Age−specific proportions of children sero-protected (post-vaccination titre cut point > = 40) by N seasons vaccinated.

*<p>Age-group as of November 1, 2007.</p

Age−specific proportions of children sero-protected (post-vaccination titre cut point > = 320) by N seasons vaccinated.

*<p>Age-group as of November 1, 2007.</p

Vaccine antigens by year.

a<p>A/New York/55/04 is antigenically equivalent to the A/California/7/04 (H3N2) virus strain; B/Jiangsu/10/03 is antigenically equivalent to the B/Shanghai/361/02 virus strain <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0051498#pone.0051498-National2" target="_blank">[10]</a> and is of the B Yamagata lineage <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0051498#pone.0051498-National1" target="_blank">[1]</a>.</p>b<p>A/Hiroshima/52/05 is antigenically equivalent to the A/Wisconsin/67/05 virus strain <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0051498#pone.0051498-National3" target="_blank">[11]</a>.</p>c<p>B/Malaysia/2506/04 belongs to the B/Victoria/02/87 lineage <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0051498#pone.0051498-National3" target="_blank">[11]</a>.</p

The burden of hepatitis B virus (HBV) infection, genotypes and drug resistance mutations in human immunodeficiency virus-positive patients in Northwest Ethiopia

<div><p>Background</p><p>In sub-Saharan Africa, the hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections are endemic. Although there has been great progress in HIV care, universal HBV vaccination and care is lacking. In this study, we aimed to determine the prevalence of HBV, HBV genotypes, and drug resistance mutations in dual infected cases in a cohort of HIV patients in Northwest Ethiopia.</p><p>Methods</p><p>A total of 308 HIV-1 positive patients were enrolled into the study and tested for HBsAg in plasma. In HBsAg positive samples, HBV DNA was analyzed for HBV genotype using in-house nested PCR with HBV-specific pre-core / core or surface primers, and for HBV drug resistance mutations (DRMs) in polymerase region. Odds ratio at 95% confidence interval was calculated.</p><p>Results</p><p>Of the 308 HIV-positive subjects, 62.7% were female, median age 38 years (range 18–68, IQR: 27–49), and the median CD4 count 405 cells/μl (IQR: 75–734). Overall, 94.2% were on antiretroviral therapy (ART) frequently with combinations of Zidovudine (AZT)- Lamivudine (3TC)—Nevirapine (NVP). HBsAg was detected in 5.5% (95%CI 2.95–8.08%) of the study participants, of which the majority were infected with HBV genotype A (7A, 2E, 2D, 1C, 1 G). All HIV/HBV positive cases were on ART with anti-HBV activity (i.e., 3TC) and 3TC associated HBV DRMs (i.e., rtV173L, rtL180M, and rtM204V) were detected in 7/13 (53.8%) subjects.</p><p>Conclusion</p><p>In this cross-sectional study of HIV-infected individuals, we found 5.5% HBV/HIV co-infected cases. Most were receiving the first generation anti-HBV therapy with a low genetic barrier to resistance, and several carried mutations associated with anti-HBV (3TC) drug resistance. These data underscore the importance of integrating HBV screening to the HIV treatment guidelines for better management and prevention of HBV-related liver disease.</p></div

Clinical and virological characteristics of HBV/HIV co-infected patients (n = 17).

<p>Clinical and virological characteristics of HBV/HIV co-infected patients (n = 17).</p

Sociodemographic and clinical characteristics of study subjects at ART clinic of the University of Gondar Hospital.

<p>Sociodemographic and clinical characteristics of study subjects at ART clinic of the University of Gondar Hospital.</p

Effect of Influenza Vaccination of Children on Infection Rate in Hutterite Communities: Follow-Up Study of a Randomized Trial

<div><p>Background</p><p>An earlier cluster randomized controlled trial (RCT) of Hutterite colonies had shown that if more than 80% of children and adolescents were immunized with influenza vaccine there was a statistically significant reduction in laboratory-confirmed influenza among all unimmunized community members. We assessed the impact of this intervention for two additional influenza seasonal periods.</p><p>Methods</p><p>Follow-up data for two influenza seasonal periods of a cluster randomized trial involving 1053 Canadian children and adolescents aged 36 months to 15 years in Season 2 and 1014 in Season 3 who received the study vaccine, and 2805 community members in Season 2 and 2840 in Season 3 who did not receive the study vaccine. Follow-up for Season 2 began November 18, 2009 and ended April 25, 2010 while Season 3 extended from December 6, 2010 and ended May 27, 2011. Children were randomly assigned in a blinded manner according to community membership to receive either inactivated trivalent influenza vaccine or hepatitis A. The primary outcome was confirmed influenza A and B infection using RT-PCR assay. Due to the outbreak of 2009 H1N1 pandemic, data in Season 2 were excluded for analysis.</p><p>Results</p><p>For an analysis of the combined Season 1 and Season 3 data, among non-recipients (i.e., participants who did not receive study vaccines), 66 of the 2794 (2.4%) participants in the influenza vaccine colonies and 121 of the 2301 (5.3%) participants in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 60% (95% CI, 6% to 83%; P = 0.04); among all study participants (i.e., including both those who received study vaccine and those who did not), 125 of the 3806 (3.3%) in the influenza vaccine colonies and 239 of the 3243 (7.4%) in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 63% (95% CI, 5% to 85%; P = 0.04).</p><p>Conclusion</p><p>Immunizing children and adolescents with inactivated influenza vaccine can offer a protective effect among unimmunized community members for influenza A and B together when considered over multiple years of seasonal influenza.</p><p>Trial Registration</p><p>Clinicaltrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT00877396?term=NCT00877396&rank=1" target="_blank">NCT00877396</a></p></div

Protective Effectiveness of Immunizing Children and Adolescents With Influenza Vaccine on All Participants.

<p>Protective Effectiveness of Immunizing Children and Adolescents With Influenza Vaccine on All Participants.</p

Association of secondary outcomes in all participants ^a.

<p>Association of secondary outcomes in all participants <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0167281#t005fn001" target="_blank">^a</a>.</p

Influenza A or B Detected in All Participants in the Study ^a.

<p>Influenza A or B Detected in All Participants in the Study <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0167281#t002fn001" target="_blank">^a</a>.</p