Incidence Of Seroconversion Research Articles

Seroepidemiology of herpes simplex virus type 1 and 2 in pregnant women in Switzerland: an obstetric clinic based study

Objective To assess the seroprevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) IgG antibodies and the seroincidence of HSV-1 and HSV-2 infections in pregnant women attending the maternity clinic of the University Hospital Lausanne. Study design Blood samples from 1030 women were taken at the usual pregnancy visit in the first trimester to assess the prevalence rate of IgG antibodies against HSV-1 and HSV-2 using a type-specific assay. A second blood sample was taken 6–8 weeks postpartum from returning women who were seronegative for HSV-2 or HSV-1 to assess the incidence of seroconversion (primary infection). Results The seroprevalence rates were 79.4% (95% CI: 76.9–81.9) for HSV-1 and 21.2% (18.7–23.7) for HSV-2 in women 14–46 years old. Type-specific serostatus patterns were as follows: 17.3% HSV-1/-2: +/+, 62.1% HSV-1/-2: +/−, 3.9% HSV-1/-2: −/+, 16.7% HSV-1/-2: −/−. Two hundred and sixty five women (59 of the 212 seronegative for HSV-1 (27.8%) and 265 of the 812 seronegative for HSV-2 (32.6%)) returned to the outpatient clinic for the post-delivery check and a second blood sample was obtained. One HSV-1 seroconversion was detected (HSV-1 seroconversion rate 2.4%/100 patient × year (95% CI: 0.06–13.4)) in a patient who had symptoms compatible with primary genital herpes. No HSV-2 seroconversion was detected (HSV-2 seroconversion rate: 0/100 patient × year (97.5% one-sided CI: 0–2)). Conclusion Compared to a previous population-based study, our study results suggest a rise in the prevalence of HSV-2 among pregnant women in Switzerland. The low incidence of seroconversion detected during pregnancy is consistent with the very low reported incidence of neonatal herpes in Switzerland. Condensation This study in a public hospital in Western Switzerland suggests an increasing prevalence of HSV-2, but a low incidence of primary infections in women of childbearing age.

Low Risk for Hepatitis C Seroconversion in Methadone Maintenance Treatment

To study the risk factors for seroconversion to hepatitis C virus (HCV) infection since admission to methadone maintenance treatment (MMT) and to characterize the seronegative admitted group. All 657 patients admitted to our MMT clinic in Tel Aviv, Israel, between 1993 and 2008 were prospectively followed up. Those who were HCV negative (n = 271) with >1 HCV tests (n = 207) were included for seroconversion analyses. Proportions of ever drug injectors, benzodiazepine abuse, and former USSR immigrants were higher among HCV sera-positive versus sera-negative patients on admission to MMT. The incidence of HCV seroconversion in MMT was 2/100 person years [py] (25 seroconversions, 1133.9 py). Seroconversion rates were higher among 44 younger patients (<30 years: 9.6/100 vs 1.4/100 py, P < 0.0005), among 103 patients with positive urine results to benzodiazepines (3.6/100 vs 1/100 py, P = 0.005), among 118 patients who injected the drugs (3.9/100 vs 1/100 py, P = 0.003), and among 43 patients who dropped out and were readmitted to the MMT (4.3/100 vs 1.7/100 py, P = 0.04). There was a trend of higher seroconversion among 61 females (P = 0.1), among 62 patients with no children (P = 0.1), and among those having hepatitis B antigen (n = 7; P = 0.09). Variables that predicted seroconversion were drug injection, benzodiazepine abuse, and being younger at admission to MMT. Being a former USSR immigrant did not predict seroconversion. The HCV seroconversion rate of patients in MMT is low, also, for former USSR immigrants. The predictors for seroconversion were only admission variables (younger age at admission to MMT, ever drug injector, and having positive urine to benzodiazepines at MMT admission). Specific intervention to eliminate seroconversion is needed for these high-risk groups.

Viral screening at the time of each donation in ART patients: is it justified?

The frequency for virology testing for couples undergoing assisted reproductive treatment (ART) in Europe is currently under debate, with little scientific data available to support the time-frame imposed by EU legislation. The aim of this study was to determine the incidence of blood-borne viruses (BBV) in this population and to assess the likelihood of seroconversion after an initial negative screen and the possible cost saving to couples. We identified all cases where a BBV screen was performed on patients attending our tertiary referral unit for ART. We calculated the incidence of Hepatitis B surface antigen, Hepatitis C antibody and HIV infection in this population and the incidence of seroconversion in follow-up screening (which included Hepatitis B core antibody) following the implementation of the EU legislation. In all cases identified, we sought to assess the risk of seroconversion after an initial negative screen. Between 1998 and 2009, we identified a total of 79 291 tests performed in over 12 500 patients. The incidence in this population of Hepatitis B surface antigen was 0.28% (37/12,797), Hepatitis B core antibody 3.32% (96/2891), Hepatitis C antibody 0.33% (43/12,762) and HIV 0.007% (1/12,819). We were able to show that for over 6500 individuals who were tested and re-tested for all three viruses, no seroconversions were reported. Based on the above measured negligible risk of seroconversion after an initial negative screen in co-habitating couples participating in an ART programme, current legislation requiring screening of couples at each procurement of cells in the assisted reproductive setting is not clinically justified.

A Randomized Noninferiority Trial of Standard Versus Enhanced Risk Reduction and Adherence Counseling for Individuals Receiving Post-Exposure Prophylaxis Following Sexual Exposures to HIV

The National HIV/AIDS Strategy proposes to scale-up post-exposure prophylaxis (PEP). Intensive risk reduction and adherence counseling appear to be effective but are resource intensive. Identifying simpler interventions that maximize the HIV prevention potential of PEP is critical. A randomized noninferiority study comparing 2 (standard) or 5 (enhanced) risk reduction counseling sessions was performed. Adherence counseling was provided in the enhanced arm. We measured changes in unprotected sexual intercourse acts at 12 months, compared with baseline; HIV acquisition; and PEP adherence. Outcomes were stratified by degree of baseline risk. We enrolled 457 individuals reporting unprotected intercourse within 72 h with an HIV-infected or at-risk partner. Participants were 96% male and 71% white. There were 1.8 and 2.3 fewer unprotected sex acts in the standard and enhanced groups. The maximum potential risk difference, reflected by the upper bound of the 95% confidence interval, was 3.9 acts. The difference in the riskier subset may have been as many as 19.6 acts. The incidence of HIV seroconversion was 2.9% and 2.6% among persons randomized to standard and enhanced counseling, respectively, with a maximum potential difference of 3.4%. The absolute and maximal HIV seroconversion incidence was 9.9% and 20.4% greater in the riskier group randomized to standard, compared with enhanced, counseling. Adherence outcomes were similar, with noninferiority in the lower risk group and concerning differences among the higher-risk group. Risk assessment is critical at PEP initiation. Standard counseling is only noninferior for individuals with lower baseline risk; thus, enhanced counseling should be targeted to individuals at higher risk.

77 Comparison of Hepatitis C Seroconversion in Two Centers and Reuse Practices

COMPARISON OF HEPATITIS C SEROCONVERSION IN TWO CENTERS AND REUSE PRACTICES Maria de Jesus, Vivek Soi, Sancar Eke, Yahya Osman Malik, Jerry Yee, Roque Diaz. Henry Ford Hospital, Detroit, Michigan, USA. Several mechanisms could potentially contribute to nosocomial HCV transmission between hemodialysis patients. These include internal contamination of hemodialysis machines, contamination of the hands of staff members, item sharing and dialyzer reuse. The relationship between dialyzer reuse and anti-HCV positivity has been confirmed in some but not all studies. The purpose of this retrospective study was to compare the incidence of Hepatitis C seroconversion in two urban centers which differed with respect to dialyzer reuse. The incidence of Hepatitis C seroconversion was calculated for the two urban centers. Data between 2001 and 2006 from 339 patients from Center A and 356 from Center B was analyzed. During this time, dialyzer reuse occurred at Center B but did not occur at Center A. Because seroconversion was expected to occur at very low rates, a Poisson regression model was used to compare rates between centers as well as to estimate the relative risk of developing a seroconversion . Association between Dialyser Reuse (Center) and Seroconversion Rate Center Incidence Relative Risk (95% CI) P-value Center B (Reuse) 0.011 5.52 (1.93, 15.78) 0.002 Center A 0.062 The incidence of seroconversion was higher at Center A (0.062) where hemodialyzers were not reused than at Center B (0.011) where hemodialyzers were reused. The ratio of incidence of seroconversion for Center A relative to Center B was 5.52. There was between a 1.93 and 15.78 greater probability of seroconversion if a patient had hemodialysis at a center that did not reuse hemodialyzers relative to a center that did participate in reuse.This study illustrates that a non-reuse strategy does not significantly lower the risk of seroconversion when compared to the alternative. Other variables including the number of surgeries, transfusion load, race, and sex, were not significant predictors of seroconversion in the Poisson regression model. Intensification of other infection control procedures should be emphasized to prevent the spread of the Hepatitis C virus.

IgG-class anti-PF4/heparin antibodies and symptomatic DVT in orthopedic surgery patients receiving different anti-thromboembolic prophylaxis therapeutics

BackgroundHeparin-induced thrombocytopenia (HIT) is a thromboembolic complication that can occur with unfractionated heparin (UFH) or low molecular weight heparin (LMWH). Our objective was to determine and compare the incidence of IgG-class HIT antibodies in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) with different antithrombotic prophylaxis therapies and their contributions to the occurrence of venous thromboembolism (VTE).MethodsA prospective observational study was performed for 374 Japanese patients undergoing THA or TKA to determine the incidence of VTE. IgG-class anti-PF4/heparin antibodies were measured using IgG-specific EIA before and after the operation.ResultsIn the clinical outcome, the incidence of symptomatic deep vein thrombosis (DVT) was 15.0% (56/374, TKA; 35, THA; 21) and pulmonary emboli (PE) were not observed. The total seroconversion incidence of IgG-class PF4/heparin antibodies was 19.8% (74/374). The seroconversion incidence of IgG-class PF4/heparin antibodies was higher in patients receiving UFH (32.7%) compared to those receiving LMWH (9.5%) or fondaparinux (14.8%). Furthermore, the seroconversion incidence was significantly higher in patients undergoing TKA compared to those undergoing THA. Based on multivariate analysis, seroconversion of the IgG-class PF4/heparin antibodies was independent a risk factor for symptomatic DVT.ConclusionOur findings show that the seroconversion of IgG-class anti-PF4/heparin antibodies differed with various anti-thrombotic prophylaxis therapeutics and was associated with the risk of DVT in a subset of patients undergoing total joint arthroplasty (TKA and THA).

LTB4 increases nasal neutrophil activity and conditions neutrophils to exert antiviral effects

BackgroundLeukotriene B4 (LTB4) recruits and activates neutrophils. Accordingly, this leukotriene is involved in innate defense actions.ObjectiveTo examine if nasal LTB4 can produce neutrophil activity and to explore whether or not LTB4 can condition neutrophils to exert virucidal effects in vitro and in vivo.Methods1. Twenty-three healthy subjects received nasal LTB4 in a randomized and sham-controlled design. Symptoms were scored and nasal lavages carried out. Myeloperoxidase (MPO) and α-defensins were monitored as indices of neutrophil activity. IL-8, eosinophil cationic protein (ECP) and α2-macroglobulin were measured as indices of pro-inflammatory cytokine production, eosinophil activity, and plasma exudation. 2. Supernatants from neutrophils activated by LTB4 in vitro were assayed for virucidal activity against respiratory viruses. 3. In 38 healthy individuals, nasal inoculation with human rhinovirus-16 (HRV-16) was performed. In a preliminary study, intervention with LTB4 was given in a randomized and controlled design. Symptoms, virus replication, and antibody-titres were monitored.Results1. LTB4 produced statistically significant increases in MPO and α-defensins, whereas IL-8, ECP, and α2-macroglobulin were unaffected. 2. The supernatants efficiently killed human coronavirus, respiratory syncytial virus, and influenza B virus. 3. HRV-16 replication was lower in subjects receiving LTB4, but this difference failed to reach statistical significance. Common cold symptoms and incidence of seroconversion were unaffected.ConclusionNasal LTB4 induces a selective recruitment/activation of neutrophils. LTB4 can condition neutrophils to exert virucidal effects in vitro and may reduce virus replication in vivo. We suggest that the condition induced by LTB4 reflects an enhanced state of innate defense.

HIV seroconversions among male non-occupational post-exposure prophylaxis service users: a data linkage study

Despite widespread prescription of non-occupational post-exposure prophylaxis (NPEP) in Victoria, little is known about subsequent HIV acquisition among NPEP users. We linked the Victorian NPEP Service (VNPEPS) database and the Victorian HIV Surveillance Registry to determine the number, incidence rate and predictive factors of HIV seroconversions among users of the VNPEPS. Records from male patients that received NPEP in the VNPEPS database (n = 1420) between January 2001 and February 2008 were linked with all entries in the Victorian HIV Surveillance Registry up to May 2008. Sixty-one men who presented to the VNPEPS were identified as HIV seropositive; 16 of these were diagnosed at initial presentation for NPEP. The incidence of HIV seroconversion in males who were HIV seronegative at first presentation for NPEP was 1.27 (95% confidence interval 0.95-1.70) per 100 person-years. There was no association between HIV seroconversion and number of NPEP presentations or age. The median age of seroconversion was 34.6 years. The incidence of HIV infection among men presenting to the VNPEPS is slightly lower than the HIV incidence in NPEP users in a recent Australian cohort study of men who have sex with men, but higher than HIV incidence in general gay male populations. Frequency of NPEP use was not associated with risk of HIV seroconversion. Examination of risk behaviour before and after NPEP use in this population is required to further assess the impact of NPEP availability and use on HIV incidence rates and risk behaviour in Australia.

Hepatitis E Seroprevalence and Seroconversion among US Military Service Members Deployed to Afghanistan

Hepatitis E virus (HEV) has been recognized as a threat to military forces since its discovery. Although HEV seroprevalence in Afghanistan is not known, HEV infection is thought to be highly endemic in that country. This study determined the incidence of HEV seroconversion among United States (US) service members who were deployed to Afghanistan, as well as the prevalence of antibodies to HEV prior to the deployment. A random sample of 1500 subjects was selected from the cohort of service members who were deployed to Afghanistan between 2002 and 2006. Predeployment and postdeployment serum samples from these subjects were tested by enzyme immunoassay for total antibodies to HEV. Results. The seroprevalence of antibodies to HEV in US service members prior to deployment was 1.1%. The seroconversion rate among service members deployed to Afghanistan was 0.13%. Although subpopulations may be at higher risk for HEV exposure during deployment, the risk among US service members deployed to Afghanistan in this study was low. Previously implemented and current preventive measures in theater appear to have been adequate. With future deployments to new areas or changes in military operations in areas of risk, continued surveillance for HEV infection in the military will be warranted.

Infectivity of equine H3N8 influenza virus in bovine cells and calves

Serological evidence for influenza A, subtype H1 and H3 virus infections of bovines, associated with respiratory disease and decreased milk production, has been reported. Equine H3N8 influenza virus circulates widely and was responsible for the introduction of H3N8 influenza into canines. To explore the possibility that equine H3N8 influenza might also infect bovines. To assess the incidence of seroconversion in the field, a retrospective survey of bovine serum samples was carried out. Also, primary cultures of bovine nasal turbinate cells, and live beef calves, were studied for their permissiveness to infection. We found serological evidence of exposure of bovines in Kentucky to H3 influenza. We demonstrate that cultured bovine respiratory epithelium is permissive for the growth of equine H3N8 influenza virus in vitro, but this virus does not replicate extensively or produce disease in experimentally inoculated cattle.

West Nile virus circulation in Emilia-Romagna, Italy: the integrated surveillance system 2009

Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.

Effects of housing on the incidence of visna/maedi virus infection in sheep flocks

The incidence of seroconversion to visna/maedi virus (VMV) infection and its relationship with management and sheep building structure was investigated in 15 dairy sheep flocks in Spain during 3-7years. Incidence rates were 0.09 per sheep-year at risk in semi-intensive Latxa flocks and 0.44 per sheep-year at risk in intensive Assaf flocks and was greatest for the one year old Assaf replacement flock. Separate multivariable models developed for replacement and adult flocks indicated that in both cases seroconversion was strongly associated to direct contact exposure to infected sheep and to being born to a seropositive dam. The latter effect was independent of the mode of rearing preweaning and the risk of seroconversion was similar for sheep fed colostrum and milk from a seropositive or a seronegative dam. These results are further evidence of the efficiency of horizontal VMV transmission by close contact between sheep and also suggest a inheritable component of susceptibility and resistance to infection. In contrast, indirect aerogenous contact with seropositive sheep was not associated with seroconversion as evidenced in replacement sheep housed in separate pens in the same building as adult infected sheep for one year. Consequently, VMV may not be efficiently airborne over short distances and this is important for control of infection. Moreover, there was no relationship between seroconversion and shed open areas. The latter could be related to having examined few flocks in which high infection prevalence dominated the transmission process while ventilation, may depend on a variety of unrecorded factors whose relationship to infection needs to be further investigated.

Reducing Sexual Risk Behavior Among Steady Heterosexual Serodiscordant Couples in a Testing and Counseling Program

To assess the effect of an HIV counseling and testing program targeting steady heterosexual serodiscordant couples. We studied 564 couples who attended a sexually transmitted infections/HIV clinic in Madrid in the period 1989 to 2007 and participated in couples counseling and testing. Sociodemographic, epidemiologic, clinical, and behavioral information of both partners was obtained before testing the nonindex partner. Sexual practices reported in the first (preintervention) and second visit were compared, as well those reported in 4 additional visits. Among the 399 couples who returned for a second visit (71%), the median number of sexual risk practices in the previous 6 months decreased (26.9-0; P <0.001) and the percentage of couples who had not engaged in sexual risk behavior increased (46.1-66.7; P <0.001). This reduction was maintained by the 143 couples who had 4 return visits. The diagnosis of HIV-infection in the index case previous to entering the program was associated with a lower frequency of sexual risk behavior. Independent predictors of postintervention risky sexual behavior included preintervention sexual risk behavior (odds ratio [OR]: 2.8, 95% confidence interval: 1.7-4.4), index case aged over 35 (OR: 2.0, 1.2-3.3), and a recent pregnancy (OR: 3.1, 1.6-6.3). The incidence of HIV seroconversion was 3.9 per 1000 couple-years (1.4-9.7). The diagnosis of HIV-infection and counseling appears to provide complementary reductions in sexual risk behaviors among serodiscordant steady heterosexual couples at follow-up, but the risk of transmission was not totally eliminated.

Seroconversion to bovine viral diarrhoea virus and infectious bovine rhinotracheitis virus in dairy herds of Michoacan, Mexico

Bovine viral diarrhoea virus (BVDV) and infectious bovine rhinotracheitis virus (IBRV) are important viral diseases around the world. The objective of this study was to estimate the incidence of seroconversion to BVDV and IBRV and to identify associated risk factors in dairy herds of Michoacan, Mexico. The longitudinal study included 62 herds and ran from December 2001 to November 2002. The total number of animals enrolled and completing the study were 392 and 342 animals for BVDV and 925 and 899 animals for IBRV. Animals were tested monthly for 12 months, for the presence of antibodies. Risk factors were: herd size (2-9, 10-25 and 26-55 animals), herd serostatus (seropositive or seronegative, only for IBRV), age group of the animal (6 to 12, 13 to 24, 25 to 48 and > 48 months) and animal origin (born in farm, purchased). The cumulative incidences for BVDV and IBRV were 16.4% and 3.4%, respectively; whereas, the incidence density rates for BVDV and IBRV were 15.9 and 2.9 per 1000 animal-months at risk, respectively. Seroconversion curves were statistically different for age group for BVDV and IBRV and for herd status for IBR. The relatively high incidence of seroconversion for BVDV suggests that a successful control programme should be oriented towards the identification and elimination of the PI animals and towards avoiding the introduction of PI cattle to the farm. The scenario of IBRV is favourable to implement a programme directed to reduce the number of new seropositive herds.

Cytomegalovirus infection following renal transplantation in patients administered low-dose rituximab induction therapy

Anti-CD20 antibody (rituximab) is recently being used as a B cell-depleting agent in renal transplantation (RTx). However, the incidence of infectious complications associated with rituximab therapy remains uncertain. We evaluated the incidence of cytomegalovirus (CMV) infection associated with rituximab therapy in RTx. A total of 83 patients were enrolled. The immunosuppressive regimen consisted of tacrolimus or cyclosporin, mycophenolate mofetil, methylprednisolone and basiliximab. In 54 patients, only one dose of rituximab (200 or 500 mg/kg body weight) was given before RTx. A total of 25 of 43 (58.1%) recipients who were CMV seropositive prior to RTx and who received rituximab induction therapy developed CMV infection, compared to 18 of 24 (75%) CMV seropositive recipients who did not receive rituximab therapy (P = 0.1676). A total of 8 of 11 patients who were CMV seronegative prior to RTx and who received rituximab developed CMV infection. However, CMV seroconversion was seen in all 8 of these infected patients. Low-dose rituximab induction therapy in renal transplant recipients appears to have no influence on the incidence of CMV infection and CMV seroconversion. However, we have to consider anti-CMV prophylaxis therapy, because of high incidents of CMV infection, especially for CMV seronegative recipients who received rituximab.

HIV Testing Rates and Outcomes in a South African Community, 2001-2006: Implications for Expanded Screening Policies

Revised World Health Organization recommendations seek to increase HIV testing. We assessed the need for expanded testing in South Africa by examining current testing and treatment trends among a high prevalence population. We determined the numbers of adults receiving HIV testing and antiretroviral treatment (ART) during 2001-2006 using testing registers linked to patient records from 2 health care facilities believed responsible for virtually all HIV services available to the population. We evaluated annual population testing rates using census population counts; proportions of clients testing seropositive (yield); CD4 counts and World Health Organization stage at diagnosis; and ART initiation rates. HIV testing rates rose from 4% in 2001 to 20% in 2006 (P < 0.001) and were highest among pregnant females receiving provider-initiated testing. Yield for first-time testers decreased from 47% in 2001 to 28% in 2006; annual incidence of seroconversion among initially HIV-negative retesters was 1.9%. Median CD4 counts and World Health Organization stage distributions for newly diagnosed clients remained stable. HIV-infected clients receiving ART within 6 months of eligibility increased from 0% in 2001 to 68% in 2006 (P < 0.001). Population testing and ART initiation rates rose dramatically during 2001-2006. Yet, yield remained high, and HIV-infected persons continued to receive late diagnoses. These findings highlight the continuing need for expanded testing and linkage to care.

Effect of annual influenza immunization on antibody response in lung transplant patients

Influenza viral infections cause significant morbidity and mortality each season. Lung transplant patients may be at higher risk because of their underlying pathophysiology. Although annual immunization is the standard of care, its efficacy remains largely unproven. Previous studies showed poor antibody response to influenza vaccine in lung transplant patients, but no data on the antibody response in consecutive seasons have been published. We studied antibody responses to influenza vaccine in 122 subjects: 66 lung transplant recipients, 28 control subjects, and 28 patients awaiting lung transplantation. We compared antibody response rates to individual viruses contained in influenza vaccines in consecutive years within the 3 groups. Serum antibody concentrations were measured at baseline and 2 to 4 weeks after vaccination by using the hemagglutination inhibition assay. Log-transformed antibody concentrations and incidence of serconversion and seroprotection were calculated. Median log-transformed antibody responses were similar in consecutive seasons in lung transplant subjects. Incidences of seroprotection and seroconversion did not differ between consecutive seasons in lung transplant recipients. Antibody responses were similar in consecutively measured years in lung transplant subjects. Annual influenza vaccination in lung transplant subjects produces similar immune responses in 2 consecutive years, indicating that these patients are not at significantly increased risk of vaccine failure.

Effect of Annual Influenza Immunization on Antibody Response in Lung Transplant Patients

Influenza viral infections cause significant morbidity and mortality each season. Lung transplant patients may be at higher risk because of their underlying pathophysiology. Although annual immunization is the standard of care, its efficacy remains largely unproven. Previous studies showed poor antibody response to influenza vaccine in lung transplant patients, but no data on the antibody response in consecutive seasons have been published. We studied antibody responses to influenza vaccine in 122 subjects: 66 lung transplant recipients, 28 control subjects, and 28 patients awaiting lung transplantation. We compared antibody response rates to individual viruses contained in influenza vaccines in consecutive years within the 3 groups. Serum antibody concentrations were measured at baseline and 2 to 4 weeks after vaccination by using the hemagglutination inhibition assay. Log-transformed antibody concentrations and incidence of serconversion and seroprotection were calculated. Median log-transformed antibody responses were similar in consecutive seasons in lung transplant subjects. Incidences of seroprotection and seroconversion did not differ between consecutive seasons in lung transplant recipients. Antibody responses were similar in consecutively measured years in lung transplant subjects. Annual influenza vaccination in lung transplant subjects produces similar immune responses in 2 consecutive years, indicating that these patients are not at significantly increased risk of vaccine failure.

Infections sexuellement transmissibles et contaminations sexuelles par le virus de l’immunodéficience humaine dans les armées françaises en 2006

Servicemen constitute a group at risk for exposure to sexually transmitted diseases (STD) and for this reason specific surveillance of STD and human immunodeficiency virus (HIV) seroconversion has been conducted in the French Armed Forces since 1996.All cases of STD and HIV seroconversion occurring in military personnel and corresponding to the notification criteria are reported by a military doctor, wherever the diagnosis is made. Incidence rates are calculated based on numbers of military personnel provided by the Ministry of Defence Social Observatory.In 2006, 67 cases of STD and 10 of HIV seroconversion due to sexual contamination were reported in the French Forces. The incidence of STD and HIV seroconversion was respectively 19.2 and 2.8 cases per 100,000. Gonorrhoea was the principal notified STD, with half of the cases of HIV seroconversion involving acute HIV infection. 59.7% of STD and 70.0% of HIV seroconversion were contracted in metropolitan France.STD and HIV seroconversion remain a subject of concern for the French Medical Forces despite low rates of incidence.

High Seroprevalence But Low Incidence of HCV Infection in a Cohort of Patients With Sexually Transmitted HIV in Andalusia, Spain

To analyze the prevalence and the incidence of hepatitis C virus (HCV) seropositivity in sexually transmitted human immunodeficiency virus (HIV) patients. Observational study of 1468 sexually transmitted HIV-infected patients from 7 hospitals (Southern Spain). Characteristics of HCV cases, and incidence of HCV seroconversion was assessed. Seroprevalence of HCV was 16.1%, higher among heterosexual than homosexual patients, and similar between heterosexual men and women. Seroincidence was 0.16 cases per 100 patient-years, similar between homosexual and heterosexual patients. HCV patients had a mean CD4 of 523 cells/microl, 82.0% were on highly active antiretroviral therapy (HAART), and 72.0% had undetectable HIV viral load. Serum HCV-RNA was positive in 79.0% cases, and only 16.0% had ever received HCV treatment. HCV seroprevalence among sexually transmitted HIV-infected patients is more frequent than in the general population; however, incidence of HCV infection is currently low. Patients with sexually transmitted HIV coinfected with HCV have their HIV infection well controlled, but HCV infection was treated in few cases.