RESUMO
With the spread of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is a need to assess the protection conferred by both previous infections and current vaccination. Here we tested the neutralizing activity of infected and/or vaccinated individuals against pseudoviruses expressing the spike of the original SARS-CoV-2 isolate Wuhan-Hu-1 (WH1), the D614G mutant and the B.1.1.7 variant. Our data show that parameters of natural infection (time from infection and nature of the infecting variant) determined cross-neutralization. Uninfected vaccinees showed a small reduction in neutralization against the B.1.1.7 variant compared to both the WH1 strain and the D614G mutant. Interestingly, upon vaccination, previously infected individuals developed more robust neutralizing responses against B.1.1.7, suggesting that vaccines can boost the neutralization breadth conferred by natural infection.
Assuntos
Anticorpos Neutralizantes/sangue , Vacinas contra COVID-19/imunologia , COVID-19/imunologia , Testes de Neutralização/estatística & dados numéricos , SARS-CoV-2/imunologia , Vacinação/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/imunologia , COVID-19/sangue , Teste Sorológico para COVID-19/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem , Reações Cruzadas/imunologia , Feminino , Humanos , Imunidade Humoral , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , SARS-CoV-2/genéticaRESUMO
BACKGROUND: Prevalence of late diagnosis (LD) and identifying missed opportunities. METHODS: Retrospective observational study of new HIV diagnoses between 2013 and 2018 in our referral area. Sociodemographic and clinical-analytical variables were analysed at the time of diagnosis. The patient's clinical history in the last 5 years before the HIV diagnoses was reviewed to identify missed opportunities for early diagnosis. RESULTS: Seventy-four patients were included. The prevalence of LD was 44.6%, and 23% as an advanced disease. A tendency for LD was observed in patients older than 40 years, especially among Spaniards. Being tested 11for HIV protected against LD. All patients who had previous contact with the health system had clinical indicators or risk factors associated with HIV, but only 50% had ever been tested in their lifetime of HIV. CONCLUSIONS: In spite of multiple contacts with our health system, almost half of the new cases of HIV infection are diagnosticated late. Different strategies should be implemented to improve the identification of the risk factors and clinical indicators of possible HIV infection.