28 results on '"Bizimana J"'
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2. Age, Education and Income Levels As Demographic Determinants of Retirement Planning of Public Health Sector Employees in Ngororero District, Rwanda
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Bizimana J. C and Ogbe, A. A.
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General Medicine - Abstract
This study aimed to assess the effects of age, education and income levels as determinants of retirement planning of public health sector employees in Ngororero District. The theoretical review of this research suggests that the wealth of a nation is distributed in such a way that the younger households have little wealth, the middle-aged households have relatively more wealth and the most wealth is secured by households immediately before their retirement. This study was conducted through quantitative and qualitative approaches employing descriptive survey design. The target population consisted of 487 employees working in Public Health Sector in Ngororero District. The sample size is composed of 108 respondents for questionnaire items and interview schedule. The sampling techniques consisted of stratified sampling, simple random sampling and purposive sampling. The data have been collected using questionnaires and interview schedules. The validity has been established and the reliability of the data was tested. The data have been analyzed through descriptive analysis. Spearman’s Rank Correlation Coefficient was used to establish the relationship between independent and dependent variables. Analysis of Variance (ANOVA) technique was used to test the hypotheses (p≤ 0.05). This study found that age, education and income levels have a strong positive correlation with retirement planning of public health sector employees in Ngororero District (Correlation Coefficient is above 0.99). They also have a significant effect on retirement planning of public health sector employees in Ngororero District. Exception is for gender which does not have a significant effect of retirement planning. The study concluded that age, education and income levels have a great effect on retirement planning of employees as it impacts of their retirement decisions. The study recommended the necessity of encouraging people to plan for retirement at early stage so that they secure welfare at old age. Social Security Organizations should design specific programs meant to increase the level of awareness of retirement saving schemes in public health sector. The Local Government and Private Sector should embrace investment opportunities and development projects meant to increase the level of income of the population.
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- 2023
3. Opfer des Völkermords in Murambi, Ruanda
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Jopp-van Well, E., Schaarschmidt, D., Bizimana, J.-D., Gasanabo, J.-D., Krebs, O., Lehmann, M., and Püschel, K.
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- 2019
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4. Bridging the Soil Map of Rwanda with the ‘Farmer’s Mental Soil Map’ for an Effective Integrated and Participatory Watershed Management Research Model
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Rushemuka, P. N., Bizimana, J. P., Mbonigaba, J. J. M., Bock, L., Vanlauwe, Bernard, editor, van Asten, Piet, editor, and Blomme, Guy, editor
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- 2014
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5. Identification of quantitative trait loci for salinity tolerance in rice (Oryza sativa L.) using IR29/Hasawi mapping population
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Bizimana, J. B., Luzi-Kihupi, A., Murori, Rosemary W., and Singh, R. K.
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- 2017
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6. Impact of Kigali City master plan implementation on living conditions of urban dwellers: case of Nyarugenge District in Rwanda
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Nyiransabimana, M J, primary, Rwabudandi, I, additional, de Vries, W T, additional, Bizimana, J P, additional, and Benineza, G G, additional
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- 2019
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7. Mapping QTLs using a novel source of salinity tolerance from Hasawi and their interaction with environments in rice
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Rahman, M. Akhlasur, primary, Bimpong, Isaac Kofi, additional, Bizimana, J. B., additional, Pascual, Evangeline D., additional, Arceta, Marydee, additional, Swamy, B. P. Mallikarjuna, additional, Diaw, Faty, additional, Rahman, M. Sazzadur, additional, and Singh, R. K., additional
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- 2017
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8. Assessment of anti-HIV-1 antibodies in oral and nasal compartments of volunteers from three different populations
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Bergin, P, Langat, R, Omosa-Manyonyi, G, Farah, B, Ouattara, G, Park, H, Coutinho, H, Laufer, D, Fast, P, Verlinde, C, Bizimana, J, Umviligihozo, G, Nyombayire, J, Ingabire, R, Kuldanek, K, Cox, J, McMorrow, M, Fidler, S, Karita, E, Gilmour, J, and Anzala, O
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Science & Technology ,Immunology ,mucosal ,HIV ,nasal ,1103 Clinical Sciences ,HIV-1 VACCINE ,REGIONS ,DOUBLE-BLIND ,Infectious Diseases ,vaccine ,antibody ,Virology ,INFECTION ,salivary ,VIRUS ,TEST-OF-CONCEPT ,CHALLENGE ,Life Sciences & Biomedicine ,EFFICACY TRIAL ,RESPONSES - Abstract
In this study, we assessed the feasibility of collecting standardized nasal and salivary samples at centers in Nairobi (Kenya), Kigali (Rwanda) and London (UK) using different collection devices and media (Synthetic absorptive matrices versus flocked swabs, and Salimetrics Oral swabs versus whole oral fluid collection). We detected anti Gag (p24) and envelope (gp140) antibodies in both nasal fluid and salivary collections from all HIV-infected individuals, and cross-reactive anti-p24 antibodies were detected in 10% of HIV-uninfected individuals enrolled at one site. Collections from the nasal turbinates were comparable to samples collected deeper in the nasopharyngeal tract, and the yield of anti-p24 IgA in the whole oral fluid samples was higher than in samples collected from the parotid gland. We noted a trend toward reduced levels of anti-HIV antibody in the volunteers receiving anti-retroviral therapy (ART). Levels of antibodies were stable over multiple collection visits. Overall, this study shows that nasal and salivary samples can be collected in a standardized manner over repeated visits in both low and high resource settings. These methods may be used in support of future HIV vaccine clinical trials.
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- 2016
9. Bridging the Soil Map of Rwanda with the `Farmer's Mental Soil Map' for an Effective Integrated and Participatory Watershed Management Research Model.
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Rushemuka, P. N., Bizimana, J. P., Mbonigaba, J. J. M., and Bock, L.
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- 2014
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10. Under-two child mortality according to maternal HIV status in Rwanda: assessing outcomes within the National PMTCT Program
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Mugwaneza, P, primary, Wa Shema, NU, additional, Ruton, H, additional, Rukundo, A, additional, Lyambabaje, A, additional, De Dieu Bizimana, J, additional, Tsague, L, additional, Wagner, CM, additional, Nyankesha, E, additional, Muita, J, additional, Mutabazi, V, additional, Nyemazi, JP, additional, Nsanzimana, S, additional, Karema, C, additional, and Binagwaho, A, additional
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- 2011
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11. P1-S6.23 Impact evaluation of performance-based financing (PBF) for HIV testing and counselling for individuals and couples in Rwanda
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Bautista, S., primary, Binagwaho, A., additional, de Dieu Bizimana, J., additional, Condo, J., additional, de Walque, D., additional, Gertler, P., additional, Kwan, A., additional, and Sturdy, J., additional
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- 2011
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12. P14-09. Use of HIV rapid tests for assessment of persistence of vaccine induced antibodies among HIV vaccine recipients
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Karita, E, primary, Kayitenkore, K, additional, Bayingana, R, additional, Sebahungu, F, additional, Bizimana, J, additional, Grabowski, K, additional, Tichacek, A, additional, Schmidt, C, additional, Fast, P, additional, Hunter, E, additional, and Allen, S, additional
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- 2009
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13. Spatial Multi-criteria evaluation for implementation of national urbanisation policy in Rwanda
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Habonimana, H., Bizimana, J. P., Uwayezu, E., Gilbert, M., Luc Boerboom, Department of Urban and Regional Planning and Geo-Information Management, UT-I-ITC-PLUS, and Faculty of Geo-Information Science and Earth Observation
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METIS-314530
14. Colonization of patients hospitalized at orthopedic department of tertiary hospital in Uganda with extended-spectrum beta-lactamase-producing enterobacterales.
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Bizimana J, Ndayisenga J, Kajumbura H, Mulepo P, and Christine NF
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- Humans, Adolescent, Enterobacteriaceae, Tertiary Care Centers, Uganda epidemiology, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, beta-Lactamases, Enterobacteriaceae Infections epidemiology, Enterobacteriaceae Infections drug therapy, Gammaproteobacteria
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Background: Beta-lactamase production remains the most contributing factor to beta-lactam resistance. Extended-Spectrum Beta-Lactamase-Producing Enterobacterales (ESBL-PE) are associated with risk factors both in hospital and community settings., Objectives: To assess the incidence and risk factors for intestinal carriage of ESBL-PE among patients admitted to orthopedic ward of Mulago National Referral Hospital, and to analyze the acquisition of ESBL-PE during hospital stay and associated factors., Methods: We screened 172 patients aged 18 years old and above who got admitted to the orthopedic ward of Mulago National Referral Hospital between May to July 2017. Stool samples or rectal swabs were collected at admission, every 3 days until fourteen days and screened for ESBL-PE. Data on demographic status, antibiotic use, admission and travel, length of hospital stay, hygiene practices and drinking boiled water were analyzed by logistic regression and cox regression model., Results: At admission, 61% of patients showed intestinal ESBL-PE carriage. Co- resistance was common but no Carbapenem resistance was detected. Of the ESBL-PE negative, 49% were colonized during hospitalization. On admission, prior antibiotic use was significantly associated with carriage, but none was associated with acquisition during hospitalization at p-value < 0.05., Conclusion: Carriage of ESBL-PE on admissions and acquisition at orthopedic ward of Mulago Hospital were high, and dissemination into the community are of substantial concern. We suggested refinement of empirical treatment based on risk stratification, and enhanced infection control measures that target health care workers, patients and attendants., (© 2023. The Author(s).)
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- 2023
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15. Antibiotic-resistant Neisseria gonorrhoeae and changes to the 2019 Rwandan National STI Guidelines.
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Wall KM, Nyombayire J, Parker R, Ingabire R, Bizimana J, Mukamuyango J, Mazzei A, Price MA, Unyuzimana MA, Tichacek A, Allen S, and Karita E
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- Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Drug Resistance, Bacterial, Humans, Microbial Sensitivity Tests, Rwanda, Gonorrhea diagnosis, Gonorrhea drug therapy, Gonorrhea epidemiology, Neisseria gonorrhoeae
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- 2022
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16. Increased Frequency of Inter-Subtype HIV-1 Recombinants Identified by Near Full-Length Virus Sequencing in Rwandan Acute Transmission Cohorts.
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Umviligihozo G, Muok E, Nyirimihigo Gisa E, Xu R, Dilernia D, Herard K, Song H, Qin Q, Bizimana J, Farmer P, Hare J, Gilmour J, Allen S, Karita E, Hunter E, and Yue L
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Most studies of HIV-1 transmission have focused on subtypes B and C. In this study, we determined the genomic sequences of the transmitted founder (TF) viruses from acutely infected individuals enrolled between 2005 and 2011 into IAVI protocol C in Rwanda and have compared these isolates to viruses from more recent (2016-2019) acute/early infections in three at risk populations - MSM, high risk women (HRW), and discordant couples (DC). For the Protocol C samples, we utilized near full-length single genome (NFLG) amplification to generate 288 HIV-1 amplicons from 26 acutely infected seroconverters (SC), while for the 21 recent seroconverter samples (13 from HRW, two from DC, and six from MSM), we PCR amplified overlapping half-genomes. Using PacBio SMRT technology combined with the MDPseq workflow, we performed multiplex sequencing to obtain high accuracy sequences for each amplicon. Phylogenetic analyses indicated that the majority of recent transmitted viruses from DC and HRW clustered within those of the earlier Protocol C cohort. However, five of six sequences from the MSM cohort branched together and were greater than 97% identical. Recombination analyses revealed a high frequency (6/26; 23%) of unique inter-subtype recombination in Protocol C with 19% AC and 4% CD recombinant viruses, which contrasted with only 6.5% of recombinants defined by sequencing of the pol gene previously. The frequency of recombinants was significantly higher (12/21; 57%) in the more recent isolates, although, the five related viruses from the MSM cohort had identical recombination break points. While major drug resistance mutations were absent from Protocol C viruses, 4/21 of recent isolates exhibited transmitted nevirapine resistance. These results demonstrate the ongoing evolution and increased prevalence of recombinant and drug resistant transmitted viruses in Rwanda and highlight the importance of defining NFLG sequences to fully understand the nature of TF viruses and in particular the prevalence of unique recombinant forms (URFs) in transmission cohorts., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Umviligihozo, Muok, Nyirimihigo Gisa, Xu, Dilernia, Herard, Song, Qin, Bizimana, Farmer, Hare, Gilmour, Allen, Karita, Hunter and Yue.)
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- 2021
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17. Developing and validating a risk algorithm to diagnose Neisseria gonorrhoeae and Chlamydia trachomatis in symptomatic Rwandan women.
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Wall KM, Nyombayire J, Parker R, Ingabire R, Bizimana J, Mukamuyango J, Mazzei A, Price MA, Unyuzimana MA, Tichacek A, Allen S, and Karita E
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- Adult, Chlamydia Infections epidemiology, Chlamydia Infections microbiology, Female, Gonorrhea epidemiology, Gonorrhea microbiology, Humans, Logistic Models, Mass Screening, Predictive Value of Tests, Prevalence, Risk Factors, Rwanda epidemiology, Sensitivity and Specificity, Young Adult, Algorithms, Chlamydia Infections diagnosis, Chlamydia trachomatis, Gonorrhea diagnosis, Neisseria gonorrhoeae
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Background: Algorithms that bridge the gap between syndromic sexually transmitted infection (STI) management and treatment based in realistic diagnostic options and local epidemiology are urgently needed across Africa. Our objective was to develop and validate a risk algorithm for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) diagnosis among symptomatic Rwandan women and to compare risk algorithm performance to the current Rwandan National Criteria for NG/CT diagnosis., Methods: The risk algorithm was derived in a cohort (n = 468) comprised of symptomatic women in Kigali who sought free screening and treatment for sexually transmitted infections and vaginal dysbioses at our research site. We used logistic regression to derive a risk algorithm for prediction of NG/CT infection. Ten-fold cross-validation internally validated the risk algorithm. We applied the risk algorithm to an external validation cohort also comprised of symptomatic Rwandan women (n = 305). Measures of calibration, discrimination, and screening performance of our risk algorithm compared to the current Rwandan National Criteria are presented., Results: The prevalence of NG/CT in the derivation cohort was 34.6%. The risk algorithm included: age < =25, having no/primary education, not having full-time employment, using condoms only sometimes, not reporting genital itching, testing negative for vaginal candida, and testing positive for bacterial vaginosis. The model was well calibrated (Hosmer-Lemeshow p = 0.831). Higher risk scores were significantly associated with increased prevalence of NG/CT infection (p < 0.001). Using a cut-point score of > = 5, the risk algorithm had a sensitivity of 81%, specificity of 54%, positive predictive value (PPV) of 48%, and negative predictive value (NPV) of 85%. Internal and external validation showed similar predictive ability of the risk algorithm, which outperformed the Rwandan National Criteria. Applying the Rwandan National Criteria cutoff of > = 2 (the current cutoff) to our derivation cohort had a sensitivity of 26%, specificity of 89%, PPV of 55%, and NPV of 69%., Conclusions: These data support use of a locally relevant, evidence-based risk algorithm to significantly reduce the number of untreated NG/CT cases in symptomatic Rwandan women. The risk algorithm could be a cost-effective way to target treatment to those at highest NG/CT risk. The algorithm could also aid in sexually transmitted infection risk and prevention communication between providers and clients.
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- 2021
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18. Etiologies of genital inflammation and ulceration in symptomatic Rwandan men and women responding to radio promotions of free screening and treatment services.
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Wall KM, Nyombayire J, Parker R, Ingabire R, Bizimana J, Mukamuyango J, Mazzei A, Price MA, Unyuzimana MA, Tichacek A, Allen S, and Karita E
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- Adult, Candida albicans, Candidiasis diagnosis, Chlamydia Infections diagnosis, Chlamydia trachomatis pathogenicity, Female, Genitalia, Gonorrhea diagnosis, HIV Infections epidemiology, Humans, Inflammation, Male, Mass Screening methods, Middle Aged, Neisseria gonorrhoeae pathogenicity, Prevalence, Rwanda epidemiology, Sexually Transmitted Diseases epidemiology, Syphilis epidemiology, Trichomonas vaginalis, Urogenital System, Vaginosis, Bacterial diagnosis, Vaginosis, Bacterial epidemiology, Chlamydia Infections epidemiology, Gonorrhea epidemiology, Sexually Transmitted Diseases etiology
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Introduction: The longstanding inadequacies of syndromic management for genital ulceration and inflammation are well-described. The Rwanda National Guidelines for sexually transmitted infection (STI) syndromic management are not yet informed by the local prevalence and correlates of STI etiologies, a component World Health Organization guidelines stress as critical to optimize locally relevant algorithms., Methods: Radio announcements and pharmacists recruited symptomatic patients to seek free STI services in Kigali. Clients who sought services were asked to refer sexual partners and symptomatic friends. Demographic, behavioral risk factor, medical history, and symptom data were collected. Genital exams were performed by trained research nurses and physicians. We conducted phlebotomy for rapid HIV and rapid plasma reagin (RPR) serologies and vaginal pool swab for microscopy of wet preparation to diagnose Trichomonas vaginalis (TV), bacterial vaginosis (BV), and vaginal Candida albicans (VCA). GeneXpert testing for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) were conducted. Here we assess factors associated with diagnosis of NG and CT in men and women. We also explore factors associated with TV, BV and VCA in women. Finally, we describe genital ulcer and RPR results by HIV status, gender, and circumcision in men., Results: Among 974 men (with 1013 visits), 20% were positive for CT and 74% were positive for NG. Among 569 women (with 579 visits), 17% were positive for CT and 27% were positive for NG. In multivariate analyses, factors associated with CT in men included younger age, responding to radio advertisements, <17 days since suspected exposure, and not having dysuria. Factors associated with NG in men included not having higher education or full-time employment, <17 days since suspected exposure, not reporting a genital ulcer, and having urethral discharge on physical exam. Factors associated with CT in women included younger age and < = 10 days with symptoms. Factors associated with NG in women included younger age, lower education and lack of full-time employment, sometimes using condoms vs. never, using hormonal vs. non-hormonal contraception, not having genital ulcer or itching, having symptoms < = 10 days, HIV+ status, having BV, endocervical discharge noted on speculum exam, and negative vaginal wet mount for VCA. In multivariate analyses, only reporting >1 partner was associated with BV; being single and RPR+ was associated with TV; and having < = 1 partner in the last month, being pregnant, genital itching, discharge, and being HIV and RPR negative were associated with VCA. Genital ulcers and positive RPR were associated with being HIV+ and lack of circumcision among men. HIV+ women were more likely to be RPR+. In HIV+ men and women, ulcers were more likely to be herpetic rather than syphilitic compared with their HIV- counterparts., Conclusions: Syndromic management guidelines in Rwanda can be improved with consideration of the prevalence of confirmed infections from this study of symptomatic men and women representative of those who would seek care at government health centers. Inclusion of demographic and risk factor measures shown to be predictive of STI and non-STI dysbioses may also increase diagnostic accuracy., Competing Interests: No authors have competing interests.
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- 2021
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19. Performance of International AIDS Vaccine Initiative African clinical research laboratories in standardised ELISpot and peripheral blood mononuclear cell processing in support of HIV vaccine clinical trials.
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Langat RK, Farah B, Indangasi J, Ogola S, Omosa-Manyonyi G, Anzala O, Bizimana J, Tekirya E, Ngetsa C, Silwamba M, Muyanja E, Chetty P, Jangano M, Hills N, Gilmour J, Dally L, Cox JH, and Hayes P
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Background: Standardisation of procedures for performing cellular functional assays across laboratories participating in multicentre clinical trials is key for generating comparable and reliable data., Objective: This article describes the performance of accredited laboratories in Africa and Europe on testing done in support of clinical trials., Methods: For enzyme-linked immunospot assay (ELISpot) proficiency, characterised peripheral blood mononuclear cells (PBMCs) obtained from 48 HIV-negative blood donors in Johannesburg, South Africa, were sent to participating laboratories between February 2010 and February 2014. The PBMCs were tested for responses against cytomegalovirus, Epstein Barr and influenza peptide pools in a total of 1751 assays. In a separate study, a total of 1297 PBMC samples isolated from healthy HIV-negative participants in clinical trials of two prophylactic HIV vaccine candidates in Kenya, Uganda, Rwanda and Zambia were analysed for cell viability, cell yield and cell recovery from frozen PBMCs., Results: Most (99%) of the 1751 ELISpot proficiency assays had data within acceptable ranges with low responses to mock stimuli. No significant statistical difference were observed in ELISpot responses at the five laboratories actively conducting immunological analyses. Of the 1297 clinical trial PBMCs processed, 94% had cell viability above 90% and 96% had cell yield above 0.7 million per mL of blood in freshly isolated cells. All parameters were within the predefined acceptance criteria., Conclusion: We demonstrate that multiple laboratories can generate reliable, accurate and comparable data by using standardised procedures, having regular training, having regular equipment maintenance and using centrally sourced reagents., Competing Interests: The authors have declared that no competing interests exist., (© 2021. The Authors.)
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- 2021
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20. Female sex workers in Kigali, Rwanda: a key population at risk of HIV, sexually transmitted infections, and unplanned pregnancy.
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Ingabire R, Parker R, Nyombayire J, Ko JE, Mukamuyango J, Bizimana J, Price MA, Laufer D, Tichacek A, Wall K, Allen S, and Karita E
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- Adolescent, Adult, Cross-Sectional Studies, Female, HIV Infections ethnology, Humans, Pregnancy, Prevalence, Risk Factors, Risk-Taking, Rwanda epidemiology, Safe Sex, Sexual Behavior, Sexually Transmitted Diseases ethnology, Condoms statistics & numerical data, Contraception Behavior statistics & numerical data, HIV Infections epidemiology, Pregnancy, Unplanned ethnology, Sex Work statistics & numerical data, Sex Workers statistics & numerical data, Sexually Transmitted Diseases epidemiology, Unsafe Sex statistics & numerical data
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Female sex workers (FSWs) were recruited from known hotspots in Kigali, Rwanda, and offered free, anonymous human immunodeficiency virus (HIV) counseling and testing, diagnosis and treatment of sexually transmitted infections (STIs) and long-acting reversible contraception (LARC). From September 2012 to March 2015, 1168 FSWs sought services, including 587 (50%) who were HIV-positive. More than 90% had previously tested for HIV, and 26% who reported previously testing negative had seroconverted. Of the 349 who already knew their HIV-positive status, 74% were on antiretroviral treatment. The prevalence of serologic syphilis was 43% in HIV-positive and 19% in HIV-negative FSWs (p < 0.0001), and Trichomonas vaginalis was found in vaginal wet mounts in 21% of HIV-positive and 13% of HIV-negative FSWs (p < 0.0001). Signs and symptoms of STIs were found in 35% of HIV-positive compared with 21% of HIV-negative FSWs (p < 0.0001). Only one-third reported consistent condom use in the last month. Modern contraceptive use was reported by 43% of HIV-positive and 56% of HIV-negative FSWs (p < 0.0001). Current pregnancy was reported by 4% of HIV-positive and 6% of HIV-negative FSWs (p = 0.0409). Despite Rwanda's successes with preventing 70% of new infections in the general population through nationwide couples' testing in antenatal clinics, prevention and timely treatment in key populations including FSWs are lacking. The prevalence of HIV - including many new cases - and STIs among FSWs in Kigali is high and condom and contraceptive use are low. Tailored and integrated HIV/STIs and family planning programs are urgently needed for FSWs.
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- 2019
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21. First-in-Human Evaluation of the Safety and Immunogenicity of an Intranasally Administered Replication-Competent Sendai Virus-Vectored HIV Type 1 Gag Vaccine: Induction of Potent T-Cell or Antibody Responses in Prime-Boost Regimens.
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Nyombayire J, Anzala O, Gazzard B, Karita E, Bergin P, Hayes P, Kopycinski J, Omosa-Manyonyi G, Jackson A, Bizimana J, Farah B, Sayeed E, Parks CL, Inoue M, Hironaka T, Hara H, Shu T, Matano T, Dally L, Barin B, Park H, Gilmour J, Lombardo A, Excler JL, Fast P, Laufer DS, and Cox JH
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- AIDS Vaccines administration & dosage, AIDS Vaccines genetics, Administration, Intranasal, Adult, Female, Genes, Viral immunology, Genetic Vectors, HIV Antibodies blood, HIV Antibodies immunology, HIV Infections immunology, HIV-1 genetics, Humans, Immunity, Cellular, Immunity, Humoral, Immunization, Secondary, Immunogenicity, Vaccine, Kenya, Male, Middle Aged, Rwanda, Sendai virus immunology, Sendai virus physiology, United Kingdom, Vaccines, DNA administration & dosage, Virus Replication, AIDS Vaccines adverse effects, AIDS Vaccines immunology, CD8-Positive T-Lymphocytes immunology, HIV Infections prevention & control, HIV-1 immunology, Sendai virus genetics, Vaccines, DNA adverse effects, Vaccines, DNA immunology
- Abstract
Background: We report the first-in-human safety and immunogenicity assessment of a prototype intranasally administered, replication-competent Sendai virus (SeV)-vectored, human immunodeficiency virus type 1 (HIV-1) vaccine., Methods: Sixty-five HIV-1-uninfected adults in Kenya, Rwanda, and the United Kingdom were assigned to receive 1 of 4 prime-boost regimens (administered at 0 and 4 months, respectively; ratio of vaccine to placebo recipients, 12:4): priming with a lower-dose SeV-Gag given intranasally, followed by boosting with an adenovirus 35-vectored vaccine encoding HIV-1 Gag, reverse transcriptase, integrase, and Nef (Ad35-GRIN) given intramuscularly (S
L A); priming with a higher-dose SeV-Gag given intranasally, followed by boosting with Ad35-GRIN given intramuscularly (SH A); priming with Ad35-GRIN given intramuscularly, followed by boosting with a higher-dose SeV-Gag given intranasally (ASH ); and priming and boosting with a higher-dose SeV-Gag given intranasally (SH SH )., Results: All vaccine regimens were well tolerated. Gag-specific IFN-γ enzyme-linked immunospot-determined response rates and geometric mean responses were higher (96% and 248 spot-forming units, respectively) in groups primed with SeV-Gag and boosted with Ad35-GRIN (SL A and SH A) than those after a single dose of Ad35-GRIN (56% and 54 spot-forming units, respectively) or SeV-Gag (55% and 59 spot-forming units, respectively); responses persisted for ≥8 months after completion of the prime-boost regimen. Functional CD8+ T-cell responses with greater breadth, magnitude, and frequency in a viral inhibition assay were also seen in the SL A and SH A groups after Ad35-GRIN boost, compared with those who received either vaccine alone. SeV-Gag did not boost T-cell counts in the ASH group. In contrast, the highest Gag-specific antibody titers were seen in the ASH group. Mucosal antibody responses were sporadic., Conclusions: SeV-Gag primed functional, durable HIV-specific T-cell responses and boosted antibody responses. The prime-boost sequence appears to determine which arm of the immune response is stimulated., Clinical Trials Registration: NCT01705990., (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.)- Published
- 2017
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22. Mental Health and Antiretroviral Adherence Among Youth Living With HIV in Rwanda.
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Smith Fawzi MC, Ng L, Kanyanganzi F, Kirk C, Bizimana J, Cyamatare F, Mushashi C, Kim T, Kayiteshonga Y, Binagwaho A, and Betancourt TS
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- Adolescent, Child, Cross-Sectional Studies, Female, HIV Infections psychology, Humans, Male, Mental Health, Rural Population, Rwanda epidemiology, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, Medication Adherence psychology, Mental Disorders epidemiology
- Abstract
Background and Objectives: In Rwanda, significant progress has been made in advancing access to antiretroviral therapy (ART) among youth. As availability of ART increases, adherence is critical for preventing poor clinical outcomes and transmission of HIV. The goals of the study are to (1) describe ART adherence and mental health problems among youth living with HIV aged 10 to 17; and (2) examine the association between these factors among this population in rural Rwanda., Methods: A cross-sectional analysis was conducted that examined the association of mental health status and ART adherence among youth (n = 193). ART adherence, mental health status, and related variables were examined based on caregiver and youth report. Nonadherence was defined as ever missing or refusing a dose of ART within the past month. Multivariate modeling was performed to examine the association between mental health status and ART adherence., Results: Approximately 37% of youth missed or refused ART in the past month. In addition, a high level of depressive symptoms (26%) and attempt to hurt or kill oneself (12%) was observed in this population of youth living with HIV in Rwanda. In multivariate analysis, nonadherence was significantly associated with some mental health outcomes, including conduct problems (odds ratio 2.90, 95% confidence interval 1.55-5.43) and depression (odds ratio 1.02, 95% confidence interval 1.01-1.04), according to caregiver report. A marginally significant association was observed for youth report of depressive symptoms., Conclusions: The findings suggest that mental health should be considered among the factors related to ART nonadherence in HIV services for youth, particularly for mental health outcomes, such as conduct problems and depression., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2016 by the American Academy of Pediatrics.)
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- 2016
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23. Assessment of Anti-HIV-1 Antibodies in Oral and Nasal Compartments of Volunteers From 3 Different Populations.
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Bergin PJ, Langat R, Omosa-Manyonyi G, Farah B, Ouattara G, Park H, Coutinho H, Laufer D, Fast P, Verlinde C, Bizimana J, Umviligihozo G, Nyombayire J, Ingabire R, Kuldanek K, Cox J, McMorrow M, Fidler S, Karita E, Gilmour J, and Anzala O
- Subjects
- Case-Control Studies, Enzyme-Linked Immunosorbent Assay, HIV Infections immunology, Humans, Kenya, Limit of Detection, Rwanda, United Kingdom, HIV Antibodies analysis, HIV Infections virology, HIV-1 immunology, Mouth virology, Nasal Cavity virology
- Abstract
In this study, we assessed the feasibility of collecting standardized nasal and salivary samples at centers in Nairobi (Kenya), Kigali (Rwanda), and London (United Kingdom) using different collection devices and media (synthetic absorptive matrices versus flocked swabs, and Salimetrics oral swabs versus whole oral fluid collection). We detected anti-Gag (p24) and envelope (gp140) antibodies in both nasal fluid and salivary collections from all HIV-infected individuals, and cross-reactive anti-p24 antibodies were detected in 10% of HIV-uninfected individuals enrolled at one site. Collections from the nasal turbinates were comparable with samples collected deeper in the nasopharyngeal tract, and the yield of anti-p24 IgA in the whole oral fluid samples was higher than in samples collected from the parotid gland. We noted a trend toward reduced levels of anti-HIV antibody in the volunteers receiving anti-retroviral therapy. Levels of antibodies were stable over multiple collection visits. Overall, this study shows that nasal and salivary samples can be collected in a standardized manner over repeated visits in both low- and high-resource settings. These methods may be used in support for future HIV vaccine clinical trials.
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- 2016
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24. Correction: Ethics in Community-Based Research with Vulnerable Children: Perspectives from Rwanda.
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Betancourt TS, Smith Fawzi MC, Stevenson A, Kanyanganzi F, Kirk C, Ng L, Mushashi C, Bizimana J, Beardslee W, Raviola G, Smith S, Kayiteshonga Y, and Binagwaho A
- Abstract
[This corrects the article DOI: 10.1371/journal.pone.0157042.].
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- 2016
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25. Using provider performance incentives to increase HIV testing and counseling services in Rwanda.
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de Walque D, Gertler PJ, Bautista-Arredondo S, Kwan A, Vermeersch C, de Dieu Bizimana J, Binagwaho A, and Condo J
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- AIDS Serodiagnosis statistics & numerical data, Counseling statistics & numerical data, Female, HIV Infections diagnosis, Humans, Male, Prospective Studies, Rwanda, AIDS Serodiagnosis economics, Counseling economics, Reimbursement, Incentive organization & administration
- Abstract
Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient., (Copyright © 2014. Published by Elsevier B.V.)
- Published
- 2015
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26. HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme: a community-based household survey.
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Ruton H, Mugwaneza P, Shema N, Lyambabaje A, de Dieu Bizimana J, Tsague L, Nyankesha E, Wagner CM, Mutabazi V, Nyemazi JP, Nsanzimana S, Karema C, and Binagwaho A
- Subjects
- Adult, Anti-HIV Agents therapeutic use, Child, Preschool, Data Collection, Family Characteristics, Female, HIV Infections drug therapy, HIV Infections transmission, Humans, Infant, Male, Pregnancy, Residence Characteristics statistics & numerical data, Rwanda, Young Adult, HIV Infections mortality, HIV Infections prevention & control, Infectious Disease Transmission, Vertical, National Health Programs, Program Evaluation
- Abstract
Background: Operational effectiveness of large-scale national programmes for the prevention of mother to child transmission (PMTCT) of HIV in sub-Saharan Africa remains limited. We report on HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the national PMTCT programme in Rwanda., Methods: We conducted a national representative household survey between February and May 2009. Participants were mothers who had attended antenatal care at least once during their most recent pregnancy, and whose children were aged nine to 24 months. A two-stage stratified (geographic location of PMTCT site, maternal HIV status during pregnancy) cluster sampling was used to select mother-infant pairs to be interviewed during household visits. Alive children born from HIV-positive mothers (HIV-exposed children) were tested for HIV according to routine HIV testing protocol. We calculated HIV-free survival at nine to 24 months. We subsequently determined factors associated with mother to child transmission of HIV, child death and HIV-free survival using logistic regression., Results: Out of 1448 HIV-exposed children surveyed, 44 (3.0%) were reported dead by nine months of age. Of the 1340 children alive, 53 (4.0%) tested HIV positive. HIV-free survival was estimated at 91.9% (95% confidence interval: 90.4-93.3%) at nine to 24 months. Adjusting for maternal, child and health system factors, being a member of an association of people living with HIV (adjusted odds ratio: 0.7, 95% CI: 0.1-0.995) improved by 30% HIV-free survival among children, whereas the maternal use of a highly active antiretroviral therapy (HAART) regimen for PMTCT (aOR: 0.6, 95% CI: 0.3-1.07) had a borderline effect., Conclusions: HIV-free survival among HIV-exposed children aged nine to 24 months is estimated at 91.9% in Rwanda. The national PMTCT programme could achieve greater impact on child survival by ensuring access to HAART for all HIV-positive pregnant women in need, improving the quality of the programme in rural areas, and strengthening linkages with community-based support systems, including associations of people living with HIV.
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- 2012
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27. Indeterminate and discrepant rapid HIV test results in couples' HIV testing and counselling centres in Africa.
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Boeras DI, Luisi N, Karita E, McKinney S, Sharkey T, Keeling M, Chomba E, Kraft C, Wall K, Bizimana J, Kilembe W, Tichacek A, Caliendo AM, Hunter E, and Allen S
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- Africa, Antibodies, Viral blood, Antibodies, Viral immunology, Counseling, Female, HIV immunology, HIV Infections immunology, HIV Infections psychology, HIV Infections virology, Heterosexuality statistics & numerical data, Humans, Male, Sexual Partners psychology, HIV Infections diagnosis, Heterosexuality psychology
- Abstract
Background: Many HIV voluntary testing and counselling centres in Africa use rapid antibody tests, in parallel or in sequence, to establish same-day HIV status. The interpretation of indeterminate or discrepant results between different rapid tests on one sample poses a challenge. We investigated the use of an algorithm using three serial rapid HIV tests in cohabiting couples to resolve unclear serostatuses., Methods: Heterosexual couples visited the Rwanda Zambia HIV Research Group testing centres in Kigali, Rwanda, and Lusaka, Zambia, to assess HIV infection status. Individuals with unclear HIV rapid antibody test results (indeterminate) or discrepant results were asked to return for repeat testing to resolve HIV status. If either partner of a couple tested positive or indeterminate with the screening test, both partners were tested with a confirmatory test. Individuals with indeterminate or discrepant results were further tested with a tie-breaker and monthly retesting. HIV-RNA viral load was determined when HIV status was not resolved by follow-up rapid testing. Individuals were classified based on two of three initial tests as "Positive", "Negative" or "Other". Follow-up testing and/or HIV-RNA viral load testing determined them as "Infected", "Uninfected" or "Unresolved"., Results: Of 45,820 individuals tested as couples, 2.3% (4.1% of couples) had at least one discrepant or indeterminate rapid result. A total of 65% of those individuals had follow-up testing and of those individuals initially classified as "Negative" by three initial rapid tests, less than 1% were resolved as "Infected". In contrast, of those individuals with at least one discrepant or indeterminate result who were initially classified as "Positive", only 46% were resolved as "Infected", while the remainder was resolved as "Uninfected" (46%) or "Unresolved" (8%). A positive HIV serostatus of one of the partners was a strong predictor of infection in the other partner as 48% of individuals who resolved as "Infected" had an HIV-infected spouse., Conclusions: In more than 45,000 individuals counselled and tested as couples, only 5% of individuals with indeterminate or discrepant rapid HIV test results were HIV infected. This represented only 0.1% of all individuals tested. Thus, algorithms using screening, confirmatory and tie-breaker rapid tests are reliable with two of three tests negative, but not when two of three tests are positive. False positive antibody tests may persist. HIV-positive partner serostatus should prompt repeat testing.
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- 2011
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28. Safety and immunogenicity study of Multiclade HIV-1 adenoviral vector vaccine alone or as boost following a multiclade HIV-1 DNA vaccine in Africa.
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Jaoko W, Karita E, Kayitenkore K, Omosa-Manyonyi G, Allen S, Than S, Adams EM, Graham BS, Koup RA, Bailer RT, Smith C, Dally L, Farah B, Anzala O, Muvunyi CM, Bizimana J, Tarragona-Fiol T, Bergin PJ, Hayes P, Ho M, Loughran K, Komaroff W, Stevens G, Thomson H, Boaz MJ, Cox JH, Schmidt C, Gilmour J, Nabel GJ, Fast P, and Bwayo J
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- Adenoviridae genetics, Adolescent, Adult, Antibodies, Viral immunology, Double-Blind Method, Drug-Related Side Effects and Adverse Reactions, Genetic Vectors adverse effects, Genetic Vectors genetics, HIV Infections prevention & control, HIV Infections virology, HIV-1 classification, HIV-1 genetics, HIV-1 immunology, Humans, Immunization, Secondary, Male, Middle Aged, Vaccines, DNA adverse effects, Young Adult, gag Gene Products, Human Immunodeficiency Virus adverse effects, gag Gene Products, Human Immunodeficiency Virus genetics, gag Gene Products, Human Immunodeficiency Virus immunology, pol Gene Products, Human Immunodeficiency Virus adverse effects, pol Gene Products, Human Immunodeficiency Virus genetics, pol Gene Products, Human Immunodeficiency Virus immunology, AIDS Vaccines adverse effects, AIDS Vaccines immunology, Adenoviridae immunology, Genetic Vectors immunology, HIV Infections immunology, Vaccines, DNA immunology
- Abstract
Background: We conducted a double-blind, randomized, placebo-controlled Phase I study of a recombinant replication-defective adenovirus type 5 (rAd5) vector expressing HIV-1 Gag and Pol from subtype B and Env from subtypes A, B and C, given alone or as boost following a DNA plasmid vaccine expressing the same HIV-1 proteins plus Nef, in 114 healthy HIV-uninfected African adults., Methodology/principal Findings: Volunteers were randomized to 4 groups receiving the rAd5 vaccine intramuscularly at dosage levels of 1×10(10) or 1×10(11) particle units (PU) either alone or as boost following 3 injections of the DNA vaccine given at 4 mg/dose intramuscularly by needle-free injection using Biojector® 2000. Safety and immunogenicity were evaluated for 12 months. Both vaccines were well-tolerated. Overall, 62% and 86% of vaccine recipients in the rAd5 alone and DNA prime - rAd5 boost groups, respectively, responded to the HIV-1 proteins by an interferon-gamma (IFN-γ) ELISPOT. The frequency of immune responses was independent of rAd5 dosage levels. The highest frequency of responses after rAd5 alone was detected at 6 weeks; after DNA prime - rAd5 boost, at 6 months (end of study). At baseline, neutralizing antibodies against Ad5 were present in 81% of volunteers; the distribution was similar across the 4 groups. Pre-existing immunity to Ad5 did not appear to have a significant impact on reactogenicity or immune response rates to HIV antigens by IFN-γ ELISPOT. Binding antibodies against Env were detected in up to 100% recipients of DNA prime - rAd5 boost. One volunteer acquired HIV infection after the study ended, two years after receipt of rAd5 alone., Conclusions/significance: The HIV-1 rAd5 vaccine, either alone or as a boost following HIV-1 DNA vaccine, was well-tolerated and immunogenic in African adults. DNA priming increased the frequency and magnitude of cellular and humoral immune responses, but there was no effect of rAd5 dosage on immunogenicity endpoints., Trial Registration: ClinicalTrials.gov NCT00124007.
- Published
- 2010
- Full Text
- View/download PDF
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