ABSTRACT
Our study surveyed over 2000 employees of a community health care system in the Southeast United States for SARS-CoV2 antibodies. Survey included subjects' expectation of the result. Our local area had low community prevalence of SARS-CoV2 but low diagnostic testing capacity during much of the early phase of the epidemic. Despite only 3% positivity rate for antibodies in this population, 17% of subjects expected to have positive antibodies.
Subject(s)
Antibodies, Viral/blood , COVID-19 , Health Personnel , COVID-19/diagnosis , COVID-19/immunology , COVID-19 Serological Testing , Hospitals, Community , Humans , North Carolina/epidemiology , Seroepidemiologic StudiesABSTRACT
In the United States, clinical trials of COVID-19 vaccines and therapeutics quickly exhausted available clinical research capacity at large medical centers. The NIAID Division of Clinical Research tapped community hospitals to help fill the gap.
Subject(s)
COVID-19 , Emergencies , COVID-19 Vaccines , Government , Hospitals, Community , Humans , Public Health , SARS-CoV-2 , United StatesABSTRACT
This study was a retrospective chart review from January 1, 2015 through June 30, 2017, comparing the incidence of Clostridium difficile-associated diarrhea (CDAD) in patients taking select broad spectrum antibiotics with probiotics versus without probiotics. The purpose was to determine if probiotic use was associated with a reduction in the incidence of CDAD. A total of 5,574 hospital encounters were reviewed, showing a 0.96% incidence of CDAD in patients receiving a probiotic compared to a 2.19% incidence of CDAD in patients with no probiotic (risk ratioâ¯=â¯0.442; Pâ¯=â¯.00743). These findings show probiotic use was associated with a statistically significant lower incidence of positive C. difficile test results compared to no probiotic use.
Subject(s)
Clostridioides difficile , Diarrhea/prevention & control , Enterocolitis, Pseudomembranous/microbiology , Enterocolitis, Pseudomembranous/prevention & control , Probiotics/pharmacology , Anti-Bacterial Agents/adverse effects , Enterocolitis, Pseudomembranous/etiology , Humans , Retrospective StudiesABSTRACT
BACKGROUND: The association between abacavir (ABC) and cardiovascular disease (CVD) risk in HIV-infected individuals is unclear. Putative mechanisms for an effect of ABC on CVD risk including endothelial dysfunction have been proposed; however, a biological mechanism has not been established. METHODS: This was a cross-sectional study of HIV-infected subjects with HIV RNA levels <400 copies/ml, who were randomly assigned to ABC or tenofovir (TDF) as initial therapy during a prior clinical trial. A small cohort of subjects on zidovudine (AZT; not randomly assigned) were studied to explore long-term exposure to this agent. All underwent brachial artery ultrasound for flow-mediated dilation (FMD), and D-dimer, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and fasting lipids were measured. Between-arm differences were evaluated by multivariable linear or logistic regression modelling. RESULTS: There were 148 subjects (46 on ABC, 72 on TDF and 30 on AZT). Demographic characteristics were balanced across the groups except, as expected, AZT-treated participants were older, had higher CD4(+) T-cell counts, and longer antiretroviral therapy duration. After adjusting for age, brachial artery diameter, and treatment duration, FMD was similar in those on ABC (3.9%) and TDF (5.4%; P=0.181). FMD was higher in those on AZT (6.1%; P<0.005). Levels of IL-6, hsCRP and detectable D-dimer were similar between groups. CONCLUSIONS: Among individuals assigned to ABC or TDF in randomized clinical trials there were no significant differences in FMD or markers of inflammation and coagulation. Whether ABC contributes to risk of CVD remains unclear, but our results suggest that endothelial dysfunction, heightened inflammation, and altered coagulation are unlikely to be mechanisms by which the drug could increase CVD risk above that seen with TDF.
Subject(s)
Adenine/analogs & derivatives , Anti-HIV Agents/therapeutic use , Cardiovascular Diseases/metabolism , Dideoxynucleosides/therapeutic use , HIV Infections/drug therapy , Organophosphonates/therapeutic use , Adenine/administration & dosage , Adenine/adverse effects , Adenine/therapeutic use , Adult , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/adverse effects , Biomarkers/blood , Blood Coagulation/drug effects , Blood Coagulation/physiology , Cardiovascular Diseases/chemically induced , Dideoxynucleosides/administration & dosage , Dideoxynucleosides/adverse effects , Endothelium, Vascular/drug effects , Endothelium, Vascular/physiology , Female , HIV Infections/metabolism , Humans , Inflammation/metabolism , Male , Middle Aged , Organophosphonates/administration & dosage , Organophosphonates/adverse effects , Risk Factors , Tenofovir , Zidovudine/administration & dosage , Zidovudine/adverse effects , Zidovudine/therapeutic useABSTRACT
Acute HIV-1 infection causes a rapid total body depletion of CD4(+) T cells in most individuals and HIV-1-specific CD8(+) T cell expansion in response to viral replication. A numerically high CD8 T cell response may indicate limited T cell repertoire against HIV and rapid progression. We present a detailed evaluation of an acutely infected individual with a strong HIV-1-specific CD8 T cell response targeting multiple epitopes demonstrating that the upper limit of CD8 expansion in this setting may be much higher than previously reported and was likely driven by the narrow HIV-specific response.