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Herrero‐Sánchez A, Haroyan‐Darbinyan E. Prevalence of Epstein-Barr Virus, Cytomegalovirus, and Periodontopathic Bacteria in Patients With Periodontitis: A Case-Control Study. Clin Exp Dent Res 2025; 11:e70084. [PMID: 39916439 PMCID: PMC11803075 DOI: 10.1002/cre2.70084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 01/05/2025] [Accepted: 01/24/2025] [Indexed: 02/11/2025] Open
Abstract
OBJECTIVES Opportunistic viruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV) have been detected in gingival crevicular fluid (GCF) and saliva of patients with periodontal disease. However, the relationship between herpesviruses and periodontitis remains obscure. The aim of this case-control study was the detection and association of CMV and EBV with periodontitis. MATERIAL AND METHODS Forty-eight adults were included in this study: 24 patients with periodontitis (CP) and 24 periodontally healthy individuals (HS). All patients underwent periodontal examination, including probing depth (PD), clinical attachment loss (CAL), plaque index (PI), and bleeding on probing (BOP). Subgingival biofilm samples were collected from all patients and real-time PCR was performed for viral and bacterial detection. The odds ratio (OR) was calculated, and the chi-squared test or Fisher's exact test was performed to analyze the significant differences. RESULTS EBV was detected only in one healthy patient meanwhile no CMV was found. No statistically significant differences were found between the periodontal clinical parameters of EBV-positive patients and the negative ones: PI (p = 0.090), PD (p = 0.857), CAL (p = 0.801), and BOP (p = 0.104). Except for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Prevotella intermedia (Pi), and Treponema denticola (Td) showed a statistically significant association (p < 0.001) with the clinical periodontal parameters. Aa presence was not statistically associated with periodontal sites (p < 0.296). Tf and Pg were the most frequently detected periodontopathic bacteria in the CP group (91.7% sites). CONCLUSION The present case-control study showed that the prevalence of EBV and CMV did not show significant differences between the groups evaluated in the Spanish population.
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Affiliation(s)
- Alicia Herrero‐Sánchez
- Private PracticeMadridSpain
- Faculty of DentistryComplutense University of Madrid (U.C.M)MadridSpain
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Sarkar BK, Bhattacharya M, Agoramoorthy G, Dhama K, Chakraborty C. Entropy-Driven, Integrative Bioinformatics Approaches Reveal the Recent Transmission of the Monkeypox Virus from Nigeria to Multiple Non-African Countries. Mol Biotechnol 2024; 66:2816-2829. [PMID: 37798393 DOI: 10.1007/s12033-023-00889-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023]
Abstract
Monkeypox virus (mpox) has currently affected multiple countries around the globe. This study aims to analyze how the virus spread globally. The study uses entropy-driven bioinformatics in five directions to analyze the 60 full-length complete genomes of mpox. We analyzed the topological entropy distribution of the genomes, principal component analysis (PCA), the dissimilarity matrix, entropy-driven phylogenetics, and genome clustering. The topological entropy distribution showed genome positional entropy. We found five clusters of the mpox genomes through the two PCA, while the three PCA elucidated the clustering events in 3D space. The clustering of genomes was further confirmed through the dissimilarity matrix and phylogenetic analysis which showed the bigger size of Cluster 1 and size similarity between Clusters 2 and 4 as well as Clusters 3 and 5. It corroborated with the phylogenetics of the genomes, where Cluster 1 showed clear segregation from the other four clusters. Finally, the study concluded that the spreading of the mpox is likely to have originated from African countries to the rest of the non-African countries. Overall, the spreading and distribution of the mpox will shed light on its evolution and pathogenicity of the mpox and help to adopt preventive measures to stop the spreading of the virus.
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Affiliation(s)
- Bimal Kumar Sarkar
- Department of Physics, Adamas University, Kolkata, West Bengal, 700126, India
| | - Manojit Bhattacharya
- Department of Zoology, Fakir Mohan University, Vyasa Vihar, Balasore, 756020, Odisha, India
| | | | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India.
| | - Chiranjib Chakraborty
- Department of Biotechnology, School of Life Science and Biotechnology, Adamas University, Kolkata, West Bengal, 700126, India.
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Alves P, Emmel V, Stefanoff G, Krsticevic F, Ezpeleta J, Murillo J, Tapia E, Delatorre E, Abdelhay E, Hassan R. Unique synapomorphies and high diversity in South American Raji-related Epstein-Barr virus genomes. Mem Inst Oswaldo Cruz 2023; 118:e230122. [PMID: 37937604 PMCID: PMC10629697 DOI: 10.1590/0074-02760230122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Epstein-Barr virus (EBV) is a human gammaherpesvirus etiologically linked to several benign and malignant diseases. EBV-associated malignancies exhibit an unusual global distribution that might be partly attributed to virus and host genetic backgrounds. OBJECTIVES To assemble a new genome of EBV (CEMO3) from a paediatric Burkitt's lymphoma from Rio de Janeiro State (Southeast Brazil). In addition, to perform global phylogenetic analysis using complete EBV genomes, including CEMO3, and investigate the genetic relationship of some South American (SA) genomes through EBV subgenomic targets. METHODS CEMO3 was sequenced through next generation sequencing and its coverage and gaps were corrected through the Sanger method. CEMO3 and 67 EBV genomes representing diverse geographic regions were evaluated through maximum likelihood phylogenetic analysis. Further, the polymorphism of subgenomic regions of some SA EBV genomes were assessed. FINDINGS The whole bulk tumour sequencing yielded 23,217 reads related to EBV, which 172,713 base pairs of the newly EBV genome CEMO3 was assembled. The CEMO3 and most SA EBV genomes clustered within the SA subclade closely related to the African Raji strain, forming the South American/Raji clade. Notably, these Raji-related genomes exhibit significant genetic diversity, characterised by distinctive synapomorphies at some gene levels absent in the original Raji strain. CONCLUSION The CEMO3 represents a new South American EBV genome assembled. Albeit the majority of EBV genomes from SA are Raji-related, it harbours a high diversity different from the original Raji strain.
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Affiliation(s)
- Paula Alves
- Instituto Nacional de Câncer, Centro de Transplante de Medula Óssea, Rio de Janeiro, RJ, Brasil
- Universidad Nacional de Rosario, Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas, Rosario, Argentina
| | - Vanessa Emmel
- Instituto Nacional de Câncer, Centro de Transplante de Medula Óssea, Rio de Janeiro, RJ, Brasil
| | - Gustavo Stefanoff
- Instituto Nacional de Câncer, Centro de Transplante de Medula Óssea, Rio de Janeiro, RJ, Brasil
- Instituto Nacional de Câncer, Coordenação de Pesquisa Clínica, Rio de Janeiro, RJ, Brasil
| | - Flavia Krsticevic
- Instituto Nacional de Câncer, Centro de Transplante de Medula Óssea, Rio de Janeiro, RJ, Brasil
- Universidad Nacional de Rosario, Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas, Rosario, Argentina
| | - Joaquín Ezpeleta
- Universidad Nacional de Rosario, Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas, Rosario, Argentina
| | - Javier Murillo
- Universidad Nacional de Rosario, Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas, Rosario, Argentina
| | - Elizabeth Tapia
- Universidad Nacional de Rosario, Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas, Rosario, Argentina
| | - Edson Delatorre
- Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Patologia, Laboratório de Genômica e Ecologia Viral, Vitória, ES, Brasil
| | - Eliana Abdelhay
- Instituto Nacional de Câncer, Centro de Transplante de Medula Óssea, Rio de Janeiro, RJ, Brasil
| | - Rocio Hassan
- Instituto Nacional de Câncer, Centro de Transplante de Medula Óssea, Rio de Janeiro, RJ, Brasil
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Solomay TV, Semenenko TA. [Epstein-Barr viral infection is a global epidemiological problem]. Vopr Virusol 2022; 67:265-273. [PMID: 36097708 DOI: 10.36233/0507-4088-122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/10/2022] [Indexed: 06/15/2023]
Abstract
The number of studies devoted to Epstein-Barr viral infection (EBV infection) has been growing in recent years. However, they all relate to the clinical aspects of this problem. Epidemiology issues remain practically unexplored. A review of domestic and foreign publications has shown that at the present stage there is a high intensity of the epidemic process of EBV infection both in Russia and abroad. The main indicators of unfavorable epidemiological situation are the ubiquitous spread of the pathogen and the increase in the incidence of infectious mononucleosis in recent years. The deterioration of the epidemic situation of EBV infection is influenced by changes in the immunological reactivity of various population groups due to the spread of HIV, HBV, HCV, the causative agent of tuberculosis and SARS-CoV-2. The above makes it possible to classify the problem as a global one and determines the need for the rapid implementation of the system of epidemiological surveillance of EBV infection and optimization of the complex of preventive and anti-epidemic measures. Reducing the burden of EBV is possible only with the consolidated participation of specialists of various profiles.
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Affiliation(s)
- T V Solomay
- Interregional Department No. 1 of the FMBA of Russia; I.I. Mechnikov Research Institute of Vaccines and Serums of the Ministry of Education and Science of Russia
| | - T A Semenenko
- National Research Center of Epidemiology and Microbiology named after Honorary Academician N.F. Gamaleya of the Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia
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Alves P, Larrate M, Garcia-Costa A, Rohan P, Gama BE, Abdelhay E, Delatorre E, Hassan R. Spatial Dispersal of Epstein-Barr Virus in South America Reveals an African American Variant in Brazilian Lymphomas. Viruses 2022; 14:v14081762. [PMID: 36016384 PMCID: PMC9412316 DOI: 10.3390/v14081762] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Epstein−Barr virus (EBV) is a saliva-borne ɣ-herpesvirus associated with benign and malignant lymphoproliferation. EBV-mediated tumorigenic mechanisms are not fully understood and may be related to viral genetic variations. In this work, we characterize the genetic diversity of EBV from Brazil, assessing 82 samples derived from saliva from asymptomatic carriers (n = 45), biopsies of benign reactive hyperplasia (n = 4), and lymphomas (n = 33). Phylogenetic and phylogeographic analysis of the entire coding region of the LMP-1 was performed. Additionally, type 1/type 2 distinction by the EBNA3C gene and Zp variants were evaluated. Our results revealed a high diversity of EBV in Brazil, with the co-circulation of four main clades, described here as: Mediterranean (40.2%, n = 33), Raji/Argentine (39%, n = 32), B95-8 (6.1%, n = 5), and Asian II (1.2%, n = 1). The Raji/Argentine and Mediterranean clades were the most prevalent in South America (45% and 28%, respectively). The Raji/Argentine clade was associated with polymorphisms I124V/I152L, del30 bp, and ins15 bp (p < 0.0001, to all clades) and with a high haplotype diversity related to EBV type and Zp variants. We found that a Raji/Argentine subclade spread primarily from Brazil and later to other South American countries. Although no LMP1 variant has been directly associated with disease, the Raji/Argentine clade was predominantly clustered with lymphomas (61%) and the Mediterranean clade with non-malignant cases (59%) (p = 0.1). These data highlight the high genetic diversity of EBV circulating in Brazil, calling attention to a Raji-related variant with great recombination potential in Brazilian lymphomas.
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Affiliation(s)
- Paula Alves
- Laboratório de Oncovirologia, Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer “José Alencar Gomes da Silva” (INCA), Ministério da Saúde, Rio de Janeiro 20230-130, Brazil
- Correspondence: (P.A.); (E.D.)
| | - Marcella Larrate
- Laboratório de Oncovirologia, Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer “José Alencar Gomes da Silva” (INCA), Ministério da Saúde, Rio de Janeiro 20230-130, Brazil
| | - Aruanã Garcia-Costa
- Laboratório de Oncovirologia, Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer “José Alencar Gomes da Silva” (INCA), Ministério da Saúde, Rio de Janeiro 20230-130, Brazil
| | - Paulo Rohan
- Laboratório de Oncovirologia, Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer “José Alencar Gomes da Silva” (INCA), Ministério da Saúde, Rio de Janeiro 20230-130, Brazil
| | - Bianca Ervatti Gama
- Laboratório de Oncovirologia, Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer “José Alencar Gomes da Silva” (INCA), Ministério da Saúde, Rio de Janeiro 20230-130, Brazil
| | - Eliana Abdelhay
- Laboratório de Células Tronco, Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer “José Alencar Gomes da Silva” (INCA), Ministério da Saúde, Rio de Janeiro 20230-130, Brazil
| | - Edson Delatorre
- Departamento de Biologia, Centro de Ciências Exatas, Naturais e da Saúde, Universidade Federal do Espírito Santo, Alegre 29500-000, Brazil
- Correspondence: (P.A.); (E.D.)
| | - Rocio Hassan
- Laboratório de Oncovirologia, Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer “José Alencar Gomes da Silva” (INCA), Ministério da Saúde, Rio de Janeiro 20230-130, Brazil
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Palmer WH, Telford M, Navarro A, Santpere G, Norman PJ. Human herpesvirus diversity is altered in HLA class I binding peptides. Proc Natl Acad Sci U S A 2022; 119:e2123248119. [PMID: 35486690 PMCID: PMC9170163 DOI: 10.1073/pnas.2123248119] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/30/2022] [Indexed: 11/18/2022] Open
Abstract
Herpesviruses are ubiquitous, genetically diverse DNA viruses, with long-term presence in humans associated with infrequent but significant pathology. Human leukocyte antigen (HLA) class I presents intracellularly derived peptide fragments from infected tissue cells to CD8+ T and natural killer cells, thereby directing antiviral immunity. Allotypes of highly polymorphic HLA class I are distinguished by their peptide binding repertoires. Because this HLA class I variation is a major determinant of herpesvirus disease, we examined if sequence diversity of virus proteins reflects evasion of HLA presentation. Using population genomic data from Epstein–Barr virus (EBV), human cytomegalovirus (HCMV), and Varicella–Zoster virus, we tested whether diversity differed between the regions of herpesvirus proteins that can be recognized, or not, by HLA class I. Herpesviruses exhibit lytic and latent infection stages, with the latter better enabling immune evasion. Whereas HLA binding peptides of lytic proteins are conserved, we found that EBV and HCMV proteins expressed during latency have increased peptide sequence diversity. Similarly, latent, but not lytic, herpesvirus proteins have greater population structure in HLA binding than nonbinding peptides. Finally, we found patterns consistent with EBV adaption to the local HLA environment, with less efficient recognition of EBV isolates by high-frequency HLA class I allotypes. Here, the frequency of CD8+ T cell epitopes inversely correlated with the frequency of HLA class I recognition. Previous analyses have shown that pathogen-mediated natural selection maintains exceptional polymorphism in HLA residues that determine peptide recognition. Here, we show that HLA class I peptide recognition impacts diversity of globally widespread pathogens.
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Affiliation(s)
- William H. Palmer
- Division of Biomedical Informatics and Personalized Medicine, University of Colorado, Aurora, CO 80045
- Department of Immunology and Microbiology, University of Colorado, Aurora, CO 80045
| | - Marco Telford
- Neurogenomics Group, Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, 08003 Barcelona, Catalonia, Spain
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510
| | - Arcadi Navarro
- Institut de Biologia Evolutiva (Universitat Pompeu Fabra - Consejo Superior de Investigaciones Científicas), Department of Medicine and Life Sciences (MELIS), Barcelona Biomedical Research Park, Universitat Pompeu Fabra, 08003 Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats and Universitat Pompeu Fabra, 08010 Barcelona, Spain
- Centre for Genomic Regulation, The Barcelona Institute of Science and Technology, 08003 Barcelona, Spain
- Barcelona Beta Brain Research Center, Pasqual Maragall Foundation, 08005 Barcelona, Spain
| | - Gabriel Santpere
- Neurogenomics Group, Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, 08003 Barcelona, Catalonia, Spain
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510
| | - Paul J. Norman
- Division of Biomedical Informatics and Personalized Medicine, University of Colorado, Aurora, CO 80045
- Department of Immunology and Microbiology, University of Colorado, Aurora, CO 80045
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Liao HM, Liu H, Chin PJ, Li B, Hung GC, Tsai S, Otim I, Legason ID, Ogwang MD, Reynolds SJ, Kerchan P, Tenge CN, Were PA, Kuremu RT, Wekesa WN, Masalu N, Kawira E, Ayers LW, Pfeiffer RM, Bhatia K, Goedert JJ, Lo SC, Mbulaiteye SM. Epstein-Barr Virus in Burkitt Lymphoma in Africa Reveals a Limited Set of Whole Genome and LMP-1 Sequence Patterns: Analysis of Archival Datasets and Field Samples From Uganda, Tanzania, and Kenya. Front Oncol 2022; 12:812224. [PMID: 35340265 PMCID: PMC8948429 DOI: 10.3389/fonc.2022.812224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
Epstein-Barr virus (EBV) is associated with endemic Burkitt lymphoma (eBL), but the contribution of EBV variants is ill-defined. Studies of EBV whole genome sequences (WGS) have identified phylogroups that appear to be distinct for Asian versus non-Asian EBV, but samples from BL or Africa, where EBV was first discovered, are under-represented. We conducted a phylogenetic analysis of EBV WGS and LMP-1 sequences obtained primarily from BL patients in Africa and representative non-African EBV from other conditions or regions using data from GenBank, Sequence Read Archive, or Genomic Data Commons for the Burkitt Lymphoma Genome Sequencing Project (BLGSP) to generate data to support the use of a simpler biomarker of geographic or phenotypic associations. We also investigated LMP-1 patterns in 414 eBL cases and 414 geographically matched controls in the Epidemiology of Burkitt Lymphoma in East African children and minors (EMBLEM) study using LMP-1 PCR and Sanger sequencing. Phylogenetic analysis revealed distinct genetic patterns of African versus Asian EBV sequences. We identified 281 single nucleotide variations (SNVs) in LMP-1 promoter and coding region, which formed 12 unique patterns (A to L). Nine patterns (A, AB, C, D, F, I, J, K and L) predominated in African EBV, of which four were found in 92% of BL samples (A, AB, D, and H). Predominant patterns were B and G in Asia and H in Europe. EBV positivity in peripheral blood was detected in 95.6% of EMBLEM eBL cases versus 79.2% of the healthy controls (odds ratio [OR] =3.83; 95% confidence interval 2.06-7.14). LMP-1 was successfully sequenced in 66.7% of the EBV DNA positive cases but in 29.6% of the controls (ORs ranging 5-11 for different patterns). Four LMP-1 patterns (A, AB, D, and K) were detected in 63.1% of the cases versus 27.1% controls (ORs ranges: 5.58-11.4). Dual strain EBV infections were identified in WGS and PCR-Sanger data. In conclusion, EBV from Africa is phylogenetically separate from EBV in Asia. Genetic diversity in LMP-1 formed 12 patterns, which showed promising geographic and phenotypic associations. Presence of multiple strain infection should be considered in efforts to refine or improve EBV markers of ancestry or phenotype. Lay Summary Epstein-Barr virus (EBV) infection, a ubiquitous infection, contributes to the etiology of both Burkitt Lymphoma (BL) and nasopharyngeal carcinoma, yet their global distributions vary geographically with no overlap. Genomic variation in EBV is suspected to play a role in the geographical patterns of these EBV-associated cancers, but relatively few EBV samples from BL have been comprehensively studied. We sought to compare phylogenetic patterns of EBV genomes obtained from BL samples in Africa and from tumor and non-tumor samples from elsewhere. We concluded that EBV obtained from BL in Africa is genetically separate from EBV in Asia. Through comprehensive analysis of nucleotide variations in EBV's LMP-1 gene, we describe 12 LMP-1 patterns, two of which (B and G) were found mostly in Asia. Four LMP-1 patterns (A, AB, D, and F) accounted for 92% of EBVs sequenced from BL in Africa. Our results identified extensive diversity of EBV, but BL in Africa was associated with a limited number of variants identified, which were different from those identified in Asia. Further research is needed to optimize the use of PCR and sequencing to study LMP-1 diversity for classification of EBV variants and for use in epidemiologic studies to characterize geographic and/or phenotypic associations of EBV variants with EBV-associated malignancies, including eBL.
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Affiliation(s)
- Hsiao-Mei Liao
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Hebing Liu
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Pei-Ju Chin
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Bingjie Li
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Guo-Chiuan Hung
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Shien Tsai
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Isaac Otim
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D. Legason
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Martin D. Ogwang
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Patrick Kerchan
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Constance N. Tenge
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Pamela A. Were
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Robert T. Kuremu
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Walter N. Wekesa
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Nestory Masalu
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Bugando Medical Center, Mwanza, Tanzania
| | - Esther Kawira
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Leona W. Ayers
- Department of Pathology, The Ohio State University, Columbus, OH, United States
| | - Ruth M. Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - James J. Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Shyh-Ching Lo
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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