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Lakhal-Naouar I, Hack HR, Moradel E, Jarra A, Grove HL, Ismael RM, Padilla S, Coleman D, Ouellette J, Darden J, Storme C, Peachman KK, Hall TL, Huhtanen ME, Scott PT, Hakre S, Jagodzinski LL, Peel SA. Analytical validation of quantitative SARS-CoV-2 subgenomic and viral load laboratory developed tests conducted on the Panther Fusion® (Hologic) with preliminary application to clinical samples. PLoS One 2023; 18:e0287576. [PMID: 37384714 PMCID: PMC10309597 DOI: 10.1371/journal.pone.0287576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/07/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE Validate the performance characteristics of two analyte specific, laboratory developed tests (LDTs) for the quantification of SARS-CoV-2 subgenomic RNA (sgRNA) and viral load on the Hologic Panther Fusion® using the Open Access functionality. METHODS Custom-designed primers/probe sets targeting the SARS-CoV-2 Envelope gene (E) and subgenomic E were optimized. A 20-day performance validation following laboratory developed test requirements was conducted to assess assay precision, accuracy, analytical sensitivity/specificity, lower limit of detection and reportable range. RESULTS Quantitative SARS-CoV-2 sgRNA (LDT-Quant sgRNA) assay, which measures intermediates of replication, and viral load (LDT-Quant VLCoV) assay demonstrated acceptable performance. Both assays were linear with an R2 and slope equal to 0.99 and 1.00, respectively. Assay precision was evaluated between 4-6 Log10 with a maximum CV of 2.6% and 2.5% for LDT-Quant sgRNA and LDT-Quant VLCoV respectively. Using negative or positive SARS-CoV-2 human nasopharyngeal swab samples, both assays were accurate (kappa coefficient of 1.00 and 0.92). Common respiratory flora and other viral pathogens were not detected and did not interfere with the detection or quantification by either assay. Based on 95% detection, the assay LLODs were 729 and 1206 Copies/mL for the sgRNA and VL load LDTs, respectively. CONCLUSION The LDT-Quant sgRNA and LDT-Quant VLCoV demonstrated good analytical performance. These assays could be further investigated as alternative monitoring assays for viral replication; and thus, medical management in clinical settings which could inform isolation/quarantine requirements.
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Affiliation(s)
- Ines Lakhal-Naouar
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Holly R. Hack
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Edgar Moradel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Amie Jarra
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Hannah L. Grove
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Rani M. Ismael
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Steven Padilla
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Dante Coleman
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Jason Ouellette
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Janice Darden
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Casey Storme
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Kristina K. Peachman
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Tara L. Hall
- Moncrief Army Health Clinic, Fort Jackson, South Carolina, United States of America
| | - Mark E. Huhtanen
- Moncrief Army Health Clinic, Fort Jackson, South Carolina, United States of America
| | - Paul T. Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Shilpa Hakre
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Linda L. Jagodzinski
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Sheila A. Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
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Ollerton MT, Folkvord JM, Peachman KK, Shashikumar S, Morrison EB, Jagodzinski LL, Peel SA, Khreiss M, D’Aquila RT, Casares S, Rao M, Connick E. HIV-1 infected humanized DRAGA mice develop HIV-specific antibodies despite lack of canonical germinal centers in secondary lymphoid tissues. Front Immunol 2022; 13:1047277. [PMID: 36505432 PMCID: PMC9732419 DOI: 10.3389/fimmu.2022.1047277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
A major barrier in the use of humanized mice as models of HIV-1 (HIV) infection is the inadequate generation of virus-specific antibody responses. Humanized DRAGA (hDRAGA) mice generate antigen-specific class switched antibodies to several pathogens, but whether they do so in HIV infection and the extent to which their secondary lymphoid tissues (sLT) support germinal center responses is unknown. hDRAGA mice were evaluated for their ability to support HIV replication, generate virus-specific antibody responses, develop splenocyte subsets, and organize sLT architecture. hDRAGA mice supported persistent HIV replication and developed modest levels of gp41-specific human IgM and IgG. Spleens from uninfected and HIV infected hDRAGA mice contained differentiated B and CD4+ T cell subsets including germinal center (GC) B cells and T follicular helper cells (TFH); relative expansions of TFH and CD8+ T cells, but not GC B cells, occurred in HIV-infected hDRAGA mice compared to uninfected animals. Immunofluorescent staining of spleen and mesenteric lymph node sections demonstrated atypical morphology. Most CD4+ and CD8+ T cells resided within CD20hi areas. CD20hi areas lacked canonical germinal centers, as defined by staining for IgD-Ki67+cells. No human follicular dendritic cells (FDC) were detected. Mouse FDC were distributed broadly throughout both CD20hi and CD20lo regions of sLT. HIV RNA particles were detected by in situ hybridization within CD20+ areas and some co-localized with mouse FDC. Viral RNA+ cells were more concentrated within CD20hi compared to CD20lo areas of sLT, but differences were diminished in spleen and eliminated in mesenteric lymph nodes when adjusted for CD4+ cell frequency. Thus, hDRAGA mice recapitulated multiple aspects of HIV pathogenesis including HIV replication, relative expansions in TFH and CD8+ T cells, and modest HIV-specific antibody production. Nevertheless, classical germinal center morphology in sLT was not observed, which may account for the inefficient expansion of GC B cells and generation of low titer human antibody responses to HIV-1 in this model.
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Affiliation(s)
| | - Joy M. Folkvord
- Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kristina K. Peachman
- Laboratory of Adjuvant and Antigen Research, United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Soumya Shashikumar
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States
| | - Elaine B. Morrison
- Laboratory of Adjuvant and Antigen Research, United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Linda L. Jagodzinski
- Diagnostics and Countermeasure Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Sheila A. Peel
- Diagnostics and Countermeasure Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Mohammad Khreiss
- Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Richard T. D’Aquila
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sofia Casares
- US Military Malaria Vaccine Program, Naval Medical Research Center, Silver Spring, MD, United States
| | - Mangala Rao
- Laboratory of Adjuvant and Antigen Research, United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Elizabeth Connick
- Department of Medicine, University of Arizona, Tucson, AZ, United States
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3
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Hakre S, Lakhal-Naouar I, King DB, Burns JL, Jackson KN, Krauss SW, Chandrasekaran P, McCauley MD, Ober Shepherd BL, McHenry S, Bianchi EJ, Ouellette J, Darden JM, Sanborn AD, Daye SP, Kwon PO, Stubbs J, Brigantti CL, Hall TL, Beagle MH, Pieri JA, Frambes TR, O’Connell RJ, Modjarrad K, Murray CK, Jagodzinski LL, Scott PT, Peel SA. Virological and Serological Assessment of US Army Trainees Isolated for Coronavirus Disease 2019. J Infect Dis 2022; 226:1743-1752. [PMID: 35543272 PMCID: PMC9129211 DOI: 10.1093/infdis/jiac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/09/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Laboratory screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a key mitigation measure to avoid the spread of infection among recruits starting basic combat training in a congregate setting. Because viral nucleic acid can be detected persistently after recovery, we evaluated other laboratory markers to distinguish recruits who could proceed with training from those who were infected. METHODS Recruits isolated for coronavirus disease 2019 (COVID-19) were serially tested for SARS-CoV-2 subgenomic ribonucleic acid (sgRNA), and viral load (VL) by reverse-transcriptase polymerase chain reaction (RT-PCR), and for anti- SARS-CoV-2. Cluster and quadratic discriminant analyses of results were performed. RESULTS Among 229 recruits isolated for COVID-19, those with a RT-PCR cycle threshold >30.49 (sensitivity 95%, specificity 96%) or having sgRNA log10 RNA copies/mL <3.09 (sensitivity and specificity 96%) at entry into isolation were likely SARS-CoV-2 uninfected. Viral load >4.58 log10 RNA copies/mL or anti-SARS-CoV-2 signal-to-cutoff ratio <1.38 (VL: sensitivity and specificity 93%; anti-SARS-CoV-2: sensitivity 83%, specificity 79%) had comparatively lower sensitivity and specificity when used alone for discrimination of infected from uninfected. CONCLUSIONS Orthogonal laboratory assays used in combination with RT-PCR may have utility in determining SARS-CoV-2 infection status for decisions regarding isolation.
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Affiliation(s)
- Shilpa Hakre
- Correspondence: Shilpa Hakre, DrPH MPH, Emerging Infectious Diseases Branch, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720-A Rockledge Drive, Suite 400, Bethesda, MD 20817 ()
| | - Ines Lakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - David B King
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Jennifer L Burns
- Walter Reed Army Institute of Research, Pilot Bioproduction Facility, Silver Spring, Maryland, USA
| | - Kenya N Jackson
- Walter Reed Army Institute of Research, Experimental Therapeutics, Silver Spring, Maryland, USA
| | - Stephen W Krauss
- Walter Reed Army Institute of Research, Center for Military Psychiatry and Neuroscience, Silver Spring, Maryland, USA
| | - Prabha Chandrasekaran
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Melanie D McCauley
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Brittany L Ober Shepherd
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Samantha McHenry
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Elizabeth J Bianchi
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Jason Ouellette
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Janice M Darden
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Aaron D Sanborn
- Walter Reed Army Institute of Research, Clinical Trials Center, Silver Spring, Maryland, USA
| | - Sharon P Daye
- Walter Reed Army Institute of Research, One Health Branch, Silver Spring, Maryland, USA
| | - Paul O Kwon
- Program Executive Office for Simulation, Training and Instrumentation, Orlando, Florida, USA
| | | | - Crystal L Brigantti
- DiLorenzo Pentagon Health Clinic, Optometry, Washington, District of Columbia, USA
| | - Tara L Hall
- Moncrief Army Health Clinic, Fort Jackson, South Carolina, USA
| | | | - Jason A Pieri
- United States Army Training Center, Fort Jackson, South Carolina, USA
| | - Timothy R Frambes
- United States Army Training Center, Fort Jackson, South Carolina, USA
| | | | - Kayvon Modjarrad
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA
| | | | - Linda L Jagodzinski
- Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Paul T Scott
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA
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4
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Johnston SC, Ricks KM, Lakhal-Naouar I, Jay A, Subra C, Raymond JL, King HAD, Rossi F, Clements TL, Fetterer D, Tostenson S, Cincotta CM, Hack HR, Kuklis C, Soman S, King J, Peachman KK, Kim D, Chen WH, Sankhala RS, Martinez EJ, Hajduczki A, Chang WC, Choe M, Thomas PV, Peterson CE, Anderson A, Swafford I, Currier JR, Paquin-Proulx D, Jagodzinski LL, Matyas GR, Rao M, Gromowski GD, Peel SA, White L, Smith JM, Hooper JW, Michael NL, Modjarrad K, Joyce MG, Nalca A, Bolton DL, Pitt MLM. A SARS-CoV-2 Spike Ferritin Nanoparticle Vaccine Is Protective and Promotes a Strong Immunological Response in the Cynomolgus Macaque Coronavirus Disease 2019 (COVID-19) Model. Vaccines (Basel) 2022; 10:vaccines10050717. [PMID: 35632473 PMCID: PMC9145473 DOI: 10.3390/vaccines10050717] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has had a staggering impact on social, economic, and public health systems worldwide. Vaccine development and mobilization against SARS-CoV-2 (the etiologic agent of COVID-19) has been rapid. However, novel strategies are still necessary to slow the pandemic, and this includes new approaches to vaccine development and/or delivery that will improve vaccination compliance and demonstrate efficacy against emerging variants. Here, we report on the immunogenicity and efficacy of a SARS-CoV-2 vaccine comprising stabilized, pre-fusion spike protein trimers displayed on a ferritin nanoparticle (SpFN) adjuvanted with either conventional aluminum hydroxide or the Army Liposomal Formulation QS-21 (ALFQ) in a cynomolgus macaque COVID-19 model. Vaccination resulted in robust cell-mediated and humoral responses and a significant reduction in lung lesions following SARS-CoV-2 infection. The strength of the immune response suggests that dose sparing through reduced or single dosing in primates may be possible with this vaccine. Overall, the data support further evaluation of SpFN as a SARS-CoV-2 protein-based vaccine candidate with attention to fractional dosing and schedule optimization.
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Affiliation(s)
- Sara C. Johnston
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (J.M.S.); (J.W.H.)
- Correspondence:
| | - Keersten M. Ricks
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (K.M.R.); (T.L.C.)
| | - Ines Lakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (K.K.P.); (L.L.J.); (S.A.P.)
| | - Alexandra Jay
- Veterinary Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (A.J.); (F.R.); (D.F.); (L.W.)
| | - Caroline Subra
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Jo Lynne Raymond
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA;
| | - Hannah A. D. King
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Franco Rossi
- Veterinary Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (A.J.); (F.R.); (D.F.); (L.W.)
| | - Tamara L. Clements
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (K.M.R.); (T.L.C.)
| | - David Fetterer
- Veterinary Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (A.J.); (F.R.); (D.F.); (L.W.)
| | - Samantha Tostenson
- Core Laboratory Services Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA;
| | - Camila Macedo Cincotta
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (K.K.P.); (L.L.J.); (S.A.P.)
| | - Holly R. Hack
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (K.K.P.); (L.L.J.); (S.A.P.)
| | - Caitlin Kuklis
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (C.K.); (S.S.); (J.K.); (J.R.C.); (G.D.G.)
| | - Sandrine Soman
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (C.K.); (S.S.); (J.K.); (J.R.C.); (G.D.G.)
| | - Jocelyn King
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (C.K.); (S.S.); (J.K.); (J.R.C.); (G.D.G.)
| | - Kristina K. Peachman
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (K.K.P.); (L.L.J.); (S.A.P.)
| | - Dohoon Kim
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
| | - Wei-Hung Chen
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Rajeshwer S. Sankhala
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Elizabeth J. Martinez
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Agnes Hajduczki
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - William C. Chang
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Misook Choe
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Paul V. Thomas
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Caroline E. Peterson
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Alexander Anderson
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Isabella Swafford
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Jeffrey R. Currier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (C.K.); (S.S.); (J.K.); (J.R.C.); (G.D.G.)
| | - Dominic Paquin-Proulx
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Linda L. Jagodzinski
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (K.K.P.); (L.L.J.); (S.A.P.)
| | - Gary R. Matyas
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
| | - Mangala Rao
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
| | - Gregory D. Gromowski
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (C.K.); (S.S.); (J.K.); (J.R.C.); (G.D.G.)
| | - Sheila A. Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (K.K.P.); (L.L.J.); (S.A.P.)
| | - Lauren White
- Veterinary Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (A.J.); (F.R.); (D.F.); (L.W.)
| | - Jeffrey M. Smith
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (J.M.S.); (J.W.H.)
| | - Jay W. Hooper
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA; (J.M.S.); (J.W.H.)
| | - Nelson L. Michael
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - M. Gordon Joyce
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Aysegul Nalca
- Core Support Directorate, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA;
| | - Diane L. Bolton
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA; (I.L.-N.); (C.S.); (H.A.D.K.); (C.M.C.); (H.R.H.); (D.K.); (W.-H.C.); (R.S.S.); (E.J.M.); (A.H.); (W.C.C.); (M.C.); (P.V.T.); (C.E.P.); (A.A.); (I.S.); (D.P.-P.); (M.G.J.); (D.L.B.)
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; (G.R.M.); (M.R.)
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA;
| | - Margaret L. M. Pitt
- Office of the Science Advisor, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA;
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5
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Joyce MG, King HAD, Elakhal-Naouar I, Ahmed A, Peachman KK, Macedo Cincotta C, Subra C, Chen RE, Thomas PV, Chen WH, Sankhala RS, Hajduczki A, Martinez EJ, Peterson CE, Chang WC, Choe M, Smith C, Lee PJ, Headley JA, Taddese MG, Elyard HA, Cook A, Anderson A, McGuckin Wuertz K, Dong M, Swafford I, Case JB, Currier JR, Lal KG, Molnar S, Nair MS, Dussupt V, Daye SP, Zeng X, Barkei EK, Staples HM, Alfson K, Carrion R, Krebs SJ, Paquin-Proulx D, Karasavva N, Polonis VR, Jagodzinski LL, Amare MF, Vasan S, Scott PT, Huang Y, Ho DD, de Val N, Diamond MS, Lewis MG, Rao M, Matyas GR, Gromowski GD, Peel SA, Michael NL, Bolton DL, Modjarrad K. A SARS-CoV-2 ferritin nanoparticle vaccine elicits protective immune responses in nonhuman primates. Sci Transl Med 2022; 14:eabi5735. [PMID: 34914540 DOI: 10.1126/scitranslmed.abi5735] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants stresses the continued need for next-generation vaccines that confer broad protection against coronavirus disease 2019 (COVID-19). We developed and evaluated an adjuvanted SARS-CoV-2 spike ferritin nanoparticle (SpFN) vaccine in nonhuman primates. High-dose (50 μg) SpFN vaccine, given twice 28 days apart, induced a Th1-biased CD4 T cell helper response and elicited neutralizing antibodies against SARS-CoV-2 wild-type and variants of concern, as well as against SARS-CoV-1. These potent humoral and cell-mediated immune responses translated into rapid elimination of replicating virus in the upper and lower airways and lung parenchyma of nonhuman primates following high-dose SARS-CoV-2 respiratory challenge. The immune response elicited by SpFN vaccination and resulting efficacy in nonhuman primates supports the utility of SpFN as a vaccine candidate for SARS-causing betacoronaviruses.
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Affiliation(s)
- M Gordon Joyce
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Hannah A D King
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Ines Elakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,Diagnostics and Countermeasures Branch, WRAIR, Silver Spring, MD 20910, USA
| | - Aslaa Ahmed
- Viral Diseases Branch, WRAIR, Silver Spring, MD 20910, USA
| | | | - Camila Macedo Cincotta
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,Diagnostics and Countermeasures Branch, WRAIR, Silver Spring, MD 20910, USA
| | - Caroline Subra
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Rita E Chen
- Department of Medicine, Washington University, St. Louis, MO 63130, USA.,Department of Pathology and Immunology, Washington University, St. Louis, MO 63130, USA
| | - Paul V Thomas
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Wei-Hung Chen
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Rajeshwer S Sankhala
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Agnes Hajduczki
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Elizabeth J Martinez
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Caroline E Peterson
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - William C Chang
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Misook Choe
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Clayton Smith
- Center for Molecular Microscopy, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD 21702, USA
| | - Parker J Lee
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Jarrett A Headley
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Mekdi G Taddese
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | | | | | - Alexander Anderson
- U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA.,Oak Ridge Institute of Science and Education, Oak Ridge, TN 37830, USA
| | | | - Ming Dong
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Isabella Swafford
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - James Brett Case
- Department of Medicine, Washington University, St. Louis, MO 63130, USA
| | | | - Kerri G Lal
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Sebastian Molnar
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Manoj S Nair
- Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Vincent Dussupt
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Sharon P Daye
- Center for Infectious Diseases Research, WRAIR, Silver Spring, MD 20910, USA
| | - Xiankun Zeng
- Division of Pathology, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA
| | - Erica K Barkei
- Veterinary Pathology Department, WRAIR, Silver Spring, MD 20910, USA
| | - Hilary M Staples
- Department of Virology and Immunology, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Kendra Alfson
- Department of Virology and Immunology, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Ricardo Carrion
- Department of Virology and Immunology, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Shelly J Krebs
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Dominic Paquin-Proulx
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Nicos Karasavva
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,Diagnostics and Countermeasures Branch, WRAIR, Silver Spring, MD 20910, USA
| | | | | | - Mihret F Amare
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Sandhya Vasan
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Paul T Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA
| | - Yaoxing Huang
- Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - David D Ho
- Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Natalia de Val
- Center for Molecular Microscopy, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD 21702, USA
| | - Michael S Diamond
- Department of Medicine, Washington University, St. Louis, MO 63130, USA.,Department of Pathology and Immunology, Washington University, St. Louis, MO 63130, USA.,Department of Molecular Microbiology, Washington University, St. Louis, MO 63130, USA
| | | | - Mangala Rao
- U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Gary R Matyas
- U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | | | - Sheila A Peel
- Diagnostics and Countermeasures Branch, WRAIR, Silver Spring, MD 20910, USA
| | - Nelson L Michael
- Center for Infectious Diseases Research, WRAIR, Silver Spring, MD 20910, USA
| | - Diane L Bolton
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.,U.S. Military HIV Research Program, WRAIR, Silver Spring, MD 20910, USA
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD 20910, USA
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6
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Wuertz KM, Barkei EK, Chen WH, Martinez EJ, Lakhal-Naouar I, Jagodzinski LL, Paquin-Proulx D, Gromowski GD, Swafford I, Ganesh A, Dong M, Zeng X, Thomas PV, Sankhala RS, Hajduczki A, Peterson CE, Kuklis C, Soman S, Wieczorek L, Zemil M, Anderson A, Darden J, Hernandez H, Grove H, Dussupt V, Hack H, de la Barrera R, Zarling S, Wood JF, Froude JW, Gagne M, Henry AR, Mokhtari EB, Mudvari P, Krebs SJ, Pekosz AS, Currier JR, Kar S, Porto M, Winn A, Radzyminski K, Lewis MG, Vasan S, Suthar M, Polonis VR, Matyas GR, Boritz EA, Douek DC, Seder RA, Daye SP, Rao M, Peel SA, Joyce MG, Bolton DL, Michael NL, Modjarrad K. A SARS-CoV-2 spike ferritin nanoparticle vaccine protects hamsters against Alpha and Beta virus variant challenge. NPJ Vaccines 2021; 6:129. [PMID: 34711815 PMCID: PMC8553838 DOI: 10.1038/s41541-021-00392-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
The emergence of SARS-CoV-2 variants of concern (VOC) requires adequate coverage of vaccine protection. We evaluated whether a SARS-CoV-2 spike ferritin nanoparticle vaccine (SpFN), adjuvanted with the Army Liposomal Formulation QS21 (ALFQ), conferred protection against the Alpha (B.1.1.7), and Beta (B.1.351) VOCs in Syrian golden hamsters. SpFN-ALFQ was administered as either single or double-vaccination (0 and 4 week) regimens, using a high (10 μg) or low (0.2 μg) dose. Animals were intranasally challenged at week 11. Binding antibody responses were comparable between high- and low-dose groups. Neutralizing antibody titers were equivalent against WA1, B.1.1.7, and B.1.351 variants following two high dose vaccinations. Dose-dependent SpFN-ALFQ vaccination protected against SARS-CoV-2-induced disease and viral replication following intranasal B.1.1.7 or B.1.351 challenge, as evidenced by reduced weight loss, lung pathology, and lung and nasal turbinate viral burden. These data support the development of SpFN-ALFQ as a broadly protective, next-generation SARS-CoV-2 vaccine.
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Affiliation(s)
- Kathryn McGuckin Wuertz
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Erica K Barkei
- Veterinary Pathology Division, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Wei-Hung Chen
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Elizabeth J Martinez
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Ines Lakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Linda L Jagodzinski
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Dominic Paquin-Proulx
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Gregory D Gromowski
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Isabella Swafford
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Akshaya Ganesh
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Oak Ridge Institute of Science and Education, Oak Ridge, TN, USA
| | - Ming Dong
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Xiankun Zeng
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Paul V Thomas
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Rajeshwer S Sankhala
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Agnes Hajduczki
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Caroline E Peterson
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Caitlin Kuklis
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Sandrine Soman
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Lindsay Wieczorek
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Michelle Zemil
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Alexander Anderson
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Oak Ridge Institute of Science and Education, Oak Ridge, TN, USA
| | - Janice Darden
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Heather Hernandez
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Hannah Grove
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Vincent Dussupt
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Holly Hack
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Rafael de la Barrera
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Stasya Zarling
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - James F Wood
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Jeffrey W Froude
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Matthew Gagne
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Amy R Henry
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Elham Bayat Mokhtari
- Virus Persistence and Dynamics Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Prakriti Mudvari
- Virus Persistence and Dynamics Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Shelly J Krebs
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Andrew S Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeffrey R Currier
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | | | | | | | - Sandhya Vasan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Mehul Suthar
- Emory Vaccine Center, Department of Pediatrics, Emory School of Medicine, Atlanta, GA, USA
| | - Victoria R Polonis
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Gary R Matyas
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Eli A Boritz
- Virus Persistence and Dynamics Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Daniel C Douek
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Robert A Seder
- Cellular Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sharon P Daye
- One Health Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Mangala Rao
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Sheila A Peel
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - M Gordon Joyce
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Diane L Bolton
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Nelson L Michael
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
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7
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King HAD, Joyce MG, Lakhal-Naouar I, Ahmed A, Cincotta CM, Subra C, Peachman KK, Hack HR, Chen RE, Thomas PV, Chen WH, Sankhala RS, Hajduczki A, Martinez EJ, Peterson CE, Chang WC, Choe M, Smith C, Headley JA, Elyard HA, Cook A, Anderson A, Wuertz KM, Dong M, Swafford I, Case JB, Currier JR, Lal KG, Amare MF, Dussupt V, Molnar S, Daye SP, Zeng X, Barkei EK, Alfson K, Staples HM, Carrion R, Krebs SJ, Paquin-Proulx D, Karasavvas N, Polonis VR, Jagodzinski LL, Vasan S, Scott PT, Huang Y, Nair MS, Ho DD, de Val N, Diamond MS, Lewis MG, Rao M, Matyas GR, Gromowski GD, Peel SA, Michael NL, Modjarrad K, Bolton DL. Efficacy and breadth of adjuvanted SARS-CoV-2 receptor-binding domain nanoparticle vaccine in macaques. Proc Natl Acad Sci U S A 2021; 118:e2106433118. [PMID: 34470866 PMCID: PMC8463842 DOI: 10.1073/pnas.2106433118] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Emergence of novel variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) underscores the need for next-generation vaccines able to elicit broad and durable immunity. Here we report the evaluation of a ferritin nanoparticle vaccine displaying the receptor-binding domain of the SARS-CoV-2 spike protein (RFN) adjuvanted with Army Liposomal Formulation QS-21 (ALFQ). RFN vaccination of macaques using a two-dose regimen resulted in robust, predominantly Th1 CD4+ T cell responses and reciprocal peak mean serum neutralizing antibody titers of 14,000 to 21,000. Rapid control of viral replication was achieved in the upper and lower airways of animals after high-dose SARS-CoV-2 respiratory challenge, with undetectable replication within 4 d in seven of eight animals receiving 50 µg of RFN. Cross-neutralization activity against SARS-CoV-2 variant B.1.351 decreased only approximately twofold relative to WA1/2020. In addition, neutralizing, effector antibody and cellular responses targeted the heterotypic SARS-CoV-1, highlighting the broad immunogenicity of RFN-ALFQ for SARS-CoV-like Sarbecovirus vaccine development.
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Affiliation(s)
- Hannah A D King
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - M Gordon Joyce
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Ines Lakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Aslaa Ahmed
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Camila Macedo Cincotta
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Caroline Subra
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Kristina K Peachman
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Holly R Hack
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Rita E Chen
- Department of Medicine, Washington University, St. Louis, MO 63130
- Department of Pathology & Immunology, Washington University, St. Louis, MO 63130
| | - Paul V Thomas
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Wei-Hung Chen
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Rajeshwer S Sankhala
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Agnes Hajduczki
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Elizabeth J Martinez
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Caroline E Peterson
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - William C Chang
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Misook Choe
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Clayton Smith
- Center for Molecular Microscopy, Center for Cancer Research, National Cancer Institute, NIH, Frederick, MD 21702
| | - Jarrett A Headley
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | | | | | - Alexander Anderson
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Kathryn McGuckin Wuertz
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Ming Dong
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Isabella Swafford
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - James B Case
- Department of Medicine, Washington University, St. Louis, MO 63130
| | - Jeffrey R Currier
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Kerri G Lal
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Mihret F Amare
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Vincent Dussupt
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Sebastian Molnar
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Sharon P Daye
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Xiankun Zeng
- Division of Pathology, US Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702
| | - Erica K Barkei
- Veterinary Pathology Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Kendra Alfson
- Disease Intervention and Prevention, Texas Biomedical Research Institute, San Antonio, TX 78227
| | - Hilary M Staples
- Disease Intervention and Prevention, Texas Biomedical Research Institute, San Antonio, TX 78227
| | - Ricardo Carrion
- Disease Intervention and Prevention, Texas Biomedical Research Institute, San Antonio, TX 78227
| | - Shelly J Krebs
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Dominic Paquin-Proulx
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Nicos Karasavvas
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Victoria R Polonis
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Linda L Jagodzinski
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Sandhya Vasan
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
| | - Paul T Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Yaoxing Huang
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032
| | - Manoj S Nair
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032
| | - David D Ho
- Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032
| | - Natalia de Val
- Center for Molecular Microscopy, Center for Cancer Research, National Cancer Institute, NIH, Frederick, MD 21702
| | - Michael S Diamond
- Department of Medicine, Washington University, St. Louis, MO 63130
- Department of Pathology & Immunology, Washington University, St. Louis, MO 63130
- Department of Molecular Microbiology, Washington University, St. Louis, MO 63130
| | | | - Mangala Rao
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Gary R Matyas
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Gregory D Gromowski
- Viral Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Sheila A Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Nelson L Michael
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910;
| | - Diane L Bolton
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910;
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817
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8
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Wuertz KM, Barkei EK, Chen WH, Martinez EJ, Lakhal-Naouar I, Jagodzinski LL, Paquin-Proulx D, Gromowski GD, Swafford I, Ganesh A, Dong M, Zeng X, Thomas PV, Sankhala RS, Hajduczki A, Peterson CE, Kuklis C, Soman S, Wieczorek L, Zemil M, Anderson A, Darden J, Hernandez H, Grove H, Dussupt V, Hack H, de la Barrera R, Zarling S, Wood JF, Froude JW, Gagne M, Henry AR, Mokhtari EB, Mudvari P, Krebs SJ, Pekosz AS, Currier JR, Kar S, Porto M, Winn A, Radzyminski K, Lewis MG, Vasan S, Suthar M, Polonis VR, Matyas GR, Boritz EA, Douek DC, Seder RA, Daye SP, Rao M, Peel SA, Joyce MG, Bolton DL, Michael NL, Modjarrad K. A SARS-CoV-2 spike ferritin nanoparticle vaccine protects against heterologous challenge with B.1.1.7 and B.1.351 virus variants in Syrian golden hamsters. bioRxiv 2021:2021.06.16.448525. [PMID: 34159328 PMCID: PMC8219092 DOI: 10.1101/2021.06.16.448525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The emergence of SARS-CoV-2 variants of concern (VOC) requires adequate coverage of vaccine protection. We evaluated whether a spike ferritin nanoparticle vaccine (SpFN), adjuvanted with the Army Liposomal Formulation QS21 (ALFQ), conferred protection against the B.1.1.7 and B.1.351 VOCs in Syrian golden hamsters. SpFN-ALFQ was administered as either single or double-vaccination (0 and 4 week) regimens, using a high (10 μg) or low (0.2 μg) immunogen dose. Animals were intranasally challenged at week 11. Binding antibody responses were comparable between high- and low-dose groups. Neutralizing antibody titers were equivalent against WA1, B.1.1.7, and B.1.351 variants following two high dose two vaccinations. SpFN-ALFQ vaccination protected against SARS-CoV-2-induced disease and viral replication following intranasal B.1.1.7 or B.1.351 challenge, as evidenced by reduced weight loss, lung pathology, and lung and nasal turbinate viral burden. These data support the development of SpFN-ALFQ as a broadly protective, next-generation SARS-CoV-2 vaccine.
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Affiliation(s)
- Kathryn McGuckin Wuertz
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Erica K. Barkei
- Veterinary Pathology Division, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Wei-Hung Chen
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Elizabeth J. Martinez
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Ines Lakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Linda L. Jagodzinski
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Dominic Paquin-Proulx
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Gregory D. Gromowski
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Isabella Swafford
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Akshaya Ganesh
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Oak Ridge Institute of Science and Education, Oak Ridge, Tennessee USA
| | - Ming Dong
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Xiankun Zeng
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland USA
| | - Paul V. Thomas
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Rajeshwer S. Sankhala
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Agnes Hajduczki
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Caroline E. Peterson
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Caitlin Kuklis
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Sandrine Soman
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Lindsay Wieczorek
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Michelle Zemil
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Alexander Anderson
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Oak Ridge Institute of Science and Education, Oak Ridge, Tennessee USA
| | - Janice Darden
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Heather Hernandez
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Hannah Grove
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Vincent Dussupt
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Holly Hack
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Rafael de la Barrera
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Stasya Zarling
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - James F. Wood
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Jeffrey W. Froude
- Pilot Bioproduction Facility, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Matthew Gagne
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland USA
| | - Amy R. Henry
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland USA
| | - Elham Bayat Mokhtari
- Virus Persistence and Dynamics Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland USA
| | - Prakriti Mudvari
- Virus Persistence and Dynamics Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland USA
| | - Shelly J. Krebs
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Andrew S. Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
| | - Jeffrey R. Currier
- Virus Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | | | | | | | | | | | - Sandhya Vasan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
| | - Mehul Suthar
- Emory Vaccine Center, Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia USA
| | - Victoria R. Polonis
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Gary R. Matyas
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Eli A. Boritz
- Virus Persistence and Dynamics Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland USA
| | - Daniel C. Douek
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland USA
| | - Robert A. Seder
- Cellular Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland USA
| | - Sharon P. Daye
- One Health Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Mangala Rao
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - Sheila A. Peel
- Diagnostics Countermeasures Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
| | - M. Gordon Joyce
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
- These authors contributed equally
| | - Diane L. Bolton
- U.S. Military HIV Research Program, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland USA
- These authors contributed equally
| | - Nelson L. Michael
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- These authors contributed equally
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, Maryland USA
- These authors contributed equally
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9
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Scott PT, Cohen RL, Brett-Major DM, Hakre S, Malia JA, Okulicz JF, Beckett CG, Blaylock JM, Forgione MA, Harrison SA, Murray CK, Rentas FJ, Fahie RL, Armstrong AW, Hayat AM, Pacha LA, Dawson P, Blackwell B, Eick-Cost AA, Maktabi HH, Michael NL, Jagodzinski LL, Cersovsky SB, Peel SA. Hepatitis B seroprevalence in the U.S. military and its impact on potential screening strategies. Mil Med 2021; 185:e1654-e1661. [PMID: 32648931 PMCID: PMC7526854 DOI: 10.1093/milmed/usaa131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 11/05/2019] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Knowledge of the contemporary epidemiology of hepatitis B virus (HBV) infection among military personnel can inform potential Department of Defense (DoD) screening policy and infection and disease control strategies. MATERIALS AND METHODS HBV infection status at accession and following deployment was determined by evaluating reposed serum from 10,000 service members recently deployed to combat operations in Iraq and Afghanistan in the period from 2007 to 2010. A cost model was developed from the perspective of the Department of Defense for a program to integrate HBV infection screening of applicants for military service into the existing screening program of screening new accessions for vaccine-preventable infections. RESULTS The prevalence of chronic HBV infection at accession was 2.3/1,000 (95% CI: 1.4, 3.2); most cases (16/21, 76%) identified after deployment were present at accession. There were 110 military service-related HBV infections identified. Screening accessions who are identified as HBV susceptible with HBV surface antigen followed by HBV surface antigen neutralization for confirmation offered no cost advantage over not screening and resulted in a net annual increase in cost of $5.78 million. However, screening would exclude as many as 514 HBV cases each year from accession. CONCLUSIONS Screening for HBV infection at service entry would potentially reduce chronic HBV infection in the force, decrease the threat of transfusion-transmitted HBV infection in the battlefield blood supply, and lead to earlier diagnosis and linkage to care; however, applicant screening is not cost saving. Service-related incident infections indicate a durable threat, the need for improved laboratory-based surveillance tools, and mandate review of immunization policy and practice.
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Affiliation(s)
- Paul T Scott
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910
| | - Robert L Cohen
- U.S. Army Public Health Center, 5158 Black Hawk Road, Gunpowder, MD 21010.,United States Agency for International Development, Ronald Reagan Building, Washington, DC 20523-1000
| | - David M Brett-Major
- Department of Epidemiology University of Nebraska Medical Center College of Public Health 984395 Nebraska Medical Center Omaha NE 68198-4395
| | - Shilpa Hakre
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, 6720A Rockledge Drive, Bethesda, MD 20817
| | - Jennifer A Malia
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910
| | - Jason F Okulicz
- San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
| | - Charmagne G Beckett
- Navy Bloodborne Infection Management Center, 8901 Wisconsin Avenue, Bethesda, MD 20889
| | - Jason M Blaylock
- Infectious Disease Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889
| | - Michael A Forgione
- San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
| | - Stephen A Harrison
- San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
| | - Clinton K Murray
- San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234
| | - Francisco J Rentas
- Armed Services Blood Program Office, 7700 Arlington Boulevard, Falls Church, VA 22042-5143
| | - Roland L Fahie
- Armed Services Blood Program Office, 7700 Arlington Boulevard, Falls Church, VA 22042-5143
| | - Adam W Armstrong
- Naval Medical Research Center, 8901 Wisconsin Ave, Bethesda, MD 20889
| | - Aatif M Hayat
- U.S. Army Public Health Center, 5158 Black Hawk Road, Gunpowder, MD 21010
| | - Laura A Pacha
- U.S. Army Public Health Center, 5158 Black Hawk Road, Gunpowder, MD 21010.,Regional Health Command, Central, 2899 Schofield Road, San Antonio, TX 78234
| | - Peter Dawson
- The Emmes Corporation, 401 N Washington, Rockville, MD 20850
| | - Beth Blackwell
- The Emmes Corporation, 401 N Washington, Rockville, MD 20850
| | - Angelia A Eick-Cost
- Defense Health Agency, Armed Forces Health Surveillance Branch, 11800 Tech Road, Silver Spring, MD 20904.,Cherokee Nation Technology Solutions, 10838 E Marshall Street, Tulsa, OK 74116
| | - Hala H Maktabi
- Defense Health Agency, Armed Forces Health Surveillance Branch, 11800 Tech Road, Silver Spring, MD 20904.,Office of Assistant Secretary for Policy & Planning, Washington, DC
| | - Nelson L Michael
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910
| | - Linda L Jagodzinski
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910
| | - Steven B Cersovsky
- U.S. Army Public Health Center, 5158 Black Hawk Road, Gunpowder, MD 21010
| | - Sheila A Peel
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910
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10
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King HAD, Gordon Joyce M, Naouar IE, Ahmed A, Cincotta CM, Subra C, Peachman KK, Hack HH, Chen RE, Thomas PV, Chen WH, Sankhala RS, Hajduczki A, Martinez EJ, Peterson CE, Chang WC, Choe M, Smith C, Headley JA, Elyard HA, Cook A, Anderson A, Wuertz KM, Dong M, Swafford I, Case JB, Currier JR, Lal KG, Amare MF, Dussupt V, Molnar S, Daye SP, Zeng X, Barkei EK, Alfson K, Staples HM, Carrion R, Krebs SJ, Paquin-Proulx D, Karasavvas N, Polonis VR, Jagodzinski LL, Vasan S, Scott PT, Huang Y, Nair MS, Ho DD, de Val N, Diamond MS, Lewis MG, Rao M, Matyas GR, Gromowski GD, Peel SA, Michael NL, Modjarrad K, Bolton DL. Efficacy and breadth of adjuvanted SARS-CoV-2 receptor-binding domain nanoparticle vaccine in macaques. bioRxiv 2021. [PMID: 33851155 DOI: 10.1101/2021.04.09.439166] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Emergence of novel variants of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) underscores the need for next-generation vaccines able to elicit broad and durable immunity. Here we report the evaluation of a ferritin nanoparticle vaccine displaying the receptor-binding domain of the SARS-CoV-2 spike protein (RFN) adjuvanted with Army Liposomal Formulation QS-21 (ALFQ). RFN vaccination of macaques using a two-dose regimen resulted in robust, predominantly Th1 CD4+ T cell responses and reciprocal peak mean neutralizing antibody titers of 14,000-21,000. Rapid control of viral replication was achieved in the upper and lower airways of animals after high-dose SARS-CoV-2 respiratory challenge, with undetectable replication within four days in 7 of 8 animals receiving 50 µg RFN. Cross-neutralization activity against SARS-CoV-2 variant B.1.351 decreased only ∼2-fold relative to USA-WA1. In addition, neutralizing, effector antibody and cellular responses targeted the heterotypic SARS-CoV-1, highlighting the broad immunogenicity of RFN-ALFQ for SARS-like betacoronavirus vaccine development. Significance Statement The emergence of SARS-CoV-2 variants of concern (VOC) that reduce the efficacy of current COVID-19 vaccines is a major threat to pandemic control. We evaluate a SARS-CoV-2 Spike receptor-binding domain ferritin nanoparticle protein vaccine (RFN) in a nonhuman primate challenge model that addresses the need for a next-generation, efficacious vaccine with increased pan-SARS breadth of coverage. RFN, adjuvanted with a liposomal-QS21 formulation (ALFQ), elicits humoral and cellular immune responses exceeding those of current vaccines in terms of breadth and potency and protects against high-dose respiratory tract challenge. Neutralization activity against the B.1.351 VOC within two-fold of wild-type virus and against SARS-CoV-1 indicate exceptional breadth. Our results support consideration of RFN for SARS-like betacoronavirus vaccine development.
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11
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Joyce MG, King HAD, Naouar IE, Ahmed A, Peachman KK, Cincotta CM, Subra C, Chen RE, Thomas PV, Chen WH, Sankhala RS, Hajduczki A, Martinez EJ, Peterson CE, Chang WC, Choe M, Smith C, Lee PJ, Headley JA, Taddese MG, Elyard HA, Cook A, Anderson A, McGuckin-Wuertz K, Dong M, Swafford I, Case JB, Currier JR, Lal KG, O'Connell RJ, Molnar S, Nair MS, Dussupt V, Daye SP, Zeng X, Barkei EK, Staples HM, Alfson K, Carrion R, Krebs SJ, Paquin-Proulx D, Karasavva N, Polonis VR, Jagodzinski LL, Amare MF, Vasan S, Scott PT, Huang Y, Ho DD, de Val N, Diamond MS, Lewis MG, Rao M, Matyas GR, Gromowski GD, Peel SA, Michael NL, Bolton DL, Modjarrad K. Efficacy of a Broadly Neutralizing SARS-CoV-2 Ferritin Nanoparticle Vaccine in Nonhuman Primates. bioRxiv 2021. [PMID: 33791694 DOI: 10.1101/2021.03.24.436523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants stresses the continued need for next-generation vaccines that confer broad protection against coronavirus disease 2019 (COVID-19). We developed and evaluated an adjuvanted SARS-CoV-2 Spike Ferritin Nanoparticle (SpFN) vaccine in nonhuman primates (NHPs). High-dose (50 µ g) SpFN vaccine, given twice within a 28 day interval, induced a Th1-biased CD4 T cell helper response and a peak neutralizing antibody geometric mean titer of 52,773 against wild-type virus, with activity against SARS-CoV-1 and minimal decrement against variants of concern. Vaccinated animals mounted an anamnestic response upon high-dose SARS-CoV-2 respiratory challenge that translated into rapid elimination of replicating virus in their upper and lower airways and lung parenchyma. SpFN's potent and broad immunogenicity profile and resulting efficacy in NHPs supports its utility as a candidate platform for SARS-like betacoronaviruses. One-Sentence Summary A SARS-CoV-2 Spike protein ferritin nanoparticle vaccine, co-formulated with a liposomal adjuvant, elicits broad neutralizing antibody responses that exceed those observed for other major vaccines and rapidly protects against respiratory infection and disease in the upper and lower airways and lung tissue of nonhuman primates.
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12
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Hellmuth J, Muccini C, Colby DJ, Kroon E, de Souza M, Crowell TA, Chan P, Sacdalan C, Intasan J, Benjapornpong K, Tipsuk S, Puttamaswin S, Chomchey N, Valcour V, Sarnecki M, Tomaka F, Krebs SJ, Slike BM, Jagodzinski LL, Dumrongpisutikul N, Sailasuta N, Samboju V, Michael NL, Robb ML, Vasan S, Ananworanich J, Phanuphak P, Phanuphak N, Paul R, Spudich S. Central nervous system safety during brief analytic treatment interruption of antiretroviral therapy within four HIV remission trials: an observational study in acutely treated people living with HIV. Clin Infect Dis 2020; 73:e1885-e1892. [PMID: 32916708 DOI: 10.1093/cid/ciaa1344] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/09/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The central nervous system (CNS) is a likely reservoir of HIV, vulnerable to viral rebound, inflammation, and clinical changes upon stopping antiretroviral therapy (ART). It is critical to evaluate the CNS safety of studies using analytic treatment interruption (ATI) to assess HIV remission. METHODS Thirty participants who started ART during acute HIV infection underwent CNS assessments across four ATI remission trials. ART resumption occurred with plasma viral load >1000 copies/mL. CNS measures included paired pre- vs. post-ATI measures of mood, cognitive performance, and neurologic examination, with elective cerebrospinal fluid (CSF) sampling, brain diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). RESULTS Median participant age was 30 years old and 29/30 were male. Participants' median time on ART prior to ATI was 3 years, and ATI lasted a median of 35 days. Post-ATI, there were no differences in median mood scores or neurologic findings and cognitive performance improved modestly. During ATI, a low level of CSF HIV-1 RNA was detectable in six of 20 participants with plasma viremia, with no group changes in CSF immune activation markers or brain DTI measures. Mild worsening was identified in post-ATI basal ganglia total choline MRS, suggesting an alteration in neuronal membranes. CONCLUSION No adverse CNS effects were observed with brief, closely-monitored ATI in participants with acutely treated HIV, except a MRS alteration in basal ganglia choline. Further studies are needed to assess CNS ATI safety in HIV remission trials, particularly for studies using higher thresholds to restart ART and longer ATI durations.
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Affiliation(s)
- Joanna Hellmuth
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Camilla Muccini
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Donn J Colby
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Eugène Kroon
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Mark de Souza
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Trevor A Crowell
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Phillip Chan
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Carlo Sacdalan
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Jintana Intasan
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | - Somporn Tipsuk
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | - Nitiya Chomchey
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | | | - Frank Tomaka
- Janssen Research & Development LLC, Titusville, NJ, USA
| | - Shelly J Krebs
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Bonnie M Slike
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Linda L Jagodzinski
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | | | - Napapon Sailasuta
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii, Honolulu, Hawaii, USA
| | - Vishal Samboju
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Nelson L Michael
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Merlin L Robb
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Sandhya Vasan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Jintanat Ananworanich
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Department of Global Health, The University of Amsterdam, Amsterdam, The Netherlands
| | - Praphan Phanuphak
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St. Louis, MO, USA
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13
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Crowell TA, Danboise B, Parikh A, Esber A, Dear N, Coakley P, Kasembeli A, Maswai J, Khamadi S, Bahemana E, Iroezindu M, Kiweewa F, Owuoth J, Freeman J, Jagodzinski LL, Malia JA, Eller LA, Tovanabutra S, Peel SA, Ake JA, Polyak CS. Pretreatment and Acquired Antiretroviral Drug Resistance Among Persons Living With HIV in Four African Countries. Clin Infect Dis 2020; 73:e2311-e2322. [PMID: 32785695 PMCID: PMC8492117 DOI: 10.1093/cid/ciaa1161] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Emerging HIV drug resistance (HIVDR) could jeopardize the success of standardized HIV management protocols in resource-limited settings. We characterized HIVDR among antiretroviral therapy (ART)-naive and experienced participants in the African Cohort Study (AFRICOS). METHODS From January 2013 to April 2019, adults with HIV-1 RNA >1000 copies/mL underwent ART history review and HIVDR testing upon enrollment at 12 clinics in Uganda, Kenya, Tanzania, and Nigeria. We calculated resistance scores for specific drugs and tallied major mutations to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) using Stanford HIVDB 8.8 and SmartGene IDNS software. For ART-naive participants, World Health Organization surveillance drug resistance mutations (SDRMs) were noted. RESULTS HIVDR testing was performed on 972 participants with median age 35.7 (interquartile range [IQR] 29.7-42.7) years and median CD4 295 (IQR 148-478) cells/mm3. Among 801 ART-naive participants, the prevalence of SDRMs was 11.0%, NNRTI mutations 8.2%, NRTI mutations 4.7%, and PI mutations 0.4%. Among 171 viremic ART-experienced participants, NNRTI mutation prevalence was 83.6%, NRTI 67.8%, and PI 1.8%. There were 90 ART-experienced participants with resistance to both efavirenz and lamivudine, 33 (36.7%) of whom were still prescribed these drugs. There were 10 with resistance to both tenofovir and lamivudine, 8 (80.0%) of whom were prescribed these drugs. CONCLUSIONS Participants on failing ART regimens had a high burden of HIVDR that potentially limited the efficacy of standardized first- and second-line regimens. Management strategies that emphasize adherence counseling while delaying ART switch may promote drug resistance and should be reconsidered.
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Affiliation(s)
- Trevor A Crowell
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Brook Danboise
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Ajay Parikh
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Allahna Esber
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Nicole Dear
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Peter Coakley
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Alex Kasembeli
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,HJF Medical Research International, Kericho, Kenya
| | - Jonah Maswai
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,HJF Medical Research International, Kericho, Kenya
| | - Samoel Khamadi
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,HJF Medical Research International, Mbeya, Tanzania
| | - Emmanuel Bahemana
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,HJF Medical Research International, Mbeya, Tanzania
| | - Michael Iroezindu
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,HJF Medical Research International, Abuja, Nigeria
| | | | - John Owuoth
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,HJF Medical Research International, Kisumu, Kenya
| | - Joanna Freeman
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Linda L Jagodzinski
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Jennifer A Malia
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Leigh Ann Eller
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Sodsai Tovanabutra
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Sheila A Peel
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Julie A Ake
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Christina S Polyak
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
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14
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Mody RM, Lakhal-Naouar I, Sherwood JE, Koles NL, Shaw D, Bigley DP, Co EMA, Copeland NK, Jagodzinski LL, Mukbel RM, Smiley RA, Duncan RC, Kamhawi S, Jeronimo SMB, DeFraites RF, Aronson NE. Asymptomatic Visceral Leishmania infantum Infection in US Soldiers Deployed to Iraq. Clin Infect Dis 2020; 68:2036-2044. [PMID: 30239631 DOI: 10.1093/cid/ciy811] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/14/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL), due to Leishmania infantum, is a persistent intracellular parasitic infection transmitted by the bite of infected sand flies. Symptomatic VL has been reported in U.S. soldiers with Iraq deployment. Untreated symptomatic VL can be fatal; asymptomatic VL (AVL) may establish a lifelong risk of reactivation. We report prevalence and AVL risk factors in Operation Iraqi Freedom (OIF) deployers during 2002-11. METHODS Healthy soldiers exposed to VL endemic areas in Iraq and 50 controls who never traveled to endemic regions were recruited through military healthcare facilities (2015-17). Responses to a risk factor survey and blood samples were obtained. Leishmania research diagnostics utilized included enzyme-linked immunosorbent assay (ELISA), rk39 test strips, quantitative polymerase chain reaction (PCR), and interferon gamma release (IGRA) assays. Statistical analyses included Fisher exact test, Pearson χ2 test, Mann-Whitney U test, and logistic regression. RESULTS 200 deployed subjects were enrolled, mostly males (84.0%), of white ethnicity (79.0%), and median age 41 (range 24-61) years. 64% were seropositive for Phlebotomus alexandri saliva antibodies. Prevalence of AVL (any positive test result) was 39/200 (19.5%, 95% confidence interval 14.4%-25.8%). Two (1.0%) PCR, 10 (5%) ELISA, and 28 (14%) IGRA samples were positive. Travel to Ninewa governorate increased risk for AVL (P = .01). CONCLUSION AVL was identified in 19.5% of OIF deployers; travel to northwest Iraq correlated with infection. Further studies are needed to inform risk for reactivation VL in US veterans and to target additional blood safety and surveillance measures.
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Affiliation(s)
- Rupal M Mody
- Infectious Diseases Department, William Beaumont Army Medical Center, El Paso, Texas
| | - Ines Lakhal-Naouar
- Infectious Diseases Division, Uniformed Services University of the Health Sciences
| | - Jeffrey E Sherwood
- Infectious Diseases Department, William Beaumont Army Medical Center, El Paso, Texas
| | - Nancy L Koles
- Infectious Diseases Division, Uniformed Services University of the Health Sciences
| | - Dutchabong Shaw
- Clinical Research Unit, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Edgie-Mark A Co
- Internal Medicine Department, William Beaumont Army Medical Center, El Paso, Texas
| | | | | | - Rami M Mukbel
- Department of Basic Veterinary Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Rebecca A Smiley
- Department of Clinical Investigations, William Beaumont Army Medical Center, El Paso, Texas
| | - Robert C Duncan
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring
| | - Shaden Kamhawi
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, Rockville, Maryland
| | - Selma M B Jeronimo
- Department of Biochemistry and Institute of Tropical Medicine at Rio Grande do Norte, Natal.,National Institute of Science and Technology of Tropical Diseases, Salvador, Bahia, Brazil
| | - Robert F DeFraites
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Naomi E Aronson
- Infectious Diseases Division, Uniformed Services University of the Health Sciences
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15
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Hellmuth J, Slike BM, Sacdalan C, Best J, Kroon E, Phanuphak N, Fletcher JLK, Prueksakaew P, Jagodzinski LL, Valcour V, Robb M, Ananworanich J, Allen IE, Krebs SJ, Spudich S. Very Early Initiation of Antiretroviral Therapy During Acute HIV Infection Is Associated With Normalized Levels of Immune Activation Markers in Cerebrospinal Fluid but Not in Plasma. J Infect Dis 2019; 220:1885-1891. [PMID: 30668739 PMCID: PMC6833977 DOI: 10.1093/infdis/jiz030] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/15/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chronic immune activation in the blood and central nervous system is a consequence of human immunodeficiency virus (HIV) infection that contributes to disease morbidity and can occur despite virally suppressive antiretroviral therapy (ART). The trajectory of HIV-related inflammation may vary with the timing of ART initiation. We examined immune activation markers in cerebrospinal fluid (CSF) and blood specimens collected over 96 weeks from participants who initiated ART during acute HIV infection (AHI). METHODS RV254/SEARCH010 study participants with AHI underwent CSF (n = 89) and plasma (n = 146) sampling before initiating ART and at weeks 24 and 96 of treatment. A majority participants (64.4%) received a standard ART regimen (hereafter, "standard ART"), with some (34.7%) also receiving maraviroc and raltegravir for the first 24 weeks (hereafter, "ART plus"). We compared neopterin, CXCL10, CCL2, and interleukin 6 (IL-6) levels in the AHI group to those in 18 healthy, uninfected controls. RESULTS Following 24 and 96 weeks of treatment, levels of all CSF markers normalized while levels of several plasma markers remained elevated in the AHI group (P < .001). Participants receiving the ART-plus regimen had lower median plasma CCL2 levels at week 24 and lower plasma neopterin levels at week 96. CONCLUSIONS ART initiation during AHI differentially impacts the brain compartment, with markers of inflammation returning to normal levels in the CSF, where they were sustained at week 96, but not in plasma.
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Affiliation(s)
- Joanna Hellmuth
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Bonnie M Slike
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Carlo Sacdalan
- SEARCH Subunit, Thai Red Cross AIDS Research Center, Bangkok
| | - John Best
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Eugene Kroon
- SEARCH Subunit, Thai Red Cross AIDS Research Center, Bangkok
| | | | | | | | - Linda L Jagodzinski
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Merlin Robb
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Jintanat Ananworanich
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
- SEARCH Subunit, Thai Red Cross AIDS Research Center, Bangkok
- Department of Global Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Isabel E Allen
- Department of Biostatistics and Epidemiology, University of California, San Francisco
| | - Shelly J Krebs
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
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16
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Crowell TA, Colby DJ, Pinyakorn S, Fletcher JLK, Kroon E, Schuetz A, Krebs SJ, Slike BM, Leyre L, Chomont N, Jagodzinski LL, Sereti I, Utay NS, Dewar R, Rerknimitr R, Chomchey N, Trichavaroj R, Valcour VG, Spudich S, Michael NL, Robb ML, Phanuphak N, Ananworanich J. Acute Retroviral Syndrome Is Associated With High Viral Burden, CD4 Depletion, and Immune Activation in Systemic and Tissue Compartments. Clin Infect Dis 2019; 66:1540-1549. [PMID: 29228130 DOI: 10.1093/cid/cix1063] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/04/2017] [Indexed: 01/21/2023] Open
Abstract
Background Many individuals with acute human immunodeficiency virus infection (AHI) experience acute retroviral syndrome (ARS), which is associated with adverse long-term clinical outcomes. Methods Participants presenting for voluntary human immunodeficiency virus (HIV) testing were enrolled during AHI in Bangkok, Thailand. ARS was defined by ≥3 qualifying signs/symptoms. HIV burden, immunophenotypes, and biomarkers were stratified by ARS diagnosis at enrollment and after up to 96 weeks of antiretroviral therapy (ART). Results From 212382 samples screened, 430 participants were enrolled during AHI, including 335 (78%) with ARS. Median age was 26 years and 416 (97%) were men. Sixty (14%) underwent sigmoid biopsy and 105 (24%) underwent lumbar puncture during AHI. Common symptoms included fever (93%), fatigue (79%), pharyngitis (67%), and headache (64%). Compared to those without ARS, participants with ARS were in later Fiebig stages with higher HIV RNA in blood, colon, and cerebrospinal fluid; higher total HIV DNA in blood; CD4 depletion in blood and colon; and elevated plasma tumor necrosis factor alpha (TNF-α), C-reactive protein, and D-dimer (all P < .05). Subgroup analyses of Fiebig I/II participants (95 with ARS, 69 without) demonstrated similar findings. After 96 weeks of ART, TNF-α and interleukin 6 were elevated in the ARS group (P < .05) but other biomarkers equilibrated. Conclusions ARS was associated with high viral burden, CD4 depletion, and immune activation across multiple body compartments during AHI and prior to ART. Persistent inflammation despite suppressive ART could contribute to increased morbidity in individuals who experience ARS.
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Affiliation(s)
- Trevor A Crowell
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Donn J Colby
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Suteeraporn Pinyakorn
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | | | - Eugène Kroon
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Alexandra Schuetz
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.,Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Shelly J Krebs
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Bonnie M Slike
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Louise Leyre
- Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Université de Montréal, Quebec, Canada
| | - Nicolas Chomont
- Centre de Recherche du CHUM and Department of Microbiology, Infectiology and Immunology, Université de Montréal, Quebec, Canada
| | - Linda L Jagodzinski
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Irini Sereti
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Netanya S Utay
- Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Maryland
| | - Robin Dewar
- Virus Isolation and Serological Laboratory, National Cancer Institute at Frederick, Maryland
| | - Rungsun Rerknimitr
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nitiya Chomchey
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Rapee Trichavaroj
- Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Victor G Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco School of Medicine, New Haven, Connecticut
| | - Serena Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Nelson L Michael
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring
| | - Merlin L Robb
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | | | - Jintanat Ananworanich
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.,SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.,Department of Global Health, University of Amsterdam, The Netherlands
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17
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Tovanabutra S, Sirijatuphat R, Pham PT, Bonar L, Harbolick EA, Bose M, Song H, Chang D, Oropeza C, O'Sullivan AM, Balinang J, Kroon E, Colby DJ, Sacdalan C, Hellmuth J, Chan P, Prueksakaew P, Pinyakorn S, Jagodzinski LL, Sutthichom D, Pattamaswin S, de Souza M, Gramzinski RA, Kim JH, Michael NL, Robb ML, Phanuphak N, Ananworanich J, Valcour V, Kijak GH, Sanders-Buell E, Spudich S. Deep Sequencing Reveals Central Nervous System Compartmentalization in Multiple Transmitted/Founder Virus Acute HIV-1 Infection. Cells 2019; 8:E902. [PMID: 31443253 PMCID: PMC6721674 DOI: 10.3390/cells8080902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/10/2019] [Accepted: 08/11/2019] [Indexed: 01/31/2023] Open
Abstract
HIV-1 disseminates to a broad range of tissue compartments during acute HIV-1 infection (AHI). The central nervous system (CNS) can serve as an early and persistent site of viral replication, which poses a potential challenge for HIV-1 remission strategies that target the HIV reservoir. CNS compartmentalization is a key feature of HIV-1 neuropathogenesis. Thus far, the timing of how early CNS compartmentalization develops after infection is unknown. We examined whether HIV-1 transmitted/founder (T/F) viruses differ between CNS and blood during AHI using single-genome sequencing of envelope gene and further examined subregions in pol and env using next-generation sequencing in paired plasma and cerebrospinal fluid (CSF) from 18 individuals. Different proportions of mostly minor variants were found in six of the eight multiple T/F-infected individuals, indicating enrichment of some variants in CSF that may lead to significant compartmentalization in the later stages of infection. This study provides evidence for the first time that HIV-1 compartmentalization in the CNS can occur within days of HIV-1 exposure in multiple T/F infections. Further understanding of factors that determine enrichment of T/F variants in the CNS, as well as potential long-term implications of these findings for persistence of HIV-1 reservoirs and neurological impairment in HIV, is needed.
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Affiliation(s)
- Sodsai Tovanabutra
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.
| | - Rujipas Sirijatuphat
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Phuc T Pham
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Lydia Bonar
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Elizabeth A Harbolick
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Meera Bose
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Hongshuo Song
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - David Chang
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Celina Oropeza
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Anne Marie O'Sullivan
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Joyce Balinang
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Eugene Kroon
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
| | - Donn J Colby
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
| | - Carlo Sacdalan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
| | - Joanna Hellmuth
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Phillip Chan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
| | | | - Suteeraporn Pinyakorn
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Linda L Jagodzinski
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | | | | | - Mark de Souza
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
| | - Robert A Gramzinski
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Jerome H Kim
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- International Vaccine Institute, Seoul 08826, Korea
| | - Nelson L Michael
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Merlin L Robb
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Nittaya Phanuphak
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
| | - Jintanat Ananworanich
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok 10330, Thailand
- Academic Medical Center, Department of Global Health, University of Amsterdam, 1105AZ Amsterdam, The Netherlands
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Gustavo H Kijak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Eric Sanders-Buell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Serena Spudich
- Department of Neurology, Yale University; New Haven, CT 06510, USA
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18
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Jagodzinski LL, Manak MM, Hack HR, Liu Y, Malia JA, Freeman J, Phanuphak N, de Souza M, Kroon ED, Colby DJ, Chomchey N, Lally MA, Michael NL, Ananworanich J, Peel SA. Impact of Early Antiretroviral Therapy on Detection of Cell-Associated HIV-1 Nucleic Acid in Blood by the Roche Cobas TaqMan Test. J Clin Microbiol 2019; 57:e01922-18. [PMID: 30842229 PMCID: PMC6498003 DOI: 10.1128/jcm.01922-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/25/2019] [Indexed: 12/31/2022] Open
Abstract
The Roche Cobas AmpliPrep/Cobas TaqMan HIV-1 test, v2.0 (the CAP/CTM assay), was used to quantify cell-associated HIV-1 (CAH) nucleic acid in peripheral blood mononuclear cells (PBMC) from well-characterized clinical specimens from HIV-1-infected individuals on antiretroviral therapy (ART). Chronically infected individuals on ART with no detectable plasma HIV-1 RNA demonstrated average CAH burdens of 3.2 HIV-1 log10 copies/million cells. Assay sensitivity and specificity were 98.9% and 100%, respectively, with the positive and negative predictive values being 100% and 98.6%, respectively. The CAH burden was also measured at weeks 0, 1, 2, 8, and 60 in 37 participants (RV254/SEARCH010, Bangkok, Thailand) stratified by Fiebig stage (Fiebig stage I [FI] to FVI) at ART initiation. Prior to ART initiation, the average CAH burden was 1.4, 4.1, and 3.6 log10 copies/million PBMCs for individuals who initiated ART at FI, FII, and FIII to FVI, respectively. Initiation of ART resulted in a rapid decline of CAH in all individuals, with the greatest decrease being observed in individuals who initiated ART at FI to FIII. By week 60, 100% (FI), 71.8% (FII/FIII), and 20.5% (FIV to FVI) of samples from individuals initiating treatment were at or near the limit of quantitation. Residual CAH was detectable at 60 weeks in most individuals who initiated ART at later stages (FIV to FVI) and averaged 1.9 ± 0.7 log10 copies/million PBMCs. The modified Roche CAP/CTM assay provides a convenient, standardized approach to measure residual HIV in blood and may be useful for monitoring patients under therapy or those participating in HIV remission studies.
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Affiliation(s)
- Linda L Jagodzinski
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Mark M Manak
- U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Holly R Hack
- U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Ying Liu
- U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Jennifer A Malia
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Joanna Freeman
- U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | | | - Mark de Souza
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Eugène D Kroon
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Donn J Colby
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Nitiya Chomchey
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Michelle A Lally
- Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Nelson L Michael
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Jintanat Ananworanich
- U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
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19
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Hellmuth J, Colby D, Valcour V, Suttichom D, Spudich S, Ananworanich J, Prueksakaew P, Sailasuta N, Allen I, Jagodzinski LL, Slike B, Ochi D, Paul R. Depression and Anxiety are Common in Acute HIV Infection and Associate with Plasma Immune Activation. AIDS Behav 2017; 21:3238-3246. [PMID: 28484888 DOI: 10.1007/s10461-017-1788-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This observational study of 123 Thai participants sought to determine the rate and severity of affective symptoms during acute HIV infection (AHI) and possible associations to disease mechanisms. At diagnosis, just prior to starting combination antiretroviral therapy (cART), AHI participants completed assessments of depression and anxiety symptoms that were repeated at 4, 12, and 24 weeks. Blood markers of HIV infection and immune activation were measured at study entry, with optional cerebrospinal fluid measures. A high frequency of participants reported symptoms that exceeded published thresholds supportive of depression (55.0%) and anxiety (65.8%) at diagnosis, with significant reductions after starting cART. Meeting a threshold for clinically relevant depressive symptoms at study entry was associated with higher baseline plasma HIV RNA (5.98 vs. 5.50, t = 2.46, p = 0.015), lower CD4 counts (328 vs. 436 cells/mm3, t = 3.46, p = 0.001), and higher plasma neopterin, a marker of macrophage activation (2694 vs. 1730 pg/mL, Mann-Whitney U = 152.5, p = 0.011). Controlling for plasma HIV RNA and CD4 count, higher baseline plasma neopterin correlated with worse initial depression and anxiety scores. Depression and anxiety symptoms are frequent in acute HIV infection, associate with plasma immune activation, and can improve concurrent with cART.
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20
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Hakre S, Jagodzinski LL, Liu Y, Pham PT, Kijak GH, Tovanabutra S, McCutchan FE, Scoville SL, Cersovsky SB, Michael NL, Scott PT, Peel SA. Characteristics of HIV-infected U.S. Army soldiers linked in molecular transmission clusters, 2001-2012. PLoS One 2017; 12:e0182376. [PMID: 28759645 PMCID: PMC5536263 DOI: 10.1371/journal.pone.0182376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/17/2017] [Indexed: 11/18/2022] Open
Abstract
Objective Recent surveillance data suggests the United States (U.S.) Army HIV epidemic is concentrated among men who have sex with men. To identify potential targets for HIV prevention strategies, the relationship between demographic and clinical factors and membership within transmission clusters based on baseline pol sequences of HIV-infected Soldiers from 2001 through 2012 were analyzed. Methods We conducted a retrospective analysis of baseline partial pol sequences, demographic and clinical characteristics available for all Soldiers in active service and newly-diagnosed with HIV-1 infection from January 1, 2001 through December 31, 2012. HIV-1 subtype designations and transmission clusters were identified from phylogenetic analysis of sequences. Univariate and multivariate logistic regression models were used to evaluate and adjust for the association between characteristics and cluster membership. Results Among 518 of 995 HIV-infected Soldiers with available partial pol sequences, 29% were members of a transmission cluster. Assignment to a southern U.S. region at diagnosis and year of diagnosis were independently associated with cluster membership after adjustment for other significant characteristics (p<0.10) of age, race, year of diagnosis, region of duty assignment, sexually transmitted infections, last negative HIV test, antiretroviral therapy, and transmitted drug resistance. Subtyping of the pol fragment indicated HIV-1 subtype B infection predominated (94%) among HIV-infected Soldiers. Conclusion These findings identify areas to explore as HIV prevention targets in the U.S. Army. An increased frequency of current force testing may be justified, especially among Soldiers assigned to duty in installations with high local HIV prevalence such as southern U.S. states.
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Affiliation(s)
- Shilpa Hakre
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
- * E-mail:
| | - Linda L. Jagodzinski
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Ying Liu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Peter T. Pham
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Gustavo H. Kijak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Sodsai Tovanabutra
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Francine E. McCutchan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Stephanie L. Scoville
- U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland, United States of America
| | - Steven B. Cersovsky
- U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland, United States of America
| | - Nelson L. Michael
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Paul T. Scott
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Sheila A. Peel
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
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21
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Regules JA, Beigel JH, Paolino KM, Voell J, Castellano AR, Hu Z, Muñoz P, Moon JE, Ruck RC, Bennett JW, Twomey PS, Gutiérrez RL, Remich SA, Hack HR, Wisniewski ML, Josleyn MD, Kwilas SA, Van Deusen N, Mbaya OT, Zhou Y, Stanley DA, Jing W, Smith KS, Shi M, Ledgerwood JE, Graham BS, Sullivan NJ, Jagodzinski LL, Peel SA, Alimonti JB, Hooper JW, Silvera PM, Martin BK, Monath TP, Ramsey WJ, Link CJ, Lane HC, Michael NL, Davey RT, Thomas SJ. A Recombinant Vesicular Stomatitis Virus Ebola Vaccine. N Engl J Med 2017; 376:330-341. [PMID: 25830322 PMCID: PMC5408576 DOI: 10.1056/nejmoa1414216] [Citation(s) in RCA: 272] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The worst Ebola virus disease (EVD) outbreak in history has resulted in more than 28,000 cases and 11,000 deaths. We present the final results of two phase 1 trials of an attenuated, replication-competent, recombinant vesicular stomatitis virus (rVSV)-based vaccine candidate designed to prevent EVD. METHODS We conducted two phase 1, placebo-controlled, double-blind, dose-escalation trials of an rVSV-based vaccine candidate expressing the glycoprotein of a Zaire strain of Ebola virus (ZEBOV). A total of 39 adults at each site (78 participants in all) were consecutively enrolled into groups of 13. At each site, volunteers received one of three doses of the rVSV-ZEBOV vaccine (3 million plaque-forming units [PFU], 20 million PFU, or 100 million PFU) or placebo. Volunteers at one of the sites received a second dose at day 28. Safety and immunogenicity were assessed. RESULTS The most common adverse events were injection-site pain, fatigue, myalgia, and headache. Transient rVSV viremia was noted in all the vaccine recipients after dose 1. The rates of adverse events and viremia were lower after the second dose than after the first dose. By day 28, all the vaccine recipients had seroconversion as assessed by an enzyme-linked immunosorbent assay (ELISA) against the glycoprotein of the ZEBOV-Kikwit strain. At day 28, geometric mean titers of antibodies against ZEBOV glycoprotein were higher in the groups that received 20 million PFU or 100 million PFU than in the group that received 3 million PFU, as assessed by ELISA and by pseudovirion neutralization assay. A second dose at 28 days after dose 1 significantly increased antibody titers at day 56, but the effect was diminished at 6 months. CONCLUSIONS This Ebola vaccine candidate elicited anti-Ebola antibody responses. After vaccination, rVSV viremia occurred frequently but was transient. These results support further evaluation of the vaccine dose of 20 million PFU for preexposure prophylaxis and suggest that a second dose may boost antibody responses. (Funded by the National Institutes of Health and others; rVSV∆G-ZEBOV-GP ClinicalTrials.gov numbers, NCT02269423 and NCT02280408 .).
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Affiliation(s)
- Jason A Regules
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - John H Beigel
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Kristopher M Paolino
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Jocelyn Voell
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Amy R Castellano
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Zonghui Hu
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Paula Muñoz
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - James E Moon
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Richard C Ruck
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Jason W Bennett
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Patrick S Twomey
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Ramiro L Gutiérrez
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Shon A Remich
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Holly R Hack
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Meagan L Wisniewski
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Matthew D Josleyn
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Steven A Kwilas
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Nicole Van Deusen
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Olivier Tshiani Mbaya
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Yan Zhou
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Daphne A Stanley
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Wang Jing
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Kirsten S Smith
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Meng Shi
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Julie E Ledgerwood
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Barney S Graham
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Nancy J Sullivan
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Linda L Jagodzinski
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Sheila A Peel
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Judie B Alimonti
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Jay W Hooper
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Peter M Silvera
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Brian K Martin
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Thomas P Monath
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - W Jay Ramsey
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Charles J Link
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - H Clifford Lane
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Nelson L Michael
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Richard T Davey
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Stephen J Thomas
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
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Ndahimana JD, Riedel DJ, Mwumvaneza M, Sebuhoro D, Uwimbabazi JC, Kubwimana M, Mugabo J, Mulindabigwi A, Kirk C, Kanters S, Forrest JI, Jagodzinski LL, Peel SA, Ribakare M, Redfield RR, Nsanzimana S. Drug resistance mutations after the first 12 months on antiretroviral therapy and determinants of virological failure in Rwanda. Trop Med Int Health 2016; 21:928-35. [PMID: 27125473 DOI: 10.1111/tmi.12717] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate HIV drug resistance (HIVDR) and determinants of virological failure in a large cohort of patients receiving first-line tenofovir-based antiretroviral therapy (ART) regimens. METHODS A nationwide retrospective cohort from 42 health facilities was assessed for virological failure and development of HIVDR mutations. Data were collected at ART initiation and at 12 months of ART on patients with available HIV-1 viral load (VL) and ART adherence measurements. HIV resistance genotyping was performed on patients with VL ≥1000 copies/ml. Multiple logistic regression was used to determine factors associated with treatment failure. RESULTS Of 828 patients, 66% were women, and the median age was 37 years. Of the 597 patients from whom blood samples were collected, 86.9% were virologically suppressed, while 11.9% were not. Virological failure was strongly associated with age <25 years (adjusted odds ratio [aOR]: 6.4; 95% confidence interval [CI]: 3.2-12.9), low adherence (aOR: 2.87; 95% CI: 1.5-5.0) and baseline CD4 counts <200 cells/μl (aOR 3.4; 95% CI: 1.9-6.2). Overall, 9.1% of all patients on ART had drug resistance mutations after 1 year of ART; 27% of the patients who failed treatment had no evidence of HIVDR mutations. HIVDR mutations were not observed in patients on the recommended second-line ART regimen in Rwanda. CONCLUSIONS The last step of the UNAIDS 90-90-90 target appears within grasp, with some viral failures still due to non-adherence. Nonetheless, youth and late initiators are at higher risk of virological failure. Youth-focused programmes could help prevent further drug HIVDR development.
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Affiliation(s)
| | - David J Riedel
- Institute of Human Virology and Division of Infectious Diseases, University of Maryland, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Steve Kanters
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Global Evaluative Sciences, Vancouver, BC, Canada
| | - Jamie I Forrest
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Global Evaluative Sciences, Vancouver, BC, Canada
| | | | - Sheila A Peel
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Robert R Redfield
- Institute of Human Virology and Division of Infectious Diseases, University of Maryland, Baltimore, MD, USA
| | - Sabin Nsanzimana
- HIV/AIDS Division, Rwanda Biomedical Center, Kigali, Rwanda.,Swiss Tropical and Public Health Institute, University of Basel and Basel Institute for Clinical Epidemiology and Biostatistics, Basel, Switzerland
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23
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Hellmuth J, Fletcher JLK, Valcour V, Kroon E, Ananworanich J, Intasan J, Lerdlum S, Narvid J, Pothisri M, Allen I, Krebs SJ, Slike B, Prueksakaew P, Jagodzinski LL, Puttamaswin S, Phanuphak N, Spudich S. Neurologic signs and symptoms frequently manifest in acute HIV infection. Neurology 2016; 87:148-54. [PMID: 27287217 DOI: 10.1212/wnl.0000000000002837] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 03/01/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the incidence, timing, and severity of neurologic findings in acute HIV infection (pre-antibody seroconversion), as well as persistence with combination antiretroviral therapy (cART). METHODS Participants identified with acute HIV were enrolled, underwent structured neurologic evaluations, immediately initiated cART, and were followed with neurologic evaluations at 4 and 12 weeks. Concurrent brain MRIs and both viral and inflammatory markers in plasma and CSF were obtained. RESULTS Median estimated HIV infection duration was 19 days (range 3-56) at study entry for the 139 participants evaluated. Seventy-three participants (53%) experienced one or more neurologic findings in the 12 weeks after diagnosis, with one developing a fulminant neurologic manifestation (Guillain-Barré syndrome). A total of 245 neurologic findings were noted, reflecting cognitive symptoms (33%), motor findings (34%), and neuropathy (11%). Nearly half of the neurologic findings (n = 121, 49%) occurred at diagnosis, prior to cART initiation, and most of these (n = 110, 90%) remitted concurrent with 1 month on treatment. Only 9% of neurologic findings (n = 22) persisted at 24 weeks on cART. Nearly all neurologic findings (n = 236, 96%) were categorized as mild in severity. No structural neuroimaging abnormalities were observed. Participants with neurologic findings had a higher mean plasma log10 HIV RNA at diagnosis compared to those without neurologic findings (5.9 vs 5.4; p = 0.006). CONCLUSIONS Acute HIV infection is commonly associated with mild neurologic findings that largely remit while on treatment, and may be mediated by direct viral factors. Severe neurologic manifestations are infrequent in treated acute HIV.
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Affiliation(s)
- Joanna Hellmuth
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT.
| | - James L K Fletcher
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Victor Valcour
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Eugène Kroon
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Jintanat Ananworanich
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Jintana Intasan
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Sukalaya Lerdlum
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Jared Narvid
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Mantana Pothisri
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Isabel Allen
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Shelly J Krebs
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Bonnie Slike
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Peeriya Prueksakaew
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Linda L Jagodzinski
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Suwanna Puttamaswin
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Nittaya Phanuphak
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
| | - Serena Spudich
- From the Departments of Neurology (J.H., V.V.), Radiology (J.N.), and Epidemiology and Biostatistics (I.A.), University of California, San Francisco; SEARCH (J.L.K.F., E.K., J.I., P.P., S.P., N.P.), Thai Red Cross AIDS Research Centre, Bangkok, Thailand; US Military HIV Research Program (J.A., S.J.K., B.S., L.L.J.), Walter Reed Army Institute of Research, Silver Spring; Henry M. Jackson Foundation for the Advancement of Military Medicine (J.A., S.J.K., B.S.), Bethesda, MD; Department of Radiology (S.L., M.P.), Chulalongkorn University, Bangkok, Thailand; and Department of Neurology (S.S.), Yale University, New Haven, CT
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Robb ML, Eller LA, Kibuuka H, Rono K, Maganga L, Nitayaphan S, Kroon E, Sawe FK, Sinei S, Sriplienchan S, Jagodzinski LL, Malia J, Manak M, de Souza MS, Tovanabutra S, Sanders-Buell E, Rolland M, Dorsey-Spitz J, Eller MA, Milazzo M, Li Q, Lewandowski A, Wu H, Swann E, O'Connell RJ, Peel S, Dawson P, Kim JH, Michael NL. Prospective Study of Acute HIV-1 Infection in Adults in East Africa and Thailand. N Engl J Med 2016; 374:2120-30. [PMID: 27192360 PMCID: PMC5111628 DOI: 10.1056/nejmoa1508952] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Acute human immunodeficiency virus type 1 (HIV-1) infection is a major contributor to transmission of HIV-1. An understanding of acute HIV-1 infection may be important in the development of treatment strategies to eradicate HIV-1 or achieve a functional cure. METHODS We performed twice-weekly qualitative plasma HIV-1 RNA nucleic acid testing in 2276 volunteers who were at high risk for HIV-1 infection. For participants in whom acute HIV-1 infection was detected, clinical observations, quantitative measurements of plasma HIV-1 RNA levels (to assess viremia) and HIV antibodies, and results of immunophenotyping of lymphocytes were obtained twice weekly. RESULTS Fifty of 112 volunteers with acute HIV-1 infection had two or more blood samples collected before HIV-1 antibodies were detected. The median peak viremia (6.7 log10 copies per milliliter) occurred 13 days after the first sample showed reactivity on nucleic acid testing. Reactivity on an enzyme immunoassay occurred at a median of 14 days. The nadir of viremia (4.3 log10 copies per milliliter) occurred at a median of 31 days and was nearly equivalent to the viral-load set point, the steady-state viremia that persists durably after resolution of acute viremia (median plasma HIV-1 RNA level, 4.4 log10 copies per milliliter). The peak viremia and downslope were correlated with the viral-load set point. Clinical manifestations of acute HIV-1 infection were most common just before and at the time of peak viremia. A median of one symptom of acute HIV-1 infection was recorded at a median of two study visits, and a median of one sign of acute HIV-1 infection was recorded at a median of three visits. CONCLUSIONS The viral-load set point occurred at a median of 31 days after the first detection of plasma viremia and correlated with peak viremia. Few symptoms and signs were observed during acute HIV-1 infection, and they were most common before peak viremia. (Funded by the Department of Defense and the National Institute of Allergy and Infectious Diseases.).
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Affiliation(s)
- Merlin L Robb
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Leigh A Eller
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Hannah Kibuuka
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Kathleen Rono
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Lucas Maganga
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Sorachai Nitayaphan
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Eugene Kroon
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Fred K Sawe
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Samuel Sinei
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Somchai Sriplienchan
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Linda L Jagodzinski
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Jennifer Malia
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Mark Manak
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Mark S de Souza
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Sodsai Tovanabutra
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Eric Sanders-Buell
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Morgane Rolland
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Julie Dorsey-Spitz
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Michael A Eller
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Mark Milazzo
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Qun Li
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Andrew Lewandowski
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Hao Wu
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Edith Swann
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Robert J O'Connell
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Sheila Peel
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Peter Dawson
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Jerome H Kim
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
| | - Nelson L Michael
- From the U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring (M.L.R., L.A.E., L.L.J., J.M., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L., S.P., J.H.K., N.L.M.), Henry M. Jackson Foundation for the Advancement of Military Medicine (M.L.R., L.A.E., M. Manak, S.T., E.S.-B., M.R., J.D.-S., M.A.E., M. Milazzo, Q.L.), the Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (E.S.), Bethesda, and Emmes, Rockville (A.L., H.W., P.D.) - all in Maryland; Makerere University Walter Reed Project, Kampala, Uganda (H.K.); Walter Reed Project, Kericho, Kenya (K.R., F.K.S., S. Sinei); Mbeya Medical Research Centre, Mbeya, Tanzania (L.M.); the Armed Forces Research Institute of Medical Sciences (S.N., E.K., S. Sriplienchan, M.S.S., R.J.O.) and SEARCH, Thai Red Cross AIDS Research Center (E.K., M.S.S.) - both in Bangkok, Thailand; and the International Vaccine Institute, Seoul, South Korea (J.H.K.)
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O'Connell RJ, Excler JL, Polonis VR, Ratto-Kim S, Cox J, Jagodzinski LL, Liu M, Wieczorek L, McNeil JG, El-Habib R, Michael NL, Gilliam BL, Paris R, VanCott TC, Tomaras GD, Birx DL, Robb ML, Kim JH. Safety and Immunogenicity of a Randomized Phase 1 Prime-Boost Trial With ALVAC-HIV (vCP205) and Oligomeric Glycoprotein 160 From HIV-1 Strains MN and LAI-2 Adjuvanted in Alum or Polyphosphazene. J Infect Dis 2016; 213:1946-54. [PMID: 26908741 DOI: 10.1093/infdis/jiw059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 02/03/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Prime-boost regimens comprising ALVAC-HIV (prime) and human immunodeficiency virus type 1 (HIV) Env (boost) induce HIV-specific neutralizing antibody and cell-mediated immune responses, but the impact of boost schedule and adjuvant requires further definition. METHODS A phase 1 trial was conducted. In part A (open label), 19 volunteers received oligomeric glycoprotein 160 from HIV strains MN and LAI-2 (ogp160 MN/LAI-2) with dose escalation (25, 50, 100 μg) and either polyphosphazene (pP) or alum adjuvant. In part B, 72 volunteers received either placebo (n=12) or recombinant canarypox virus expressing HIV antigens (ALVAC-HIV [vCP205]) with different doses and schedules of ogp160 MN/LAI-2 in pP or alum (n = 60). RESULTS The vaccines were safe and well tolerated, with no vaccine-related serious adverse events. Anti-gp70 V1V2 antibody responses were detected in 17 of 19 part A volunteers (89%) and 10%-100% of part B volunteers. Use of a peripheral blood mononuclear cell-based assay revealed that US-1 primary isolate neutralization was induced in 2 of 19 recipients of ogp160 protein alone (10.5%) and 5 of 49 prime-boost volunteers (10.2%). Among ogp160 recipients, those who received pP were more likely than those who received alum to have serum that neutralized tier 2 viruses (12% vs 0%; P = .015). CONCLUSIONS Administration of ogp160 with pP induces primary isolate tier 2 neutralizing antibody responses in a small percentage of volunteers, demonstrating proof of concept and underscoring the importance of further optimization of prime-boost strategies for HIV infection prevention. CLINICAL TRIALS REGISTRATION NCT00004579.
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Affiliation(s)
- Robert J O'Connell
- Department of Retrovirology, US Army Medical Directorate, Armed Forces Institute of Medical Sciences, Bangkok, Thailand
| | - Jean-Louis Excler
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda US Military HIV Research Program
| | | | | | - Josephine Cox
- International AIDS Vaccine Initiative, New York, New York
| | | | - Michelle Liu
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda US Military HIV Research Program
| | | | | | | | | | - Bruce L Gilliam
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore
| | - Robert Paris
- US Military Malaria Research Program, Walter Reed Army Institute of Research, Silver Spring
| | | | | | | | - Merlin L Robb
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda US Military HIV Research Program
| | - Jerome H Kim
- US Military HIV Research Program International Vaccine Institute, Seoul, Republic of Korea
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Ndahimana JD, Riedel DJ, Muhayimpundu R, Nsanzimana S, Niyibizi G, Mutaganzwa E, Mulindabigwi A, Baribwira C, Kiromera A, Jagodzinski LL, Peel SA, Redfield RR. HIV drug resistance mutations among patients failing second-line antiretroviral therapy in Rwanda. Antivir Ther 2015; 21:253-9. [PMID: 26562173 DOI: 10.3851/imp3005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Studies of patients failing second-line antiretroviral therapy (ART) in resource-limited settings (RLS) are few. Evidence suggests most patients who appear to be virologically failing do so not due to drug resistance but to poor adherence, which, if properly addressed, could allow continued use of less expensive first- and second-line regimens. Drug resistant mutations (DRMs) were characterized among patients virologically failing second-line ART in Rwanda. METHODS A total of 128 adult patients receiving second-line ART for at least 6 months were invited to participate; 74 agreed and had HIV-1 viral load (VL) measured. Resistance genotypes were conducted in patients with virological failure (VF; that is, VL ≥1,000 copies/ml). RESULTS In total, 35 patients met the criteria for VF. The median time on lopinavir/ritonavir-based second-line ART was 2.7 years. Of 30 successful resistance genotype analyses, 13 (43%) had ≥1 nucleoside reverse transcriptase inhibitor (NRTI) mutation, 18 (60%) had at least 1 non-NRTI mutation and 5 (17%) had at least 1 major protease inhibitor mutation. Eleven (37%) had virus without significant mutations that would be fully sensitive to first-line ART; 12 (40%) had DRM to first-line ART but sensitive to second-line ART. Only 7 patients (23%) demonstrated a DRM profile requiring third-line ART. CONCLUSIONS Among 30 genotyped samples of patients with VF on second-line ART, more than one-third had no significant DRMs, implicating poor adherence as the primary cause of VF. The majority of patients (77%) would not have required third-line ART. These findings reinforce the need for intensive adherence assessment and counselling for patients who appear to be failing second-line ART in RLS.
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Pacha LA, Hakre S, Myles O, Sanders-Buell EE, Scoville SL, Kijak GH, Price MW, Mody RM, Liu Y, Miller SL, Pham PT, Michael NL, Kim JH, Peel SA, Tovanabutra S, Jagodzinski LL, Cersovsky SB, Scott PT. Centralized HIV Program Oversight: An Investigation of a Case Series of New HIV Infections among US Army Soldiers, 2012 to 2013. Medicine (Baltimore) 2015; 94:e2093. [PMID: 26579822 PMCID: PMC4652831 DOI: 10.1097/md.0000000000002093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/16/2015] [Accepted: 10/01/2015] [Indexed: 11/29/2022] Open
Abstract
Centralized HIV program oversight and repeal of the Department of Defense policy "Don't Ask Don't Tell" permitted characterization of HIV transmission among soldiers assigned to a large US Army base continental United States from 2012 to 2013. An investigation of a greater than expected number of new HIV infections among soldiers was initiated to characterize transmission and identify opportunities to disrupt transmission and deliver services.All soldiers who were assigned to the base at the time of their first positive HIV test and who had their first positive HIV test in 2012 or in the first 6 months of 2013 and who had a clinical genotype available for analysis were eligible for inclusion in the investigation.All patients (n = 19) were men; most were black (52%) and less than 30 years old (64%). Fifteen of the 19 patients participated in in-depth interviews. Eighty percent were men who have sex with men who reported multiple sex partners having met through social and electronic networks. All were subtype B infections. Significant knowledge gaps and barriers to accessing testing and care in the military healthcare system were identified. Most (58%) belonged to transmission networks involving other soldiers.This investigation represents an important step forward in on-going efforts to develop a comprehensive understanding of transmission networks in the Army that can inform delivery of best practices combination prevention services. The Army is developing plans to directly engage individuals in key affected populations most at risk for HIV infection to identify and address unmet needs and expand delivery and uptake of prevention services. Further investigation is underway and will determine whether these findings are generalizable to the Army.
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Affiliation(s)
- Laura A Pacha
- U.S. Army Public Health Command, Aberdeen Proving Ground (LAP, SLS, SBC); U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD (SH, OM, EES-B, GHK, YL, SLM, PTP, ST), U.S. Army Medical Command, San Antonio, TX (MWP, RMM); and U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD (NLM, JHK, SAP, LLJ, PTS)
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Crowell T, Fletcher JL, Kroon E, Pinyakorn S, Schuetz A, Sereti I, Krebs SJ, Slike BM, Chomont N, Jagodzinski LL, Sandler N, Dewar R, Rerknimitr R, Rattanamanee S, Trichavaroj R, Valcour VG, Spudich S, Robb ML, Kim JH, Michael NL, Phanuphak N, Ananworanich J. 641Acute Retroviral Syndrome is Associated with Gut Mucosal CD4 Depletion, Inflammation and High Viral and Proviral Burden in Systemic and Tissue Compartments. Open Forum Infect Dis 2014. [PMCID: PMC5781688 DOI: 10.1093/ofid/ofu051.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Trevor Crowell
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | | | - Eugene Kroon
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Department of Retrovirology, Armed Forces Research Institute of Medical Sciences – United States Component, Bangkok, Thailand
| | | | - Alexandra Schuetz
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
- Department of Retrovirology, Armed Forces Research Institute of Medical Sciences – United States Component, Bangkok, Thailand
| | - Irini Sereti
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Shelly J. Krebs
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Bonnie M. Slike
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Nicolas Chomont
- Vaccine and Gene Therapy Institute of Florida, Port St. Lucie, FL
| | - Linda L. Jagodzinski
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Netanya Sandler
- Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX
| | - Robin Dewar
- Virus Isolation and Serological Lab, National Cancer Institute at Frederick, Frederick, MD
| | - Rungsun Rerknimitr
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Rapee Trichavaroj
- Department of Retrovirology, Armed Forces Research Institute of Medical Sciences – United States Component, Bangkok, Thailand
| | - Victor G. Valcour
- Department of Neurology, University of California San Francisco School of Medicine, San Francisco, CA
| | - Serena Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, CT
| | - Merlin L. Robb
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Jerome H. Kim
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Nelson L. Michael
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
| | | | - Jintanat Ananworanich
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
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Chun HM, Mesner O, Thio CL, Bebu I, Macalino G, Agan BK, Bradley WP, Malia J, Peel SA, Jagodzinski LL, Weintrob AC, Ganesan A, Bavaro M, Maguire JD, Landrum ML. HIV outcomes in Hepatitis B virus coinfected individuals on HAART. J Acquir Immune Defic Syndr 2014; 66:197-205. [PMID: 24694929 PMCID: PMC4034265 DOI: 10.1097/qai.0000000000000142] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Understanding the impact of hepatitis B virus (HBV) coinfection on HIV outcomes in the highly active antiretroviral therapy (HAART) era continues to be a critical priority given the high prevalence of coinfection and the potential for impaired immunologic, virologic, and clinical recovery. METHODS Participants from the US Military HIV Natural History Study with an HIV diagnosis on HAART and serologically confirmed HBV infection status at HAART initiation (HI) were classified into 4 HBV infection (HB) groups. HIV virologic, immunologic, and clinical outcomes were evaluated by HB status. RESULTS Of 2536 HIV-positive HAART recipients, with HBV testing results available to determine HB status in the HI window, HB status at HI was classified as HB negative (n = 1505; 66%), resolved HB (n = 518; 23%), isolated hepatitis B core antigen (n = 139; 6%), or chronic HB (n = 131; 6%). HIV virologic suppression and failure at 6 months or 1 year were not significantly different by HB status. A significantly faster rate of increase in CD4 cell count during the period between 4 and 12 years was observed for chronic HB relative to HB negative. Chronic and resolved HB were associated with an increased risk of AIDS/death compared with HB-negative individuals (chronic HB-hazard ratio = 1.68, 95% confidence interval: 1.05 to 2.68; resolved HB-hazard ratio = 1.61, 95% confidence interval: 1.15 to 2.25). CONCLUSIONS HB status did not have a significant impact on HIV virologic outcomes, however, CD4 cell count reconstitution after HI and the risk of an AIDS event or death after HI may be associated with HB status.
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Affiliation(s)
- Helen M. Chun
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Octavio Mesner
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Chloe L. Thio
- Division of Infectious Diseases, Johns Hopkins University, United States of America
| | - Ionut Bebu
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Grace Macalino
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Brian K. Agan
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - William P. Bradley
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Jennifer Malia
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- US Military HIV Research Program, Walter Reed Army Institute of Research, United States of America
| | - Sheila A. Peel
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- US Military HIV Research Program, Walter Reed Army Institute of Research, United States of America
| | - Linda L. Jagodzinski
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- US Military HIV Research Program, Walter Reed Army Institute of Research, United States of America
| | - Amy C. Weintrob
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Mary Bavaro
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Infectious Disease Clinic, Naval Medical Center, San Diego, California, United States of America
| | - Jason D. Maguire
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Division of Infectious Diseases, Naval Medical Center, Portsmouth, Virginia, United States of America
| | - Michael L. Landrum
- Bellin Health Green Bay and Clinica Hispana, Green Bay WI, United States of America
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Beck Z, Jagodzinski LL, Eller MA, Thelian D, Matyas GR, Kunz AN, Alving CR. Platelets and erythrocyte-bound platelets bind infectious HIV-1 in plasma of chronically infected patients. PLoS One 2013; 8:e81002. [PMID: 24282562 PMCID: PMC3839895 DOI: 10.1371/journal.pone.0081002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 10/08/2013] [Indexed: 01/24/2023] Open
Abstract
Chronic HIV-1 infection is associated with persistent viremia in most patients, but it remains unclear how free virus may survive the potential hostile effects of plasma. We investigated whether sites might exist on the surfaces of circulating blood cells for protection of infectious HIV-1 particles. Red blood cells (RBC) either from blood of uninfected normal individuals, or from blood obtained without EDTA from chronically infected HIV-1 patients, invariably contained a small number of RBC having attached platelets as determined by flow cytometry, light microscopy, and immunofluorescence microscopy. After mixing normal RBC with platelet-rich plasma, discrete populations of RBC, platelets, and complexes of platelets attached to RBC were purified by fluorescence-activated cell sorting. Upon incubation of purified cells or platelets with HIV-1 followed by washing and co-incubation with CD4-positive peripheral blood mononuclear cells (PBMC), platelets, and platelet-RBC complexes, but not platelet-free RBC, caused infection of PBMC. Infection was prevented by pre-treating the platelet-RBC complexes with EDTA. Plasma and RBC (comprising a RBC/platelet-RBC mixture) from chronically infected patients with low viral loads were also co-incubated with PBMC ex vivo to determine the presence of infectious HIV-1. All freshly isolated plasmas from the HIV-1-infected donors, obtained in the absence of anticoagulant, were noninfectious. Interestingly, the RBC from most of the patients caused cell-cell infection of PBMC that was prevented by stripping the RBC with EDTA. A monoclonal antibody to DC-SIGN partially inhibited cell-cell HIV-1 infection of PBMC by normal RBC pre-incubated with platelets and HIV-1. We conclude: (a) platelet-free EDTA-free plasma from chronically infected HIV-1 patients, although containing viral RNA, is an environment that lacks detectable infectious HIV-1; (b) platelets and platelet-RBC complexes, but not purified RBC, bind infectious HIV-1; (c) DC-SIGN, and possibly other C-type lectins, may represent binding sites for infectious HIV-1 on platelets and platelet-RBC complexes.
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Affiliation(s)
- Zoltan Beck
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Silver Spring, Maryland, United States of America
| | - Linda L. Jagodzinski
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Michael A. Eller
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Silver Spring, Maryland, United States of America
| | - Doris Thelian
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Silver Spring, Maryland, United States of America
| | - Gary R. Matyas
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Anjali N. Kunz
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Carl R. Alving
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
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Heipertz RA, Sanders-Buell E, Kijak G, Howell S, Lazzaro M, Jagodzinski LL, Eggleston J, Peel S, Malia J, Armstrong A, Michael NL, Kim JH, O'Connell RJ, Scott PT, Brett-Major DM, Tovanabutra S. Molecular epidemiology of early and acute HIV type 1 infections in the United States Navy and Marine Corps, 2005-2010. AIDS Res Hum Retroviruses 2013; 29:1310-20. [PMID: 23972100 DOI: 10.1089/aid.2013.0087] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The U.S. military represents a unique population within the human immunodeficiency virus 1 (HIV-1) pandemic. The last comprehensive study of HIV-1 in members of the U.S. Navy and Marine Corps (Sea Services) was completed in 2000, before large-scale combat operations were taking place. Here, we present molecular characterization of HIV-1 from 40 Sea Services personnel who were identified during their seroconversion window and initially classified as HIV-1 negative during screening. Protease/reverse transcriptase (pro/rt) and envelope (env) sequences were obtained from each member of the cohort. Phylogenetic analyses were carried out on these regions to determine relatedness within the cohort and calculate the most recent common ancestor for the related sequences. We identified 39 individuals infected with subtype B and one infected with CRF01_AE. Comparison of the pairwise genetic distance of Sea Service sequences and reference sequences in the env and pro/rt regions showed that five samples were part of molecular clusters, a group of two and a group of three, confirmed by single genome amplification. Real-time molecular monitoring of new HIV-1 acquisitions in the Sea Services may have a role in facilitating public health interventions at sites where related HIV-1 infections are identified.
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Affiliation(s)
- Richard A. Heipertz
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Eric Sanders-Buell
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
| | - Gustavo Kijak
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
| | - Shana Howell
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
| | - Michelle Lazzaro
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
| | - Linda L. Jagodzinski
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - John Eggleston
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
| | - Sheila Peel
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Jennifer Malia
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
- United States Public Health Service, Rockville, Maryland
| | - Adam Armstrong
- Navy Bloodborne Infection Management Center, Navy Marine Corps Public Health Center, Bethesda, Maryland
| | - Nelson L. Michael
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Jerome H. Kim
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Robert J. O'Connell
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Paul T. Scott
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - David M. Brett-Major
- Naval Medical Research Center, Silver Spring, Maryland
- Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, Maryland
| | - Sodsai Tovanabutra
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
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Hakre S, Manak MM, Murray CK, Davis KW, Bose M, Harding AJ, Maas PR, Jagodzinski LL, Kim JH, Michael NL, Rentas FJ, Peel SA, Scott PT, Tovanabutra S. Transfusion-transmitted human T-lymphotropic virus Type I infection in a United States military emergency whole blood transfusion recipient in Afghanistan, 2010. Transfusion 2013; 53:2176-82. [PMID: 23362944 DOI: 10.1111/trf.12101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 11/19/2012] [Accepted: 11/26/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND The United States introduced human T-lymphotropic virus Type I (HTLV-I) screening of blood donors in 1988. The US military uses freshly collected blood products for life-threatening injuries when available stored blood components in theater have been exhausted or when these components are unsuccessful for resuscitation. These donors are screened after donation by the Department of Defense (DoD) retrospective testing program. All recipients of blood collected in combat are tested according to policy soon after and at 3, 6, and 12 months after transfusion. CASE REPORT A 31-year-old US Army soldier tested positive for HTLV-I 44 days after receipt of emergency blood transfusions for severe improvised explosive device blast injuries. One donor's unit tested HTLV-I positive on the DoD-mandated retrospective testing. Both the donor and the recipient tested reactive with enzyme immunoassay and supplemental confirmation by HTLV-I Western blot. The donor and recipient reported no major risk factors for HTLV-I. Phylogenetic analysis of HTLV-I sequences indicated Cosmopolitan subtype, Subgroup B infections. Comparison of long terminal repeat and env sequences revealed molecular genetic linkage of the viruses from the donor and recipient. CONCLUSION This case is the first report of transfusion transmission of HTLV-I in the US military during combat operations. The emergency fresh whole blood policy enabled both the donor and the recipient to be notified of their HTLV-I infection. While difficult in combat, predonation screening of potential emergency blood donors with Food and Drug Administration-mandated infectious disease testing as stated by the DoD Health Affairs policy should be the goal of every facility engaged with emergency blood collection in theater.
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Affiliation(s)
- Shilpa Hakre
- Armed Services Blood Program Office, Falls Church, Virginia; San Antonio Military Medical Center, San Antonio, Texas; United States Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland; United States Military HIV Research Program, Walter Reed Army Institute of Research, Rockville, Maryland
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O'Connell RJ, Polonis VR, Ratto-Kim S, Cox J, Jagodzinski LL, Malia J, Michael NL, Excler J, Robb ML, Kim JH. Safety and immunogenicity of a randomized phase I prime-boost trial with ALVAC-HIV (vCP205) and gp160 MN/LAI-2 adjuvanted in alum or polyphosphazene. Retrovirology 2012. [PMCID: PMC3441772 DOI: 10.1186/1742-4690-9-s2-o50] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Todd CS, Nasir A, Mansoor GF, Sahibzada SM, Jagodzinski LL, Salimi F, Khateri MN, Hale BR, Barthel RV, Scott PT. Cross-sectional assessment of prevalence and correlates of blood-borne and sexually-transmitted infections among Afghan National Army recruits. BMC Infect Dis 2012; 12:196. [PMID: 22909128 PMCID: PMC3482585 DOI: 10.1186/1471-2334-12-196] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 08/03/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Few data are available in Afghanistan to shape national military force health practices, particularly with regard to sexually-transmitted infections (STIs). We measured prevalence and correlates of HIV, syphilis, herpes simplex 2 virus (HSV-2), and hepatitis C virus (HCV) among Afghan National Army (ANA) recruits. METHODS A cross-sectional sample of male ANA recruits aged 18-35 years were randomly selected at the Kabul Military Training Center between February 2010 and January 2011. Participants completed an interviewer-administered questionnaire and serum-based rapid testing for syphilis and hepatitis C virus antibody on-site; HIV and HSV-2 screening, and confirmatory testing were performed off-site. Prevalence of each infection was calculated and logistic regression analysis performed to identify correlates. RESULTS Of 5313 recruits approached, 4750 consented to participation. Participants had a mean age of 21.8 years (SD±3.8), 65.5% had lived outside Afghanistan, and 44.3% had no formal education. Few reported prior marijuana (16.3%), alcohol (5.3%), or opiate (3.4%) use. Of sexually active recruits (58.7%, N = 2786), 21.3% reported paying women for sex and 21.3% reported sex with males. Prevalence of HIV (0.063%, 95% CI: 0.013- 0.19), syphilis (0.65%, 95% CI: 0.44 - 0.93), and HCV (0.82%, 95% CI: 0.58 - 1.12) were quite low. Prevalence of HSV-2 was 3.03% (95% CI: 2.56 - 3.57), which was independently associated with age (Adjusted Odds Ratio (AOR) = 1.04, 95% CI: 1.00 - 1.09) and having a television (socioeconomic marker) (AOR = 1.46, 95% CI: 1.03 - 2.05). CONCLUSION Though prevalence of HIV, HCV, syphilis, and HSV-2 was low, sexual risk behaviors and intoxicant use were present among a substantial minority, indicating need for prevention programming. Formative work is needed to determine a culturally appropriate approach for prevention programming to reduce STI risk among Afghan National Army troops.
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Affiliation(s)
- Catherine S Todd
- Department of Obstetrics & Gynecology, Columbia University, 622 West 168th Street PH 16-69, New York, NY 10032, USA.
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Hakre S, Upshaw-Combs DR, Sanders-Buell EE, Scoville SL, Kuper JD, Jagodzinski LL, Bradfield AN, Davison DC, Callis WG, Owens AB, Michael NL, O'Connell RJ, Peel SA, Gardner JW, Thompson ND, Hu DJ, Kim JH, Tovanabutra S, Scott PT, LaFon SG. An Investigation of Bloodborne Pathogen Transmission Due to Multipatient Sharing of Insulin Pens. Mil Med 2012; 177:930-8. [DOI: 10.7205/milmed-d-11-00458] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Chun HM, Roediger MP, Hullsiek KH, Thio CL, Agan BK, Bradley WP, Peel SA, Jagodzinski LL, Weintrob AC, Ganesan A, Wortmann G, Crum-Cianflone NF, Maguire JD, Landrum ML. Hepatitis B virus coinfection negatively impacts HIV outcomes in HIV seroconverters. J Infect Dis 2012; 205:185-93. [PMID: 22147794 PMCID: PMC3244364 DOI: 10.1093/infdis/jir720] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 07/18/2011] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Understanding the impact of hepatitis B virus (HBV) in human immunodeficiency virus (HIV) coinfection has been limited by heterogeneity of HIV disease. We evaluated HBV coinfection and HIV-related disease progression in a cohort of HIV seroconverters. METHODS Participants with HIV diagnosis seroconversion window of ≤ 3 years and serologically confirmed HBV infection (HB) status were classified at baseline into 4 HB groups. The risk of clinical AIDS/death in HIV seroconverters was calculated by HB status. RESULTS Of 2352 HIV seroconverters, 474 (20%) had resolved HB, 82 (3%) had isolated total antibody to hepatitis B core antigen (HBcAb), and 64 (3%) had chronic HB. Unadjusted rates (95% confidence intervals [CIs]) of clinical AIDS/death for the HB-negative, resolved HB, isolated HBcAb, and chronic HB groups were 2.43 (2.15-2.71); 3.27 (2.71-3.84); 3.75 (2.25-5.25); and 5.41 (3.41-7.42), respectively. The multivariable risk of clinical AIDS/death was significantly higher in the chronic HB group compared to the HB-negative group (hazard ratio [HR], 1.80; 95% CI, 1.20-2.69); while the HRs were increased but nonsignificant for those with resolved HB (HR, 1.17; 95% CI, .94-1.46) and isolated HBcAb (HR, 1.14; 95% CI, .75-1.75). CONCLUSIONS HBV coinfection has a significant impact on HIV outcomes. The hazard for an AIDS or death event is almost double for those with chronic HB compared, with HIV-monoinfected persons.
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Affiliation(s)
- Helen M. Chun
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center
| | - Mollie P. Roediger
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Division of Biostatistics, University of Minnesota, Minneapolis
| | - Katherine Huppler Hullsiek
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Division of Biostatistics, University of Minnesota, Minneapolis
| | - Chloe L. Thio
- Division of Infectious Diseases, Johns Hopkins University, Baltimore
| | - Brian K. Agan
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
| | - William P. Bradley
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
| | - Sheila A. Peel
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Division of Retrovirology, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Linda L. Jagodzinski
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Division of Retrovirology, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Amy C. Weintrob
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Infectious Disease Service, Walter Reed Army Medical Center, Washington, DC
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Division of Infectious Diseases, National Naval Medical Center, Bethesda
| | - Glenn Wortmann
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Infectious Disease Service, Walter Reed Army Medical Center, Washington, DC
| | - Nancy F. Crum-Cianflone
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Infectious Disease Clinic, Naval Medical Center, San Diego, California
| | - Jason D. Maguire
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Division of Infectious Diseases, Naval Medical Center, Portsmouth, Virginia
| | - Michael L. Landrum
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
- Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, Texas
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Cox JH, Ferrari MG, Earl P, Lane JR, Jagodzinski LL, Polonis VR, Kuta EG, Boyer JD, Ratto-Kim S, Eller LA, Pham DT, Hart L, Montefiori D, Ferrari G, Parrish S, Weiner DB, Moss B, Kim JH, Birx D, VanCott TC. Inclusion of a CRF01_AE HIV envelope protein boost with a DNA/MVA prime-boost vaccine: Impact on humoral and cellular immunogenicity and viral load reduction after SHIV-E challenge. Vaccine 2012; 30:1830-40. [PMID: 22234262 DOI: 10.1016/j.vaccine.2011.12.131] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 12/21/2011] [Accepted: 12/28/2011] [Indexed: 01/13/2023]
Abstract
The current study assessed the immunogenicity and protective efficacy of various prime-boost vaccine regimens in rhesus macaques using combinations of recombinant DNA (rDNA), recombinant MVA (rMVA), and subunit gp140 protein. The rDNA and rMVA vectors were constructed to express Env from HIV-1 subtype CRF01_AE and Gag-Pol from CRF01_AE or SIVmac 239. One of the rMVAs, MVA/CMDR, has been recently tested in humans. Immunizations were administered at months 0 and 1 (prime) and months 3 and 6 (boost). After priming, HIV env-specific serum IgG was detected in monkeys receiving gp140 alone or rMVA but not in those receiving rDNA. Titers were enhanced in these groups after boosting either with gp140 alone or with rMVA plus gp140. The groups that received the rDNA prime developed env-specific IgG after boosting with rMVA with or without gp140. HIV Env-specific serum IgG binding antibodies were elicited more frequently and of higher titer, and breadth of neutralizing antibodies was increased with the inclusion of the subunit Env boost. T cell responses were measured by tetramer binding to Gag p11c in Mamu-A*01 macaques, and by IFN-γ ELISPOT assay to SIV-Gag. T cell responses were induced after vaccination with the highest responses seen in macaques immunized with rDNA and rMVA. Macaques were challenged intravenously with a novel SHIV-E virus (SIVmac239 Gag-Pol with an HIV-1 subtype E-Env CAR402). Post challenge with SHIV-E, antibody titers were boosted in all groups and peaked at 4 weeks. Robust T cell responses were seen in all groups post challenge and in macaques immunized with rDNA and rMVA a clear boosting of responses was seen. A greater than two-log drop in RNA copies/ml at peak viremia and earlier set point was achieved in macaques primed with rDNA, and boosted with rMVA/SHIV-AE plus gp140. Post challenge viremia in macaques immunized with other regimens was not significantly different to that of controls. These results demonstrate that a gp140 subunit and inclusion of SIV Gag-Pol may be critical for control of SHIV post challenge.
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Hakre S, Peel SA, O'Connell RJ, Sanders-Buell EE, Jagodzinski LL, Eggleston JC, Myles O, Waterman PE, McBride RH, Eader SA, Davis KW, Rentas FJ, Sateren WB, Naito NA, Tobler SK, Tovanabutra S, Petruccelli BP, McCutchan FE, Michael NL, Cersovsky SB, Scott PT. Transfusion-transmissible viral infections among US military recipients of whole blood and platelets during Operation Enduring Freedom and Operation Iraqi Freedom. Transfusion 2010; 51:473-85. [PMID: 20946199 DOI: 10.1111/j.1537-2995.2010.02906.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Current US military clinical practice guidelines permit emergency transfusions of non-Food and Drug Administration (FDA)-compliant freshly collected blood products in theaters of war. This investigation aimed to characterize the risks of transfusion-transmitted infections (TTIs) associated with battlefield transfusions of non-FDA-compliant blood products. STUDY DESIGN AND METHODS US Service members who received emergency transfusion products in Iraq and Afghanistan (March 1, 2002-September 30, 2007) were tested for hepatitis C virus (HCV), human immunodeficiency virus (HIV), and hepatitis B virus (HBV) infections using reposed pre- and posttransfusion sera. Selected regions of viral genomes from epidemiologically linked infected recipients and their donors were sequenced and compared. RESULTS Of 761 US Service members who received emergency transfusion products, 475 were tested for HCV, 472 for HIV, and 469 for HBV. One transfusion-transmitted HCV infection (incidence rate of 2.1/1000 persons) was identified. The pretransfusion numbers (prevalence per 1000 persons) were HCV-four (8/1000), HIV-zero (0/1000), chronic HBV-two (4 /1000), and naturally immune (antibody to HBV core antigen)-nine (19/1000). CONCLUSION One HCV TTI was determined to be associated with emergency blood product use. The pretransfusion HCV and HBV prevalence in transfusion recipients, themselves members of the potential donor population, indicates better characterization of the deployed force's actual donor population, and further investigations of the TTI prevalence in these donors are needed. These data will inform countermeasure development and clinical decision making.
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Affiliation(s)
- Shilpa Hakre
- Armed Services Blood Program Office and the United States Army Blood Program, Falls Church, Virginia, USA.
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39
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Lloyd B, O'Connell RJ, Michael NL, Aviles R, Palou E, Hernandez R, Cooley J, Jagodzinski LL. Prevalence of resistance mutations in HIV-1-Infected Hondurans at the beginning of the National Antiretroviral Therapy Program. AIDS Res Hum Retroviruses 2008; 24:529-35. [PMID: 18366313 DOI: 10.1089/aid.2007.0172] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Honduran Ministry of Health (MOH) HIV antiretroviral treatment program began widespread treatment in 2003. We investigated the prevalence of antiretroviral genotypic resistance in specimens collected and archived from HIV-1-infected antiretroviral-naive patients presenting to initiate treatment between 1 July, 2002 and 30 June, 2003 in San Pedro Sula and Tegucigalpa, Honduras. Of 416 specimens collected, 336 (80.8%) were successfully genotyped. All genotypes were HIV-1, group M and 99.1% were subtype B. The prevalence of nucleoside reverse transcriptase inhibitor mutations was 7.7% with M184V and T215F/Y present in 6.0% and 3.0%, respectively. The prevalence of nonnucleoside reverse transcriptase inhibitor mutations was 7.1%. K103N mutations were present in 3.0% of study specimens. The prevalence of major protease inhibitor mutations was 2.7%. Overall, 9.2% of the specimens harbored clinically significant mutations that predict at least intermediate resistance to the Honduran first-line antiretroviral medications. These mutations were more common in San Pedro Sula (14.0%) than in Tegucigalpa (6.5%, p = 0.02). A significant number of patients presenting to initiate antiretroviral therapy in Honduran MOH clinics harbored HIV-1 isolates resistant to the MOH's first-line regimen and resistance varied by region. Further studies to assess the impact of the Honduran antiretroviral program on genotypic resistance are warranted.
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Affiliation(s)
- Bradley Lloyd
- Department of Infectious Disease, Wilford Hall Medical Center, Lackland AFB, Texas 78236
| | - Robert J. O'Connell
- Division of Retrovirology, Walter Reed Army Institute of Research, Rockville, Maryland 20850
| | - Nelson L. Michael
- Division of Retrovirology, Walter Reed Army Institute of Research, Rockville, Maryland 20850
| | | | - Elsa Palou
- Instituto Nacional Del Tórax, Tegucigalpa, Honduras
| | | | - John Cooley
- Henry M. Jackson Foundation, Rockville, Maryland 20850
| | - Linda L. Jagodzinski
- Division of Retrovirology, Walter Reed Army Institute of Research, Rockville, Maryland 20850
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40
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Salazar JC, Rathi A, Michael NL, Radolf JD, Jagodzinski LL. Assessment of the kinetics of Treponema pallidum dissemination into blood and tissues in experimental syphilis by real-time quantitative PCR. Infect Immun 2007; 75:2954-8. [PMID: 17438037 PMCID: PMC1932886 DOI: 10.1128/iai.00090-07] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Little is known about the size and kinetics of treponemal burdens in blood and tissues during acquired or experimental syphilitic infection. We used real-time quantitative PCR to measure Treponema pallidum DNA levels in rabbits infected intratesticularly with the prototype Nichols strain. At the outset, we performed a series of in vitro blood spiking experiments to determine the effect of blood processing procedures on the distribution of treponemes in various blood components. T. pallidum DNA levels in plasma and whole blood were approximately 10-fold higher than those in serum and more than 200-fold greater than those in peripheral blood mononuclear cells (PBMCs). Ten rabbits were inoculated intratesticularly with doses of treponemes ranging from 4 x 10(7) to 2 x 10(8) organisms. In five rabbits, T. pallidum DNA levels were measured sequentially in serum, plasma, whole blood, and PBMCs until sacrifice at peak orchitis, at which time brain, kidney, liver, spleen, and testicles were harvested; blood and organs were also harvested at orchitis from the other five rabbits. T. pallidum DNA was detected in plasma within 24 h postinfection. Treponeme levels in whole blood and blood components increased significantly with the development of peak orchitis. Overall, levels in serum and PBMCs were lower than those in plasma and whole blood; this disparity was particularly marked at early time points. Significantly greater numbers of spirochetes were found in the spleen than in liver, kidney, or brain tissue at the time of sacrifice. Our findings highlight the remarkable capacity of T. pallidum to disseminate from the site of infection to blood and tissues, and they identify the spleen as a prime target for treponemal invasion.
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Affiliation(s)
- Juan C Salazar
- Walter Reed Army Institute of Research, 1600 East Gude Drive, Rockville, MD 20850, USA
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41
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Ratto-Kim S, Garner RP, Kim JH, Jagodzinski LL, Michael NL, Paris R, Redfield RR, Birx DL. Prospective Analyses of HIV‐1–Specific Proliferative Responses, Recall Antigen Proliferative Responses, and Clinical Outcomes in an HIV‐1–Seropositive Cohort. J Infect Dis 2004; 189:1988-95. [PMID: 15143464 DOI: 10.1086/386285] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2003] [Accepted: 11/12/2003] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In cross-sectional studies of chronically infected individuals, lymphoproliferative responses to human immunodeficiency virus (HIV) type 1 p24 Gag antigen have previously been associated with lower virus load. It was not known whether this association would be predictive of better clinical outcome in longitudinal studies. METHODS In blood samples from 608 HIV-seropositive individuals enrolled in a trial of glycoprotein 160 vaccine therapy over the course of 3-5 years, lymphoproliferative responses to HIV-1 antigens, tetanus toxoid (TT), and mitogens were measured and correlated with clinical outcome and other parameters of progression. Baseline lymphoproliferative responses to antigens and mitogens were used to categorize the cohort into responders or nonresponders. RESULTS Although response to recall antigens did not correlate with clinical indices of disease progression, positive baseline lymphoproliferative responses to p24 and TT were associated with lower plasma levels of HIV-1 RNA. Persistently positive lymphoproliferative responses to the antigens also inversely correlated with repeated measurements of virus load, although the significance was lost once the measurements were adjusted for virus load and CD4(+) cell count at baseline, by use of generalized estimating equation analysis. CONCLUSIONS These observations suggest that the effect of the association between lymphoproliferative response and virus load is established early during HIV-1 infection and does not increase over time and suggest that antigen-specific lymphoproliferative responses reflect the dynamic state of HIV-1 infection and are inversely associated with virus load.
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Affiliation(s)
- Silvia Ratto-Kim
- Hawaii AIDS Clinical Research Program, University of Hawaii School of Medicine, Honolulu, 96816, USA.
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42
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Wegner SA, Wallace MR, Aronson NE, Tasker SA, Blazes DL, Tamminga C, Fraser S, Dolan MJ, Stephan KT, Michael NL, Jagodzinski LL, Vahey MT, Gilcrest JL, Tracy L, Milazzo MJ, Murphy DJ, McKenna P, Hertogs K, Rinehart A, Larder B, Birx DL. Long‐Term Efficacy of Routine Access to Antiretroviral‐Resistance Testing in HIV Type 1–Infected Patients: Results of the Clinical Efficacy of Resistance Testing Trial. Clin Infect Dis 2004; 38:723-30. [PMID: 14986258 DOI: 10.1086/381266] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2003] [Accepted: 10/07/2003] [Indexed: 11/03/2022] Open
Abstract
The long-term efficacy of making resistance testing routinely available to clinicians has not been established. We conducted a clinical trial at 6 US military hospitals in which volunteers infected with human immunodeficiency virus type-1 were randomized to have routine access to phenotype resistance testing (PT arm), access to genotype resistance testing (GT arm), or no access to either test (VB arm). The primary outcome measure was time to persistent treatment failure despite change(s) in antiretroviral therapy (ART) regimen. Overall, routine access to resistance testing did not significantly increase the time to end point. Time to end point was significantly prolonged in the PT arm for subjects with a history of treatment with > or =4 different ART regimens or a history of treatment with nonnucleoside reverse-transcriptase inhibitors before the study, compared with that in the VB arm. These results suggest that routine access to resistance testing can improve long-term virologic outcomes in HIV-infected patients who are treatment experienced but may not impact outcome in patients who are naive to or have had limited experience with ART.
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Affiliation(s)
- Scott A Wegner
- Tri-Service AIDS Clinical Consortium, US Military HIV Research Program, Walter Reed Army Institute of Research, Rockville, MD 20850, USA.
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43
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Jagodzinski LL, Cooley JD, Weber M, Michael NL. Performance characteristics of human immunodeficiency virus type 1 (HIV-1) genotyping systems in sequence-based analysis of subtypes other than HIV-1 subtype B. J Clin Microbiol 2003; 41:998-1003. [PMID: 12624021 PMCID: PMC150292 DOI: 10.1128/jcm.41.3.998-1003.2003] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Given the diversity of human immunodeficiency virus type 1 (HIV-1) subtypes and the emergence of subtypes other than HIV-1 subtype B in the United States, genotypic assays must be capable of delivering sequence data on diverse HIV-1 subtypes. We evaluated the performance of Visible Genetics TRUGENE HIV-1 genotyping kit and Applied Biosystems ViroSeq HIV-1 genotyping system on a panel of 34 well-characterized HIV-1 viral stocks (subtypes A through H). Both assays perform well on diverse HIV-1 subtypes despite being designed for HIV-1 subtype B. The TRUGENE assay produced sequence data for 31 isolates but not for one C and two G isolates. The TRUGENE assay using prototype 1.5 RT-PCR primers and the ViroSeq assay were both successful for all variants tested, although five isolates lacked double-strand sequence coverage in the ViroSeq assay. The availability of standardized HIV-1 genotyping kits that perform reliably with all HIV subtypes will facilitate broad implementation of HIV-1 resistance testing.
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Affiliation(s)
- Linda L Jagodzinski
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland 20850, USA.
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44
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Stiegler G, Armbruster C, Vcelar B, Stoiber H, Kunert R, Michael NL, Jagodzinski LL, Ammann C, Jäger W, Jacobson J, Vetter N, Katinger H. Antiviral activity of the neutralizing antibodies 2F5 and 2G12 in asymptomatic HIV-1-infected humans: a phase I evaluation. AIDS 2002; 16:2019-25. [PMID: 12370500 DOI: 10.1097/00002030-200210180-00006] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The human monoclonal antibodies (MAbs) 2F5 and 2G12 were identified to be two of the most potent neutralizing antibodies against HIV-1. In a first human study they have been shown to be safe after repeated intravenous infusions to asymptomatic HIV-1-infected individuals. However, the antiviral effects of antibody treatment have not been fully analyzed in this first clinical trial. METHODS The aim of the present study was to gain a preliminary insight into the antiviral effects of 2F5 and 2G12 in humans. For this purpose, plasma samples obtained from the previous phase I study were studied for RNA copy numbers by reverse transcriptase-polymerase chain reaction. As a measure for activation of complement levels of the major complement factor C3 were measured by enzyme-linked immunosorbent assay. Flow cytometry was used to study T-lymphocyte counts and the amount of infected peripheral blood mononuclear cells (PBMC) was determined by co-culture with uninfected donor PBMC. Virus escape from antibody neutralization was determined in vitro in a PBMC neutralization assay. RESULTS Transient reduction in viral loads was observed in five of seven patients. Vigorous complement activation was observed directly after HIV-specific antibody infusions. The number of infective peripheral blood mononuclear cells was reduced in some patients whereas CD4+ T-lymphocyte counts and CD4+/CD8+ ratios were transiently increased in all patients. Virus escape occurred only against 2G12. CONCLUSIONS Analysis of disease progression markers indicate that antibody therapy may have antiviral effects. These findings suggest that neutralizing antibodies should be further evaluated as an alternative therapeutic approach in HIV-1 disease.
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Affiliation(s)
- Gabriela Stiegler
- Institute of Applied Microbiology, University of Agricultural Sciences, Muthgasse, Vienna, Austria.
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45
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Vahey MT, Nau ME, Jagodzinski LL, Yalley-Ogunro J, Taubman M, Michael NL, Lewis MG. Impact of viral infection on the gene expression profiles of proliferating normal human peripheral blood mononuclear cells infected with HIV type 1 RF. AIDS Res Hum Retroviruses 2002; 18:179-92. [PMID: 11839152 DOI: 10.1089/08892220252781239] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Exploiting the power of high-density gene arrays, the simultaneous expression analysis of 5600 cellular genes was executed on proliferating peripheral blood mononuclear cells (PBMCs) from three normal human donors that were infected in vitro with the T cell tropic laboratory strain of HIV-1, RF. Profiles of expressed genes were assessed at 1, 12, 24, 48, and 72 hr postinfection and compared with those of matched uninfected PBMCs. Viral infection resulted in an overall increase in the number of genes expressed with peaks of expression at 1, 12, and 48 hr postinfection. Functional clustering of genes whose expression level in infected PBMCs varied by 2-fold or greater from levels in the controls indicated that cellular activation markers, proteins associated with immune cell function and with transcription and translation, exhibited increased expression subsequent to viral infection. Gene families exhibiting a decline in gene expression were confined to the 72 hr time point and included genes associated with catabolism and a subset of genes involved with cell signaling and synthetic pathways. Self-organizing map (SOM) cluster analysis identified temporal patterns of coordinated gene expression in infected PBMCs including genes associated with the immune response, the cytoskeleton, and ribosomal subunit structural proteins required for protein synthesis.
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Affiliation(s)
- Maryanne T Vahey
- Division of Retrovirology, Walter Reed Army Institute of Research, Washington, DC, USA.
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46
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Carr JK, Torimiro JN, Wolfe ND, Eitel MN, Kim B, Sanders-Buell E, Jagodzinski LL, Gotte D, Burke DS, Birx DL, McCutchan FE. The AG recombinant IbNG and novel strains of group M HIV-1 are common in Cameroon. Virology 2001; 286:168-81. [PMID: 11448170 DOI: 10.1006/viro.2001.0976] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The genetic diversity of group M HIV-1 is highest in west central Africa. Blood samples from four locations in Cameroon were collected to determine the molecular epidemiology of HIV-1. The C2-V5 region of envelope was sequenced from 39 of the 40 samples collected, and 7 samples were sequenced across the genome. All strains belonged to group M of HIV-1. The circulating recombinant form CRF02 AG (IbNG) was the most common strain (22/39, 56%). Two of these were confirmed by full genome analysis. Four samples (4/39, 10%) clustered with the sub-subtype F2 and one of these was confirmed by full genome sequencing. Recombinant forms, each different but containing subtype A, accounted for the next most common form (7/39, 18%). Among these recombinants, those combining subtypes A and G were the most common (4/7, 57%). Also found were 3 subtype A, 2 subtype G, and 1 subtype B strain. Many recombination break points were shared between IbNG and the other AG recombinants, though none of these other AG recombinants included IbNG as a parent. This suggests that there was an ancestral AG recombinant that gave rise to CRF02 AG (IbNG), the successful circulating recombinant form, and to others that were less successful and are now rare.
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Affiliation(s)
- J K Carr
- Henry M. Jackson Foundation, Rockville, Maryland 20850, USA.
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47
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Walter EA, Gilliam B, Delmar JA, Spooner K, Morris JT, Aronson N, Wegner SA, Michael NL, Jagodzinski LL. Clinical implications of identifying non-B subtypes of human immunodeficiency virus type 1 infection. Clin Infect Dis 2000; 31:798-802. [PMID: 11017832 DOI: 10.1086/314044] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/1999] [Revised: 02/28/2000] [Indexed: 11/03/2022] Open
Abstract
Although human immunodeficiency virus type 1 (HIV-1) infection in the United States has predominantly involved subtype B, increasing global travel is leading to wider dissemination of genetically heterogeneous subtypes. While physicians depend on HIV-1 viral load measurements to guide antiretroviral therapy, commonly used molecular assays may underestimate the viral load of patients with non-B subtypes. Nine patients with non-B subtypes of HIV-1 were identified by physicians who suspected a non-B subtype on the basis of a low or undetectable HIV-1 viral load, by the Amplicor HIV-1 Monitor test, version 1.0, in conjunction with either a declining CD4 cell count or history of travel outside the United States. Use of version 1.5 of the Amplicor HIV-1 Monitor test detected a median HIV-1 viral load that was 2.0 log(10) RNA copies/mL higher than was determined with version 1.0. Clinical management was altered in all cases after diagnosis of a non-B-subtype infection. These cases demonstrate that it is critical for physicians to suspect and diagnose non-B subtypes of HIV-1 so that an assay with reliable subtype performance can be used to guide antiretroviral therapy.
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Affiliation(s)
- E A Walter
- Infectious Diseases Service, Department of Medicine, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX 78236-5300, USA.
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48
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Emery S, Bodrug S, Richardson BA, Giachetti C, Bott MA, Panteleeff D, Jagodzinski LL, Michael NL, Nduati R, Bwayo J, Kreiss JK, Overbaugh J. Evaluation of performance of the Gen-Probe human immunodeficiency virus type 1 viral load assay using primary subtype A, C, and D isolates from Kenya. J Clin Microbiol 2000; 38:2688-95. [PMID: 10878065 PMCID: PMC87000 DOI: 10.1128/jcm.38.7.2688-2695.2000] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Accurate and sensitive quantification of human immunodeficiency virus type 1 (HIV-1) RNA has been invaluable as a marker for disease prognosis and for clinical monitoring of HIV-1 disease. The first generation of commercially available HIV-1 RNA tests were optimized to detect the predominant HIV-1 subtype found in North America and Europe, subtype B. However, these tests are frequently suboptimal in detecting HIV-1 genetic forms or subtypes found in other parts of the world. The goal of the present study was to evaluate the performance of a new viral load assay with non-subtype B viruses. A transcription-mediated amplification method for detection and quantitation of diverse HIV-1 subtypes, called the Gen-Probe HIV-1 viral load assay, is under development. In this study we examined the performance of the Gen-Probe HIV-1 viral load assay relative to that of the commonly used commercial HIV-1 RNA assays using a panel of primary isolates from Kenya. For comparison, we included several subtype B cloned viruses, and we quantified each virus using an in-house quantitative-competitive reverse transcriptase PCR (QC-RT-PCR) method and gag(p24) antigen capture. The Gen-Probe HIV-1 viral load assay and a version of the Roche AMPLICOR HIV-1 MONITOR test (version 1.5) that was designed to detect a broader range of subtypes were both sensitive for the quantification of Kenyan primary isolates, which represented subtype A, C, and D viruses. The Gen-Probe HIV-1 viral load assay was more sensitive for the majority of viruses than the Roche AMPLICOR HIV-1 MONITOR test version 1.0, the Bayer Quantiplex HIV RNA 3.0 assay, or a QC-RT-PCR method in use in our laboratory, suggesting that it provides a useful method for quantifying HIV-1 RNAs from diverse parts of the world, including Africa.
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Affiliation(s)
- S Emery
- Division of Human Biology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington 98109, USA
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49
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Jagodzinski LL, Wiggins DL, McManis JL, Emery S, Overbaugh J, Robb M, Bodrug S, Michael NL. Use of calibrated viral load standards for group M subtypes of human immunodeficiency virus type 1 to assess the performance of viral RNA quantitation tests. J Clin Microbiol 2000; 38:1247-9. [PMID: 10699033 PMCID: PMC86389 DOI: 10.1128/jcm.38.3.1247-1249.2000] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Optimal management of human immunodeficiency virus type 1 (HIV-1) disease requires accurate quantitation of viral RNA concentrations in plasma. Evidence for increasing geographic intermixing of HIV-1 subtypes makes equivalent quantitation of all subtypes essential. The performances of six quantitative viral RNA tests are described, for the first time, with calibrated viral isolates of diverse subtypes.
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Affiliation(s)
- L L Jagodzinski
- Henry M. Jackson Foundation, Walter Reed Army Institute of Research, Rockville, Maryland 20850, USA.
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Michael NL, Herman SA, Kwok S, Dreyer K, Wang J, Christopherson C, Spadoro JP, Young KK, Polonis V, McCutchan FE, Carr J, Mascola JR, Jagodzinski LL, Robb ML. Development of calibrated viral load standards for group M subtypes of human immunodeficiency virus type 1 and performance of an improved AMPLICOR HIV-1 MONITOR test with isolates of diverse subtypes. J Clin Microbiol 1999; 37:2557-63. [PMID: 10405401 PMCID: PMC85282 DOI: 10.1128/jcm.37.8.2557-2563.1999] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/1998] [Accepted: 05/10/1999] [Indexed: 11/20/2022] Open
Abstract
Accurate determination of plasma human immunodeficiency virus type 1 (HIV-1) RNA levels is critical for the effective management of HIV-1 disease. The AMPLICOR HIV-1 MONITOR Test, a reverse transcription-PCR-based test for quantification of HIV-1 RNA in plasma, was developed when little sequence information on HIV-1 isolates from outside North America was available. It has since become apparent that many non-subtype B isolates, particularly subtypes A and E, are detected inefficiently by the test. We describe here the AMPLICOR HIV-1 MONITOR Test, version 1.5, an upgraded test developed to minimize subtype-related variation. We also developed a panel of HIV-1 standards containing 30 HIV-1 isolates of subtypes A through G. The virus particle concentration of each cultured viral stock was standardized by electron microscopic virus particle counting. We used this panel to determine the performance of the original AMPLICOR HIV-1 MONITOR Test and version 1.5 of the test with HIV-1 subtypes A through G. The original test underestimated the concentration of HIV-1 subtype A, E, F, and G RNA by 10-fold or more, whereas version of the 1.5 test yielded equivalent quantification of HIV-1 RNA regardless of the subtype. In light of the increasing intermixing of HIV-1 subtypes worldwide, standardization of PCR-based tests against well-characterized viral isolates representing the full range of HIV-1 diversity will be essential for the continued utility of these important clinical management tools.
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Affiliation(s)
- N L Michael
- Division of Retrovirology, Walter Reed Army Institute of Research, Rockville, Maryland 20850, USA.
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