2,706 research outputs found
Cost-Effectiveness of Pre-exposure HIV Prophylaxis During Pregnancy and Breastfeeding in Sub-Saharan Africa
Antiretroviral pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition is cost-effective when delivered to those at substantial risk. Despite a high incidence of HIV infection among pregnant and breastfeeding women in sub-Saharan Africa (SSA), a theoretical increased risk of preterm birth on PrEP could outweigh the HIV prevention benefit
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Decline in CD4 T lymphocytes with monotherapy bridging strategy for non-adherent adolescents living with HIV infection: Results of the IMPAACT P1094 randomized trial
Introduction
Management of persistently non-adherent youth living with HIV (YLHIV) with virologic failure (VF) on combination antiretroviral therapy (cART) remains challenging. One strategy has been using 3TC/ FTC monotherapy (3TC/FTC), which in the presence of the M184V resistance mutation, does not suppress viral replication nor select for additional drug resistance mutations, and reduces viral fitness with limited side effects. P1094 compared the immunologic outcome of continuing failing cART vs. switching to 3TC/FTC as a “bridging strategy” to subsequent suppressive cART for non-adherent YLHIV with pre-existing M184V resistance.
Materials & methods
Participants with documented nonadherence, M184V mutation, CD4+ T cell count ≥100 cells/mm3 and VF (HIV-1 plasma RNA ≥400 copies/mL (2.6 log10 HIV-1 RNA) were enrolled and randomized to continue failing cART vs. switch to 3TC/FTC. The primary endpoint (time to ≥30% CD4+ T cell decline or development of CDC class C events) at 28-weeks were assessed by Kaplan-Meier (K-M) curves in an intent-to-treat analysis.
Results
Thirty-three perinatally acquired YLHIV participants (16 continuing cART and 17 3TC/FTC) enrolled in the study. The median age, entry CD4+ T cell count, and viral load were 15 years (Inter-quartile range (IQR) 14–20), 472 cells/mm3 (IQR 384–651), and 4.0 log10HIV-1 RNA copies/ml (IQR 3.2–4.5), respectively. Five participants, all in the 3TC/FTC arm, reached the primary endpoint for absolute CD4+ T cell decline (p = 0.02, exact log-rank test comparing monotherapy to cART). The Kaplan-Meier estimate of probability of primary endpoint on 3TC/FTC at 28 weeks was 0.41 (standard error 0.14). There were no CDC class C events or deaths and no statistically significant difference in frequencies of adverse events between the arms.
Conclusions
Non-adherent participants randomized to 3TC/FTC were more likely than those maintained on failing cART to experience a confirmed decline in CD4+ count of ≥30%. Although this study suffers from limitations of small sample size and premature discontinuation, the randomized comparison to continuing failing cART indicates that 3TC/FTC provides inferior protection from immunologic deterioration for non-adherent youth with M184V resistance. Better alternatives to 3TC/FTC such as ART with higher barriers to resistance and novel adherence and treatment strategies for nonadherent youth are urgently needed
A Blueprint to Address Research Gaps in the Development of Biomarkers for Pediatric Tuberculosis
Childhood tuberculosis contributes significantly to the global tuberculosis disease burden but remains challenging to diagnose due to inadequate methods of pathogen detection in paucibacillary pediatric samples and lack of a child-specific host biomarker to identify disease. Accurately diagnosing tuberculosis in children is required to improve case detection, surveillance, healthcare delivery, and effective advocacy. In May 2014, the National Institutes of Health convened a workshop including researchers in the field to delineate priorities to address this research gap. This blueprint describes the consensus from the workshop, identifies critical research steps to advance this field, and aims to catalyze efforts toward harmonization and collaboration in this are
Search for charged Higgs decays of the top quark using hadronic tau decays
We present the result of a search for charged Higgs decays of the top quark,
produced in collisions at 1.8 TeV. When the charged
Higgs is heavy and decays to a tau lepton, which subsequently decays
hadronically, the resulting events have a unique signature: large missing
transverse energy and the low-charged-multiplicity tau. Data collected in the
period 1992-1993 at the Collider Detector at Fermilab, corresponding to
18.70.7~pb, exclude new regions of combined top quark and charged
Higgs mass, in extensions to the standard model with two Higgs doublets.Comment: uuencoded, gzipped tar file of LaTeX and 6 Postscript figures; 11 pp;
submitted to Phys. Rev.
Inclusive jet cross section in collisions at TeV
The inclusive jet differential cross section has been measured for jet
transverse energies, , from 15 to 440 GeV, in the pseudorapidity region
0.10.7. The results are based on 19.5 pb of data
collected by the CDF collaboration at the Fermilab Tevatron collider. The data
are compared with QCD predictions for various sets of parton distribution
functions. The cross section for jets with GeV is significantly
higher than current predictions based on O() perturbative QCD
calculations. Various possible explanations for the high- excess are
discussed.Comment: 8 pages with 2 eps uu-encoded figures Submitted to Physical Review
Letter
Measurement of Dijet Angular Distributions at CDF
We have used 106 pb^-1 of data collected in proton-antiproton collisions at
sqrt(s)=1.8 TeV by the Collider Detector at Fermilab to measure jet angular
distributions in events with two jets in the final state. The angular
distributions agree with next to leading order (NLO) predictions of Quantum
Chromodynamics (QCD) in all dijet invariant mass regions. The data exclude at
95% confidence level (CL) a model of quark substructure in which only up and
down quarks are composite and the contact interaction scale is Lambda_ud(+) <
1.6 TeV or Lambda_ud(-) < 1.4 TeV. For a model in which all quarks are
composite the excluded regions are Lambda(+) < 1.8 TeV and Lambda(-) < 1. 6
TeV.Comment: 16 pages, 2 figures, 2 tables, LaTex, using epsf.sty. Submitted to
Physical Review Letters on September 17, 1996. Postscript file of full paper
available at http://www-cdf.fnal.gov/physics/pub96/cdf3773_dijet_angle_prl.p
Search for New Particles Decaying to Dijets at CDF
We have used 106 pb^-1 of data collected with the Collider Detector at
Fermilab to search for new particles decaying to dijets. We exclude at the 95%
confidence level models containing the following new particles: axigluons and
flavor universal colorons with mass between 200 and 980 GeV/c, excited quarks
with mass between 80 and 570 GeV/c^2 and between 580 and 760 GeV/c^2, color
octet technirhos with mass between 260 and 480 GeV/c^2, W' bosons with mass
between 300 and 420 GeV/c^2, and E_6 diquarks with mass between 290 and 420
GeV/c^2.Comment: 18 pages, 4 figures, 1 table. Submitted to Physical Review D Rapid
Communications. Postscript file of paper is also available at
http://www-cdf.fnal.gov/physics/pub97/cdf3276_dijet_search_prd_rc.p
Congenital microcephaly: Case definition & guidelines for data collection, analysis, and presentation of safety data after maternal immunisation.
Need for developing case definitions and guidelines for data collection, analysis, and presentation for congenital microcephaly as an adverse event following maternal immunisation
Congenital microcephaly, also referred to as primary microcephaly due to its presence in utero or at birth, is a descriptive term for a structural defect in which a fetus or infant’s head (cranium) circumference is smaller than expected when compared to other fetuses or infants of the same gestational age, sex and ethnic background
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