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Este artículo revisa la inclusión social de la mujer en el fortalecimiento y eficiencia de la cadena de valor del maíz en Ecuador. Para cumplir este propósito se analiza las limitaciones y oportunidades de la mujer en la gestión administrativa, procesos de producción y otras actividades, y como incide en el desempeño de la cadena de valor del maíz. Utilizando los resultados de las encuestas aplicadas a setenta y un mujeres agricultoras, comerciantes agrícolas, procesadoras de alimentos, emprendedoras y/o amas de casa—, se estima un modelo Logit para evaluar la incidencia de las características sociales y económicas de las mujeres de la región en la cadena de valor del maíz. Los resultados permiten evidenciar que la participación de la mujer en actividades relacionadas con el maíz han mejorado la posición social, el empoderamiento y la participación comunitaria, a pesar de la mayor participación de los hombres en todos los nodos de la cadena, a la vez que han generado una mejora en la cadena de valor.

Olive groves in the Mediterranean basin have undergone a tremendous increase during the last two decades, with most of the new olive groves being planted on arable land. This conversion may affect habitat suitability for steppe birds, which are associated with arable land and other open-land habitats, such as natural pastures. In this work, we evaluate the presence of new olive groves in the distribution of the Great Bustard Otis tarda and the Little Bustard Tetrax tetrax in Southern Spain (the largest olive oil production zone in the world), and we compare the percentage of different land uses in 2000 and 2018 using data provided by the Corine Land Cover. From 2000 to 2018, new olive groves occupied 2.14 and 2.61% of the distribution areas of the Great Bustard and the Little Bustard, respectively. The decrease in arable land and the increase in permanent crops were the main drivers of the landscape composition changes during the study period. The fragmentation index of arable land was higher in 2018 than 2000. These changes in the landscape suggest a decrease in habitat availability and suitability for steppe birds that could affect the distribution and abundance of their populations. Moreover, there were no differences in the proportion of new olive groves planted inside and outside the limits of Important Bird Areas (IBAs) from 2000 to 2018, which were created to protect these steppe birds, thus suggesting that the management policy of the IBAs should be reviewed to prevent harmful land-use changes.

Patients with cancer (PC) are at high risk of acquiring COVID-19 and can develop more serious complications. Deeper understanding of vaccines immunogenicity in this population is crucial for adequately planning vaccines programs. The ONCOVac study aimed to comprehensively assess the immunogenicity of mRNA-1273 vaccine in terms of humoral and cellular response.We conducted a prospective, single-center study including patients with solid tumours treated with cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6i), immunotherapy (IT) or chemotherapy (CT). Patients were enrolled previously to vaccination with mRNA-1273. We also involved health care workers (HCW) to serve as a control group. We took blood samples before first dose administration (BL), after first dose (1D), and after second dose (2D). The primary objective was to compare the rate and magnitude of T cell response after second dose whereas safety and humoral response were defined as secondary objectives. We also collected patient reported outcomes after both the first and second vaccine dose and a six-month follow-up period to diagnose incident COVID-19 cases was planned.The rate of specific anti-S serologic positivity (anti-S IgG cut-off point at 7,14 BAU/mL) was significantly higher in HCW compared to PC after 1D (100% versus 83.8%; p = 0.04), but similar after 2D (100% versus 95.8%; p = 0.5). This difference after 1D was driven by PC treated with CT (100% versus 64.5%; p = 0.001). Cellular response after 2D was significantly lower in PC than in HCW for both CD4+ (91.7% versus 59.7%; p = 0.001) and CD8+ (94.4% versus 55.6%; p 0.001) T cells. We found a difference on pre-existing CD4+ T cell response in HCW comparing to PC (36% and 17%, p = 0.03); without difference in pre-existing CD8+ T cell response (31% and 23%, p = 0.5). After excluding patients with pre-existing T cell response, PC achieved even lower CD4+ (50.9% versus 95.5%, p 0.001) and CD8+ (45.5% versus 95.5%, p 0.001) T cell response compared with HCW. Regarding safety, PC reported notably more adverse events than HCW (96.6% versus 69.2%, p 0.001).We demonstrated that PC showed a similar humoral response but a lower T cell response following two doses of mRNA-1273 vaccination. Further studies are needed to complement our results and determine the implication of low T cell response on clinical protection of PC against COVID-19.

Purpose:Fanconi anemia rare disease is characterized by bone marrow failure and a high predisposition to solid tumors, especially head and neck squamous cell carcinoma (HNSCC). Patients with Fanconi anemia with HNSCC are not eligible for conventional therapies due to high toxicity in healthy cells, predominantly hematotoxicity, and the only treatment currently available is surgical resection. In this work, we searched and validated two already approved drugs as new potential therapies for HNSCC in patients with Fanconi anemia.Experimental Design:We conducted a high-content screening of 3,802 drugs in a FANCA-deficient tumor cell line to identify nongenotoxic drugs with cytotoxic/cytostatic activity. The best candidates were further studied in vitro and in vivo for efficacy and safety.Results:Several FDA/European Medicines Agency (EMA)-approved anticancer drugs showed cancer-specific lethality or cell growth inhibition in Fanconi anemia HNSCC cell lines. The two best candidates, gefitinib and afatinib, EGFR inhibitors approved for non–small cell lung cancer (NSCLC), displayed nontumor/tumor IC50 ratios of approximately 400 and approximately 100 times, respectively. Neither gefitinib nor afatinib activated the Fanconi anemia signaling pathway or induced chromosomal fragility in Fanconi anemia cell lines. Importantly, both drugs inhibited tumor growth in xenograft experiments in immunodeficient mice using two Fanconi anemia patient–derived HNSCCs. Finally, in vivo toxicity studies in Fanca-deficient mice showed that administration of gefitinib or afatinib was well-tolerated, displayed manageable side effects, no toxicity to bone marrow progenitors, and did not alter any hematologic parameters.Conclusions:Our data present a complete preclinical analysis and promising therapeutic line of the first FDA/EMA-approved anticancer drugs exerting cancer-specific toxicity for HNSCC in patients with Fanconi anemia.

Figure S5. FACS gating strategy to analyze white blood cell population in WT and Fanca-deficient mice.

Figure S8. Additional data on genotoxicity in blood samples from WT or Fanca-deficient mice, by gefitinib and afatinib treatment.

Figure S2. Additional data on gefitinib and afatinib in vivo mouse xenograft experiments. Weight control.

Supplementary Fig. S3 from Relevance of the Fanconi anemia pathway in the response of human cells to trabectedin

Trabectedin (Yondelis; ET-743) is a potent anticancer drug that binds to DNA by forming a covalent bond with a guanine in one strand and one or more hydrogen bonds with the opposite strand. Using a fluorescence-based melting assay, we show that one single trabectedin-DNA adduct increases the thermal stability of the double helix by >20°C. As deduced from the analysis of phosphorylated H2AX and Rad51 foci, we observed that clinically relevant doses of trabectedin induce the formation of DNA double-strand breaks in human cells and activate homologous recombination repair in a manner similar to that evoked by the DNA interstrand cross-linking agent mitomycin C (MMC). Because one important characteristic of this drug is its marked cytotoxicity on cells lacking a functional Fanconi anemia (FA) pathway, we compared the response of different subtypes of FA cells to MMC and trabectedin. Our data clearly show that human cells with mutations in FANCA, FANCC, FANCF, FANCG, or FANCD1 genes are highly sensitive to both MMC and trabectedin. However, in marked contrast to MMC, trabectedin does not induce any significant accumulation of FA cells in G2-M. The critical relevance of FA proteins in the response of human cells to trabectedin reported herein, together with observations showing the role of the FA pathway in cancer suppression, strongly suggest that screening for mutations in FA genes may facilitate the identification of tumors displaying enhanced sensitivity to this novel anticancer drug. [Mol Cancer Ther 2008;7(5):1309–18]

Figure S3. Additional immunohistochemistry images from tumor xenografts.

Figure S7. Additional data on gefitinib and afatinib toxicity analysis in WT and Fanca-deficient mice.

Figure S6. Additional data on gefitinib and afatinib toxicity analysis in WT and Fanca-deficient mice.

Figure S1. Additional data from high content screening and validation

Supplementary Text

Background Inflammasome activation is increased in people with human immunodeficiency virus (PWH), but its relationship with coronary plaque is poorly understood in this setting. Methods In a large human immunodeficiency virus cardiovascular prevention cohort, relationships between caspase-1, interleukin (IL)-1β, and IL-18 and coronary plaque indices were assessed by multivariate logistic regression. Results Higher IL-18 and IL-1β were associated with Leaman score, an integrative measure of plaque burden and composition. Conclusions As Leaman score >5 is associated with cardiovascular events in the general population, future work is needed to determine how the inflammasome relates to events and whether strategies to reduce its activation affect events or plaque progression among PWH.

The lack of refuge has been suggested as one of the main factors affecting reptiles in intensive crops, but this theory has not been explored to any great extent. The aim of this work is to compare the reptile abundance and species richness between traditional and intensive vineyards and olive groves, and to test the acceptance of artificial shelter due to its scarcity in the new intensive woody crop. A total of 288 transects were carried out (144 in olive groves and 144 in vineyards) in six different types of plots: traditional olive groves, traditional vineyards, intensive olive groves with and without artificial refuge, and trellis vineyards with and without artificial refuge. The results showed a greater species richness and abundance of reptiles in the traditional plots than in the intensive plots (independently of the experimental refuges added). An important number of animals were observed using the artificial refuges in olive groves. Furthermore, most of the individuals were located on or escaped to old trees in traditional systems, including an important proportion of reptiles hidden in olive trunk cavities, whereas more individuals were observed on the ground in intensive systems. Our finding suggests the importance for reptile communities of the traditional agricultural systems due to the high availability of the refuge provided by old olive tree trunks and free-standing gobelet vineyards. Our results show that providing refuge may mitigate the negative effects of woody crops intensification on reptile communities.

SARS-CoV-2 infection produces lymphopenia and CD4+ T-cell decrease, which could lead to a higher risk of bacterial co-infection or impair immunological evolution in people living with HIV (PLWH).We investigated the rate of co-infection and superinfection, and the evolution of CD4+ count and CD4+/CD8+ ratio, in hospitalized PLWH with COVID-19.From March to December 2020, 176 PLWH had symptomatic COVID-19 and 62 required hospitalization (median age, 56 years, 89% males). At admission, 7% and 13% of patients had leukocytosis or increased procalcitonin values and 37 (60%) received empiric antibiotic therapy, but no bacterial co-infection was diagnosed. There were seven cases of superinfection (12%), and one case of P. jiroveci pneumonia during ICU stay. No significant change in CD4+ count or CD4+/CD8+ ratio was observed after discharge.Bacterial co-infection is not frequent in PLWH with COVID-19. Immune recovery is observed in most of patients after the disease.

Current guidelines recommend screening people with HIV (PWH) for bone disease using predictive tools developed for the general population, although data on PWH are scarce. In this study, we assessed the performance of FRAX and QFracture scoring systems to predict the occurrence of fragility fractures in a prospective cohort of 17,671 adults with human immunodeficiency virus (HIV) included in the HIV/AIDS research network (CoRIS) in Spain. The survival estimates of fragility fractures during follow-up were calculated and FRAX and QFracture scores were computed at cohort inclusion. For both tools, discriminatory measures and the observed-to-expected (O/E) ratios were assessed. During a follow-up time of 42,411.55 person-years, 113 fragility fractures were recorded. Areas under the curve were 0.66 [95% confidence interval (95% CI) 0.61-0.71] for FRAX and 0.67 (95% CI 0.62-0.73) for QFracture for major osteoporotic fractures, and 0.72 (95% CI 0.57-0.88) and 0.81 (95% CI 0.68-0.95) for hip fracture, respectively. The O/E was 1.67 for FRAX and 5.49 for QFracture for major osteoporotic fractures, and 11.23 for FRAX and 4.87 for QFracture for hip fractures. Moreover, O/E raised as the risk increased for both tools and in almost all age groups. When using the recommended assessment thresholds,6% and 10% of major osteoporotic and hip fractures would have been identified, respectively. In conclusion, FRAX and QFracture displayed acceptable discrimination, although both tools significantly underestimated the risk of fragility fractures in PWH. The recommended assessment thresholds may not be appropriate for this population as they were unable to identify individuals with fragility fractures during follow-up.

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection induces elevated levels of inflammatory cytokines, which are mainly produced by the innate response to the virus. The role of NK cells, which are potent producers of IFN-γ and cytotoxicity, has not been sufficiently studied in the setting of SARS-CoV-2 infection. We confirmed a different distribution of NK cell subsets in hospitalized COVID-19 patients despite their NK cell deficiency. The impairment of this innate defense is mainly focused on the cytotoxic capacity of the CD56dim NK cells. On the one hand, we found an expansion of the CD56dimCD16neg NK subset, lower cytotoxic capacities, and high frequencies of inhibitory 2DL1 and 2DL1/S1 KIR receptors in COVID-19 patients. On the other hand, the depletion of CD56dimCD16dim/bright NK cell subsets, high cytotoxic capacities, and high frequencies of inhibitory 2DL1 KIR receptors were found in COVID-19 patients. In contrast, no differences in the distribution of CD56bright NK cell subsets were found in this study. These alterations in the distribution and phenotype of NK cells might enhance the impairment of this crucial innate line of defense during COVID-19 infection.

Sub-national economic policies increasingly use labor market areas (LMAs) rather than administrative areas for analysis and implementation. How a set of LMAs was defined influences the results of such analyses, and so accurate policy delivery needs appropriately defined LMAs. Multinational bodies need comparable LMA definitions in many countries, calling for a definition method that is transferable across national boundaries. This article applies quantitative metrics to evaluate LMAs defined in three contrasting countries by three methods that represent the main methodological approaches. The deductive approach—based on a center and hinterland—is too inflexible to deal with differing geographical circumstances and cannot cope with statistical zones that are very small, or do not respect settlement structure. The alternative inductive methods tested define appropriate LMAs in each country, with the newer method performing slightly better in statistical terms. The article also exemplifies the usefulness of the metrics for comparisons of alternative regionalizations. Funding for related Spanish analyses was via Project PID2020-114896RB-100/Agencia Estatal de Investigación, AEI/10.13039/501100011033, Spanish State Plan for Scientific and Technical Research, and Innovation 2017–2020, and Project AICO/2021/062, Generalitat Valenciana, Department of Innovation, Universities, Science and Digital Society.

People living with HIV-1 and HTLV-2 concomitantly show slower CD4+ T cell depletion and AIDS progression, more frequency of the natural control of HIV-1, and lower mortality rates. A similar beneficial effect of this infection has been reported on HCV coinfection reducing transaminases, increasing the spontaneous clearance of HCV infection and delaying the development of hepatic fibrosis. Given the critical role of CD8+ T cells in controlling HIV-1 infection, we analysed the role of CD8+ T cell-mediated cytotoxic activity in coinfected individuals living with HIV-1. One hundred and twenty-eight individuals living with HIV-1 in four groups were studied: two groups with HTLV-2 infection, including individuals with HCV infection (N = 41) and with a sustained virological response (SVR) after HCV treatment (N = 25); and two groups without HTLV-2 infection, including individuals with HCV infection (N = 25) and with a sustained virological response after treatment (N = 37). We found that CD8+ T cell-mediated HIV-1 inhibition in vitro was higher in individuals with HTLV-2. This inhibition activity was associated with a higher frequency of effector memory CD8+ T cells, higher levels of granzyme A and granzyme B cytolytic enzymes, and perforin. Hence, cellular and soluble cytolytic factors may contribute to the lower HIV-1 pre-ART viral load and the HIV-1 proviral load during ART therapy associated with HTLV-2 infection. Herein, we confirmed and expanded previous findings on the role of HTLV-2 in the beneficial effect on the pathogenesis of HIV-1 in coinfected individuals.

There are many local fragmentation metrics, but most can be grouped into four types (composition/area, isolation, edge, and shape), and none of them alone determines the degree of fragmentation of a patch. Here, we grouped together the main fragmentation metrics (area, edge, shape, and isolation) in order to propose a new metric/index, the Patch Fragmentation Index (PFI), with which to determine fragmentation at patch scale. The index was subsequently verified with the Ecuadorian seasonal dry forest by employing geographic information layers and temporal land uses changes in 1990, 2000, 2008, and 2018. The PFI was applied to calculate the fragmentation per patch, spatial and temporal changes of fragmentation based on PFI were assessed, and the spatial patterns (Getis-Ord Gi * analysis) were calculated. The Ecuadorian seasonal dry forest obtained a mean PFI value of 0.88 (median = 0.99) in 2018. This value has increased by 8.6% since 1990, and 3451 patches of forest disappeared between 1990 and 2018. The Getis-Ord Gi * analysis was effective with regard to describing the spatial patterns, and 62% of the patches that were classified as hot patches in 1990 had disappeared by 2018. The PFI has proven to be a useful tool with which to describe fragmentation patterns at patch scale (regardless of its size) and can be extrapolated to other landscapes. The PFI will provide a new vision and can help in the decision-making related to the conservation and management of fragmented ecosystems.

Despite in vitro activity of interferon-β (IFN-β) against SARS-CoV-2 infection, its clinical efficacy remains controversial. We evaluated the impact of IFN-β treatment in a cohort of 3590 patients hospitalized with COVID-19 during March–April 2020. The primary endpoint was a composed variable of admission to intensive care unit (ICU)/death. Overall, 153 patients (4%) received IFN-β. They were significantly more severely ill, with a worse clinical and analytical situation, explaining a higher ICU admission (30% vs. 17%; p < 0.01), and a shorter time to the composed variable. In a Cox regression analysis, older age, lymphopenia, renal failure, or increased neutrophil-to-lymphocyte ratio were associated with a greater hazard ratio (HR) of admission at ICU/death. Notably, the HR of IFN-β for the outcome variable was no longer significant after adjustment (HR, 1.03; 95% CI, 0.82–1.30), and different sensitivity analysis (early IFN use, ICU admission) showed no changes in the estimates. A propensity score matching analysis showed no association of IFN-β therapy and outcome. In conclusion, in this large cohort of hospitalized COVID-19 patients, IFN-β was used mainly in patients with advanced disease, reflecting an important bias of selection. After adjusting by severity, IFN-β was not associated with a higher rate of ICU admission or mortality.

Background and aims There are no population data on bone mass in individuals with HIV in Spain, adjusted for age and sex. Materials and methods Bone mineral density (BMD) data were obtained by dual X-ray absorptiometry in a cohort of individuals with HIV infection compared with cohort data from the general population in Spain and the United States of America. Results Of 928 individuals (mean 46 years, 25% women), the prevalence of osteoporosis in the lumbar spine/femoral neck was 18%/5% in men, and 17%/10% in women, respectively. The rate increased from the age of 40 in men and from 50 in women (osteoporosis in 20% and 27%, respectively). BMD was lower than that observed in the general population in almost all age groups (mean, -6%; between 0%–11% lower compared to the Spanish cohort, and -8%; between 0%–14% lower than the American cohort). Conclusions Our cohort of individuals with HIV had a lower BMD in all age groups after adjustment for age and sex, compared with the general population. This fact must be considered when making recommendations.

espanolAntecedentes y objetivo No existen datos poblacionales de masa osea en pacientes con VIH en Espana, ajustados por edad y sexo. Materiales y metodos Se recogieron los datos de densidad mineral osea (DMO) mediante absorciometria dual de rayos X en una cohorte de pacientes con infeccion por VIH, comparandose con los valores observados en cohortes de poblacion general espanolas y estadounidenses. Resultados En 928 pacientes (media 46 anos, 25% mujeres), la prevalencia de osteoporosis en columna lumbar/cuello femoral fue del 18/5% en varones, y 17/10% en mujeres, respectivamente, aumentando desde los 40 anos en varones y desde los 50 anos en mujeres (osteoporosis en 20 y 27%, respectivamente). La DMO fue inferior a la observada en la poblacion general en casi todos los grupos etarios (media, -6%; entre 0-11% inferior respecto a la cohorte espanola, y -8%; entre 0-14% inferior a la estadounidense). Conclusiones Nuestra cohorte de pacientes con VIH tiene una menor DMO en todos los grupos etarios ajustados por edad y sexo, en comparacion con la poblacion general. Este hecho debe ser considerado en las recomendaciones de manejo. EnglishBackground and aims There are no population data on bone mass in individuals with HIV in Spain, adjusted for age and sex. Materials and methods Bone mineral density (BMD) data were obtained by dual X-ray absorptiometry in a cohort of individuals with HIV infection compared with cohort data from the general population in Spain and the United States of America. Results Of 928 individuals (mean 46 years, 25% women), the prevalence of osteoporosis in the lumbar spine/femoral neck was 18%/5% in men, and 17%/10% in women, respectively. The rate increased from the age of 40 in men and from 50 in women (osteoporosis in 20% and 27%, respectively). BMD was lower than that observed in the general population in almost all age groups (mean, -6%; between 0%-11% lower compared to the Spanish cohort, and -8%; between 0%-14% lower than the American cohort). Conclusions Our cohort of individuals with HIV had a lower BMD in all age groups after adjustment for age and sex, compared with the general population. This fact must be considered when making recommendations.

People with HIV (PWH) might have a higher risk of adverse coronavirus disease 2019 (COVID-19) outcomes. Several scores were developed to predict COVID-19 progression to critical disease and are often used among PWH. We assessed the performance of two commonly used risk equations among PWH and COVID-19. Participants were identified from a multicenter cohort of 6,361 PWH on regular follow-up at 2 university hospitals. Of 99 HIV-infected individuals with confirmed SARS-CoV-2 infection, 63 had complete data and were included in this analysis. CALL and COVID-GRAM scores were calculated and participants were stratified into low-, intermediate-, and high-risk groups for each. Discrimination was assessed using receiver operating characteristic curves. Calibration was evaluated using observed versus expected (O:E) ratios and the Hosmer-Lemeshow χ

Background Fragmentation and deforestation are one of the greatest threats to forests, and these processes are of even more concern in the tropics, where the seasonal dry forest is possibly one of the most threatened ecosystems with the least remaining surface area. Methods The deforestation and fragmentation patterns that had occurred in Ecuadorian seasonal dry forests between 1990 and 2018 were verified, while geographic information systems and land cover shapes provided by the Ecuadorian Ministry of the Environment were employed to classify and evaluate three types of seasonal dry forests: deciduous, semi-deciduous, and transition. The study area was tessellated into 10 km2 hexagons, in which six fragmentation parameters were measured: number of patches, mean patch size, median patch size, total edge, edge density and reticular fragmentation index (RFI). The RFI was also measured both outside and inside protected natural areas (unprotected, national protected areas and protected forest). Moreover, the areas with the best and worst conservation status, connectivity and risk of disappearance values were identified by means of a Getis-Ord Gi* statistical analysis. Results The deforestation of seasonal dry forests affected 27.04% of the original surface area still remaining in 1990, with an annual deforestation rate of − 1.12% between 1990 and 2018. The RFI has increased by 11.61% as a result of the fact that small fragments of forest have tended to disappear, while the large fragments have been fragmented into smaller ones. The semi-deciduous forest had the highest levels of fragmentation in 2018. The three categories of protection had significantly different levels of fragmentation, with lower RFI values in national protected areas and greater values in protected forests. Conclusions The seasonal dry forest is fragmenting, deforesting and disappearing in some areas. An increased protection and conservation of the Ecuadorian seasonal dry forest is, therefore, necessary owing to the fact that not all protection measures have been effective.

PurposeTo analyze the impact of SARS-COV-2-specific memory B cells (MBC) on the immune response after two doses of mRNA-based Comirnaty COVID-19 vaccine in seronegative health care workers. This study is seeking a rationale for boosting vaccines.MethodsLongitudinal study including 31 seronegative health care workers with undetectable specific MBCs (IgG−MBC− group), 24 seronegative with detectable specific MBCs (IgG−MBC+ group), and 24 seropositive with detectable specific MBCs (IgG+MBC+ group). The level of antibodies that inhibit ACE2-RBD interaction, and anti-Spike IgG, IgA, and IgM antibodies was quantified by ELISA. In addition, specific memory B and T cells were quantified by flow cytometry.ResultsThe level of specific MBCs, and isotypes, in the IgG−MBC− group was lower compared to that found in IgG−MBC+ (p = 0.0001) and IgG+MBC+ (p −MBC−group after the vaccine. Specific MBCs directly correlated with specific CD4+ T cells (although not significant, p = 0.065), while no correlation was found with specific CD8+ T cells (p = 0.156) after the vaccine. In parallel, ACE2-RBD neutralizing antibodies only positively correlated with specific CD4+ T cells (p = 0.034).ConclusionIgG−MBC− individuals showed the worst humoral and cellular responses, both in frequency and magnitude, after vaccination. Individuals whose antibodies wane and become undetectable after a given period of time post vaccination and show no specific MBCs are less protected and hence are good candidates for boosting vaccine. On the other hand, seronegative individuals with specific MBC showed faster and higher responses compared to the IgG−MBC− group.

Summary Background Information about incidence, clinical characteristics, and outcomes of HIV-infected individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is scarce. We characterised individuals with COVID-19 among a cohort of HIV-infected adults in Madrid. Methods In this observational prospective study, we included all consecutive HIV-infected individuals (aged ≥18 years) who had suspected or confirmed COVID-19 as of April 30, 2020, at the Hospital Universitario Ramon y Cajal (Madrid, Spain). We compared the characteristics of HIV-infected individuals with COVID-19 with a sample of HIV-infected individuals assessed before the COVID-19 pandemic, and described the outcomes of individuals with COVID-19. Findings 51 HIV-infected individuals were diagnosed with COVID-19 (incidence 1·8%, 95% CI 1·3–2·3). Mean age of patients was 53·3 years (SD 9·5); eight (16%) were women, and 43 (84%) men. 35 (69%) cases of co-infection had laboratory confirmed COVID-19, and 28 (55%) required hospital admission. Age and CD4 cell counts in 51 patients diagnosed with COVID-19 were similar to those in 1288 HIV-infected individuals without; however, 32 (63%) with COVID-19 had at least one comorbidity (mostly hypertension and diabetes) compared with 495 (38%) without COVID-19 (p=0·00059). 37 (73%) patients had received tenofovir before COVID-19 diagnosis compared with 487 (38%) of those without COVID-19 (p=0·0036); 11 (22%) in the COVID-19 group had previous protease inhibitor use (mostly darunavir) compared with 175 (14%; p=0·578). Clinical, analytical, and radiological presentation of COVID-19 in HIV-infected individuals was similar to that described in the general population. Six (12%) individuals were critically ill, two of whom had CD4 counts of less than 200 cells per μL, and two (4%) died. SARS-CoV-2 RT-PCR remained positive after a median of 40 days from symptoms onset in six (32%) individuals, four of whom had severe disease or low nadir CD4 cell counts. Interpretation HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general population. Funding None.