Towards zero new HIV infections in Amsterdam in 2026; building bridges between community organizations, undocumented migrants and sexual healthcare providers.

BACKGROUND: In the four largest cities in the Netherlands, an estimated 400 people live with undiagnosed HIV, including 170 in Amsterdam. Amsterdam targets having zero new HIV infections in 2026. Undocumented migrants are disproportionately affected by HIV and often contract HIV after migration. Moreover, they often experience difficulties accessing healthcare. The aim of this study was to analyze the outcomes of an HIV/STI testing program for undocumented migrants through community based testing. METHODS: Between May 2021 and January 2022 data for this cross sectional study was collected during outreach testing activities of the Amsterdam Center for Sexual Health (CSH) of the Public Health Service, and the NGO Doctors of the World. Activities were organized in collaboration with migrant partner organizations. Participants were tested free-of-charge for HIV, syphilis, gonorrhea, chlamydia and if indicated for Hepatitis B and C. Prior to testing, a healthcare provider-administered questionnaire was filled out. RESULTS: 126 people from 22 countries were tested for HIV during 28 outreach activities. Mean age was 37 (IQR 32-43). Forty-nine people (39%) were additionally tested, (through self-sampling) for chlamydia, gonorrhea and syphilis, 42 (33%) for Hepatitis B and 14 (11%) for Hepatitis C. We found zero new HIV infections and 5 positive chlamydia cases.Reaching 52 HIV first time testers and 19 first time testers since migration shows the importance of these activities. The number of participants tested were lower than initially expected due to lower attendance per testing day for various reasons. CONCLUSIONS: To increase the likelihood of reaching undocumented migrants for HIV/STI testing and linkage to care, focus should be on on-site provider-initiated testing, e.g. during outreach healthcare activities, and on easy access to centers for sexual health. Collaboration between healthcare providers and community stakeholders is essential.

A randomized phase 2 study exploring the role of bevacizumab and a chemotherapy-free approach in HER2-positive metastatic breast cancer: The HAT study (BOOG 2008-2003), a Dutch Breast Cancer Research Group trial.

BACKGROUND: To explore the role of bevacizumab and a chemotherapy-free approach, the authors evaluated the combination of bevacizumab, trastuzumab, and paclitaxel (HAT) and the regimen of trastuzumab and bevacizumab (HA) with the addition of paclitaxel after progression (HA-HAT) as first-line treatment for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. METHODS: In a noncomparative phase 2 trial, patients were randomized between HAT and HA-HAT. The primary endpoint was the progression-free rate at 1 year (1-year PFR). In the HA-HAT group, progression-free survival (PFS) was separately established for HA (PFS1) and HAT (PFS2). RESULTS: Eighty-four patients received HAT (n = 39) or HA-HAT (n = 45). The 1-year PFR was 74.4% (95% confidence interval [CI], 61.8%-89.4%) and 62.2% (95% CI, 49.6%-89.4%) in the HAT and HA-HAT arms, respectively. The median PFS was 19.8 months (95% CI, 14.9-25.6 months) in the HAT arm and 19.6 months (95% CI, 12.0-32.0 months) in the HA-HAT arm. In the HA-HAT arm, the median PFS1 was 10.4 months (95% CI, 6.2-15.0 months), and the median PFS2 was 8.2 months (95% CI, 7.0-12.6 months). The number and severity of adverse events were comparable between the arms. CONCLUSIONS: Both HAT and HA-HAT have promising activity in patients with HER2-positive metastatic breast cancer. In particular, starting with only targeted agents and delaying chemotherapy is worth further exploration. Cancer 2016;122:2961-2970. © 2016 American Cancer Society.

High level of alpha1-acid glycoprotein in human seminal plasma is associated with high branching and expression of Lewis(a) groups on its glycans: supporting evidence for a prostatic origin.

BACKGROUND: Changes in concentration of seminal plasma alpha(1)-acid glycoprotein (AGP) have been studied in detail before. However, the source of high levels of AGP as well as the glycosylation of seminal plasma AGP has not been elucidated yet. METHODS: The glycosylation of AGP was studied by crossed affinity immunoelectrophoresis using fucose-specific lectins and immunostaining. Glycan structure and monosaccharide analyses were performed by high pH anion exchange chromatography with pulsed amperometric detection. Fucosyltransferases were analyzed for activity and their substrate specificity was determined. RESULTS: Two types of fucosylation were detected; Lewis(x) and Lewis(a). Lewis(a) groups were only present on AGP of individuals with a high concentration and were completely absent when the AGP concentration in seminal plasma was low. Lewis(a) expression coincides with a higher degree of branching of the glycans and a relative increased alpha4-fucosyltransferase activity. The molecular weight of all seminal plasma AGP was slightly higher than of blood plasma AGP (approx. 47 vs. 41-43 kDa). CONCLUSIONS: The results indicate that AGP in seminal fluid most likely originates from the prostate and that it is either alpha3- or alpha4-fucosylated.