RESUMEN
OBJECTIVES: To assess the prevalence and patterns of pre-treatment HIV drug resistance (PDR) and HIV-1 subtype in infants from Argentina with exposure to different antiretroviral drugs (ARVs) for the prevention of mother-to-child transmission (PMTCT). PATIENTS AND METHODS: HIV-1 genotyping was performed in 115 infants (median age = 2.3 months) born between 2007 and 2014 to screen for drug resistance mutations (DRMs) before starting first-line ART. HIV-1 subtype was characterized by phylogenetic and recombination analysis. RESULTS: Overall, DRMs were found in 34 of 115 infants (PDR level 30% to any ARV, 3.5% to PIs, 12% to NRTIs and 22% to NNRTIs). Of the 115 infants, 22 (19.1%) were ARV-unexposed. Another 93 were ARV-exposed: 28 (24.3%) to short-course zidovudine monotherapy ARV prophylaxis; 25 (21.7%) to nevirapine-based ARV prophylaxis; 12 (10.4%) to perinatal infant zidovudine prophylaxis + maternal combination ART with NNRTIs; and 28 (24.3%) to perinatal infant zidovudine prophylaxis+maternal combination ART with PIs. Transmitted drug resistance among ARV-unexposed infants was 32% (5% to PIs, 9% to NRTIs and 18% to NNRTIs). ART-exposed infants showed multi-class ARV resistance. Importantly, vertical transmission of a triple-class-resistant virus was confirmed in one case. Patterns of DRMs predicted high-level resistance to NNRTIs in a similar and high proportion (>50%) of infants with at least one DRM independently of ARV exposure. BF recombinants were found in 74%, subtype B in 20%, subtype C in 3% and novel AG and AB recombinants in 3%. CONCLUSIONS: PDR in HIV-1-infected children from Argentina is among the highest reported, jeopardizing successful lifelong suppressive ART as well as the efficacy of current PMTCT regimens.
Asunto(s)
Farmacorresistencia Viral , Infecciones por VIH/prevención & control , Infecciones por VIH/virología , VIH-1/genética , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Fármacos Anti-VIH/farmacología , Fármacos Anti-VIH/uso terapéutico , Argentina/epidemiología , Femenino , Genotipo , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , VIH-1/efectos de los fármacos , Humanos , Lactante , Masculino , Mutación , Prevalencia , Vigilancia en Salud Pública , Factores de Riesgo , Productos del Gen pol del Virus de la Inmunodeficiencia HumanaRESUMEN
The COVID-19 pandemic has lately been driven by Omicron. This work aimed to study the dynamics of SARS-CoV-2 Omicron lineages during the third and fourth waves of COVID-19 in Argentina. Molecular surveillance was performed on 3431 samples from Argentina, between EW44/2021 and EW31/2022. Sequencing, phylogenetic and phylodynamic analyses were performed. A differential dynamic between the Omicron waves was found. The third wave was associated with lineage BA.1, characterized by a high number of cases, very fast displacement of Delta, doubling times of 3.3 days and a low level of lineage diversity and clustering. In contrast, the fourth wave was longer but associated with a lower number of cases, initially caused by BA.2, and later by BA.4/BA.5, with doubling times of about 10 days. Several BA.2 and BA.4/BA.5 sublineages and introductions were detected, although very few clusters with a constrained geographical distribution were observed, suggesting limited transmission chains. The differential dynamic could be due to waning immunity and an increase in population gatherings in the BA.1 wave, and a boosted population (for vaccination or recent prior immunity for BA.1 infection) in the wave caused by BA2/BA.4/BA.5, which may have limited the establishment of the new lineages.
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COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , COVID-19/epidemiología , Argentina/epidemiología , Pandemias , FilogeniaRESUMEN
Recent studies have shown a temporal increase in the neutralizing antibody potency and breadth to SARS-CoV-2 variants in coronavirus disease 2019 (COVID-19) convalescent individuals. Here, we examined longitudinal antibody responses and viral neutralizing capacity to the B.1 lineage virus (Wuhan related), to variants of concern (VOC; Alpha, Beta, Gamma, and Delta), and to a local variant of interest (VOI; Lambda) in volunteers receiving the Sputnik V vaccine in Argentina. Longitudinal serum samples (N = 536) collected from 118 volunteers obtained between January and October 2021 were used. The analysis indicates that while anti-spike IgG levels significantly wane over time, the neutralizing capacity for the Wuhan-related lineages of SARS-CoV-2 and VOC is maintained within 6 months of vaccination. In addition, an improved antibody cross-neutralizing ability for circulating variants of concern (Beta and Gamma) was observed over time postvaccination. The viral variants that displayed higher escape to neutralizing antibodies with respect to the original virus (Beta and Gamma variants) were the ones showing the largest increase in susceptibility to neutralization over time after vaccination. Our observations indicate that serum neutralizing antibodies are maintained for at least 6 months and show a reduction of VOC escape to neutralizing antibodies over time after vaccination. IMPORTANCE Vaccines have been produced in record time for SARS-CoV-2, offering the possibility of halting the global pandemic. However, inequalities in vaccine accessibility in different regions of the world create a need to increase international cooperation. Sputnik V is a recombinant adenovirus-based vaccine that has been widely used in Argentina and other developing countries, but limited information is available about its elicited immune responses. Here, we examined longitudinal antibody levels and viral neutralizing capacity elicited by Sputnik V vaccination. Using a cohort of 118 volunteers, we found that while anti-spike antibodies wane over time, the neutralizing capacity to viral variants of concern and local variants of interest is maintained within 4 months of vaccination. In addition, we observed an increased cross-neutralization activity over time for the Beta and Gamma variants. This study provides valuable information about the immune response generated by a vaccine platform used in many parts of the world.
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Vacunas contra la COVID-19 , COVID-19 , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus , Humanos , Anticuerpos Neutralizantes , Anticuerpos Antivirales , COVID-19/prevención & control , Estudios Longitudinales , Glicoproteína de la Espiga del Coronavirus/inmunología , Vacunación , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/uso terapéuticoRESUMEN
Heterologous vaccination against coronavirus disease 2019 (COVID-19) provides a rational strategy to rapidly increase vaccination coverage in many regions of the world. Although data regarding messenger RNA (mRNA) and ChAdOx1 vaccine combinations are available, there is limited information about the combination of these platforms with other vaccines widely used in developing countries, such as BBIBP-CorV and Sputnik V. Here, we assess the immunogenicity and reactogenicity of 15 vaccine combinations in 1,314 participants. We evaluate immunoglobulin G (IgG) anti-spike response and virus neutralizing titers and observe that a number of heterologous vaccine combinations are equivalent or superior to homologous schemes. For all cohorts in this study, the highest antibody response is induced by mRNA-1273 as the second dose. No serious adverse events are detected in any of the schedules analyzed. Our observations provide rational support for the use of different vaccine combinations to achieve wide vaccine coverage in the shortest possible time.
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COVID-19 , Vacunas Virales , Vacuna nCoV-2019 mRNA-1273 , Anticuerpos Antivirales , COVID-19/prevención & control , Humanos , Inmunización , ARN Mensajero/genética , SARS-CoV-2 , VacunaciónRESUMEN
Se exponen los resultados obtenidos en el Programa de Evaluación Externa de Calidad (PEEC) en Hematología de la Federación Bioquímica de la provincia de Buenos Aires, durante el período 1989-1991. Este Programa está inserto en el Programa de Evaluación Externa de Calidad en Bioquímica Clínica. El mismo es de carácter voluntario, explícito o anónimo. Inicialmente fueron 911 los inscriptos, y en la actualidad han superado los 1300, incluyendo laboratorios de otras provincias. En esta etapa sólo se ha implementado la evaluación externa para la hemoglobinometría. Se llevaron a cabo ocho encuestas, una de ellas a dos niveles de concentración, observándose que los porcentajes de respuestas aceptados, es decir que caen dentro de Xñ3 DE, oscilan entre 31-95%, con coeficiente de variación (CV) entre 5.8-14.2%. Los porcentajes de laboratorios que se encuentran dentro del límite de aceptabilidad de ñ5% varían entre 22-51%. El envío simultáneo de muestras a dos niveles arrojó diferencias para ambos valores asignados de -10% y -13.5%, lo que indica presencia de un error sistemático. El grado de estandirización logrado está relacionado con el empleo mayoritario de espectrofotómetros de haz simple, del uso de un solo punto de calibración y, como factor más crítico aún, de la existencia de 7-8% de laboratorios que aún no han adoptado el método recomendado de cianmetahemaglobina, todo lo cual justifica ampliamente la continuidad del PEEC