Comparative Analysis of Central and Effector Memory CD8+ T Cells in African Green Monkeys and Rhesus Macaques

Contrary to rhesus macaques, studies on African green monkeys revealed that the latter do not develop AIDS-like symptoms after infection with the Simian Immunodeficiency Virus. In our strive to understand the underlying mechanisms that differentiate the two species of primates, their CD8+ T cells have been studied. CD8+ T cells are responsible for cellular immunity and, thus, are crucial for fighting viral infections. Furthermore, the drop of viral load during acute infection with the human or Simian Immunodeficiency Viruses (in human and non-human primate, respectively) coincides with peak CD8+ T cell response. We also focused on a subpopulation of T cells, known as multifunctional T cells, that is known for its more robust responses. These cells secrete multiple cytokines and/or exhibit multiple functions such as the expression of degranulation markers. This study was focused on pre-infection differences between the two species to identify candidate traits that could explain the divergent infection outcome in the two species. Our analysis involved comparison of surface expression of key molecules such as CD3, CD8+, CD28, and CD154 in activated and resting CD8+ T cells. Additionally, we mass stimulated the cells using phorbol 12-myristate 13-acetate and ionomycin to compare cytokine secretion patterns and expression of the degranulation marker CD107a

Treatment outcomes and costs of a simplified antiviral treatment strategy for hepatitis C among monoinfected and HIV and/or hepatitis B virus-co-infected patients in Myanmar.

Access to hepatitis C virus (HCV) testing and treatment is limited in Myanmar. We assessed an integrated HIV and viral hepatitis testing and HCV treatment strategy. Sofosbuvir/velpatasvir (SOF/VEL) ± weight-based ribavirin for 12 weeks was provided at three treatment sites in Myanmar and sustained virologic response (SVR) assessed at 12 weeks after treatment. Participants co-infected with HBV were treated concurrently with tenofovir. Cost estimates in 2018 USD were made at Yangon and Mandalay using standard micro-costing methods. 803 participants initiated SOF/VEL; 4.8% were lost to follow-up. SVR was achieved in 680/803 (84.6%) by intention-to-treat analysis. SVR amongst people who inject drugs (PWID) was 79.7% (381/497), but 92.5% among PWID on opioid substitution therapy (OST) (74/80), and 97.4% among non-PWID (298/306). Utilizing data from 492 participants, of whom 93% achieved SVR, the estimated average cost of treatment per patient initiated was $1030 (of which 54$1109 and real-world estimate of $1250. High SVR rates were achieved for non-PWID and PWID on OST. However, the estimated average cost of the intervention (under the assumption of no genotype testing and reduced real-world effectiveness) of$1250/patient is unaffordable for a national elimination strategy. Reductions in the cost of antivirals and linkage to social and behavioural health services including substance use disorder treatment to increase retention and adherence to treatment are critical to HCV elimination in this population