Initial Virologic Response and HIV Drug Resistance Among HIV-Infected Individuals Initiating First-line Antiretroviral Therapy at 2 Clinics in Chennai and Mumbai, India

Human immunodeficiency virus drug resistance (HIVDR) in cohorts of patients initiating antiretroviral therapy (ART) at clinics in Chennai and Mumbai, India, was assessed following World Health Organization (WHO) guidelines. Twelve months after ART initiation, 75% and 64.6% of participants at the Chennai and Mumbai clinics, respectively, achieved viral load suppression of <1000 copies/mL (HIVDR prevention). HIVDR at initiation of ART (P <.05) and 12-month CD4 cell counts <200 cells/μL (P <.05) were associated with HIVDR at 12 months. HIVDR prevention exceeded WHO guidelines (≥70%) at the Chennai clinic but was below the target in Mumbai due to high rates of loss to follow-up. Findings highlight the need for defaulter tracing and scale-up of routine viral load testing to identify patients failing first-line AR

Are two doses of human papillomavirus vaccine sufficient for girls aged 15–18 years? Results from a cohort study in India

Extending two-dose recommendations of HPV vaccine to girls between 15 and 18 years will reduce program cost and improve compliance. Immunogenicity and vaccine targeted HPV infection outcomes were compared between 1795 girls aged 15–18 years receiving two (1–180 days) and 1515 girls of same age receiving three (1–60–180 days) doses. Immunogenicity outcomes in 15–18 year old two-dose recipients were also compared with the 10–14 year old three-dose (N = 2833) and two-dose (N = 3184) recipients. The 15–18 year old two-dose recipients had non-inferior L1-binding antibody titres at seven months against vaccine-targeted HPV types compared to three-dose recipients at 15–18 years and three-dose recipients at 10–14 years of age. Neutralizing antibody titres at 18 months in 15–18 year old two-dose recipients were non-inferior to same age three-dose recipients for all except HPV 18. The titres were inferior to those in the 10–14 year old three-dose recipients for all targeted types. Frequency of incident infections from vaccine-targeted HPV types in the 15–18 year old two-dose recipients was similar to the three dose recipients. None of the girls receiving two or three doses had persistent infection from vaccine-targeted types. These findings support that two doses of HPV vaccine can be extended to girls aged 15–18 years. Keywords: Human papillomavirus, Quadrivalent vaccine, Two doses, age 15–18 years, Immunogenicity, Incident infections, Persistent infection