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Background: HVTN 505 was a human immunodeficiency virus type 1 (HIV-1) preventive vaccine efficacy trial of a DNA/recombinant adenovirus serotype 5 (rAd5) vaccine regimen. We assessed antibody responses measured 1 month after final vaccination (month 7) as correlates of HIV-1 acquisition risk.Methods: Binding antibody responses were quantified in serum samples from 25 primary endpoint vaccine cases (diagnosed with HIV-1 infection between month 7 and month 24) and 125 randomly sampled frequency-matched vaccine controls (HIV-1 negative at month 24). We prespecified for a primary analysis tier 6 antibody response biomarkers that measure immunoglobulin G (IgG) and immunoglobulin A (IgA) binding to Env proteins and 2 previously assessed T-cell response biomarkers.Results: Envelope-specific IgG responses were significantly correlated with decreased HIV-1 risk. Moreover, the interaction of IgG responses and Env-specific CD8+ T-cell polyfunctionality score had a highly significant association with HIV-1 risk after adjustment for multiple comparisons.Conclusions: Vaccinees with higher levels of Env IgG have significantly decreased HIV-1 risk when CD8+ T-cell responses are low. Moreover, vaccinees with high CD8+ T-cell responses generally have low risk, and those with low CD8+ T-cell and low Env antibody responses have high risk. These findings suggest the critical importance of inducing a robust IgG Env response when the CD8+ T-cell response is low. [ABSTRACT FROM AUTHOR]

Background: Rectal and genital sampling in HIV prevention trials permits assessments at the site of HIV entry. Yet the safety and acceptability of circumcision and sigmoidoscopy (and associated abstinence recommendations) are unknown in uncircumcised men who have sex with men (MSM) at high risk of HIV infection. Methods: Twenty-nine HIV-seronegative high-risk Peruvian MSM agreed to elective sigmoidoscopy biopsy collections (weeks 2 and 27) and circumcision (week 4) in a 28-week cohort study designed to mimic an HIV vaccine study mucosal collection protocol. We monitored adherence to abstinence recommendations, procedure-related complications, HIV infections, peripheral immune activation, and retention. Results: Twenty-three (79.3%) underwent a first sigmoidoscopy, 21 (72.4%) were circumcised, and 16 (55.2%) completed a second sigmoidoscopy during the study period. All who underwent procedures completed the associated follow-up safety visits. Those completing the procedures reported they were well tolerated, and complication rates were similar to those reported in the literature. Immune activation was detected during the healing period (1 week post-sigmoidoscopy, 6 weeks post-circumcision), including increases in CCR5+CD4+T cells and α4β7+CD4+T cells. Most participants adhered to post-circumcision abstinence recommendations whereas reduced adherence occurred post-sigmoidoscopy. Conclusion: Rectosigmoid mucosal and genital tissue collections were safe in high-risk MSM. Although the clinical implications of the post-procedure increase in peripheral immune activation markers are unknown, they reinforce the need to provide ongoing risk reduction counseling and support for post-procedure abstinence recommendations. Future HIV vaccine studies should also consider the effects of mucosal and tissue collections on peripheral blood endpoints in trial design and analysis. Trial Registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Phase IIb or III HIV-1 vaccine efficacy trials are generally large and operationally challenging. To mitigate this challenge, the HIV Vaccine Trials Network is designing a Phase IIb efficacy trial accommodating the evaluation of multiple vaccine regimens concurrently. As this efficacy trial would evaluate a limited number of vaccine regimens, there is a need to develop a framework for optimizing the strategic selection of regimens from the large number of vaccine candidates tested in Phase I/IIa trials. In this paper we describe the approaches for the selection process, including the choice of immune response endpoints and the statistical criteria and algorithms. We illustrate the selection approaches using data from HIV-1 vaccine trials. [ABSTRACT FROM AUTHOR]

A novel post-treatment system, jet loop reactor (JLR), was proposed for anaerobic bioreactor effluent polishing purposes. The performance of the JLR, with respect to residual organics, total Kjeldahl nitrogen (TKN) and ammonia-nitrogen removal at different hydraulic retention times (HRTs), was the main focus of this study. The JLR, on average, was capable of removing approximately 99% of ammonia-nitrogen and 95% of TKN at HRTs of 8 and 5 h, respectively. The integrated system had an average removal of more than 85% of total BOD and COD and more than 95% of filtered BOD and COD. However, the JLR did not have a consistent performance due to dynamic MLSS concentration (and SRT). Overall the results indicate that the JLR can be considered as a feasible alternative for post-treatment of anaerobic bioreactor effluent. [ABSTRACT FROM AUTHOR]

An abstract of the article "Circulating CD4+ T-cells Are Transiently Activated Following Sigmoidoscopy or Circumcision in MSM at High Risk of HIV Infection" by Maria P. Lemos, Javier R. Lama, Shelly Karuna, and colleagues is presented.

Introduction: There is a paucity of data on the prehospital presentation of stroke patients. Our assumption was that there are gender differences in S.B.P. and D.B.P. when paramedics first arrive at the scene to evaluate patients with acute non-traumatic cerebral deficit. According to the 2010 A.H.A. guidelines blood pressure elevation should not be treated acutely in the pre-hospital setting.METHODS: A retrospective review of run sheets was conducted to determine age, race, sex, initial blood pressure, onset of symptoms and whether the patients were being treated for hypertension. Minitab 16 was used to analyze the data. 2 sample poison test was used to compare groups.Results: •214 total records were reviewed •There were 142 Caucasian, 63 Afro-American and 6 Hispanic patients •The initial presenting E.K.G. rhythm was a. Fib in 14 patients, N.S.R. in 186 patients and a paced rhythm in 11 patients •All 209 patients were transported to stroke receiving hospitals without untoward consequences •46 patients called 911 more than 3.5 hrs after the onset of symptoms51/117 (43%) of women were on antihypertensive agents. 45/92 (48%) of men were on antihypertensive agents.Conclusions: For patients who call 911 after the onset of a non-traumatic acute cerebral deficit: there is no difference between men’s and women’s systolic and diastolic blood pressures; despite a significant difference in age and significant variation in treatment regiments for high blood pressure prior to the onset of symptoms. [ABSTRACT FROM AUTHOR]