ANTI-RBD IgG RESPONSE AFTER A PRIMARY ANTI-SARS-COV-2 VACCINATION COURSE WITH BNT162B2 AND AFTER A THIRD DOSE WITH A FIRST-GENERATION mRNA VACCINE IN A COHORT OF PEOPLE LIVING WITH HIV

Background Data on the immunogenicity of vaccines against SARS-CoV-2 document the reduction of the antibody titer six months after the end of the primary vaccination course and suggest the benefit of an additional vaccine dose, especially in frail and/or immunosuppressed subjects. Data on SARS-CoV-2 m-RNA vaccines immunogenicity in people living with HIV (PLWH) are currently limited, in relation to both the primary vaccination course and the boosting dose. Methods A cohort of PLWH on antiretroviral therapy attending a SARS-CoV-2 vaccination program were included prospectively after receiving a primary vaccine course with BNT162b2 and after a boosting dose with a first-generation m-RNA vaccine. Participants were stratified by baseline CD4 T-lymphocytes count (poor CD4 recovery, PCDR: <200/mm3; intermediate CD4 recovery, ICDR: 200–500/mm3; high CD4 recovery, HCDR: >500/mm3). RBD-binding IgG were measured using a commercial chemiluminescence microparticle antibody assay (Roche Elecsys® Anti-SARS-CoV-2 S) and titers were stratified in five categories: non-reactive (<5.58 BAU/mL); inconclusive (>5.58 BAU/mL and <45 BAU/mL); positive low (>45 BAU/mL and <205 BAU/mL); positive intermediate (>205 BAU/mL and <817 BAU/mL), and positive high (>817 BAU/mL). PLWH were evaluated at four successive time points: before the start of vaccination (T1), 3 weeks after the first dose (T2), 3 months + 1 month after the first dose (T3) and 1 month + 1 month after the third dose (T4). The onset of break-through infection was evaluated up to 6 months after the third vaccine dose. Results A total of 304 subjects were enrolled. Three months after the primary vaccination course with BNT162b2, 97% of 214 PLWH naïve for SARS-CoV-2 infection had a detectable antibody response, mainly at intermediate (51%) and high (35%) titers. Elicited titer was mainly positive-intermediate, for subjects both with low and with high pre-vaccinal CD4 T-lymphocyte counts (56% vs 50%). A positive-high anti-RBD IgG titer was reached especially in subjects with more than 500/mm3 CD4 T-lymphocytes at baseline in comparison to those with less than 500/mm3 (39% vs 21%). Advanced age and male gender were associated with the probability of developing a medium-low antibody titer. The presence of two or more comorbidities also seemed to be associated with a higher probability of developing a low-medium serological response. Current CD4 T-lymphocytes count greater than 500/mm3 before the administration of the first vaccine dose, was associated with an increased likelihood of developing a high serological response (OR 2.39; CI95% 1.04-5.53), but only at univariable analysis. An additional dose of SARS-CoV-2 mRNA vaccine after the initial two-dose vaccination, resulted in higher levels of immunity, both in PLWH with a baseline CD4 T-lymphocytes count higher and lower than 500/mm3 (97% vs 83%). 27% of 301 evaluable PLWH experienced at least one SARS-CoV-2 infection, mainly asymptomatic or pauci-symptomatic and at an average of 4.2 ± 3.2 months after the third booster dose (80% of infectious episodes). The probability of becoming infected after the booster was higher among SARS-CoV-2 naïve individuals (P .001). Conclusions 97% of PLWHs developed a humoral response against SARS-CoV-2 within three months after receiving a primary course with BNT162b2, albeit poorer in those with CD4 T-cell <500/mm3 versus those with >500 cell/mm3 at baseline. An additional dose of a m-RNA vaccine resulted in higher levels of immunity, independently from the baseline CD4 T-lymphocyte counts. First generation m-RNA vaccines, including booster doses, did not prevent SARS-CoV-2 infection in 27% of subjects but infective episodes were asymptomatic or pauci-symptomatic, suggesting the ability to prevent severe COVID-19 also caused by Omicron. Studies to monitor over time the humoral responses after boosting vaccination and on the immunogenicity of new bivalent omicron-containing vaccine are needed, also in PLWH

Italian Wild Rocket (Diplotaxis Tenuifolia (L.) DC.): Influence of Agricultural Practices on Antioxidant Molecules and on Cytotoxicity and Antiproliferative Effects

Wild rocket [ Diplotaxis tenuifolia (L.) DC.] belongs to the Brassicaceae family and has its origin in the Mediterranean region. The effect of conventional and integrated cultivation practices on the nutritional properties and benefits of wild rocket [ Diplotaxis tenuifolia (L.) DC.] were studied. Bioactive molecules content (vitamin C, quercetin, lutein), antioxidant properties and bioactivity of polyphenolic extracts from the edible part of rocket in Caco-2 cells were determined. Regarding antioxidant properties, FRAP (Ferric Reducing Antioxidant Power) values ranged from 4.44 ± 0.11 mmol/kg fw to 9.92 ± 0.46 mmol/kg fw for conventional rocket and from 4.13 ± 0.17 fw mmol/kg to 11.02 ± 0.45 mmol/kg fw for integrated rocket. The characteristics of wild rocket as a dietary source of antioxidants have been pointed out. Significant differences in the quality of conventional and integrated rocket have been shown, while no influence of agronomic practice on biological activity was reported. A significant accumulation of cells in G1 phase and a consequent reduction in the S and G2 + M phases were observed in Caco-2 cells treated with rocket polyphenol extract

Performance of alere determine HIV-1/2 Ag/Ab combo rapid test for acute HIV infection: A case report | Performance del test rapido Alere Determine HIV-1/2 Ag/Ab Combo nell?infezione acuta da HIV: Un caso clinic

We describe a case of symptomatic acute HIV infection in a young man where a fourth-generation rapid screening test combining HIV-specific antibody and p24 antigen was negative. In highly suspicious cases of acute HIV infection, plasma HIV RNA assays together with conventional, non-rapid screening tests should be used

VACCELERATE Site Network: Real-time definition of clinical study capacity in Europe

Background: The inconsistent European vaccine trial landscape rendered the continent of limited interest for vaccine developers. The VACCELERATE consortium created a network of capable clinical trial sites throughout Europe. VACCELERATE identifies and provides access to state-of-the-art vaccine trial sites to accelerate clinical development of vaccines. Methods: Login details for the VACCELERATE Site Network (vaccelerate.eu/site-network/) questionnaire can be obtained after sending an email to. Interested sites provide basic information, such as contact details, affiliation with infectious disease networks, main area of expertise, previous vaccine trial experience, site infrastructure and preferred vaccine trial settings. In addition, sites can recommend other clinical researchers for registration in the network. If directly requested by a sponsor or sponsor representative, the VACCELERATE Site Network pre-selects vaccine trial sites and shares basic study characteristics provided by the sponsor. Interested sites provide feedback with short surveys and feasibility questionnaires developed by VACCELERATE and are connected with the sponsor to initiate the site selection process. Results: As of April 2023, 481 sites from 39 European countries have registered in the VACCELERATE Site Network. Of these, 137 (28.5 %) sites have previous experience conducting phase I trials, 259 (53.8 %) with phase II, 340 (70.7 %) with phase III, and 205 (42.6 %) with phase IV trials, respectively. Infectious diseases were reported as main area of expertise by 274 sites (57.0 %), followed by any kind of immunosuppression by 141 (29.3 %) sites. Numbers are super additive as sites may report clinical trial experience in several indications. Two hundred and thirty-one (47.0 %) sites have the expertise and capacity to enrol paediatric populations and 391 (79.6 %) adult populations. Since its launch in October 2020, the VACCELERATE Site Network has been used 21 times for academic and industry trials, mostly interventional studies, focusing on different pathogens such as fungi, monkeypox virus, Orthomyxoviridae/influenza viruses, SARS-CoV-2, or Streptococcus pneumoniae/pneumococcus. Conclusions: The VACCELERATE Site Network enables a constantly updated Europe-wide mapping of experienced clinical sites interested in executing vaccine trials. The network is already in use as a rapid-turnaround single contact point for the identification of vaccine trials sites in Europe.The VACCELERATE Site Network has received funding from the European Union’s Horizon 2020 research and innovation pro gramme (grant agreement No 101037867) and the German Federal Ministry of Education and Research (Bundesministerium für Bil dung und Forschung [BMBF]) (grant agreement No BMBF01KX2040).S

Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions

Predicting the next pandemic: VACCELERATE ranking of the World Health Organization's Blueprint for Action to Prevent Epidemics

Introduction: The World Health Organization (WHO)'s Research and Development (R&D) Blueprint for Action to Prevent Epidemics, a plan of action, highlighted several infectious diseases as crucial targets for prevention. These infections were selected based on a thorough assessment of factors such as transmissibility, infectivity, severity, and evolutionary potential. In line with this blueprint, the VACCELERATE Site Network approached infectious disease experts to rank the diseases listed in the WHO R&D Blueprint according to their perceived risk of triggering a pandemic. VACCELERATE is an EU-funded collaborative European network of clinical trial sites, established to respond to emerging pandemics and enhance vaccine development capabilities. Methods: Between February and June 2023, a survey was conducted using an online form to collect data from members of the VACCELERATE Site Network and infectious disease experts worldwide. Participants were asked to rank various pathogens based on their perceived risk of causing a pandemic, including those listed in the WHO R&D Blueprint and additional pathogens. Results: A total of 187 responses were obtained from infectious disease experts representing 57 countries, with Germany, Spain, and Italy providing the highest number of replies. Influenza viruses received the highest rankings among the pathogens, with 79 % of participants including them in their top rankings. Disease X, SARS-CoV-2, SARS-CoV, and Ebola virus were also ranked highly. Hantavirus, Lassa virus, Nipah virus, and henipavirus were among the bottom-ranked pathogens in terms of pandemic potential. Conclusion: Influenza, SARS-CoV, SARS-CoV-2, and Ebola virus were found to be the most concerning pathogens with pandemic potential, characterised by transmissibility through respiratory droplets and a reported history of epidemic or pandemic outbreaks

Prevenzione e trattamento delle complicanze infettive secondarie all\u2019 impiego dei presidi ad accesso venoso (cap. 16\ub0)

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