30 fold in the past five decades. There are four serotypes of dengue virus and transmission to humans is by female anopheles mosquito. The clinical presentation varies from asymptomatic to the most serious manifestation such as dengue hemorrhagic fever/dengue shock syndrome which may be fatal in 40%–50% of untreated patients. Thrombocytopenia is the hallmark of dengue infection (DENV), which may sometimes lead to life-threatening complications. Objective: The objective of this study was to evaluate thrombocytopenia in DENV and comparing frequencies between the different age groups and clinical forms to predict the severity of the disease. Materials and Methods: It was a retrospective study conducted for 10 months at Sree Balaji Medical College and Hospital, Chromepet, Chennai. A total of 100 serologically positive cases were evaluated with reference to clinical presentation and laboratory framework. Results: Majority of cases were males and in the age group of 15–30 years. Fever is the predominant symptom in all cases. The severity of the infection can be evaluated from the results and can help by enabling the adaptation of the therapeutic conduct to the needs of individual patients. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal condition mainly manifested by abdominal pain, discomfort and alteration in gut habits. Therapeutic approaches are mainly focused on symptoms mitigation and modification of life style. It was believed that GIT infection, inflammation and changes in mucosal flora may be involved in IBS development. Abnormal modification of gut-nervous system interaction may be also implicated. Helicobacter pylori (H. pylori) is a well-known cause of peptic ulcer with greater prevalence in developing communities. Some studies have linked this gram negative bacterium with several extra-gastric diseases like pre-eclampsia. It was proposed that infection with H. pylori can initiate systemic inflammation leading to IBS development through alterations in gut permeability, normal flora and interaction with nervous system. However, the precise association between IBS prevalence and H. pylori infection is still controversial. The aim of current study was to evaluate any possible relationship between irritable bowel syndrome prevalence and Helicobacter pylori seropositivity. Method: Lateral flow immunochromatographic assay was employed to screen 30 IBS patients and 30 control (without IBS) volunteers for H. pylori IgG antibodies. Results and Conclusions: Our regression analysis didn't show any significant association between irritable bowel syndrome prevalence and H. pylori seropositivity. [ABSTRACT FROM AUTHOR]