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Pitasi M.A.,Emory University | Smith A.J.,NCHHSTP | Teshale E.H.,NCHHSTP
AIDS and Behavior | Year: 2014

Men who have sex with men (MSM) bear a disproportionate burden of hepatitis B virus (HBV) infections. We used serologic data from the National HIV Behavioral Surveillance (NHBS) system to determine the prevalence and correlates of HBV infection, immunization, and susceptibility in a sample of Los Angeles County MSM. Approximately 19 % (95 % CI 15-24 %) had serologic evidence of current or past infection, while 35 % (95 % CI 30-40 %) were susceptible. Compared with the youngest age group, MSM ages 40-49 years had a lower prevalence of immunization (aPR 0.28, 95 % CI 0.17-0.45) and a higher prevalence of infection (aPR 8.53, 95 % CI 3.95-18.4) and susceptibility (aPR 2.02, 95 % CI 1.13-3.63). We also observed poor concordance between self-reported and serologic measures of vaccination. Our results indicate the possibility of missed opportunities to vaccinate MSM. Gaps in implementing existing vaccination strategies must be addressed to increase hepatitis B vaccination coverage for MSM, especially in older age groups. © 2013 Springer Science+Business Media New York.


Lanier Y.,NCHHSTP | Castellanos T.,NCHHSTP | Barrow R.Y.,Centers for Disease Control and Prevention | Jordan W.C.,HIV AIDS Advisory Committee | And 2 more authors.
AIDS Patient Care and STDs | Year: 2014

Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts. © 2014, Mary Ann Liebert, Inc.


Truman B.I.,National Center for HIV AIDS | Vernon-Smiley M.,NCHHSTP | Johnson V.C.,Emory University | Johnson R.L.,Rutgers New Jersey Medical School | And 5 more authors.
American Journal of Preventive Medicine | Year: 2016

Context Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, tired, and hungry, and more likely to have impaired vision and hearing - obstacles to lifetime educational achievement and predictors of adult morbidity and premature mortality. If school-based health centers (SBHCs) can overcome educational obstacles and increase receipt of needed medical services in disadvantaged populations, they can advance health equity. Evidence acquisition A systematic literature search was conducted for papers published through July 2014. Using Community Guide systematic review methods, reviewers identified, abstracted, and summarized available evidence of the effectiveness of SBHCs on educational and health-related outcomes. Analyses were conducted in 2014-2015. Evidence synthesis Most of the 46 studies included in the review evaluated onsite clinics serving urban, low-income, and racial or ethnic minority high school students. The presence and use of SBHCs were associated with improved educational (i.e., grade point average, grade promotion, suspension, and non-completion rates) and health-related outcomes (i.e., vaccination and other preventive services, asthma morbidity, emergency department use and hospital admissions, contraceptive use among females, prenatal care, birth weight, illegal substance use, and alcohol consumption). More services and more hours of availability were associated with greater reductions in emergency department overuse. Conclusions Because SBHCs improve educational and health-related outcomes in disadvantaged students, they can be effective in advancing health equity. © 2016 American Journal of Preventive Medicine.


MONTRÉAL, CANADA--(Marketwired - 1 nov. 2016) - Theratechnologies Inc. (Theratechnologies) (TSX:TH) a annoncé aujourd'hui qu'elle a été l'hôte, à Toronto, d'une présentation faite à des analystes financiers du secteur de la santé. Le but de cette rencontre était de fournir, à la communauté des analystes affectés au secteur de la santé, un sommaire des développements des dernières années au sujet de notre entreprise, des activités récentes touchant EGRIFTAMD (tésamoréline pour injection) et de procéder à une revue complète de l'ibalizumab, un antirétroviral biologique à action prolongée présentement sous étude clinique. Theratechnologies a discuté des données cliniques de l'ibalizumab présentées la semaine dernière au prestigieux congrès scientifique IDWeek 2016MC. Ces données, récemment dévoilées à ce congrès, ont été revues en détail, de même que les résultats d'études de marché pour l'ibalizumab aux États-Unis. Celles-ci ont été réalisées par notre équipe à l'interne et aussi par des conseillers indépendants externes se spécialisant dans ce genre de recherches auprès des médecins et des payeurs. La principale conclusion de cette analyse est que, présentement, il y a approximativement 20 000 à 25 000 patients aux États-Unis qui sont, à l'heure actuelle, infectés par un VIH-1 pluri-résistant aux médicaments (PRM) disponibles (défini comme étant résistant à au moins un médicament dans au moins trois classes de thérapies antirétrovirales (TAR)). Ces chiffres sont significativement plus élevés que ce qui avait été avancé par la Compagnie jusqu'à présent. Bien que la science médicale ait fait d'importants progrès depuis les 35 dernières années, les patients PRM demeurent très difficiles à traiter, et nos recherches démontrent que 50 à 56% de ces patients éprouvent une défaillance virologique à l'intérieur d'une période de 48 semaines de traitement qui requiert que leur médecin modifie leur thérapie. L'ibalizumab a obtenu la désignation de « percée thérapeutique » de la U.S. Food and Drug Administration (FDA) qui lui a aussi attribué le titre de « médicament orphelin » en plus de lui accorder une évaluation prioritaire. Les résultats pour le paramètre primaire de l'étude de phase III de l'ibalizumab ont été mis en avant-plan lors d'une présentation orale de dernière minute à IDWeek 2016MC le 29 octobre 2016 et ont aussi été sélectionnés par le comité scientifique d'IDWeek 2016MC pour être présentés lors d'une conférence de presse tenue le 28 octobre 2016. Ces résultats ont également été diffusés dans un communiqué de presse que nous avons émis le 28 octobre 2016. « Nous avons constaté, au cours des derniers jours, que la communauté scientifique s'intéresse grandement à l'ibalizumab et nous sommes heureux que les données d'ibalizumab aient été partagées avec la communauté médicale au cours de la dernière fin de semaine et avec les analystes financiers aujourd'hui, » a déclaré Luc Tanguay, président et chef de la direction de Theratechnologies. « Les informations supplémentaires transmises aux analystes aujourd'hui démontrent qu'un nombre important de personnes infectées par le VIH-1 PRM pourrait tirer des bénéfices de l'ibalizumab, s'il est approuvé, » a-t-il ajouté. Notre recherche auprès des payeurs américains a aussi permis de constater que les programmes privés et publics d'assurance reconnaissent le besoin médical non satisfait pour les patients infectés par le VIH-1 PRM et ils ont exprimé des points de vue favorables par rapport à un produit qui pourrait offrir un profil d'innocuité avantageux et une efficacité clinique pour ces patients difficilement traitables. Notre partenaire, TaiMed Biologics, Inc., a récemment annoncé la conclusion de la portion de traitement de l'étude pivot de phase III et nous sommes impatients de pouvoir présenter les premiers résultats sur l'innocuité et les paramètres secondaires d'efficacité sur une période de 24 semaines d'ici quelques semaines. Nous continuons à travailler diligemment à la préparation du lancement commercial potentiel d'ibalizumab aux États-Unis dans les meilleurs délais. L'information présentée aujourd'hui est basée sur l'analyse d'un certain nombre de recherches publiquement disponibles en plus d'études de marché effectuées, pour notre compte, par nos conseillers externes indépendants. Les données publiques sont notamment issues du North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), du NCHHSTP Atlas (Center for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention), du Stanford University HIV Drug Resistance Database et du Swiss HIV Cohort Study. L'ibalizumab est un anticorps monoclonal humanisé présentement en développement pour le traitement potentiel de l'infection au VIH-1. Contrairement aux autres médicaments antirétroviraux, l'ibalizumab se lie principalement au deuxième domaine extracellulaire du récepteur CD4, qui est éloigné des sites de liaison au complexe majeur d'histocompatibilité de classe II (CMH II). L'ibalizumab prévient potentiellement l'infection des cellules immunitaires CD4 par le VIH-1 tout en préservant la fonction immunitaire normale. L'ibalizumab est actif contre le VIH-1 résistant à tous les médicaments antirétroviraux approuvés. L'ibalizumab a été testé en phase I et II du programme de recherche clinique et la phase III est la dernière étude clinique pivot requise par la FDA afin de compléter le Biologic Licence Application (BLA) à être soumis à la FDA. Theratechnologies (TSX:TH) est une société pharmaceutique spécialisée dans le traitement de besoins médicaux non satisfaits en vue de promouvoir auprès des patients infectés par le VIH un mode de vie sain et une qualité de vie améliorée. D'autres renseignements sur Theratechnologies sont disponibles sur le site Web de la Société au www.theratech.com et sur SEDAR au www.sedar.com. Information prospective Le présent communiqué de presse renferme des énoncés prospectifs et de l'information prospective (collectivement, les « énoncés prospectifs ») au sens de la législation applicable en valeurs mobilières qui reposent sur les opinions et les hypothèses de la direction et sur l'information dont celle-ci dispose présentement. Vous pouvez identifier les énoncés prospectifs par l'emploi de mots tels que « peut », « va », « pourrait », « voudrait », « devrait », « perspectives », « croit », « planifie », « envisage », « prévoit », « s'attend » et « estime » ou la forme négative de ces termes ou des variations de ceux-ci. Les énoncés prospectifs présents dans ce communiqué de presse incluent notamment le nombre de patients infectés par le VIH-1 PRM, le pourcentage de patients présentant une augmentation de la charge virale sur une période de 48 semaines, le dépôt d'un BLA à la FDA pour l'ibalizumab, la présentation des premiers résultats de l'étude concernant l'innocuité et les paramètres secondaires d'efficacité pour la période de 24 semaines et le lancement de l'ibalizumab pour le traitement du VIH aux États-Unis. Les énoncés prospectifs sont fondés sur un certain nombre d'hypothèses et sont sujets à des risques et incertitudes dont plusieurs sont hors de la volonté de Theratechnologies et pourraient entrainer un écart marqué entre les résultats réellement obtenus et ceux exprimés, expressément ou implicitement, par de tels énoncés prospectifs. Ces hypothèses incluent notamment que nos estimés dans la détermination du nombre de patients infectés par la VIH-1 PRM et dans le pourcentage de patients présentant une augmentation de la charge virale sur une période 48 semaines sont exacts, qu'il n'y aura pas de retard dans l'analyse des premiers résultats de l'étude concernant l'innocuité et les paramètres secondaires d'efficacité pour la période de 24 semaines, que l'ibalizumab sera approuvé par la FDA en tant que traitement pour le VIH et que, si l'ibalizumab est approuvé par la FDA, Theratechnologies aura, en temps opportun, mis en place l'infrastructure requise pour le lancement de l'ibalizumab. Les risques et incertitudes incluent notamment le risque que les sources consultées, afin de tirer des conclusions quant à nos estimés, ne soient plus à jour, que nous avons mal calculé nos estimés, que les résultats complets de l'étude pivot de phase III ne soient pas suffisamment satisfaisants pour la soumission d'un BLA auprès de la FDA, que la FDA n'approuve pas l'ibalizumab en tant que traitement pour le VIH, que la FDA exige la tenue d'essais cliniques supplémentaires et que nous ne soyons pas en mesure de mettre en place l'infrastructure requise pour le lancement de l'ibalizumab aux États-Unis, s'il est approuvé par la FDA. Les investisseurs éventuels sont priés de se reporter à la rubrique « Facteurs de risque » de la notice annuelle de la société datée du 24 février 2016 pour plus d'informations sur les risques et incertitudes touchant Theratechnologies. La notice annuelle peut être consultée à l'adresse www.sedar.com. Le lecteur est prié d'examiner ces risques et incertitudes attentivement et de ne pas se fier indûment aux énoncés prospectifs. Les énoncés prospectifs reflètent les attentes actuelles concernant des événements futurs. Ils ne sont valables qu'à la date du présent communiqué de presse et traduisent nos attentes à cette date. Nous ne nous engageons aucunement à mettre à jour ou à réviser l'information contenue dans ce communiqué de presse, que ce soit à la suite de l'obtention de nouveaux renseignements, à la suite de nouveaux événements ou circonstances ou pour toute autre raison que ce soit, sauf si les lois en vigueur l'exigent.


News Article | November 1, 2016
Site: www.marketwired.com

MONTREAL, CANADA--(Marketwired - Nov. 1, 2016) - Theratechnologies Inc. (Theratechnologies) (TSX:TH) today announced that it hosted a presentation with healthcare securities analysts in Toronto. The purpose of the meeting was to provide the healthcare analyst community with a summary of our corporate developments over the last few years, our current activities with EGRIFTA® (tesamorelin for injection) and to provide detailed review of ibalizumab, an investigational HIV biologic and long-acting antiretroviral drug. Theratechnologies discussed clinical data on ibalizumab that were presented last week at a prestigious scientific conference, IDWeek 2016™. Previously published clinical data were also reviewed in detail, along with the results of our market studies on ibalizumab for the United States market. These market studies were carried out by our internal team, and by independent external consultants specialized in physician and payer market research. The main conclusion of this analysis is that approximately 20,000 to 25,000 patients in the United States are currently infected with multi-drug resistant (MDR) HIV-1 (defined as resistant to at least one drug in at least 3 different classes of antiretroviral therapies (ART)). These numbers are significantly higher than those previously discussed by the Company. While medical science has made tremendous progress over the past 35 years, MDR patients are still very difficult to treat, and our research shows that between 50%-56% of these patients experience a virological failure over a period of 48 weeks of treatment requiring their physician to modify their treatment. Ibalizumab was granted "Breakthrough Therapy" designation by the United States Food and Drug Administration (FDA), received "Orphan Drug" status as well as "Fast Track" designation. Ibalizumab Phase III primary end point results were featured in an oral late-breaker presentation at IDWeek 2016™ on October 29th, 2016 and were also selected by the scientific committee of IDWeek 2016™ to be presented at a press conference on Friday, October 28, 2016. These results were also highlighted in our press release of October 28, 2016. "We have received a substantial amount of interest from the scientific community in the past few days on ibalizumab, and we are pleased that ibalizumab data were shared with the medical community over the past weekend and with financial analysts today" said Luc Tanguay, President and CEO of Theratechnologies. "The additional information shared with analysts today show that a significant number of people infected with HIV-1 MDR could benefit from ibalizumab, if approved" he added. Our research with U.S. payers also showed that both private and public insurance plans recognize the unmet medical need for MDR HIV-1 infected patients, and have expressed positive views towards a product that could demonstrate a favorable safety profile and clinical efficacy for these difficult to treat patients. Our partner, TaiMed Biologics, Inc., recently announced the completion of the treatment phase of the pivotal Phase III trial, and we look forward to announcing the top-line safety and secondary endpoint results for the 24-week treatment period in the next few weeks. We continue to work diligently in preparing for the potential commercial launch of ibalizumab in the United States in a timely manner. The information presented today is based on our analysis of a number of publicly available research studies, as well as on market research carried out by independent external consultants on our behalf. Publicly available data were sourced from, among others, the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), the NCHHSTP Atlas (the Center for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention), the Stanford University HIV Drug Resistance Database and the Swiss HIV Cohort Study. Ibalizumab is a humanized monoclonal antibody being developed for the potential treatment of HIV-1 infection. Unlike other antiretroviral agents, Ibalizumab binds primarily to the second extracellular domain of the CD4 receptor, away from Major Histocompatibility Complex II molecule (MHC II) binding sites. It potentially prevents HIV virus from infecting CD4+ immune cells while preserving normal immunological function. Ibalizumab is active against HIV-1 resistant to all approved antiretroviral agents. Ibalizumab has been tested in phase I and II clinical trials and the phase III study is the last pivotal clinical study necessary for the completion of a Biologic License Application (BLA) to be filed with the FDA. Theratechnologies (TSX:TH) is a specialty pharmaceutical company addressing unmet medical needs to promote healthy living and an improved quality of life among HIV patients. Further information about Theratechnologies is available on the Company's website at www.theratech.com and on SEDAR at www.sedar.com. This press release contains forward-looking statements and forward-looking information, or, collectively, forward-looking statements, within the meaning of applicable securities laws, that are based on our management's belief and assumptions and on information currently available to our management. You can identify forward-looking statements by terms such as "may", "will", "should", "could", "would", "outlook", "believe", "plan", "envisage", "anticipate", "expect" and "estimate" or the negatives of these terms, or variations of them. The forward-looking statements contained in this press release include, but are not limited to, the number of patients infected with MDR HIV-1, the percentage of patients experiencing an increase in viral load over a 48-week period, the filing of a BLA with the FDA for ibalizumab, the announcement of topline results of safety and secondary efficacy endpoints for the 24-week treatment period related to the study and the launch of ibalizumab as an HIV treatment in the United States. Forward-looking statements are based upon a number of assumptions and are subject to a number of risks and uncertainties, many of which are beyond Theratechnologies' control that could cause actual results to differ materially from those that are disclosed in or implied by such forward-looking information. These assumptions include but are not limited to, the following: our estimates in determining the number of patients infected with MDR HIV-1 and the percentage of patients experiencing an increase in viral load over a 48-week period are accurate, no delay will occur in the analysis of the topline results of the safety and secondary efficacy endpoints for the 24-week treatment period of the study, ibalizumab will be approved by the FDA as a treatment for HIV, and, if ibalizumab is approved by the FDA, Theratechnologies will have set-up on time the necessary infrastructure to launch ibalizumab. These risks and uncertainties include, but are not limited to, the risk that the sources consulted to draw conclusions on our estimates are no longer up to date, we miscalculated our estimates, the complete results from the phase III pivotal-study are not good enough to file a BLA with the FDA, the FDA does not approve ibalizumab as a treatment for HIV, the FDA requires additional clinical trials to be conducted and that we are unable to have all the necessary infrastructure set-up to successfully launch ibalizumab in the United States, if approved by the FDA. We refer potential investors to the "Risk Factors" section of our Annual Information Form (AIF) dated February 24, 2016 for additional risks and uncertainties about Theratechnologies. The AIF is available on SEDAR at www.sedar.com. The reader is cautioned to consider these and other risks and uncertainties carefully and not to put undue reliance on forward-looking statements. Forward-looking statements reflect current expectations regarding future events and speak only as of the date of this press release and represent our expectations as of that date. We undertake no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances or otherwise, except as may be required by applicable law.


Oster A.M.,National Center for HIV AIDS | Sternberg M.,National Center for Environmental Health | Nebenzahl S.,National Center for HIV AIDS | Broz D.,National Center for HIV AIDS | And 4 more authors.
Sexually Transmitted Diseases | Year: 2014

BACKGROUND: Men who have sex with men (MSM), injection drug users (IDUs), and certain subgroups of heterosexuals are disproportionately affected by the syndemics of HIV, other sexually transmitted infections, and viral hepatitis. Although understanding the burden of these infections in these populations by urbanicity (the degree to which a geographic area is urban) is critical to targeting prevention programs, few studies have done so. METHODS: We analyzed nationally representative 1999 to 2010 data from the National Health and Nutrition Examination Survey on persons aged 18 to 59 years. We estimated the weighted prevalence of HIV, herpes simplex virus type 2 (HSV-2), human papillomavirus, chlamydia, hepatitis B, and hepatitis C, stratified by urbanicity level, for the overall sample, MSM, IDUs, and heterosexuals. Geographic areas with population at least million are classified into large central and large fringe metropolitan counties. RESULTS: Overall, large central metropolitan areas had a higher prevalence of HIV, HSV-2, and hepatitis B. HIV prevalence among MSM was elevated in large central and large fringe metro areas (14.5% and 16.9%, respectively). Among heterosexuals, large central metropolitan areas had elevated prevalence of HSV-2, chlamydia, and hepatitis B. Human papillomavirus and hepatitis C prevalence did not vary significantly by urbanicity for any population, including IDUs. CONCLUSIONS: Infections with higher prevalence in urban areas merit a geographically focused approach to screening and prevention programs, whereas those with uniform prevalence across levels of urbanicity would benefit from a generalized prevention approach. These nationally representative, population-based data allow for more effective planning for prevention programs. © 2014 American Sexually Transmitted Diseases Association.


PubMed | Centers for Disease Control and Prevention and NCHHSTP
Type: | Journal: Antimicrobial resistance and infection control | Year: 2016

We assessed the validity of testing for antimicrobial susceptibility of clinical and mutant One hundred and five clinical isolates and ten laboratory-mutants were tested following Clinical Laboratory Standard Institute (CLSI) and manufacturers standards for each of the three methods. The measured diameters by the disk diffusion method were tested for correlation with the MIC values by agar dilution. In addition, comparisons with the Etest were made. Categorical results for concordance, based on standard CLSI cutoffs, between the disk diffusion and the other two methods, respectively, were tested using the Chi-square statistics. Reproducibility was tested for CFX across a 6-month interval by repeated disk tests.Across all 115 specimens, the disk diffusion tests produced good categorical agreements, exhibiting concordance of 93.1%, 92.1%, and 90.4% with agar dilution and 93.0%, 92.1%, and 90.4% with Etest, for CRO, CFX, and CPD, respectively. Pearson correlations between disk-diffusion diameters and agar dilution MICs were -0.59, -0.67, and -0.81 for CRO, CFX, and CPD, respectively. The correlations between disk diffusion and Etest were -0.58, -0.73, and -0.49. Pearson correlation between the CFX disk readings over a 6-month interval was 91%.Disk diffusion tests remain to be a useful, reliable and fast screening method for qualitative antimicrobial susceptibility testing for ceftriaxone, cefixime, and cefpodoxime.


PubMed | Rutgers New Jersey Medical School, Morehouse School of Medicine, NCHHSTP, University of California at Los Angeles and 5 more.
Type: Journal Article | Journal: American journal of preventive medicine | Year: 2016

Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, tired, and hungry, and more likely to have impaired vision and hearing-obstacles to lifetime educational achievement and predictors of adult morbidity and premature mortality. If school-based health centers (SBHCs) can overcome educational obstacles and increase receipt of needed medical services in disadvantaged populations, they can advance health equity.A systematic literature search was conducted for papers published through July 2014. Using Community Guide systematic review methods, reviewers identified, abstracted, and summarized available evidence of the effectiveness of SBHCs on educational and health-related outcomes. Analyses were conducted in 2014-2015.Most of the 46 studies included in the review evaluated onsite clinics serving urban, low-income, and racial or ethnic minority high school students. The presence and use of SBHCs were associated with improved educational (i.e., grade point average, grade promotion, suspension, and non-completion rates) and health-related outcomes (i.e., vaccination and other preventive services, asthma morbidity, emergency department use and hospital admissions, contraceptive use among females, prenatal care, birth weight, illegal substance use, and alcohol consumption). More services and more hours of availability were associated with greater reductions in emergency department overuse.Because SBHCs improve educational and health-related outcomes in disadvantaged students, they can be effective in advancing health equity.


Vishwanathan S.A.,NCHHSTP | Guenthner P.C.,NCHHSTP | Lin C.Y.,NCHHSTP | Dobard C.,NCHHSTP | And 7 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2011

Fluctuations in susceptibility to HIV or SHIV during the menstrual cycle are currently not fully documented. To address this, the time point of infection was determined in 19 adult female pigtail macaques vaginally challenged during their undisturbed menstrual cycles with repeated, low-dose SHIVSF162P3 exposures. Eighteen macaques (95%) first displayed viremia in the follicular phase, as compared with 1 macaque (5%) in the luteal phase (P < 0.0001). Due to a viral eclipse phase, we estimated a window of most frequent virus transmission between days 24 and 31 of the menstrual cycle, in the late luteal phase. Thus, susceptibility to vaginal SHIV infection is significantly elevated in the second half of the menstrual cycle when progesterone levels are high and when local immunity may be low. Such susceptibility windows have been postulated before but not definitively documented. Our data support the findings of higher susceptibility to HIV in women during progesterone-dominated periods including pregnancy and contraceptive use. © 2011 by Lippincott Williams & Wilkins.


Heijne J.C.M.,University of Bern | Tao G.,NCHHSTP | Kent C.K.,NCHHSTP | Low N.,University of Bern
American Journal of Preventive Medicine | Year: 2010

Background: Routine chlamydia screening is a recommended preventive intervention for sexually active women aged ≤25 years in the U.S. but rates of regular uptake are not known. Purpose: This study aimed to examine rates of annual chlamydia testing and factors associated with repeat testing in a population of U.S. women. Methods: Women aged 1525 years at any time from January 1, 2002, to December 31, 2006 who were enrolled in 130 commercial health plans were included. Data relating to chlamydia tests were analyzed in 2009. Chlamydia testing rates (per 100 woman-years) by age and rates of repeated annual testing were estimated. Poisson regression was used to examine the effects of age and previous testing on further chlamydia testing within the observation period. Results: In total, 2,632,365 women were included. The chlamydia testing rate over the whole study period was 13.6 per 100 woman years after adjusting for age-specific sexual activity; 8.5 (95% CI=6.0, 12.3) per 100 woman-years in those aged 15 years; and 17.7 (95% CI=17.1, 18.9) in those aged 25 years. Among women enrolled for the entire 5-year study period, 25.9% had at least one test but only 0.1% had a chlamydia test every year. Women tested more than once and older women were more likely to be tested again in the observation period. Conclusions: The low rates of regular annual chlamydia testing do not comply with national recommendations and would not be expected to have a major impact on the control of chlamydia infection at the population level. © 2010 American Journal of Preventive Medicine.

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