Extended Analysis of HIV Infection in Cisgender Men and Transgender Women Who Have Sex with Men Receiving Injectable Cabotegravir for HIV Prevention: HPTN 083

HPTN 083 demonstrated that injectable cabotegravir (CAB) was superior to oral tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) for HIV prevention in cisgender men and transgender women who have sex with men. We previously analyzed 58 infections in the blinded phase of HPTN 083 (16 in the CAB arm and 42 in the TDF-FTC arm). This report describes 52 additional infections that occurred up to 1 year after study unblinding (18 in the CAB arm and 34 in the TDF-FTC arm). Retrospective testing included HIV testing, viral load testing, quantification of study drug concentrations, and drug resistance testing. The new CAB arm infections included 7 with CAB administration within 6 months of the first HIV-positive visit (2 with on-time injections, 3 with ≥1 delayed injection, and 2 who restarted CAB) and 11 with no recent CAB administration. Three cases had integrase strand transfer inhibitor (INSTI) resistance (2 with on-time injections and 1 who restarted CAB). Among 34 CAB infections analyzed to date, diagnosis delays and INSTI resistance were significantly more common in infections with CAB administration within 6 months of the first HIV-positive visit. This report further characterizes HIV infections in persons receiving CAB preexposure prophylaxis and helps define the impact of CAB on the detection of infection and the emergence of INSTI resistance

Effects of Intermittent IL-2 Alone or with Peri-Cycle Antiretroviral Therapy in Early HIV Infection: The STALWART Study

BackgroundThe Study of Aldesleukin with and without antiretroviral therapy (STALWART) evaluated whether intermittent interleukin-2 (IL-2) alone or with antiretroviral therapy (ART) around IL-2 cycles increased CD4(+) counts compared to no therapy.MethodologyParticipants not on continuous ART with > or = 300 CD4(+) cells/mm(3) were randomized to: no treatment; IL-2 for 5 consecutive days every 8 weeks for 3 cycles; or the same IL-2 regimen with 10 days of ART administered around each IL-2 cycle. CD4(+) counts, HIV RNA, and HIV progression events were collected monthly.Principal findingsA total of 267 participants were randomized. At week 32, the mean CD4(+) count was 134 cells greater in the IL-2 alone group (p<0.001), and 133 cells greater in the IL-2 plus ART group (p<0.001) compared to the no therapy group. Twelve participants in the IL-2 groups compared to 1 participant in the group assigned to no therapy experienced an opportunistic event or died (HR 5.84, CI: 0.59 to 43.57; p = 0.009).ConclusionsIL-2 alone or with peri-cycle HAART increases CD4(+) counts but was associated with a greater number of opportunistic events or deaths compared to no therapy. These results call into question the immunoprotective significance of IL-2-induced CD4(+) cells.Trial registrationClinicalTrials.gov NCT00110812

Randomized clinical trial to assess the impact of the broadly neutralizing HIV-1 monoclonal antibody VRC01 on HIV-1 persistence in individuals on effective ART

Background. Broadly neutralizing monoclonal antibodies (bnMAbs) may promote clearance of HIV-1-expressing cells through antibody-dependent cell-mediated cytotoxicity. We evaluated the effect of the CD4-binding site bnMAb, VRC01, on measures of HIV-1 persistence in chronically infected individuals. Methods. A5342 was a phase 1, randomized, double-blind, placebo-controlled, parallel-arm study. Participants on effective antiretroviral therapy (ART) were randomized to receive 2 infusions of VRC01 (40 mg/kg) at entry and week 3, and 2 infusions of placebo (saline) at weeks 6 and 9; or 2 infusions of placebo at entry and week 3, and 2 infusions of VRC01 at weeks 6 and 9. Results. Infusion of VRC01 was safe and well tolerated. The median fold-change in the cell-associated HIV-1 RNA/DNA ratio from baseline to week 6 was 1.12 and 0.83 for the VRC01 and placebo arms, respectively, with no significant difference between arms (P = .16). There were no significant differences in the proportions with residual plasma viremia ≥1 copies/mL or in phorbol 12-myristate 13-acetate/ionomycin-induced virus production from CD4+ T cells between arms (both P > .05). Conclusions. In individuals with chronic HIV-1 infection on ART, VRC01 infusions were safe and well tolerated but did not affect plasma viremia, cellular HIV-1 RNA/DNA levels, or stimulated virus production from CD4+ T cells

Óxidos de ferro de solos formados sobre gnaisse do Complexo Bação, Quadrilátero Ferrífero, Minas Gerais Iron oxides of soils formed on gneiss of the Bação Complex geodomain, Quadrilátero Ferrífero, Minas Gerais, Brazil

O objetivo deste trabalho foi efetuar a caracterização mineralógica dos óxidos de ferro de horizontes B de três perfis de solos desenvolvidos sobre gnaisse do geodomínio do Complexo Bação, no Quadrilátero Ferrífero, em Minas Gerais. As amostras foram coletadas ao longo dos segmentos de alta, média e baixa vertente. As frações de terra fina (diâmetro médio, fi = 2 mm) foram separadas, em todas as amostras. A composição química dos elementos maiores foi determinada por meio da técnica de fluorescência de raios X; a análise mineralógica foi realizada com difratometria de raios X e espectroscopia Mössbauer. Todas as amostras têm composição mineralógica similar, cuja ocorrência geral corresponde à seqüência quartzo >> gibbsita > caulinita > goethita. Os resultados Mössbauer a 4,2 K confirmam a coexistência de goethita (majoritária) e hematita. Os conteúdos de alumínio isomórfico foram deduzidos dos valores de campos hiperfinos e correspondem às seguintes fórmulas químicas das goethitas: alfaFe0,79Al0,21OOH (alta vertente), alfaFe0,75Al0,25OOH (meia vertente) e alfaFe0,78Al0,22OOH (baixa vertente). A dinâmica de transformação dos óxidos de ferro nos horizontes B ao longo da vertente é um indicador das oscilações paleoclimáticas na área: goethita mais aluminosa é um indicador do paleoambiente úmido, e goethita menos aluminosa revela condições pedogênicas mais secas.<br>The objective of this work was to characterize iron oxides from B-horizons of three soil profiles developing on gneiss of the Bação Complex geodomain in the Quadrilátero Ferrífero, Minas Gerais, Brazil. Samples were collected from the uppest, middle and lowest segments along the slope. The earth fine fractions (mean diameter, phi = 2 mm) were separated for all samples. The chemical composition of the major elements was determined with the X-ray fluorescence technique; the mineralogical analysis was performed with powder X-ray diffractomer and Mössbauer spectroscopy. All samples have similar mineralogical composition, with a general occurrence corresponding to the sequence quartz >> gibbsite > kaolinite > goethite. From the 4.2 K-Mössbauer results, the coexistence of goethite (major) and hematite is confirmed. The isomorphic aluminum contents, as they were deduced from the hyperfine fields, lead to the following chemical formulas for goethites: alphaFe0.79Al0.21OOH (upslope), alphaFe0.75Al0.25OOH (midslope) and alphaFe0.78Al0.22OOH (downslope). The iron oxides transformation dynamics in B horizons along the slope is a useful indicator of the paleo-climatic oscillations in this area: aluminous goethite is an indicator of humid paleo-environments, whereas aluminous-poorer goethite reveals drier pedogenic conditions