European Union and EDCTP strategy in the global context: recommendations for preventive HIV/AIDS vaccines research

The European Commission (EC) has strong commitments and recognises the need to continue to ensure that HIV/AIDS research efforts receive global attention. The EC is facing this challenge in a global context and has made substantial investments together with European Developing Countries Clinical Trial Partnership (EDCTP) to formulate a program for the accomplishment of a scientific strategic plan promoting the European/African HIV vaccine development approach. The EC and EDCTP has convened a number of meetings by experts in basic and clinical virology, immunology, epidemiology, as well as industrial and regulatory representatives. The remit of the committee of experts was to define (1) objective criteria for selection of HIV candidates; (2) to determine criteria for selection of sites for clinical trials in Europe and Africa. The resulting consensus paper will guide the EC and EDCTP in developing HIV vaccine strategy and recommendation

A Controlled Trial of Two Nucleoside Analogues plus Indinavir in Persons with Human Immunodeficiency Virus Infection and CD4 Cell Counts of 200 per Cubic Millimeter or Less

Progress in the field of antiretroviral therapy for human immunodeficiency virus type 1 (HIV-1) infection has brought the end of the zidovudine-monotherapy era, 1 – 3 an improved understanding of the pathogenesis of HIV-1 disease, 4 – 9 demonstrations of the prognostic importance of plasma HIV-1 RNA quantification, 10 – 17 and the availability of increasingly potent therapeutic agents. Much of this progress is linked to the introduction of the HIV-protease inhibitors, drugs that inhibit the processing of Gag and Gag–Pol polyprotein precursors and thus prevent the maturation of virions. 18 – 20 Trials of HIV-protease inhibitors have shown beneficial effects on CD4 cell counts and plasma HIV-1 . . 

Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy

SummaryObjectivesRecent development of serogroup B meningococcal (MenB) vaccines highlights the importance of pharyngeal carriage data, particularly in adolescents and young adults, to inform implementation strategies. We describe current UK carriage prevalence in this high risk population and compare methods of carriage detection.MethodsIn this multisite study, pharyngeal swabs were collected on 3–4 occasions over 6–12 months, from 1040 school and university students, aged 10–25 years. Meningococcal carriage was detected by standard culture combined with seroagglutination or PCR of cultured isolates, or by direct PCR from swab. The factor H binding protein (fHBP) variants present in meningococcal isolates were determined.ResultsMeningococcal serogroups B and Y were most common, with carriage up to 6.5% and 5.5% respectively, increasing throughout adolescence. Identification by seroagglutination was often unreliable, and the sensitivity of direct PCR detection was 66% compared to culture combined with PCR. Of MenB isolates, 89.1% had subfamily A variants of fHBP. The acquisition rate of MenB carriage was estimated at 2.8 per 1000 person-months.ConclusionsIf vaccination is to precede the adolescent rise in MenB carriage, these data suggest it should take place in early adolescence. Studies assessing vaccine impact should use molecular methods to detect carriage